ABSTRACT
Tako Tsubo cardiomyopathy is a serious condition that is caused by heart failure due to inordinate stress. We here present a case of a young woman with this disorder in association with anorexia nervosa. We postulate a pathophysiological relationship and discuss the management of Tako Tsubo cardiomyopathy.
Subject(s)
Anorexia Nervosa/complications , Shock, Cardiogenic/etiology , Takotsubo Cardiomyopathy/complications , Takotsubo Cardiomyopathy/therapy , Adult , Anorexia Nervosa/physiopathology , Anticoagulants/therapeutic use , Cardiotonic Agents/therapeutic use , Female , Fluid Therapy , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Young AdultSubject(s)
Abdominal Pain/etiology , Aortic Aneurysm/complications , Aortic Dissection/complications , Heart Murmurs/etiology , Hematemesis/etiology , Abdominal Pain/diagnosis , Adult , Aortic Dissection/diagnosis , Aortic Dissection/surgery , Aortic Aneurysm/diagnosis , Aortic Aneurysm/surgery , Cocaine-Related Disorders , Heart Murmurs/diagnosis , Hematemesis/diagnosis , Humans , Male , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
During the summer of 2006 in the paediatric ward of the Spaarne Hospital in Hoofddorp, the Netherlands, a large number of children were admitted with a coxsackievirus type-B infection, one of the enteroviruses. A total of 27 children were diagnosed with this virus. Patient A, a one-month-old boy, was admitted with fever. The spinal fluid showed a high leukocyte count. He was treated with amoxicillin, ceftriaxon and acyclovir, and recovered rapidly. The spinal fluid culture was positive for coxsackievirus type B5. Patient B, a 3-year-old girl, presented with attacks of abdominal pain and groaning respiration. Infection parameters were mildly elevated. The chest X-ray was normal. She was admitted for observation and recovered spontaneously. Viral faeces culture revealed coxsackievirus type B4. Rapid recognition of an enterovirus infection is important to prevent unnecessary diagnostic and therapeutic interventions. PCR is a diagnostic technique of great importance.
Subject(s)
Antiviral Agents/therapeutic use , Coxsackievirus Infections/epidemiology , Disease Outbreaks/veterinary , Enterovirus B, Human/isolation & purification , Child, Preschool , Coxsackievirus Infections/diagnosis , Coxsackievirus Infections/drug therapy , Female , Humans , Infant, Newborn , Male , Netherlands , Polymerase Chain Reaction/methods , Treatment OutcomeABSTRACT
OBJECTIVE: Maternal cardiovascular adaptations to pregnancy are necessary for an adequate fetomaternal circulation. However, the time course of physiological haemodynamic changes during the second half of pregnancy remains unclear. Various methods, invasive and noninvasive, are described to measure these changes. The thoracic electrical bioimpedance (TEB) technique is a method which is especially suitable to measure haemodynamic changes over time. The aim of the study was to determine both individual and group trends of haemodynamic changes in healthy pregnant women during the second half of pregnancy by means of TEB. Outcome variables are heart rate (HR), stroke volume (SV), cardiac output (CO) and blood pressure. DESIGN: Longitudinal study. SETTING: Outpatient antenatal care clinic of university hospital. POPULATION: A total of 22 healthy nonsmoking women with an uncomplicated singleton pregnancy and without pre-existing vascular disorders were invited. METHODS: TEB and blood pressure measurements were performed at each regular visit from about 24 weeks of gestation through term age. MAIN OUTCOME MEASURES: Trends were calculated with the random effects model. RESULTS: Data obtained from 19 women were analysed, with a median of eight (range 3-11) measurements. HR showed a linear increase (P < 0.0005) and a quadratic trend (P < 0.0005). SV decreased linearly (P = 0.046), without a quadratic course. CO remained stable over time. CONCLUSION: During the second half of physiological pregnancy, significant trends could be determined. An increase in HR, a decrease in SV, a stable CO and an increase in systolic and diastolic blood pressures were found.
