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Acute cardiogenic pulmonary oedema

Marianna Adamo, Salvatore Curello, Ermanna Chiari, Claudia Fiorina, Giuliano Chizzola, Marco Magatelli, Elisa Locantore, Giovanni Cuminetti, Carlo Lombardi, Aldo Manzato, Marco Metra, Federica Ettori
BACKGROUND: Limited evidence is available about MitraClip therapy in patients with acute mitral regurgitation (MR) complicating myocardial infarction (MI). METHODS AND RESULTS: Among 80 consecutive patients undergoing MitraClip treatment, 5 (6.3%) had been admitted for acute MI complicated by severe MR. Mean age was 73±6years and 3 were males. At the time of admission they were in cardiogenic shock (80%) or pulmonary oedema (20%), with severe MR, left ventricular dysfunction and pulmonary hypertension...
May 1, 2017: International Journal of Cardiology
Rajdip Dulai, Aye Hline, Mahvesh Rana Javaid, Javed Akhtar
A 59-year-old woman was admitted to our hospital with acute pulmonary oedema and cardiogenic shock 35 days after anterior ST elevation myocardial infarction. She developed a new loud pan systolic murmur. Echocardiography revealed a ventricular septal rupture with a significant left to right shunt. She was immediately transferred to the local cardiothoracic unit where she underwent a successful ventricular septal defect (VSD) repair. Ventricular septal rupture often presents within the first 24 hours of acute myocardial infarction and is rare thereafter...
December 8, 2016: BMJ Case Reports
Towhid Imam, Philip Finny, Alan Choo-Kang, Rehman Khan
A 44-year-old Caucasian man presented to the emergency department in acute cardiogenic shock, with pulmonary oedema, secondary to an acute myocardial infarction and in a hyperosmolar hyperglycaemic state. The previous day he had undergone a colonoscopy, which revealed features of colitis, and was started on prednisolone. He had been previously diagnosed with type 2 diabetes, migraine and anxiety attacks. While awaiting a coronary angiogram he developed abdominal pain and a CT scan was performed and found a large right adrenal mass...
October 26, 2016: BMJ Case Reports
Jean-Pierre Frat, Stéphanie Ragot, Christophe Girault, Sébastien Perbet, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Rémi Coudroy, René Robert, Alain Mercat, Laurent Brochard, Arnaud W Thille
BACKGROUND: The use of non-invasive ventilation is controversial in immunocompromised patients with acute respiratory failure, whereas the use of high-flow nasal cannula oxygen therapy is growing as an alternative to standard oxygen. We aimed to compare outcomes of immunocompromised patients with acute respiratory failure treated with standard oxygen with those treated with high-flow nasal cannula oxygen alone or high-flow nasal cannula oxygen associated with non-invasive ventilation...
August 2016: Lancet Respiratory Medicine
Martín Cuesta, Mark J Hannon, Christopher J Thompson
Hyponatraemia is the most common electrolyte imbalance in neurosurgical patients. Acute hyponatraemia is particularly common in neurosurgical patients after any type of brain insult, including brain tumours and their treatment, pituitary surgery, subarachnoid haemorrhage or traumatic brain injury. Acute hyponatraemia is an emergency condition, as it leads to cerebral oedema due to passive osmotic movement of water from the hypotonic plasma to the relatively hypertonic brain which ultimately is the cause of the symptoms associated with hyponatraemia...
May 2016: Endocrinología y Nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición
Jitka Callerova, Roman Skulec, Karel Kucera, Jiri Knor, Patrik Merhaut, Vladimir Cerny
INTRODUCTION: Circadian variation of in-hospital acute cardiogenic pulmonary oedema (CPE) with the highest occurrence in the early morning has been reported repeatedly. However, no study evaluating circadian variation of CPE in the field has been published. Therefore, we decided to evaluate the circadian variation of CPE in the Central Bohemian Region of the Czech Republic in the patients treated by regional emergency medical service (EMS) and analyse its association with baseline blood pressure in the field...
June 2016: European Journal of Internal Medicine
Jessica Powell, David Graham, Sarah O'Reilly, Gillian Punton
Acute pulmonary oedema is a distressing and life-threatening illness that is associated with a sudden onset of symptoms. For the best possible patient outcomes, it is essential that nurses in all clinical areas are equipped to accurately recognise, assess and manage patients with acute pulmonary oedema. This article outlines the pathophysiology of acute cardiogenic and non-cardiogenic pulmonary oedema, and suggests a systematic approach to the recognition and management of its most serious manifestations. Long-term care and symptom recognition are discussed and suggestions for ongoing patient self-management are provided...
February 3, 2016: Nursing Standard
Sarah Faubel, Charles L Edelstein
Acute kidney injury (AKI) is a common complication in hospitalized patients, associated with >50% mortality in those in intensive care who require renal replacement therapy. Data suggest that AKI is a systemic disease that adversely affects the immune system and organ function, and in this way contributes to the high mortality observed in affected patients. Data from patients and animal models indicate that AKI adversely affects the lungs. Respiratory complications are common in patients with AKI and include pulmonary oedema, respiratory failure requiring mechanical ventilation, prolonged duration of mechanical ventilation, and prolonged weaning from mechanical ventilation...
January 2016: Nature Reviews. Nephrology
Miroslav Pernický, Juraj Papinčák, Adriana Reptová, Soňa Kiňová, Ján Murín
UNLABELLED: The case study describes a case of 49-year-old man with morbid obesity since childhood (BMI 40 kg/m2), arterial hypertension (approx. since aged 15, treated since 2004), dyslipidemia (since 2006), type 2 diabetes mellitus (since 2006, on insulin therapy since 2008) and smoking (until 2011, 20 cigarettes a day). TREATMENT: 16 types of medication, 8 for hypertension, statin, therapy for diabetes, aspirin, allopurinol. In 2010 (when aged 45) hospitalized in our clinic with dyspnoea and chest pain with a high pressure reading of 180/110 mm Hg (identified symptoms of heart failure with LV ejection fraction of 33 %, in NYHA II functional class, echocardiographically: left atrium: 46 mm, left ventricular chamber size in diastole: 70 mm, interventricular septum: 12 mm, septal hypokinesis, Doppler ultrasonography of lower limb arteries (calcification, diffuse atherosclerotic changes, absent stenosis), CT coronary angiography (significant stenosis of the left coronary artery)...
May 2015: Vnitr̆ní Lékar̆ství
Magdalena Mierzewska-Schmidt, Agnieszka Gawecka
Neurogenic stunned myocardium (NSM) is defined as myocardial injury and dysfunction of a sudden onset, occurring after various types of acute brain injury as a result of an imbalance in the autonomic nervous system. The typical spectrum of clinically observed abnormalities includes acute left ventricular failure, not uncommonly progressing to cardiogenic shock with hypotension that requires inotropic agents, pulmonary oedema and various arrhythmias. Commonly-seen electrocardiographic changes include: prolonged QT interval, ST segment changes, T-wave inversion, a new Q-wave or U-wave...
2015: Anaesthesiology Intensive Therapy
Jochen Hinkelbein, Christian Mey, Gerrit Brinker, Roman Pfister, Bernd W Böttiger
BACKGROUND: Tako-Tsubo cardiomyopathy (TTC) is a rare disorder with high relevance for anaesthesia. It is an acute cardiac syndrome characterized by an acute onset of reversible left ventricular dysfunction associated with emotional and physical stress. This is the only case published of a patient having five severe Tako-Tsubo incidents in five consecutive general anaesthesia procedures within one year. CASE PRESENTATION: A 61 years old female patient (height 1...
2015: BMC Anesthesiology
Daniel Lichtenstein, Simon van Hooland, Paul Elbers, Manu L N G Malbrain
Over the past decade, critical care ultrasound has gained its place in the armamentarium of monitoring tools. A greater understanding of lung, abdominal, and vascular ultrasound plus easier access to portable machines have revolutionised the bedside assessment of our ICU patients. Because ultrasound is not only a diagnostic test, but can also be seen as a component of the physical exam, it has the potential to become the stethoscope of the 21st century. Critical care ultrasound is a combination of simple protocols, with lung ultrasound being a basic application, allowing assessment of urgent diagnoses in combination with therapeutic decisions...
November 2014: Anaesthesiology Intensive Therapy
Anders Bastiansen
Within the last decade the use of non-invasive ventilation has expanded. This article reviews the studies on non-invasive ventilation in the treatment of exacerbations of chronic obstructive pulmonary disease (COPD), cardiogenic pulmonary oedema, acute respiratory distress syndrome, asthma and neuromuscular disease. Its beneficial effect has primarily been found in exacerbations of COPD where it reduces mortality with a number needed to treat of ten when added to standard medical treatment. No other conclusive evidence of the superiority of non-invasive ventilation compared to other modalities has been shown...
May 26, 2014: Ugeskrift for Laeger
Shintaro Nakano, Takatoshi Kasai, Jun Tanno, Keiki Sugi, Yasumasa Sekine, Toshihiro Muramatsu, Takaaki Senbonmatsu, Shigeyuki Nishimura
BACKGROUND: Adaptive servo-ventilation has a potential sympathoinhibitory effect in acute cardiogenic pulmonary oedema (ACPO). AIMS: To evaluate the acute effects of adaptive servo-ventilation in patients with ACPO. METHODS: Fifty-eight consecutive patients with ACPO were divided into those who underwent adaptive servo-ventilation and those who received oxygen therapy alone as part of their immediate care. Visual analogue scale, vital signs, blood gas data and plasma catecholamine concentrations at baseline and 1 h during emergency care, and subsequent clinical events (death within 30 days, intubation within seven days or between seven and 30 days, and length of hospital stay) were assessed...
August 2015: European Heart Journal. Acute Cardiovascular Care
D M Alexandrescu, Irina Iuliana Costache
AIM: The analysis of the predisposing and precipitating factors encountered in the anamnesis of the patients hospitalized with acute pulmonary oedema, in order to establish some correlations with the evolution and prognosis. MATERIAL AND METHODS: The study included 50 patients, 32 males and 18 females, admitted to the Cardiology I Clinic between 2009 and 2013, diagnosed with acute pulmonary oedema upon admission. The following aspects were investigated: cardiovascular antecedents, prodromal elements of the current episode of acute pulmonary oedema (APE), risk factors and associated co morbidities, previous treatments followed at home as well as the triggering factors of the acute episode...
April 2014: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Tiago Pereira-da-Silva, João Abreu, Ruben Ramos, Ana Galrinho, Philip Fortuna, Nuno Jalles Tavares, Rui Cruz Ferreira
Pheochromocytoma crisis typically presents as paroxysmal episodes of headache, tachycardia, diaphoresis or hypertension. We describe an uncommon case of recurrent non-hypertensive heart failure with systolic dysfunction in a young female due to pheochromocytoma compression. It presented as acute pulmonary oedema while straining during pregnancy and later on as cardiogenic shock after a recreational body massage. Such crisis occurring during pregnancy is rare. Moreover, of the few reported cases of pheochromocytoma-induced cardiogenic shock, recreational body massage has not yet been reported as a trigger for this condition...
2014: International Archives of Medicine
Benoît Bataille, Guillaume Rao, Pierre Cocquet, Michel Mora, Bruno Masson, Jean Ginot, Stein Silva, Pierre-Etienne Moussot
Extravascular lung water (EVLW) could increase by permeability pulmonary oedema, cardiogenic oedema, or both. Transthoracic echocardiography examination of a patient allows quantifying B-lines, originating from water-thickened interlobular septa, and the E/Ea ratio, related to pulmonary capillary wedge pressure. The aim of our study was to assess the correlation and the trending ability between EVLW measured by transpulmonary thermodilution and the B-lines score or the E/Ea ratio in patients with ARDS. Twenty-six intensive care unit patients were prospectively included...
February 2015: Journal of Clinical Monitoring and Computing
Catarina Patrício, Filipa Pais da Silva, Vítor Brotas
Cardiogenic flash pulmonary oedema is a common and potentially fatal cause of acute respiratory distress. Although it often results from acute decompensated heart failure, abrupt-onset aortic regurgitation can sharply rise cardiac filling pressure and, consequently, pulmonary venous pressure, leading to rapid fluid accumulation in the interstitial and alveolar spaces. We report a case of a 64-year-old woman admitted to the emergency department with a flash pulmonary oedema; a careful clinical investigation subsequently revealed a rare aetiology for this 'common' presentation...
May 2, 2014: BMJ Case Reports
S Izdes, N D Altintas, C Soykut
Verapamil intoxication is a life-threatening condition that often presents with severe hemodynamic instability and requires vasopressor support. There are also documented case reports of the development of non-cardiogenic pulmonary oedema after verapamil overdose. However, the exact mechanisms responsible for pulmonary oedema remain unclear. Here, we describe a 36-year-old woman who was admitted to the intensive care unit after ingesting high-dose verapamil and subsequently developed acute respiratory distress syndrome soon after hemodynamic stabilization...
April 2014: Acta Clinica Belgica
H M Bhandari, M Gorecha, J Woodman
A 35-year-old woman, a non-smoker with a normal body mass index, 'felt wheezy' and developed profound hypoxia 30 min after preterm vaginal delivery at 24+ weeks of gestation. She denied other symptoms, had no fever but was tachycardic and tachypnoeic with normal blood pressure. Pulmonary embolism, amniotic fluid embolism, cardiomyopathy, arrhythmias, sepsis and non-cardiogenic pulmonary oedema were considered as differential diagnoses. Chest X-ray showed an increased pulmonary vasculature, but the blood tests, ECG, echocardiogram and CT pulmonary angiogram were essentially normal...
2014: BMJ Case Reports
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