Subject(s)
Cardiac Rehabilitation , Humans , Aged , Outpatients , Heart Rate/physiology , Exercise/physiology , Exercise TestABSTRACT
BACKGROUND: A prospective single-center interventional cohort study was conducted to evaluate the effects of a 5-week comprehensive cardiac rehabilitation program on terms exercise capacity, quality of life, echocardiographic findings and autonomic modulation after first-time myocardial infarction. METHODS: We studied 37 consecutive post-myocardial infartion patients (mean age 66 years). All patients began a 5-week cardiac rehabilitation supervised training. The exercise program consisted of 40 minutes of training, three times a week, on a cycle ergometer at 60-80% of the maximal heart rate. At baseline and after training program we analyzed: the distance walked after the Six-Minutes Walking Test (6MWT); quality of life (QoL) assesed using the Psychological General Well-Being Inventory (PGWBI) questionnaire; echocardiographic finding and autonomic balance assesed heart rate variability (HRV). RESULTS: We observed statistically significant improvement in exercise capacity (from 423±94 to 496±13 m; P<0.05). Also we observed statistically significant improvements in the many PGWBI dimensions; particularly, anxiety +5.8% (from 18.11±5.2 to 19.12±4.4); depression +6.0% (from 12.00±3.0 to 12.73±2.4); positive well-being +6% (from 11.55±3.5 to 12.23±4.0); general health +10.3% (from 9.48±3.5 to 10.46±2.87); vitality +6.8% (from 12.96±4.2 to 13.85±4.2). Finally, we observed changes in HRV indices after training program: RR (from 903±169 ms to 952±163 ms; P<0.05), pNN50% (from 4.74±4.89 to 6.23±5.53; P<0.05), in time-domain; LF (from 274±169 to 362±233 ms2; P<0,05); HF (from 214±154 to 314±194 ms2; P<0.05) and LF/HF (from 1.53±0.54 to 1.24±0.47; P<0.05) in frequency-domain. CONCLUSIONS: The study suggest that a cardiac rehabilitation program in postmyocardial infarction improves exercise capacity, QoL and autonomic modulation.
Subject(s)
Exercise Therapy , Myocardial Infarction/rehabilitation , Aged , Cohort Studies , Exercise Test , Female , Heart Rate/physiology , Humans , Male , Middle Aged , Quality of LifeABSTRACT
A 51-year-old man developed symptoms (palpitations) related to a large left atrial mass attached to interatrial septum discovered by trans-thoracic heart ultrasonography. Six months earlier this patient had undergone radiofrequency ablation (RFA) of an atrial flutter substrate. The left atrial mass was removed surgically using cardiopulmonary bypass with disappearance of symptoms. A post-operative diagnosis of atrial myxoma was made. The present case shows that a big left-atrial tumor could manifest with only mild unspecific symptoms such as palpitations. It is not clear whether the development of myxomas could be related to RFA or occurrence of heart tumors after RFA (already reported in medical literature) or whether it could be just chance without a causal link with ablation procedures.
ABSTRACT
We descrive a patient who presents palpitations during cardiac rehabilitation after mitral valvuloplasty. ECG showed regular narrow QRS tachycardia compatible with Atrioventricular Node Reentrant Tachycardia. After slow pathway radiofrequency catheter ablation, the patient completed the rehabilitation program remained tachycardia and palpitations-free.
Subject(s)
Balloon Valvuloplasty , Tachycardia, Atrioventricular Nodal Reentry/etiology , Adult , Catheter Ablation , Electrocardiography , Electrophysiologic Techniques, Cardiac , Humans , Mitral Valve , Tachycardia, Atrioventricular Nodal Reentry/diagnosisABSTRACT
A finalidade do estudo foi avaliar a capacidade do fenoterol em modificar os níveis séricos de potássio, observar os riscos de seu uso e sua eventual aplicaçäo terapêutica. Vinte nove pacientes admitidos ao Hospital Säo Lucas da PUCRS em Porto Alegre para tratamento de diversas patologias foram submetidos a inalaçäo com 5mg de fenoterol durante 5 minutos. Amostras de potássio foram colhidas antes da terapia inalatória e 5,30 e 60 minutos após. Pressäo arterial, frequência cardíaca e a presença de sintomas e sinais foram anotados durante o estudo. Análise estatística foi efetuada através dos testes de Wilcoxon Friedman e Anova
Subject(s)
Humans , Fenoterol/pharmacology , Fenoterol , Fenoterol/adverse effects , Fenoterol/therapeutic useABSTRACT
O diabete gestacional, manifestado por intolerância aos carboidratos que inicia ou tem primeiro diagnóstico durante a gravidez é entidade importante, pois determina aumento da morbidade materna e fetal e da mortalidade perinatal. O manejo clínico inclui screening para todas as gestantes com 24 a 28 semanas de gestaçäo, independente da existência ou näo de fatores de risco para diabete mellitus. A via de parto e sua época sujeitam-se aos critérios habituais, desde que o diabete esteja sendo bem controlado. A gestaçäo näo deve exceder as 40 semanas nos casos insulino-dependentes. A monitorizaçäo fetal deve ser iniciada com 34 semanas. O tratamento será desenvolvido segundo a gravidade, por meio de dieta apropriada e/ou insulina
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Diabetes, Gestational/physiopathology , Diabetes, Gestational/complications , Diabetes, Gestational/prevention & control , Diabetes, Gestational/therapyABSTRACT
Este trabalho apresenta uma síntese dos principais mecanismos envolvidos no desenvolvimento de tolerância ao uso dos nitratos e orienta a melhor maneira de minimizar o problema na prática clínica
