Pickwick syndrome

1982 ◽  
Vol 63 (3) ◽  
pp. 48-51
Author(s):  
V. I. Zhukov
Keyword(s):  
Heart Failure ◽  
Right Heart Failure ◽  
Cor Pulmonale ◽  
Left Heart ◽  
Obesity Hypoventilation Syndrome ◽  
Right Heart ◽  
Left Heart Failure ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Obesity, as you know, is often combined with atherosclerosis, hypertension and their characteristic left-heart failure. Least of all, in our opinion, obesity is associated with cor pulmonale and right-heart failure. "Pickwick syndrome", it is also known as "Ioe syndrome", "cardiopulmonary syndrome of patients with obesity", "obesity-hypoventilation syndrome".

scholarly journals Massive Scrotal Edema: An Unusual Manifestation of Obstructive Sleep Apnea and Obesity-Hypoventilation Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Stephanie E. Dreifuss ◽  
Ernest K. Manders
Keyword(s):  
Heart Failure ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Right Heart Failure ◽  
Obesity Hypoventilation Syndrome ◽  
Right Heart ◽  
Obstructive Sleep ◽  
Scrotal Edema ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Obstructive sleep apnea (OSA) may occur in association with obesity-hypoventilation (Pickwickian) syndrome, a disorder of ventilatory control affecting individuals with morbid obesity. Through the pressor effects of chronic hypercapnia and hypoxemia, this syndrome may result in pulmonary hypertension, right heart failure, and massive peripheral edema. We present a case of severe scrotal edema in a 36-year-old male with OSA and obesity-hypoventilation syndrome. A tracheostomy was performed to relieve hypoxemia and led to dramatic improvement of scrotal edema. No scrotal surgery was necessary. Followup at two months showed complete resolution of scrotal edema, improvement in mental status, and normalization of arterial blood gas measurements. This case demonstrates that OSA and obesity-hypoventilation syndrome may present with massive scrotal edema. Furthermore, if OSA is recognized as the cause of right heart failure, and if the apnea is corrected, the resultant improvement in cardiac function may allow reversal of massive peripheral, including scrotal, edema.

P4511Characteristic hemodynamic and metabolic response patterns differ between patients with stable chronic left vs right heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Dumitrescu ◽  
H Ten Freyhaus ◽  
H Hagmanns ◽  
F Gerhardt ◽  
S Baldus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stroke Volume ◽  
Stress Echocardiography ◽  
Right Heart Failure ◽  
Response Patterns ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Group 2 ◽  
Group 1

Abstract Background Patients with chronic left and right heart failure show a reduction in peak oxygen uptake (VO2), even with optimal medical therapy. A non-invasive determination whether the mechanism of exercise limitation is primarily due to left or right-heart failure may be a challenge in clinical practice. The simultaneous analysis of metabolic and hemodynamic responses during exercise may allow an improved differentiation of exercise limitation. However, only little is known about the combined hemodynamic/metabolic exercise response patterns in these patients. OBJECTIVES We sought to characterize the simultaneous hemodynamic and metabolic response to exercise in stable patients with chronic, isolated left vs right heart failure. Methods We analyzed a cohort of highly selected patients with isolated right heart failure (group 1) and isolated left heart failure (group 2). All patients were in functional class II and III, and under stable medical Treatment. All patients had received right heart catheterization before enrollment. All of the patients in group 1 and none of the patients in group 2 showed an elevated pulmonary vascular resistance (PVR). All patients received a cardiopulmonary exercise test (CPET) with a ramp protocol up to maximal exercise tolerance. During a second visit, a combined CPET/stress echocardiography was performed with a two step constant work rate protocol. For step 1, a workrate below the patients' anaerobic threshold was chosen. For step 2, 80% of the patients' maximum workrate from the ramp test was chosen. Each step was performed until a complete echocardiographic image acquisition was obtained. Echocardiographic parameters, including stroke volume measurements, were obtained once at rest and for each of the two exercise steps. Results We recruited 18 patients (n=9 in group 1, n=9 in group 2). There were no significant differences in demographic baseline characteristics. There were no adverse events. In the inital ramp CPET, both groups showed a moderate reduction in peak VO2 (53,0±12,4 vs 63,3±12,8% of predicted). The absolute peak VO2 values, corrected for body weight, showed no significant difference (16,7±4,5 vs 16,5±5,1 ml/min/kg). While the increase in VO2 (Figure 1A) and cardiac index (Figure 1B) during step 1 and step 2 of the simultaneous CPET/stress echocardiography was similar between both groups, the increase of stroke volume index with exercise was significantly reduced in the group with right heart failure, while the group with left heart failure increased stroke volume index during exercise (Figure 1C). Figure 1 Conclusions The simultaneous evaluation of hemodynamic and metabolic parameters by CPET/stress echocardiography is safe and may reveal characteristic response patterns to exercise in patients with chronic left vs right heart failure. Patients with right heart failure seem to be less able to increase stroke volume during exercise than patients with left heart failure. Acknowledgement/Funding This project was partly funded by Actelion Pharmaceuticals

Cardiac Troponin I Levels in Patients with Left Heart Failure and Cor Pulmonale

Angiology ◽  
2001 ◽  
Vol 52 (5) ◽  
pp. 317-322 ◽  
Author(s):  
Niyazi Güler ◽  
Mehmet Bilge ◽  
Beyhan Eryonucu ◽  
Kürcat Uzun ◽  
Mehmet Emin Avci ◽  
...  
Keyword(s):  
Heart Failure ◽  
Creatine Kinase ◽  
Pulmonary Disease ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Creatine Kinase Mb

Cardiac troponin levels are regarded as the most specific of currently available biochemical markers of myocardial damage. Elevated levels of troponin have been previously reported in patients with left heart failure, reflecting small areas of undetected myocardial cell death. The aim of this study was to compare the levels of the cardiac troponin I (cTnl) in patients with left- and right-sided heart failure. Cardiac troponin I levels were studied with immunochemical methods in patients with right heart failure (n = 17) resulting from chronic obstructive pulmonary disease, ischemic left heart failure (n = 23), and nonischemic left heart failure (n = 18) who were admitted to departments of cardiology and chest diseases. Also, cTnl levels were measured in 32 healthy subjects as control group. Protein markers of myocardial injury (cTnl and myoglobin) in patients with left and right heart failure were collected approximately 12 to 36 hours after onset of obvious symptoms. Serum creatine kinase MB band was determined on admission and thereafter twice a day during the first 3 days. Elevated levels of serum cTnl were found in patients with nonischemic (0.83 ±0.6 ng/mL, p<0.01) and ischemic left heart failure (0.9 ±0.5 ng/mL, p<0.01) when compared to healthy subjects, whereas serum cTnl levels in patients with right heart failure due to chronic obstruc tive pulmonary disease were not significantly different from those of control subjects (0.22 ±0.1 vs 0.16 ±0.1 ng/mL, p> 0.05). In addition, creatine kinase MB band and myoglobin levels were not significantly different between patient and healthy groups. The mean of cTnl levels in ischemic and even nonischemic left heart failure were increased compared to the mean of values in healthy individuals but without significant creatine kinase MB band and myoglobin elevations. But cTnl levels were not increased in patients with right heart failure due to chronic obstructive pulmonary disease. These data indicate that the cTnl levels are abnormal in left heart failure but not in cor pulmonale.

Body composition changes assessment by bioelectrical impedance vectorial analysis in right heart failure and left heart failure

Heart & Lung ◽  
2020 ◽  
Vol 49 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Dulce González-Islas ◽  
Estefanía Arámbula-Garza ◽  
Arturo Orea-Tejeda ◽  
Lilia Castillo-Martínez ◽  
Candace Keirns-Davies ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Composition ◽  
Bioelectrical Impedance ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Composition Changes

Differences in Exercise Capacity in Patients with Chronic Left Heart Failure and Chronic Right Heart Failure

2014 ◽  
Vol 23 (11) ◽  
pp. 1036-1040 ◽  
Author(s):  
Wei-Hua Liu ◽  
Qin Luo ◽  
Zhi-Hong Liu ◽  
Qing Zhao ◽  
Qun-Ying Xi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Capacity ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure

Differences in the Quality of Life Between Patients with Left Heart Failure and Right Heart Failure Secondary to COPD

2020 ◽  
Author(s):  
Karen Aide Santillan Reyes ◽  
Viridiana Peláez Hernández ◽  
Laura Arely Martínez Bautista ◽  
Karla Leticia Rosales Castillo ◽  
Lizzbett Luna Rodríguez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure
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