scholarly journals Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis

2019 ◽  
Author(s):  
Shouming Chen ◽  
Lan Wu ◽  
xiaoqin Jiang
Keyword(s):  
Cardiac Arrest ◽  
Aortic Stenosis ◽  
Cesarean Section ◽  
Case Presentation ◽  
Sudden Loss ◽  
Clinical Scenarios ◽  
Subvalvular Aortic Stenosis ◽  
Emergency Events ◽  
Hypotensive Syndrome ◽  
Timely Delivery

Abstract Background Maternal cardiac arrest during cesarean section (CS) is an extremely rare but devastating complication. Preventing emergency events from developing into maternal cardiac arrest is one of the most challenging clinical scenarios. Case presentation A 35-year-old pregnant woman with subvalvular aortic stenosis who was scheduled for elective CS under epidural anesthesia, and experienced devastating supine hypotensive syndrome, but was successfully resuscitated after delivery. Conclusions The performance of tilt position strictly or high-quality continue manual left uterine displacement (LUD) should be performed until the fetus is delivered, otherwise timely delivery of the fetus may be the best way to optimize the deadly condition.

scholarly journals Aortocaval compression resulting in sudden loss of consciousness and severe bradycardia and hypotension during cesarean section in a patient with subvalvular aortic stenosis

2019 ◽  
Author(s):  
Shouming Chen ◽  
Lan Wu ◽  
Xiaoqin Jiang
Keyword(s):  
Cardiac Arrest ◽  
Aortic Stenosis ◽  
Cesarean Section ◽  
Case Presentation ◽  
Sudden Loss ◽  
Clinical Scenarios ◽  
Subvalvular Aortic Stenosis ◽  
Emergency Events ◽  
Hypotensive Syndrome ◽  
Timely Delivery

Abstract Background: Maternal cardiac arrest during cesarean section (CS) is an extremely rare but devastating complication. Preventing emergency events from developing into maternal cardiac arrest is one of the most challenging clinical scenarios. Case presentation: A 35-year-old pregnant woman with subvalvular aortic stenosis (SAS) who was scheduled for elective CS under epidural anesthesia, and experienced devastating supine hypotensive syndrome, but was successfully resuscitated after delivery. Conclusions: The performance of tilt position strictly or high-quality continue manual left uterine displacement (LUD) should be performed until the fetus is delivered, otherwise timely delivery of the fetus may be the best way to optimize the deadly condition. Keywords: Subvalvular aortic stenosis, Pregnancy, Cesarean section, Hypotension.

scholarly journals Immediate post partum macular subretinal bleeding in a highly myopic patient: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karen Bitton ◽  
J.-L. Bacquet ◽  
F. Amoroso ◽  
S. Mrejen ◽  
M. Paques ◽  
...  
Keyword(s):  
Valsalva Maneuver ◽  
Post Partum ◽  
Pathologic Myopia ◽  
Pathological Myopia ◽  
Case Presentation ◽  
Sudden Loss ◽  
Corrected Visual Acuity ◽  
First Case ◽  
History Of ◽  
Macular Hemorrhage

Abstract Background Pathologic myopia is a major cause of visual impairment and blindness. Case presentation We report a case of an immediate post partum macular subretinal bleeding observed in a highly myopic patient. A 30-years-old woman presented two days after childbirth for sudden loss of vision in her right eye. Multimodal imaging showed macular hemorrhage masking a subtle yellowish linear lesion corresponding to lacker crack. Due to the lack of evidence for choroidal neovascularization, a simple clinical and imaging monitoring was recommended. Six weeks later, we noted an improvement in her best-corrected visual acuity and a decreased in size of the macular hemorrhage. Conclusions This is the first case reporting a macular subretinal bleeding on macular lacquer cracks in a highly myopic patient in immediate post partum. Valsalva maneuver associated with vaginal delivery could explain the occurrence of the hemorrhage associated with lacquer crack. However, natural history of pathological myopia could not be excluded.

scholarly journals Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

Congenital mitral stenosis, subvalvular aortic stenosis, and congestive heart failure in a duck

2008 ◽  
Vol 10 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Elizabeth B. Mitchell ◽  
Michelle G. Hawkins ◽  
Joao S. Orvalho ◽  
William P. Thomas
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Aortic Stenosis ◽  
Mitral Stenosis ◽  
Subvalvular Aortic Stenosis ◽  
Congenital Mitral Stenosis

Evaluation of Subvalvular Aortic Stenosis in Children: A 16-Year Single-Center Experience

2013 ◽  
Vol 34 (6) ◽  
pp. 1409-1414 ◽  
Author(s):  
Fahrettin Uysal ◽  
Ozlem Mehtap Bostan ◽  
Isik Senkaya Signak ◽  
Evren Semizel ◽  
Ergun Cil
Keyword(s):  
Aortic Stenosis ◽  
Single Center ◽  
Single Center Experience ◽  
Subvalvular Aortic Stenosis

scholarly journals Case report: 2 cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endonasal transsphenoidal endoscopic pituitary surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Hongwei Cai ◽  
Huiping Ding ◽  
Xiaoping Xu
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cardiac Arrest ◽  
Case Report ◽  
Nasal Cavity ◽  
Pituitary Surgery ◽  
Case Presentation ◽  
Clinical Anesthesia ◽  
Vagus Reflex

Abstract Background Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. Case presentation This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support. Conclusion Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.

Percutaneous Treatment of Concomitant Severe Aortic Stenosis and Thoracoabdominal Aortic Aneurysm

2021 ◽  
pp. 152660282110385
Author(s):  
Ariane-Sophie Painchaud-Bouchard ◽  
Jeannot Potvin ◽  
Jessica Forcillo ◽  
Ricardo Ruz ◽  
Stephane Elkouri
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Combined Treatment ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Percutaneous Treatment ◽  
Surgical Approaches ◽  
Transcatheter Aortic Valve ◽  
Clinical Scenarios ◽  
Successful Resolution

Purpose: Although rare in occurrence, symptomatic severe aortic stenosis and large thoracoabdominal aortic aneurysm (TAAA) found in combination pose a real therapeutic challenge, especially in elderly frail patients. Surgical approaches for combined treatment are complex and at high risk of complications while staged procedures carry the risk of an unfavorable evolution of the condition temporarily left untreated. Minimally invasive approaches may therefore prove a more suitable strategy for these patients. Case Report: We present the case of a 78-year-old woman with symptomatic severe aortic stenosis (AS) and a TAAA of 7.8 cm in diameter. Transcatheter treatment of both conditions was successfully performed in a staged manner. The first intervention consisted of combined transfemoral transcatheter aortic valve implantation (TAVI) immediately followed by a zone 3 thoracic endovascular aortic endoprosthesis deployment. In order to reduce the extent of intercostal arteries coverage and mitigate the risk of medullar ischemia, a second-stage percutaneous endovascular treatment of the TAAA was performed with a customized 4-fenestration prosthesis. Early and 12-month clinical and radiologic follow-up were favorable. Conclusion: This case demonstrates how a strong multidisciplinary collaboration allows for successful resolution of complex clinical scenarios.

scholarly journals Vernix Caseosa Peritonitis after Vaginal Delivery

2013 ◽  
Vol 6 ◽  
pp. CCRep.S12771 ◽  
Author(s):  
Shameema A. Sadath ◽  
Fathiya I. Abo Diba ◽  
Surendra Nayak ◽  
Iman Al Shamali ◽  
Michael F. Diejomaoh
Keyword(s):  
Cesarean Section ◽  
Acute Abdomen ◽  
Vaginal Delivery ◽  
Vacuum Extraction ◽  
Unusual Complication ◽  
Case Presentation ◽  
Vernix Caseosa ◽  
First Case ◽  
Surgical Emergencies ◽  
Uterine Scar

Introduction Vernix caseosa peritonitis (VCP) is a very unusual complication caused by inflammatory response to amniotic fluid spilled into the maternal peritoneal cavity. Twenty-seven cases have been reported, and all occurred after cesarean section. Case presentation We present a case of VCP following vaginal delivery; this may be the first case reported after vaginal delivery. Mrs. A, 28 years old, gravida 3, para 2, with one previous cesarean section, was admitted at 41 weeks gestation in active labor. Vacuum extraction was performed to deliver a healthy male baby, 4.410 kg, Apgar scores 7, 8. She developed fever, acute abdominal pain, and distension about 3 hours after delivery. A diagnosis of acute abdomen was made. Laparotomy was performed and it revealed neither uterine scar rupture nor other surgical emergencies, but 500 mL of turbid fluid and some cheesy material on the serosal surface of all viscera. Biopsies were taken. She had a course of antibiotics and her recovery was complete. Histology of the peritoneal fluid and tissue biopsy resulted in a diagnosis of VCP. Conclusion Clinical diagnosis of peritonitis due to vernix caseosa should be considered in patients presenting postpartum with an acute abdomen after vaginal delivery.

Out-of-Hospital Resuscitation: Have We Gone Too Far?

2006 ◽  
Vol 21 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Corita Grudzen
Keyword(s):  
Cardiac Arrest ◽  
Prehospital Care ◽  
Sudden Cardiac Arrest ◽  
Hospital Setting ◽  
The United States ◽  
Spontaneous Circulation ◽  
Emergency Medical ◽  
Clinical Scenarios ◽  
Life Sustaining Treatment ◽  
Future Policy

AbstractAmericans are living longer and are more likely to be chronically or terminally ill at the time of death. Although surveys indicate that most people prefer to die at home, the majority of people in the United States die in acute care hospitals. Each year, approximately 400,000 persons suffer sudden cardiac arrest in the US, the majority occurring in the out-of-hospital setting. Mortality rates are high and reach almost 100% when prehospital care has failed to restore spontaneous circulation. Nonetheless, patients who receive little benefit or may wish to forgo life-sustaining treatment often are resuscitated. Risk versus harm of resuscitation efforts can be differentiated by various factors, including cardiac rhythm. Emergency medical services policy regarding resuscitation should consider its utility in various clinical scenarios. Patients, family members, emergency medical providers, and physicians all are important stakeholders to consider in decisions about out-of-hospital cardiac arrest. Ideally, future policy will place greater emphasis on patient preferences and quality of life by including all of these viewpoints.

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