RESUMO
This is the first documented case of a patient suffering from embolic occlusion of the left brachial artery caused by a large embolus growing on a lesion of a stenosed calcified aortic valve. Supported by their own additional observations the authors suggest that severe calcified aortic valve stenosis should be considered as an indication for anticoagulation in the period before surgical valve replacement.
Assuntos
Estenose da Valva Aórtica/complicações , Artéria Braquial , Calcinose/complicações , Embolia/etiologia , Doença Aguda , Anticoagulantes/uso terapêutico , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico , Estenose da Valva Aórtica/tratamento farmacológico , Estenose da Valva Aórtica/cirurgia , Calcinose/diagnóstico , Calcinose/tratamento farmacológico , Calcinose/cirurgia , Quimioterapia Adjuvante , Embolia/diagnóstico , Embolia/tratamento farmacológico , Embolia/cirurgia , Insuficiência Cardíaca/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
17 patients on maintenance hemodialysis were monitored for cardiac arrhythmias using ambulatory electrocardiographic recording. Atrioventricular dissociation was found in a patient with an elevated serum digoxin concentration, intradialytic supraventricular tachycardia had been present in a second patient during acute uremic pericarditis prior to the study. Ventricular premature beats (VPB) were absent or of low grade (occasional/uniform) in 14 patients and did not increase on dialysis. 3 patients had potentially dangerous VPB of higher grades (multiform, salvos or R on T) which occurred on or after dialysis in 2. 2 of these 3 patients were overdigitalized, and 2 had severe cardiac disease (amyloid, old myocardial infarction). Several other risk factors (age, hypertension, cardiac hypertrophy, smoking, hyperlipidemia, electrolyte changes) did not seem to be of importance for VPB. In these patients on maintenance hemodialysis, potentially dangerous VPB were rare and occurred mainly during or after dialysis in patients with preexisting heart disease and/or digitalization.
Assuntos
Arritmias Cardíacas/epidemiologia , Diálise Renal , Doença Crônica , Digoxina/sangue , Eletrocardiografia , Feminino , Glomerulonefrite/terapia , Humanos , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Nefropatias/induzido quimicamente , Nefropatias/terapia , Masculino , Pessoa de Meia-Idade , Fenacetina/efeitos adversos , Doenças Renais Policísticas/terapia , RiscoAssuntos
Ácido Ascórbico/metabolismo , Membrana Celular/metabolismo , Córtex Renal/metabolismo , Microvilosidades/metabolismo , Sódio/farmacologia , Animais , Azidas/farmacologia , Transporte Biológico/efeitos dos fármacos , Carbonil Cianeto p-Trifluormetoxifenil Hidrazona/farmacologia , Cinética , Ratos , Valinomicina/farmacologiaRESUMO
17 patients on maintenance hemodialysis were monitored for cardiac arrhythmias by ambulatory electrocardiographic recording. Only 3 patients had ventricular premature beats of potentially dangerous grades. Two of these cases were overdigitalized and two had severe cardiac disease (amyloid, old myocardial infarction).