Résumé
Peripartum cardiomyopathy (PPCM) is a condition that affects women during the reproductive years in the late pregnancy period and/or early postpartum period. Although it is associated with several risk factors and various hypotheses exist of its etiology the cause of this disorder is still unknown. Standard therapy for PPCM is the same as for heart failure. Studies examining new therapeutic approaches are adding to the armamentarium available to physicians treating patients with PPCM. Despite all the current knowledge the mortality rates associated with PPCM remain relatively high. This article is a review of the current knowledge of etiology, diagnosis, treatment and prognosis of PPCM and attempts to present areas of need of further research.
Sujets)
Humains , Femelle , Cardiomyopathies/étiologie , Complications cardiovasculaires de la grossesse/étiologie , Période du postpartum , Agents cardiovasculaires/usage thérapeutique , Cardiomyopathies/diagnostic , Cardiomyopathies/traitement médicamenteux , Complications cardiovasculaires de la grossesse/diagnostic , Complications cardiovasculaires de la grossesse/traitement médicamenteux , Grossesse , Facteurs de risqueRésumé
Physicians are frequently concerned with the management of the surgical risk in patients with heart disease requiring non cardiac surgery. A preoperative evaluation helps to assess the cardiac risk for the planned surgery and helps to take measures to reduce that risk. We summarize the essentials in evaluating patients with coronary artery disease, valvular heart disease, arterial hypertension, arrhythmias, permanent pacemaker bearers, and those with congestive heart failure in order to prevent cardiac complications during the required surgery. Special attention has been given to the functional capacity, cardiac risk present, presence or absence of left ventricular dysfunction and the institution of protective measures. The usefulness of the ACC AHA guidelines has been summarized
Sujets)
Humains , Sujet âgé , Facteurs âges , Troubles du rythme cardiaque , Cardiopathies/complications , Cardiopathies/diagnostic , Procédures de chirurgie opératoire/effets indésirables , Appréciation des risques , Maladie coronarienne , Électrocardiographie , Urgences , Exercice physique , Valvulopathies , Hypertension artérielle/complications , Défaillance cardiaque , Pacemaker , Facteurs de risque , Dysfonction ventriculaire gaucheRésumé
Peripheral arterial disease results from the atherosclerotic involvement of arteries of the upper and lower extremities as well as that of the renal and carotid arteries. In view of the importance of its early recognition we have summarized the clinical manifestations, diagnostic procedures and tests, and the current medical and surgical management including percutaneous revascularization. Algorithms that guide in the diagnostic steps and management decisions have been presented.