scholarly journals Anesthetic management of cesarean section in a patient with Takayasu’s arteritis: a case report

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Taichi Ando ◽  
Makoto Sumie ◽  
Shoichi Sasaki ◽  
Miho Yoshimura ◽  
Keiko Nobukuni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Pregnant Woman ◽  
Cesarean Section ◽  
Arterial Blood Pressure ◽  
Coronary Arteries ◽  
Takayasu’S Arteritis ◽  
Anesthetic Management ◽  
Takayasu's Arteritis ◽  
Arterial Blood

Abstract Background Takayasu’s arteritis (TA) is a chronic, progressive, inflammatory arteritis. We presented the case of cesarean section in a patient with TA. Case presentation A 31-year-old pregnant woman with TA underwent a planned cesarean section at 34 weeks of pregnancy. She had stenosis of the cerebral and coronary arteries and heart failure due to aortic regurgitation. Spinal anesthesia was performed. In addition to standard monitoring, arterial blood pressure in the dorsalis pedis artery and regional cerebral tissue oxygen saturation were monitored. Intraoperative arterial blood pressure was maintained using continuous infusion of noradrenaline with a careful intermittent bolus infusion of phenylephrine. All the procedures were successfully performed without significant complications. Conclusions In a pregnant woman with TA, severe stenosis of the cerebral and coronary arteries, and heart failure due to valvular heart disease, careful anesthetic management by selecting catecholamines and assessing the perfusion pressure for critical organs is important.

Abstract 1785: Renal Artery Angioplasty Improves Diastolic Cardiac Function In Patients With heart failure Possessing Renal Artery Stenosis.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Eisei Yamamoto ◽  
Hitoshi Takano ◽  
Hiroyuki Tajima ◽  
Jun Tanabe ◽  
Hidekazu Kawanaka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Blood Flow ◽  
Cardiac Function ◽  
Renal Artery ◽  
Renal Blood Flow ◽  
Renal Artery Stenosis ◽  
Arterial Blood Pressure ◽  
Arterial Blood ◽  
Diastolic Cardiac Function

Background: Renal artery stenosis (RAS) often plays an important role not only in malignant hypertension but also in sudden development of heart failure (HF) so called ‘flash pulmonary edema’ or chronic HF refractory to medical treatment. One of the possible mechanisms whereby RAS affects these unique conditions of HF is suppression of LV compliance through the complex interaction between neurohormonal systems originating from the reduction of renal blood flow. Renal artery angioplasty is expected to be an effective treatment for restoring renal blood flow in patients with RAS. The aim of the present study was whether the angioplasty can improve the impaired neurohormonal systems and diastolic cardiac function in patients with RAS. Methods: A prospective analysis was performed in 18 HF patients with RAS (age: 72±6, 3 females, NYHA I/II/III: 5/9/4) who underwent renal artery angioplasty between 2005 and 2007. Four patients with significant bilateral RAS and 3 patients with unilateral RAS in the vessel supplying a functional solitary kidney were included. We monitored the changes of biochemical and neurohormonal markers and blood pressure. Cardiac function was evaluated by tissue Doppler echocardiogram before and 3 months after the procedure. Results: Technical success was achieved in all interventions. The results are shown in table . Systolic arterial blood pressure significantly decreased by renal angioplasty. B-type natriuretic peptide (BNP) was significantly reduced 3 months after the angioplasty, whereas the change of sCr or angiotensinII was not statistically significant. Myocardial early diastolic velocity (Em), a parameter of diastolic LV function, was significantly improved compared with that measured before the procedure. Conclusions: In patients with either overt or latent HF possessing RAS, renal artery angioplasty not only decreases arterial blood pressure but also improves diastolic cardiac function in parallel with the reduction of BNP level.

LEVEL OF ARTERIAL BLOOD PRESSURE DENOTES DIFFERENT BIOMARKER PROFILE IN ACUTE HEART FAILURE PATIENTS

2018 ◽  
Vol 36 (Supplement 1) ◽  
pp. e60
Author(s):  
G. Jakutis ◽  
A. Mikalauskas ◽  
J. Simonavicius ◽  
V. Juknevicius ◽  
D. Verikas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Acute Heart Failure ◽  
Arterial Blood Pressure ◽  
Heart Failure Patients ◽  
Arterial Blood

Trials on the Effect of Cardiac Resynchronization on Arterial Blood Pressure in Patients With Heart Failure

2011 ◽  
Vol 107 (4) ◽  
pp. 561-568 ◽  
Author(s):  
Sameer Ather ◽  
Sripal Bangalore ◽  
Srinath Vemuri ◽  
Long B. Cao ◽  
Biykem Bozkurt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Cardiac Resynchronization ◽  
Arterial Blood ◽  
Patients With Heart Failure

scholarly journals Influence of the metaboreflex on arterial blood pressure in heart failure patients

2013 ◽  
Vol 27 (S1) ◽  
Author(s):  
Manda Linea Keller ◽  
Bruce D Johnson ◽  
Michael J Joyner ◽  
Kathy A O'Malley ◽  
Andrew Miller ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Heart Failure Patients ◽  
Arterial Blood

scholarly journals Influence of the metaboreflex on arterial blood pressure in heart failure patients

2014 ◽  
Vol 167 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Manda L. Keller-Ross ◽  
Bruce D. Johnson ◽  
Michael J. Joyner ◽  
Thomas P. Olson
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Heart Failure Patients ◽  
Arterial Blood

scholarly journals Is Elevated First Trimester Mean Arterial Blood Pressure Associated With Increased Risk of Placenta Accreta?

2021 ◽  
Author(s):  
Fengge Wang ◽  
Peng Lin ◽  
Liangxi Zhu ◽  
Miaomiao Qu ◽  
Fangxiang Dong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Placenta Accreta ◽  
First Trimester ◽  
Previous Cesarean Section ◽  
Smoking During Pregnancy ◽  
Arterial Blood ◽  
Previous Cesarean

Abstract Purpose: The present study investigated whether first trimester mean arterial blood pressure (MAP) differed among pregnancies with placenta accreta and healthy pregnancies.Methods: We recruited 176 pregnant females totally from 1 January 2016 to 30 September 2018 in this study, as follows: 65 cases of placenta accreta and 111 cases of BMI and age matched, healthy pregnant controls. First trimester mean arterial blood pressure (MAP) were acquired from laboratory data files. Multiple logistic regression analysis were used to study analyzed the probable risk predictor of placenta accreta. Results: The performance of MAP was lower in healthy pregnancies. The MAP of the placenta accreta group was significantly higher than that of the cont rol group (p=0.001<0.05). Our results also showed that MAP was significantly positively associated with placenta accreta after adjusting for age, BMI, fertilization type, gestational week at time of blood pressure measurement, and previous cesarean section history (odds ratio [β]: 1.11; 95% confidence interval [CI]: 1.04–1.69; p=0.0013<0.05). In addition, smoking during pregnancy (β: 7.57; 95% CI: 1.41–40.72; p=0.018<0.05) and previous cesarean section history (β: 2.57; 95% CI: 1.19–5.54; p=0.016<0.05) were significantly positively associated with placenta accreta.Conclusions: Increased first trimester MAP was significantly positively associated with placenta accreta, suggesting the potential role of MAP in identifying high-risk pregnancies for placenta accreta. Smoking during pregnancy and previous cesarean section history may be risk factors for placenta accreta.

Review of children with Takayasu’s arteritis at a Southern African tertiary care centre

2018 ◽  
Vol 28 (9) ◽  
pp. 1129-1135 ◽  
Author(s):  
Antoinette M. Cilliers ◽  
Paul E. Adams ◽  
Hopewell Ntsinjana ◽  
Udai Kala
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Abdominal Aorta ◽  
Takayasu’S Arteritis ◽  
Tertiary Care ◽  
Renal Arteries ◽  
Takayasu's Arteritis ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Fractional Shortening

AbstractIntroductionTakayasu’s arteritis is a rare idiopathic arteritis causing stenosis or aneurysms of the aorta, pulmonary arteries, and their branches. It usually occurs in women, but has been described in children.ObjectiveThe objective of this study was to determine the clinical presentation, demographic profile, vascular involvement, origins, management, and outcome of children diagnosed with Takayasu’s arteritis at a Southern African tertiary care centre between 1993 and 2015.MethodsThis is a retrospective analysis of all children with Takayasu’s arteritis captured on a computerised electronic database during the study period.ResultsA total of 55 children were identified. The female:male ratio was 3.2:1, and the mean age was 9.7±3.04 years. Most originated outside the provincial borders of the study centre. The majority presented with hypertension and heart failure. In all, 37 (67%) patients had a cardiomyopathy with a mean fractional shortening of 15±5%. A positive purified protein derivative test was documented in 73%. Abdominal aorta and renal artery stenosis were the predominant angiographic lesions. A total of 23 patients underwent 30 percutaneous interventions of the aorta, pulmonary, and renal arteries: eight stents, 22 balloon angioplasties, and seven had nephrectomies. All patients received empiric tuberculosis treatment, immunosuppressive therapy, and anti-hypertensive agents as required. Overall, there was a significant reduction in systolic blood pressure and improvement in fractional shortening (p<0.05) with all treatments.ConclusionTakayasu’s arteritis is more common in girls and frequently manifests with hypertension and heart failure. The abdominal aorta and renal arteries are mostly affected. Immunosuppressive, anti-hypertensive, and vascular intervention therapies improve blood pressure control and cardiac function.

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