scholarly journals Clinical Course of Coronary Heart Disease Concomitant with Asthma

2020 ◽  
Vol 10 (2) ◽  
pp. 131-138
Author(s):  
N. Y. Grigoryeva ◽  
T. P. Ilyushina ◽  
K. S. Kolosova ◽  
N. B. Koroleva ◽  
A. A. Streltsova ◽  
...  

The research purpose: to study features of clinical process of a coronary heart disease when it combines with a bronchial asthma.The materials and methods: 180 people were included in the research, 90 of them suffer from both CHD and BA (the first group), and also 90 people have only CHD without BA (the second group). The examination included complaint collection process, studying medical history, medical examination, percussion, auscultation, blood pressure measurement with the Korotkov’s method twice a day (in the morning and in the evening), heart rate measurement, 24-hour Holter ECG monitoring, echodoplercardiography. Besides, standard laboratory biochemical testing, including total cholesterol and lowdensity lipoprotein cholesterol, were made with the enzymatic colorimetric method.The results. Dyspnoea is the main complaint among 86 patients with both CHD and asthma, humans have (95,5%), moreover, dyspnoea combines with heartbeating in 73,8%, and is accompanied by angina pectoris only in 20%. There is a significant difference between systolic and diastolic blood pressure (р=0,001) that becomes higher if CHD combines with asthma. The signs of left ventricular and interventricular septum hypertrophy were discovered in the first group, these signs statistically significantly differ from the ones in the second group. The medium pulmonary arterial pressure is significantly higher in the combined group than in the group with only CHD (р=0,001). It is revealed with 24-hour Holter ECG monitoring that cases of myocardial ischemia are more frequent in the group which consists of patients with CHD. Besides, duration of ischemic depression per day is longer in this group too. It might be that if patients have both CHD and asthma they do not reach an ischemic threshold because of dyspnoea due to a respiratory failure.The conclusion. According to our findings bronchial asthma occurs among patients with coronary heart disease in 16.6% of cases. It is a distinctive feature of a bronchial asthma associated with coronary heart disease, that a patient often complaints to dyspnea (cardiopulmonary) and palpitation, increase in arterial blood pressure and heart rate, which appropriately indicates the activation of rennin-angiotensin-aldosteron and sympathicoadrenal systems. It requires the inclusion of appropriate drug groups in the treatment of patients.

2020 ◽  
Vol 10 (2) ◽  
pp. 131-138
Author(s):  
N. Y. Grigoryeva ◽  
T. P. Ilyushina ◽  
K. S. Kolosova ◽  
N. B. Koroleva ◽  
A. A. Streltsova ◽  
...  

The research purpose: to study features of clinical process of a coronary heart disease when it combines with a bronchial asthma.The materials and methods: 180 people were included in the research, 90 of them suffer from both CHD and BA (the first group), and also 90 people have only CHD without BA (the second group). The examination included complaint collection process, studying medical history, medical examination, percussion, auscultation, blood pressure measurement with the Korotkov’s method twice a day (in the morning and in the evening), heart rate measurement, 24-hour Holter ECG monitoring, echodoplercardiography. Besides, standard laboratory biochemical testing, including total cholesterol and lowdensity lipoprotein cholesterol, were made with the enzymatic colorimetric method.The results. Dyspnoea is the main complaint among 86 patients with both CHD and asthma, humans have (95,5%), moreover, dyspnoea combines with heartbeating in 73,8%, and is accompanied by angina pectoris only in 20%. There is a significant difference between systolic and diastolic blood pressure (р=0,001) that becomes higher if CHD combines with asthma. The signs of left ventricular and interventricular septum hypertrophy were discovered in the first group, these signs statistically significantly differ from the ones in the second group. The medium pulmonary arterial pressure is significantly higher in the combined group than in the group with only CHD (р=0,001). It is revealed with 24-hour Holter ECG monitoring that cases of myocardial ischemia are more frequent in the group which consists of patients with CHD. Besides, duration of ischemic depression per day is longer in this group too. It might be that if patients have both CHD and asthma they do not reach an ischemic threshold because of dyspnoea due to a respiratory failure.The conclusion. According to our findings bronchial asthma occurs among patients with coronary heart disease in 16.6% of cases. It is a distinctive feature of a bronchial asthma associated with coronary heart disease, that a patient often complaints to dyspnea (cardiopulmonary) and palpitation, increase in arterial blood pressure and heart rate, which appropriately indicates the activation of rennin-angiotensin-aldosteron and sympathicoadrenal systems. It requires the inclusion of appropriate drug groups in the treatment of patients.


2014 ◽  
Vol 23 (1) ◽  
pp. 8-13
Author(s):  
Idris Ali ◽  
Amirul Islam ◽  
Golam Morshed ◽  
Nurul Islam ◽  
Ashia Ali ◽  
...  

Background: Adjuvant used with local anaesthetic agent in caudal is more effective for post operative analgesia in children . Aim and objective: To find out the duration and quality of caudal analgesia in children undergoing genitourinary surgery by combination of bupivacaine and midazolam. Methods: A total number of sixty patients ASA grade I&II were selected randomly as per inclusion & exclusion criteria in two groups. Thirty in each group. In group A, caudal block was given by bupivacainemidazolam mixture and in group B, caudal block was given by bupivacaine in lateral decubitus position, just after completion of surgery before reversed from GA. In post operative period arterial blood pressure, heart rate, and duration of analgesia were recorded. Results: There was no significant difference between the groups of blood pressure, heart rate, and pain score up to 30 min but after one hour of post operative period pain scores were significant(p<0.05). Conclusion: Midazolam improves the duration and quality of analgesic effect of bupivacaine. DOI: http://dx.doi.org/10.3329/jbsa.v23i1.18152 Journal of BSA, 2010; 23(1): 8-13


2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoye Wang

【Abstract】Objective: Toanalyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.METHODS:Sixty-six elderly patients with coronary heart disease and hypertension were enrolled from December 2017 to November 2018. They were randomly divided into two groups, 33 patients in each group. Patients in the experimental group received nifedipine. In combination with enalapril, patients enrolled in the control group received nifedipine monotherapy.RESULTS:Compared with the control group, the total effective rate, Serum Nitric Oxide (Serum NO) after treatment, CRP after treatment, HCY after treatment, and blood pressure after treatment were significantly improved (P<0.05). Serum NO and treatment before treatment in the 2 groups. There was no significant difference in pre-CRP, pre-treatment HCY, pre-treatment blood pressure, and adverse reactions during treatment (P>0.05).Conclusion: Theelderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.


1995 ◽  
Vol 78 (5) ◽  
pp. 1793-1799 ◽  
Author(s):  
M. Kamitomo ◽  
T. Ohtsuka ◽  
R. D. Gilbert

We exposed fetuses to high-altitude (3,820 m) hypoxemia from 30 to 130 days gestation, when we measured fetal heart rate, right and left ventricular outputs with electromagnetic flow probes, and arterial blood pressure during an isoproterenol dose-response infusion. We also measured the distribution of cardiac output with radiolabeled microspheres during the maximal isoproterenol dose. Baseline fetal arterial blood pressure was higher in long-term hypoxemic fetuses (50.1 +/- 1.3 vs. 43.4 +/- 1.0 mmHg) but fell during the isoproterenol infusion to 41.3 +/- 1.4 and 37.5 +/- 1.4 mmHg, respectively, at the highest dose. Heart rate was the same in both groups and did not differ during isoproterenol infusion. Baseline fetal cardiac output was lower in the hypoxemic group (339 +/- 18 vs. 436 +/- 19 ml.min-1.kg-1) due mainly to a reduction in right ventricular output. During the isoproterenol infusion, right ventricular output increased to the same extent in both hypoxemic and normoxic fetuses (approximately 35%); however, left ventricular output increased only approximately 15% in the hypoxemic group compared with approximately 40% in the normoxic group. The percent change in individual organ blood flows during isoproterenol infusion in the hypoxemic groups was not significantly different from the normoxic group. All of the mechanisms that might be responsible for the differential response of the fetal left and right ventricles to long-term hypoxia are not understood and need further exploration.


1980 ◽  
Vol 58 (1) ◽  
pp. 115-117 ◽  
Author(s):  
D. B. Rowlands ◽  
T. J. Stallard ◽  
R. D. S. Watson ◽  
W. A. Littler

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Giacomo Cavallaro ◽  
Luca Filippi ◽  
Genny Raffaeli ◽  
Gloria Cristofori ◽  
Federico Schena ◽  
...  

Whole-body deep hypothermia (DH) could be a new therapeutic strategy for asphyxiated newborn. This retrospective study describes how DH modified the heart rate and arterial blood pressure if compared to mild hypothermia (MH). Fourteen in DH and 17 in MH were cooled within the first six hours of life and for the following 72 hours. Hypothermia criteria were gestational age ≥36 weeks; birth weight ≥1800 g; clinical signs of moderate/severe hypoxic-ischemic encephalopathy. Rewarming was obtained in the following 6–12 hours (0.5°C/h) after cooling. Heart rates were the same between the two groups; there was statistically significant difference at the beginning of hypothermia and during rewarming. Three babies in the DH group and 2 in the MH group showed HR < 80 bpm and QTc > 520 ms. Infant submitted to deep hypothermia had not bradycardia or Qtc elongation before cooling and after rewarming. Blood pressure was significantly lower in DH compared to MH during the cooling, and peculiar was the hypotension during rewarming in DH group. Conclusion. The deeper hypothermia is a safe and feasible, only if it is performed by a well-trained team. DH should only be associated with a clinical trial and prospective randomized trials to validate its use.


Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.


2021 ◽  
Vol 8 ◽  
Author(s):  
Menghui Liu ◽  
Shaozhao Zhang ◽  
Xiaohong Chen ◽  
Xiangbin Zhong ◽  
Zhenyu Xiong ◽  
...  

Background: The elevated blood pressure (BP) at midlife or late-life is associated with cardiovascular disease and death. However, there is limited research on the association between the BP patterns from middle to old age and incident coronary heart disease (CHD) and death.Methods: A cohort of the Atherosclerosis Risk in Communities (ARIC) Study enrolled 9,829 participants who attended five in-person visits from 1987 to 2013. We determined the association of mid- to late-life BP patterns with incident CHD and all-cause mortality using multivariable-adjusted Cox proportional hazards models.Results: During a median of 16.7 years of follow-up, 3,134 deaths and 1,060 CHD events occurred. Compared with participants with midlife normotension, the adjusted hazard ratio for all-cause mortality and CHD was 1.14 (95% CI, 1.04–1.25) and 1.28 (95% CI, 1.10–1.50) in those with midlife hypertension, respectively. In further analyses, compared with a pattern of sustained normotension from mid- to late-life, there was no significant difference for the risk of incident death (HR, 1.15; 95% CI, 0.96–1.37) and CHD (HR, 1.33; 95% CI, 0.99–1.80) in participants with a pattern of midlife normotension and late-life hypertension with effective BP control. A higher risks of death and CHD were found in those with pattern of mid- to late-life hypertension with effective BP control (all-cause mortality: HR, 1.24; 95% CI, 1.08–1.43; CHD: HR, 1.65; 95% CI 1.30–2.09), pattern of midlife normotension and late-life hypertension with poor BP control (all-cause mortality: HR, 1.27; 95% CI, 1.12–1.44; CHD: HR, 1.53; 95% CI, 1.23–1.92), and pattern of mid- to late-life hypertension with poor BP control (all-cause mortality: HR, 1.49; 95% CI, 1.30–1.71; CHD: HR, 1.87; 95% CI, 1.48–2.37).Conclusions: The current findings underscore that the management of elderly hypertensive patients should not merely focus on the current BP status, but the middle-aged BP status. To achieve optimal reductions in the risk of CHD and death, it may be necessary to prevent, diagnose, and manage of hypertension throughout middle age.


2021 ◽  
pp. 10-15
Author(s):  
Vira Tseluyko ◽  
Tetyana Pylova

The aim of the study to evaluate the effect of supplementation of basic therapy by ranolazine in patients with INOCA on exercise test parameters and Holter ECG monitoring. Materials and methods. 53 patients with stable coronary heart disease were examined, including 18 men (33.9 %) and 35 (66 %) women, the average age of patients was 57 (±9.68) years. According to the results of coronary angiography all patients had non-obstructive coronary arteries. In addition to physical and laboratory examination, bicycle ergometry, Holter ECG monitoring and echocardiography were included in the examination of patients. Patients were divided into 2 groups: group I - patients who in addition to standard therapy received ranolazine at a dose of 1000 mg twice a day for 6 months, and group II patients with standard coronary heart disease therapy. After 6 months from the beginning of the observation an objective examination, echocardiography, exercise test, Holter ECG monitoring were repeated. Results. The study found that patients receiving ranolazine in addition to standard therapy had a statistically significant increase in exercise duration after 6 months compared with baseline and group II. Before treatment in group I, the duration of the exercise test was 356.51±180.24s, and after treatment 414.32±142.10s (p=0.03). In group II, the duration of the test before treatment was 361.4±160.24 c, and after 380.5±152.2 s (p=0.15). It was also found that the duration of the test differed significantly in group I after treatment of patients from group II after treatment of patients with a standard treatment regimen (p=0.04). According to the results of Holter ECG monitoring in group I found a positive effect of ranolazine on the frequency of ventricular arrhythmias: before treatment n=1142 [30; 2012], after treatment n=729 [23; 1420], while in group II a significant difference between the number of extrasystoles before treatment and after not detected (n=1026 [17; 1920], n=985 [15; 1680], respectively) p=0.18. Conclusions. The addition of ranolazine to the basic therapy of patients with non-obstructive coronary arteries disease helps to increase exercise tolerance (according to the loading stress test) and contributes to a significant reduction in the number of ventricular arrhythmias (according to Holter-ECG) compared with both baseline and group II


2008 ◽  
Vol 60 (2) ◽  
pp. 329-334 ◽  
Author(s):  
R.L. Linardi ◽  
J.C. Canola ◽  
C.A.A. Valadão

Cardiovascular effects due to intravenous (IV) xylazine (1.0mg/kg) or amitraz (0.1 or 0.4mg/kg) were evaluated in horses. Left ventricular function indexes, heart rate (HR), and cardiac output (CO) were measured by echocardiography. Second degree atrioventricular (AV) block was detected by electrocardiography. Invasive arterial blood pressure (AP) was also evaluated. All parameters were measured immediately before and during 60 minutes after drug injection. HR, CO, and second degree AV block were different between xylazine and amitraz-0.4mg/kg groups. Xylazine induced initial hypertension 10 minutes after injection, and hypotension was observed 30 minutes after amitraz-0.4mg/kg administration. Except for the second degree AV block which occurred only at five minutes, there was no change in the echocardiographic measurements after administration of amitraz-0.1mg/kg. Thus, amitraz-0.4mg/kg and xylazine (1.0mg/kg) induced similar cardiovascular side effects, but long-lasting action of amitraz-0.4mg/kg in the cardiovascular system was observed.


Sign in / Sign up

Export Citation Format

Share Document