Cardiac Status and Differential Indication for Renal Replacement Methods

2015 ◽  
pp. 254-259 ◽  
Author(s):  
V. Wizemann ◽  
W. Kramer
Keyword(s):  
Differential Indication ◽  
Cardiac Status

scholarly journals P1296CARDIAC COMPLICATIONS OF ARTERIOVENOUS FISTULAS IN PATIENTS WITH END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nessrine Breik ◽  
Hela Jbeli ◽  
Safa Fattoum ◽  
Imen Ouertani ◽  
Badreddine Ben kaab ◽  
...  
Keyword(s):  
Vascular Access ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Chronic Hemodialysis ◽  
Cardiac Complications ◽  
Arteriovenous Fistulas ◽  
Coronary Syndrome ◽  
Group 2 ◽  
Stage Renal Disease ◽  
Cardiac Status

Abstract Background and Aims Current literature suggests the arteriovenous fistula (AVF) to be the preferred type of vascular access for hemodialysis. However, AVFs have significant and potentially deleterious effects on cardiac functions particularly in the setting of preexisting heart disease. The aim of this study is to compare the clinical and echocardiographic evolution after creation of a proximal AVF and a radial AVF. Method We conducted a retrospective descriptive study including all chronic hemodialysis patients through AVF. Group 1 (G1) included patients with proximal AVF and group 2 (G2) patients with radial AVF. Results Twenty-four patients were collected in G1 and the average age was 55 years. G2 included 13 patients with a mean age of 44 years. Systolic blood pressure decreased after AVF creation in both groups (G1: 62.5%, G2: 45%, NS). A dyspnea was noted in 70% of cases of G1 and 38.4% of cases of G2 (NS). The interventricular septum was thickened in 20.8% of cases of G1 and 38.4% of G2 (NS). Left ventricular (LV) dilatation was observed in both groups with LV diastolic telegram diameter increase of 58% in G1 versus 10% in G2 (p = 0.04). A decrease in LV ejection fraction was found in 62.5% in G1 and 46.1% in G2 (p = 0.066). The major cardiac complications in G1 were acute coronary syndrome in 5 patients and atrial fibrillation in 4 cases after an average of 60 months and 35 months, respectively. No cardiac complications were noted in G2. Conclusion AVFs remain the preferred type of vascular access for chronic hemodialysis therapy because they are associated with better long-term patency and fewer complications compared with synthetic grafts. Its seat will depend on the vascular state and the cardiac status of the dialysis patient.

Cardiac troponin I for accurate evaluation of cardiac status in myopathic patients

2007 ◽  
Vol 29 (8) ◽  
pp. 496-501 ◽  
Author(s):  
Tsuyoshi Matsumura ◽  
Toshio Saito ◽  
Harutoshi Fujimura ◽  
Susumu Shinno
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Accurate Evaluation ◽  
Cardiac Status

Diet and Growth in Congenital Heart Disease

PEDIATRICS ◽  
1976 ◽  
Vol 57 (1) ◽  
pp. 75-86
Author(s):  
Alice Strangway ◽  
Rodney Fowler ◽  
Kathrine Cunningham ◽  
J. Richard Hamilton
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nutrient Intake ◽  
Congenital Heart ◽  
Growth Failure ◽  
Entire Group ◽  
Dietary Study ◽  
Cardiac Status ◽  
Rates Of Growth ◽  
The Relationship

To assess the relationship between diet and growth in congenital heart disease we studied nutrient intake, body measurements, and cardiac status in 568 affected ambulatory patients less than 11 years of age. Most had mild heart disease, 104 were cyanotic, and only 10 were in congestive heart failure. Major disturbances of growth were uncommon. For the entire group body weight was below normal but only in those studied before 2 years of age; rates of growth and weight gain were normal over the period preceding the dietary study. There was no statistically significant relationship between intake of calories, protein, or other nutrients and growth or gain, analyzing the entire group, or analyzing patients subgrouped according to age, severity of heart disease, or severity of growth retardation. Body size and growth were diminished in cyanosed compared with noncyanosed children but cardiac status had no effect on nutrient intake. We conclude that in children with growth failure associated with congenital heart disease, nutrient intake is not an important factor limiting their growth.

Differential indication for laparoscopic nephrectomy

2002 ◽  
Vol 1 (1) ◽  
pp. 56
Author(s):  
Demetrios Kontaxis ◽  
Dieter Echtle ◽  
Detlef Frohneberg
Keyword(s):  
Laparoscopic Nephrectomy ◽  
Differential Indication

scholarly journals Depression and anxiety at time of implantable cardioverter defibrillator implantation and the biological link with cardiovascular disease

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
ACJ Van Der Lingen ◽  
MT Rijnierse ◽  
AM Hooghiemstra ◽  
S Elshout ◽  
VP Van Halm ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Autonomic Function ◽  
Nyha Class ◽  
Functional Class ◽  
Depression And Anxiety ◽  
Icd Implantation ◽  
Symptoms Of Depression ◽  
Nyha Functional Class ◽  
Inflammatory Status ◽  
Cardiac Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Psychological distress, such as symptoms of anxiety and depression, are frequently present in patients receiving an implantable cardioverter defibrillator (ICD) and they are associated with adverse outcomes. Multiple pathophysiological mechanisms may explain the link between psychological distress and cardiovascular disease, such as autonomic dysfunction, neuro-endocrine alterations and chronic inflammation. Purpose The present study aims to examine the prevalence of psychological distress at time of ICD implantation and evaluates the complex interplay between psychological distress, autonomic function, neuro-endocrine alterations and inflammatory status in ICD patients. Methods We conducted a prospective study that included ICD patients receiving an ICD for primary and secondary prevention of sudden cardiac death. Prior to implantation, patients underwent extensive psychological evaluation, including validated questionnaires for depression, anxiety and personality traits. Cardiac status was evaluated by left ventricular ejection fraction (LVEF) assessment, New York Heart Association (NYHA) functional class evaluation, 6-minute walk test (6MWT), and 24-hour Holter monitoring for heart rate variability (HRV). Thyroid function, catecholamine levels and inflammatory status were also evaluated. Results Of 178 patients included (age 64 ± 12, 79% male, LVEF 35 ± 13%), 35% had symptoms of depression and 32% had symptoms of anxiety. Symptoms of depression and anxiety increased significantly with higher NYHA functional class (P < 0.001). Depressive symptoms were associated with a reduced 6MWT (411 ± 128 m versus 488 ± 89 m, P < 0.001), lower LVEF (29 ± 9% versus 36 ± 13%, P = 0.03), higher heart rate (74 ± 13 bpm versus 70 ± 13 bpm, P = 0.02), higher thyroid stimulating hormone levels (1.8 [1.3-2.8] mU/L versus 1.5 [1.0-2.2] mU/L, P = 0.04) and multiple HRV parameters, indicating reduced HRV. Anxiety symptoms were only associated with a reduced 6MWT (433 ± 112 m versus 477 ± 102, P = 0.02). Symptoms of depression or anxiety were not correlated with c-reactive protein, NT-proBNP or catecholamine levels. Conclusion A substantial part of ICD patients has symptoms of depression and anxiety at time of ICD implantation. Depression was correlated with a higher NYHA class, reduced exercise capacity,  reduced LV-function and alterations in autonomic function, suggesting a biological link between depression and cardiac status. Whether depression and anxiety leads to an increase in ventricular arrhythmias will be determined during further follow-up. Abstract Figure. NYHA class and psychological distress

MANAGEMENT OF AN AUTISTIC CHILD UNDERGOING OPEN HEART SURGERY

PEDIATRICS ◽  
1973 ◽  
Vol 51 (2) ◽  
pp. 251-253
Author(s):  
Hugh Paul Gabriel ◽  
Regina Gluck
Keyword(s):  
Autistic Child ◽  
Heart Surgery ◽  
Psychiatric Treatment ◽  
Open Heart Surgery ◽  
Morphine Sulfate ◽  
Open Heart ◽  
Apparent Loss ◽  
Cardiac Status

The hospital course of an autistic child who underwent open heart surgery is outlined. The management using morphine sulfate intravenously for acute control followed by a structured environment with minimal sedation later was extremely effective in controlling this child without the need for restraints. Drugs potentially dangerous to the cardiac status were thus avoided and the child did not suffer any apparent loss of forward gains made during his previous psychiatric treatment.

Cardiovascular: Abdominal Aortic Aneurysm

2018 ◽  
pp. 205-210
Author(s):  
Carl Ying ◽  
Minh Chau Joe Tran
Keyword(s):  
Spinal Cord ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Therapy Monitoring ◽  
Spinal Cord Ischemia ◽  
Vasodilator Therapy ◽  
Hemodynamic Therapy ◽  
Abdominal Aortic ◽  
Intraoperative Management ◽  
Cardiac Status

In this chapter the essential aspects of anesthesia for abdominal aortic aneurysm (AAA) repair are discussed. Subtopics include airway management in expanding aneurysm, hemodynamic therapy, monitoring, vasodilator therapy, and bleeding. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics include medications, assessment of cardiac status, and hemodynamic goals for this surgery. Issues discussed related to intraoperative management include monitoring, induction, maintenance, and aortic cross-clamping and unclamping. Postoperative concerns discussed include extubation, decreased renal function, spinal cord ischemia, and other complications affecting the cardiovascular, respiratory, renal, and gastrointestinal systems.

Orthopedics: Hip Surgery in Aortic Stenosis

2018 ◽  
pp. 75-80
Author(s):  
Ruchir Gupta
Keyword(s):  
Atrial Fibrillation ◽  
Hip Fracture ◽  
Aortic Stenosis ◽  
Epidural Anesthesia ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Main Topic ◽  
Anesthesia Management ◽  
Bone Cement Implantation Syndrome ◽  
Cardiac Status

In this chapter the essential aspects of aortic stenosis are discussed. Specifically, the hemodynamic consequences of this disease as well as which drugs should be used or avoided are explored. The case discussed is of an older patient needing emergent open reduction internal fixation of a hip fracture. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative issues addressed include evaluation of the patient’s hypertension and cardiac status. Intraoperative topics include spinal versus epidural anesthesia, management of a difficult airway, and treatment of bone cement implantation syndrome and atrial fibrillation. Postoperative issues involve extubation and, in this case, managing hypertension.

Endomyocardial biopsy to monitor anthracycline therapy in children.

1984 ◽  
Vol 2 (5) ◽  
pp. 443-446 ◽  
Author(s):  
C H Pegelow ◽  
R W Popper ◽  
S A de Wit ◽  
O Y King ◽  
J R Wilbur
Keyword(s):  
Radiation Therapy ◽  
Endomyocardial Biopsy ◽  
Pediatric Population ◽  
Myocardial Damage ◽  
Anthracycline Cardiotoxicity ◽  
Thoracic Irradiation ◽  
Anthracycline Cardiomyopathy ◽  
Anthracycline Therapy ◽  
Cardiac Status ◽  
Higher Doses

Evaluation of the ultrastructure of material obtained by endomyocardial biopsy has been proposed as a means to evaluate patients for impending anthracycline cardiotoxicity. Eighteen biopsies obtained from 13 patients (age, 3-18 years) are reported. Twelve biopsy procedures were done to evaluate the cardiac status on reaching a cumulative dose of 400 mg/m2 and three patients had six subsequent biopsies after having received significantly more drug or receiving radiation therapy to the lungs or mediastinum. Scores were assigned to the tissue obtained and used to guide the decision to continue or stop anthracycline therapy. Three patients with abnormal cardiac studies at low cumulative doses, five of whom had received greater than 400 mg/m2 and three of whom had received considerably higher doses and thoracic irradiation were given more drug without incident. Two specimens were interpreted to indicate avoidance of further anthracycline and two patients were cautiously given more despite evidence of mild myocardial damage. These results indicate that endomyocardial biopsies can be performed on a pediatric population with a reasonable complication rate. Further studies should be undertaken to evaluate its usefulness as a means to predict and avoid anthracycline cardiomyopathy.

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