ABSTRACT
PURPOSE: To compare peak exercise oxygen consumption (VO2peak) of healthy individuals with asymptomatic individuals with probable heart disease. METHODS: Ninety-eight men were evaluated. They were divided into two groups: 1) 39 healthy individuals (group N) with an age range of 50 +/- 4.6 years; and 2) 59 asymptomatic individuals with signs of atherosclerotic and/or hypertensive heart disease (group C) with an age range of 51.9 +/- 10.4 years. In regard to age, height, body surface area, percentage of fat, lean body mass, and daily physical activity, both groups were statistically similar. Environmental conditions during the ergometric test were also controlled. RESULTS: Maximal aerobic power (watts), VO2peak, maximal heart rate, and maximal pulmonary ventilation were lower in group C (p < 0.01) than in group N; weight, however, was lower in group N (p = 0.031) than in group C. Differences in the respiratory gas exchange index, heart rate at rest, and the maximal double product of the two groups were not statistically significant. CONCLUSION: Signs of probable heart disease, even though asymptomatic, may reduce the functional capacity, perhaps due to the lower maximal cardiac output and/or muscle metabolic changes.
Subject(s)
Coronary Artery Disease/physiopathology , Hypertension/physiopathology , Oxygen Consumption , Case-Control Studies , Exercise Test , Heart Rate , Humans , Male , Middle Aged , Pulmonary Ventilation , Total Lung CapacityABSTRACT
In a 36-year-old man with severe aortic stenosis and refractory cardiogenic shock, an emergency percutaneous balloon aortic valvuloplasty was performed, followed by clinical improvement, allowing elective aortic valve replacement at the 48th day post-valvuloplasty. Clinical follow-up for eight months after surgery showed significant functional improvement. Aortic balloon valvuloplasty is a life-saving approach to patients with severe aortic stenosis and high surgical risk and should be considered as a bridge to planned valve replacement or cardiac transplantation. Aortic valve replacement should be considered even in patients with severe ventricular dysfunction, while the cardiac transplantation should be indicated for patients with a very marked and irreversible depression of myocardial contractility.
Subject(s)
Angioplasty, Balloon, Coronary , Aortic Valve Stenosis/therapy , Adult , Humans , Male , Severity of Illness IndexABSTRACT
We report the case of a 62-year-old man with massive pulmonary embolism and severe hemodynamic impairment. Transthoracic Doppler echocardiography was fundamental in confirming the diagnosis by direct visualization of intra-atrial thrombus and signs of right chamber overload. It allowed prompt administration of thrombolytic drug and follow-up monitoring. Doppler echocardiography is a non-invasive, available technique and its early application should be considered in the evaluation of patients with suspected massive pulmonary embolism.
