目的观察有创机械通气辅助治疗急性左心衰的治疗效果。方法回顾性分析25例经有创机械通气治疗的急性左心衰患者的临床资料,比较机械通气治疗前后患者的心率、呼吸频率、血压、血气分析及血流动力学的变化。结果机械通气治疗2h后,患者上...目的观察有创机械通气辅助治疗急性左心衰的治疗效果。方法回顾性分析25例经有创机械通气治疗的急性左心衰患者的临床资料,比较机械通气治疗前后患者的心率、呼吸频率、血压、血气分析及血流动力学的变化。结果机械通气治疗2h后,患者上述观察指标均较治疗前显著好转。21例患者(成功组)有创机械通气撤机成功,总有效率为84.0%(21/25);4例患者(失败组)有创机械通气撤机失败,3例死亡,病死率为12.0%(3/25),1例撤机失败转外科。成功组心排血量(cardiac output,CO)和心排血指数(cardiac index,CI)较失败组明显改善。2组间年龄、机械通气时间比较,差异无统计学意义(P>0.05),而急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHEⅡ)评分比较,差异有统计学意义(P<0.05)。结论有创机械通气治疗是抢救急性左心衰的有效辅助治疗措施。展开更多
Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic fai...Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic failure, pulmonary hemorrhages and cardiac arrhythmias. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed. Cardiac manifestations may vary from minor rhythm abnormalities to fatal ventricular arrhythmias. We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department with epigastric pain and congestive cardiac failure with rhythm disturbances and selective myocardial involvement mimicking as Non ST elevation Inferior wall myocardial infarction (NSTEMI). The Cardiac manifestations of Leptospirosis need meticulous intensive care management as the mortality rate is very high in this subset of patients. Index suspicion and early treatment remains the mainstay of this life threatening zoonotic disease.展开更多
Amyloidosis, an infiltrative disease characterized by deposition of high molecular weight insoluble protein has a low detection rate and poor prognosis with congestive heart failure being the most common cause of deat...Amyloidosis, an infiltrative disease characterized by deposition of high molecular weight insoluble protein has a low detection rate and poor prognosis with congestive heart failure being the most common cause of death. Although definitive diagnosis is based on endomyocardial biopsy, this is rarely performed due to procedural risk and sampling error. Traditional non-invasive imaging, such as transthoracic echocardiography (TTE) and electrocardiogram (ECG) lacks sensitivity detecting the disease in its early stages. This case report demonstrates the utility of cardiac Magnetic Resonance Imaging in addition to traditional imaging modalities in this often clinically challenging problem.展开更多
Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Postg...Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Postgraduate Medical Institute,Lady Reading Hospital Peshawar,from March 2005 to September 2007.Relevant information regarding the risk factors of congestive cardiac failure were recorded on questionnaire prepared in accordance with the objectives of the study.Results:1 019 patients with established diagnosis of cardiac failure (based on clinical findings and relevant investigations) were included.Out of total sampling 583 (57.12%) were males and 436(42.78%) were females.The age range of the patients was from 6 years to 82 years with mean age of 48.5 years and mode of age was 45 years.The distribution of causative factors of CCF was:ischemic heart disease(IHD) 36.31%,hypertension 26.30%,dilated cardiomyopathy 10.10%,obstructve and restrictive cardiomyopathies 5.39%,valvular heart diseases(VHD) 9.32%,congenital heart disease like ventricular septal defects(VSD) 4.41%,atrial septal defects(ASD) 0.58%,atrial fibrillation (AF) 2.25%,constrictive pericardidtis 1.07%.Pericardial effusion 0.68%,chronic obstructive pulmonary disease and pulmonary hypertension 1.47%,thyrotoxicosis 0.68%,complete heart block 0.29%and paget disease in 0.09%cases.Conclusion:Ischemic heart disease,hypertension,cardiomypathies,valvular heart disease and congenital heart disease are major contributor to CCF in our patients.展开更多
文摘目的观察有创机械通气辅助治疗急性左心衰的治疗效果。方法回顾性分析25例经有创机械通气治疗的急性左心衰患者的临床资料,比较机械通气治疗前后患者的心率、呼吸频率、血压、血气分析及血流动力学的变化。结果机械通气治疗2h后,患者上述观察指标均较治疗前显著好转。21例患者(成功组)有创机械通气撤机成功,总有效率为84.0%(21/25);4例患者(失败组)有创机械通气撤机失败,3例死亡,病死率为12.0%(3/25),1例撤机失败转外科。成功组心排血量(cardiac output,CO)和心排血指数(cardiac index,CI)较失败组明显改善。2组间年龄、机械通气时间比较,差异无统计学意义(P>0.05),而急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHEⅡ)评分比较,差异有统计学意义(P<0.05)。结论有创机械通气治疗是抢救急性左心衰的有效辅助治疗措施。
文摘Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic failure, pulmonary hemorrhages and cardiac arrhythmias. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed. Cardiac manifestations may vary from minor rhythm abnormalities to fatal ventricular arrhythmias. We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department with epigastric pain and congestive cardiac failure with rhythm disturbances and selective myocardial involvement mimicking as Non ST elevation Inferior wall myocardial infarction (NSTEMI). The Cardiac manifestations of Leptospirosis need meticulous intensive care management as the mortality rate is very high in this subset of patients. Index suspicion and early treatment remains the mainstay of this life threatening zoonotic disease.
文摘Amyloidosis, an infiltrative disease characterized by deposition of high molecular weight insoluble protein has a low detection rate and poor prognosis with congestive heart failure being the most common cause of death. Although definitive diagnosis is based on endomyocardial biopsy, this is rarely performed due to procedural risk and sampling error. Traditional non-invasive imaging, such as transthoracic echocardiography (TTE) and electrocardiogram (ECG) lacks sensitivity detecting the disease in its early stages. This case report demonstrates the utility of cardiac Magnetic Resonance Imaging in addition to traditional imaging modalities in this often clinically challenging problem.
文摘Objective:To determine the frequency of risk factors of congestive cardiac failure in a tertiary care hospital of Peshawar.Methods:This retrospective observational study was conducted in department of Cardiology,Postgraduate Medical Institute,Lady Reading Hospital Peshawar,from March 2005 to September 2007.Relevant information regarding the risk factors of congestive cardiac failure were recorded on questionnaire prepared in accordance with the objectives of the study.Results:1 019 patients with established diagnosis of cardiac failure (based on clinical findings and relevant investigations) were included.Out of total sampling 583 (57.12%) were males and 436(42.78%) were females.The age range of the patients was from 6 years to 82 years with mean age of 48.5 years and mode of age was 45 years.The distribution of causative factors of CCF was:ischemic heart disease(IHD) 36.31%,hypertension 26.30%,dilated cardiomyopathy 10.10%,obstructve and restrictive cardiomyopathies 5.39%,valvular heart diseases(VHD) 9.32%,congenital heart disease like ventricular septal defects(VSD) 4.41%,atrial septal defects(ASD) 0.58%,atrial fibrillation (AF) 2.25%,constrictive pericardidtis 1.07%.Pericardial effusion 0.68%,chronic obstructive pulmonary disease and pulmonary hypertension 1.47%,thyrotoxicosis 0.68%,complete heart block 0.29%and paget disease in 0.09%cases.Conclusion:Ischemic heart disease,hypertension,cardiomypathies,valvular heart disease and congenital heart disease are major contributor to CCF in our patients.
