Drugs and pacemakers for complete heart block

1967 ◽  
Vol 5 (5) ◽  
pp. 19-20
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Rate ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Heart Block ◽  
Complete Heart Block ◽  
Bundle Of His

Complete heart block can occur in ischaemic heart disease, and can acutely complicate myocardial infarction. Most other cases are associated with fibrosis of the bundle of His of unknown cause, or are congenital. In some patients with chronic heart block, especially the congenital type, adequate output is maintained. In other patients chronic or intermittent heart block may cause Stokes-Adams attacks, or heart failure may not respond to digitalis and diuretics until the heart rate is increased. These require treatment by drugs or, when this fails, by use of anartifical pacemaker.

scholarly journals The Importance of Serum Uric Acid Levels and Killip Classification in Predicting Prognosis of Acute Myocardial Infarction

2021 ◽  
Vol 10 (7) ◽  
pp. 409-413
Author(s):  
Shivakumar B.G. ◽  
Shivakumar N ◽  
Siddharth Gosavi ◽  
Shashank Shastry
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Uric Acid ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Serum Uric Acid ◽  
Left Ventricular ◽  
Class Iii ◽  
Killip Class

BACKGROUND The study was conducted in an attempt to correlate serum uric acid levels with Killip class i.e. severity of heart failure in patients with acute myocardial infarction and to assess any influence of serum uric acid levels on predicting prognosis in patients with acute myocardial infarction. Ischaemic heart disease, particularly acute myocardial infarction is one of the leading causes of death across the world accounting for 12.7 % of global mortality. Low and middle-income countries are facing 80 % of the global burden of ischaemic heart disease death. Since the pathophysiology of acute myocardial infarction is complicated, proper risk stratification is essential for appropriate management and better outcome. Serum uric acid levels (SUA) have been correlated with coronary artery calcification and atherosclerosis. High SUA levels also have been identified as a risk marker for cardiovascular disease development, progression and mortality. METHODS The study design was a one-year cross-sectional study. 100 patients admitted with acute myocardial infarction within one day of the start of symptoms in the Department of Cardiology & Medicine were included from September 2018 to September 2019. In this study, patients with known causes of elevated uric acid levels (chronic kidney disease, gout, haematological malignancy, hypothyroidism, metabolic syndrome, myeloproliferative disease, lymphoproliferative disease, drugs– pyrazinamide, diuretics, ethambutol, ethanol, malignancy, G6PD deficiency and psoriasis) were included. Patients on drugs which raise serum uric acid e.g., salicylates (2 gm / d, hydrochlorothiazide, pyrazinamide), and chronic alcoholics were not included. Patients were further subjected to investigations like serum uric acid, ECG, 2D echo and other routine investigations. Urine albumin levels, troponin I, chest x-ray, fundoscopy, and fasting lipid profile were done. Investigation reports were analysed with the clinical profile and the data was compiled and appropriate statistical test was applied. RESULTS There were more cases of myocardial infarction above 40 years as compared to below 40 years of age and males (69 %) were more as compared to females (31 %) with the commonest presentation as chest pain. Majority of the patients had inferior wall myocardial infarction (IWMI) (40 %) and most (91 %) of the patients had left ventricular (LV) dysfunction (mild, moderate and severe). More patients with Killip class III and IV had abnormal uric acid levels as compared to class I, and II. Among 27 patients who expired, 23 were in Killip class III and IV (13 in Killip class III and 10 in class IV) and the mean serum uric acid levels of expired patients were elevated on all the 3 days with maximum elevation on day 1. CONCLUSIONS Patients with higher Killip class had higher levels of serum uric acid in comparison to patients of lower Killip class. Serum uric acid level in association with Killip class is a good predictor of the severity of heart failure and short-term mortality after myocardial infarction.

Glucose abnormalities and heart failure predict poor prognosis in the population-based Reykjavik Study

2005 ◽  
Vol 12 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Inga S. Thrainsdottir ◽  
Thor Aspelund ◽  
Thordur Hardarson ◽  
Klas Malmberg ◽  
Gunnar Sigurdsson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Reference Group ◽  
Population Based ◽  
Glucose Regulation ◽  
Mortality And Morbidity ◽  
Abnormal Glucose Regulation ◽  
Glucose Abnormalities

Background The risk of cardiovascular disease increases progressively with increasing blood glucose from levels well below the diabetic threshold. In the Reykjavik Study the relationship between heart failure and abnormal glucose regulation was already apparent at the level of impaired glucose tolerance. The aim of this study was to determine the prognosis of participants with any glucose abnormality and heart failure and to test whether the combination of these conditions may adversely affect the subsequent prognosis. Design A prospective population-based study. Methods Data from the first visit of 19 381 participants were used. Participants were divided into groups according to their glycaemic and heart failure level, and comparisons were made between the groups and disease-free participants serving as a reference group. The risk of mortality and morbidity was calculated with adjustments for main cardiovascular risk factors and ischaemic heart disease. Results Participants in the reference group were younger, had lower body mass indices and more seldom a history of myocardial infarction compared with diseased groups. Mortality was lowest in the reference group ( P < 0.0001) increasing to a maximum in participants with the combination of glucose abnormality and heart failure. Prognostically, the mortality risk associated with abnormal glucose regulation was increased but was lower than the risk of diabetes. The risk of a new myocardial infarction was highest in participants with diabetes [hazard ratio (HR) 1.6; 95% confidence interval (CI) 1.3-2.0] or diabetes in combination with heart failure (HR 1.8; CI 1.1-2.7). Conclusions Heart failure or glucose abnormalities are related to increased morbidity and mortality. The combination of glucose abnormality and heart failure did, however, not add further to the unfavourable prognosis in the presence of ischaemic heart disease.

scholarly journals Incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amy Groenewegen ◽  
Victor W. Zwartkruis ◽  
Betül Cekic ◽  
Rudolf. A. de Boer ◽  
Michiel Rienstra ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Incidence Rate ◽  
Diabetes Status ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Rate Ratios ◽  
Age And Sex

Abstract Background Diabetes has strongly been linked to atrial fibrillation, ischaemic heart disease and heart failure. The epidemiology of these cardiovascular diseases is changing, however, due to changes in prevalence of obesity-related conditions and preventive measures. Recent population studies on incidence of atrial fibrillation, ischaemic heart disease and heart failure in patients with diabetes are needed. Methods A dynamic longitudinal cohort study was performed using primary care databases of the Julius General Practitioners’ Network. Diabetes status was determined at baseline (1 January 2014 or upon entering the cohort) and participants were followed-up for atrial fibrillation, ischaemic heart disease and heart failure until 1 February 2019. Age and sex-specific incidence and incidence rate ratios were calculated. Results Mean follow-up was 4.2 years, 12,168 patients were included in the diabetes group, and 130,143 individuals in the background group. Incidence rate ratios, adjusted for age and sex, were 1.17 (95% confidence interval 1.06–1.30) for atrial fibrillation, 1.66 (1.55–1.83) for ischaemic heart disease, and 2.36 (2.10–2.64) for heart failure. Overall, incidence rate ratios were highest in the younger age categories, converging thereafter. Conclusion There is a clear association between diabetes and incidence of the major chronic progressive heart diseases, notably with heart failure with a more than twice increased risk.

scholarly journals Blood pressure and heart rate in patients with ischaemic heart disease receiving nifedipine and propranolol.

BMJ ◽  
1982 ◽  
Vol 284 (6323) ◽  
pp. 1148-1151 ◽  
Author(s):  
L Harris ◽  
H J Dargie ◽  
P G Lynch ◽  
C J Bulpitt ◽  
D M Krikler
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Disease ◽  
Ischaemic Heart Disease

Inadvertent massive lidocaine overdose causing temporary complete heart block in myocardial infarction

1981 ◽  
Vol 102 (4) ◽  
pp. 801-803 ◽  
Author(s):  
Elias Badui ◽  
David Garcia-Rubi ◽  
Bruno Estañol
Keyword(s):  
Myocardial Infarction ◽  
Heart Block ◽  
Complete Heart Block ◽  
Lidocaine Overdose
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