RESUMO
Cutis laxa is manifest histologically by fragmentation of elastic tissue throughout the body. The aorta and other systemic vessels show dilatation, elongation and even aneurysm formation. We report multiple pulmonary artery branch stenoses in a child who had cutis laxa. Pulmonary artery stenoses may be the cause of the pulmonary hypertension and right heart failure observed in patients with this condition.
Assuntos
Doenças Cardiovasculares/complicações , Cútis Laxa/complicações , Pré-Escolar , Constrição Patológica , Feminino , Humanos , Hipertensão Pulmonar/complicações , Artéria PulmonarRESUMO
Eight patients undergoing coronary angiography were successfully resuscitated from ventricular fibrillation (VF), and three of these patients remained conscious and alert for 24 to 39 seconds after VF by coughing every one to three seconds. The mean aortic systolic pressure induced by cough was 139.7 mm Hg (+/- 3.8) and only 60.7 mm Hg (+/- 5.1) by external cardiopulmonary resuscitation (CPR). Cough-CPR, accomplished by abrupt, forceful coughing maintains consciousness by rhythmic compression of the heart, has several advantages over external CPR in the catheterization laboratory, and may be applicable to other situations where serious rhythm disturbances are recognized before unconsciousness occurs.
Assuntos
Cateterismo Cardíaco/efeitos adversos , Tosse , Ressuscitação , Fibrilação Ventricular/terapia , Idoso , Aorta , Pressão Sanguínea , Cardioversão Elétrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Circulação Pulmonar , Inconsciência/prevenção & controle , Fibrilação Ventricular/etiologiaRESUMO
Repeated rhythmic (every 1-3 sec.) coughs were documented to maintain consciousness up to 39 seconds in 3 patients developing ventricular fibrillation during coronary arteriography. The arterial pressure wave resulting from a cough exceeded that induced by external chest compression in 2 individuals in whom both techniques were employed and in 5 others treated by external compression alone. Cough-induced cardiac compression is self-performed, and compared to external chest compression is less likely to traumatize the chest wall or heart and can be performed in any position on any surface. It is recommended that patients undergoing coronary arteriography be previously trained to cough abruptly and repeatedly every 1-3 seconds. The potential for utilizing this technique in other areas (i.e., CCU, home) is less favorable than in catheterization-induced ventricular fibrillation, but it might be employed successfully in patients with premonitory symptoms of ventricular arrhythmias or Stokes-Adams seizures. The prior training of high risk individuals (and their spouses) to induce effective coughing in the victim might be lifesaving.
