Subject(s)
Aged , Aged, 80 and over , Pacemaker, Artificial , Femoral Vein , Treatment Outcome , Retrospective StudiesABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Takotsubo Cardiomyopathy/diagnostic imaging , Takotsubo Cardiomyopathy/therapy , Hypokinesia/diagnostic imaging , Coronary Occlusion/diagnostic imaging , Echocardiography/methods , Radiography, Thoracic , Pulmonary Edema/diagnostic imaging , Myocardial Perfusion ImagingSubject(s)
Buprenorphine/adverse effects , Narcotic Antagonists/adverse effects , Substance Withdrawal Syndrome/complications , Takotsubo Cardiomyopathy/chemically induced , Echocardiography , Electrocardiography , Female , Humans , Middle Aged , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Stroke Volume , Substance Withdrawal Syndrome/blood , Substance Withdrawal Syndrome/physiopathology , Takotsubo Cardiomyopathy/blood , Takotsubo Cardiomyopathy/diagnostic imaging , Takotsubo Cardiomyopathy/physiopathology , Troponin I/bloodABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Fistula/diagnostic imaging , Fistula/therapy , Chest Pain/etiology , Pericardial Effusion/diagnostic imaging , Sulfur Hexafluoride/therapeutic use , Aneurysm, False/diagnostic imaging , Asthenia/complications , Asthenia/diagnostic imaging , Dyspnea/complications , Dyspnea/diagnostic imaging , Hypotension/complications , Echocardiography , Aneurysm, False/therapySubject(s)
Contrast Media , Coronary Angiography , Coronary Disease/diagnostic imaging , Echocardiography , Pericardial Effusion/diagnostic imaging , Phospholipids , Sulfur Hexafluoride , Vascular Fistula/diagnostic imaging , Aged , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Emergencies , Humans , Male , Pericardial Effusion/etiology , Rupture, SpontaneousABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiac Pacing, Artificial/methods , Femoral Vein , Pacemaker, Artificial , Atrial Fibrillation/surgery , Atrioventricular Block/surgery , Vascular Access Devices , Equipment FailureABSTRACT
La integración de la función ventricular en la toma de decisiones del paciente sometido a electroestimulación cardiaca resulta fundamental para comprender la estructuración de las nuevas guías sobre estimulación cardiaca y terapia de resincronización. Para argumentar la importancia de la función ventricular en la electroestimulación cardiaca es necesario conocer: a)el efecto deletéreo de la estimulación desde el ápex del ventrículo derecho; b)el efecto del bloqueo completo de rama izquierda sobre la función ventricular izquierda, y c)la disfunción ventricular izquierda como sustrato arritmogénico. Así, cuando decidimos el modo de electroestimulación cardiaca a aplicar debemos conocer el porcentaje de estimulación ventricular que precisará y su función ventricular. Si esta es normal, permitirá estimular desde el ápex del ventrículo derecho o desde sitios alternativos al ápex. Por el contrario, si es menor del 50% es recomendable la resincronización cardiaca (CRT-P) acompañada de desfibrilación (CRT-D) si la FEVI es menor del 35%
The integration of the ventricular function is essential when making decisions over a patient subjected to cardiac electrostimulation in order to understand the structure followed in the new cardiac stimulation and resynchronising therapy guides. To support the importance of ventricular function in cardiac electrostimulation it is important to know: (i)the deleterious effect of stimulation on the right ventricle apex; (ii)the effect over the left ventricular function produced by complete blockage of the left branch, and (iii)left ventricular disfunction as arrythmogenic substrate. When it comes to decide what type of cardiac electrostimualtion to apply we will know: the percentage of ventricular stimulation needed and its ventricular function. A normal ventricular function will enable electrostimulation from the right ventricle apex or alternative site. On the contrary, if this value is lower than 50% the most recommended electrostimulation is cardiac resynchronisation (CRT-P), which will be accompanied by defibrillation (CRT-D) if FEVI is lower than 35%
Subject(s)
Humans , Ventricular Function/physiology , Cardiac Pacing, Artificial/methods , Electric Countershock/methods , Pacemaker, Artificial , Arrhythmias, Cardiac/therapy , Heart Function Tests , Cardiac Resynchronization Therapy/methods , Ventricular Dysfunction/physiopathologyABSTRACT
The integration of the ventricular function is essential when making decisions over a patient subjected to cardiac electrostimulation in order to understand the structure followed in the new cardiac stimulation and resynchronising therapy guides. To support the importance of ventricular function in cardiac electrostimulation it is important to know: (i)the deleterious effect of stimulation on the right ventricle apex; (ii)the effect over the left ventricular function produced by complete blockage of the left branch, and (iii)left ventricular disfunction as arrythmogenic substrate. When it comes to decide what type of cardiac electrostimualtion to apply we will know: the percentage of ventricular stimulation needed and its ventricular function. A normal ventricular function will enable electrostimulation from the right ventricle apex or alternative site. On the contrary, if this value is lower than 50% the most recommended electrostimulation is cardiac resynchronisation (CRT-P), which will be accompanied by defibrillation (CRT-D) if FEVI is lower than 35%.
Subject(s)
Cardiac Pacing, Artificial/methods , Electric Countershock/methods , Electrophysiologic Techniques, Cardiac/methods , Heart Ventricles/physiopathology , Cardiac Resynchronization Therapy/methods , Clinical Decision-Making , Clinical Trials as Topic , Death, Sudden, Cardiac , Heart Rate , Humans , Stroke Volume , Systole , Ventricular Dysfunction, Left/physiopathologyABSTRACT
The negative effect of artificial ventilation with positive pressure on renal function, expresses itself as a decrease of water and sodium excretion, being directly related with the raise of intrathoracic pressure. Factors participating in this process are: lowering in cardiac output, arousal of sympathic nervous system, increase in vasopressin action, activation of renin-angiotensin-aldosterone system and decrease of atrial natriuretic peptide release. This disorder of hydromineral metabolism produces: Impairment of hemodynamic equilibrium, favors the increase of hypoxia and renal failure. The effects of mechanical ventilation on renal function can be attenuated with the adoption of the following measures: a) techniques (use of low levels of PEEP and early disconnection of respirator); b) therapeutic (dopamine 2-3 mcg/kg/min, rational use of diuretics and fluids); y c) monitoring of renal function and hydro-mineral equilibrium.
Subject(s)
Renal Insufficiency/etiology , Respiration, Artificial/adverse effects , Acute Disease , Animals , Humans , Kidney/physiology , Pulmonary Circulation/physiologyABSTRACT
We assessed the incidence of clinical heart failure in patients with acute myocardial infarction admitted to a coronary care unit and treated with intravenous streptokinase. We compared 2 groups of patients: 1) treated group: patients with acute myocardial infarction admitted to the unit in the last 3 years and treated with intravenous streptokinase, following a protocol established previously. 2) CONTROL GROUP: patients with the same characteristics and selection criteria as for the treated group, admitted to the unit during the previous 2 years and conventionally treated, without thrombolytic therapy. We assessed, in both groups, the incidence of heart failure at the time of admission, at discharge and the total incidence in the unit, following the Killip and Kimball criteria. The total incidence of heart failure was higher in the control group than in the treated group (43.8 vs 19.1%, p less than 0.001). This difference was even greater when the comparison was made with the reperfused patients (43.8% vs 18%, p less than 0.001). Heart failure incidence at the time the patients were discharged from de unit was also higher in the control group (21.2% vs 4.3%, p less than 0.001). When we considered severe heart failure (III-IV Killip Group) we also observed a significant difference between both groups. In conclusion, the incidence and the severity of clinical heart failure were lower in patients treated with streptokinase than in those treated conventionally.