ABSTRACT
Aortic coarctation is a discrete narrowing of the proximal thoracic aorta. It is poorly tolerated during pregnancy because of its association with hypertension, cerebrovascular accident, and aortic rupture. We report a case of severe uncorrected congenital aortic coarctation in a 31-year-old symptomatic pregnant woman at 29 weeks of gestation who underwent successful cesarean delivery with an epidural anesthetic technique. Transthoracic echocardiography showed a gradient of 75 mm Hg. To avoid undiagnosed arterial hypotension and inadequate uteroplacental flow distal to the coarctation, double (radial and femoral) invasive arterial blood pressure measurement was used to monitor both pre- and postcoarctation arterial blood pressure.
Subject(s)
Aortic Coarctation/diagnostic imaging , Blood Pressure Determination/methods , Cesarean Section , Echocardiography/methods , Pregnancy Complications, Cardiovascular/diagnostic imaging , Adult , Aortic Coarctation/complications , Blood Pressure/physiology , Cesarean Section/methods , Female , Humans , Infant, Newborn , PregnancyABSTRACT
A dengue é uma doença infecciosa de evolução aguda, transmitida por vírus (RNA vírus). Infecta o homem através da picada do inseto fêmea Aedes aegypti. Seus sinais e sintomas são variáveis, com formas oligossintomáticas, formas clássicas (febris) e formas graves hemorrágicas, podendo até apresentar síndrome cardiovascular hipovolêmica. O diagnóstico envolve critérios clínico-laboratoriais. O diagnóstico sorológico tem fundamental importância na classificação de infecção primária ou secundária, já que a dengue hemorrágica surge com maior frequência nas infecções secundárias. O isolamento do vírus é geralmente realizado para fins de pesquisa ou epidemiológicos. As epidemias ocorrem principalmente no verão, durante ou após períodos chuvosos.
The dengue is an infectious disease of acute evolution transmitted by virus (RNA virus), infecting humans through the bite of the Aedes aegypti female insect. Presenting signs and symptoms variables with oligosymptomatic forms, classical forms (fever) and severe hemorrhagic form (DHF), this can lead to cardiovascular hypovolemic syndrome. The diagnoses of dengue disease involves clinical and laboratory criteria. Serological diagnosis has fundamental importance in the classification of primary or secondary infection, since DHF appears most often in secondary infections.Virus isolation is usually carried out for research or epidemiological studies. Epidemics occur mainly in the summer, during or after rainy periods.
