Duodenal Carcinoid with Cystic Hepatic Metastasis Presenting with Severe Anemia and Heart Failure

Background: Though anemia due to iron deficiency is quite common in India there has been little wok done on the incidence of etiopathogenesis of severe anemia without apparent cause. Anemia is prevalent throughout the world. The objective of the present endeavour was to study the prevalence of severe anemia, to form an etiological categorization of anemia and to study the prevalence of heart failure in the study groupMethods: Total of 50 patients admitted to the medical ward of MediCiti Institute of Medical Sciences and meeting all the exclusion and inclusion criterion were studied. All the patients were subjected to a detailed history and physical examination. All cases were examined in detail according to proforma, investigations, pathological examination and other special tests were carried out.Results: Female preponderance in a ratio of 3:2 was seen. Nutritional anemia was the most common etiology and all cases were seen only in females. Fatigue and tiredness were reported by all patients, hepatomegaly was the most in 42% of the patients. 38 (76%) were found to have cardiac murmurs. As the hemoglobin increased the proportion of patients with heart failure reduced. But this trend was not found to be statistically significant. The association between Hb level and presence of hepatomegaly or splenomegaly was not found to be statistically significant. Thrombocytopenia was the most common cytopenia found in 34%. Only 16% of the patients with severe anemia were found to have normocytic normochromic picture.Conclusions: Severe anemia was found to be associated with morbidity. Hence early detection and prevention by vigorous treatment is important.

Download Full-text

Complicated Stress-induced Cardiomyopathy and Heart Failure due to Bleeding Myoma

Asian Journal of Pharmacy Nursing and Medical Sciences ◽

10.24203/ajpnms.v8i1.6082 ◽

2020 ◽

Vol 8 (1) ◽

Author(s):

Ji-Hyoung Park ◽

Jaemoon Lee ◽

Eunbi Lee ◽

Kwang Ho Lee

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Acute Heart Failure ◽

Carrying Capacity ◽

Uterine Leiomyoma ◽

Sympathetic Tone ◽

Severe Anemia ◽

Common Complication ◽

Low Level ◽

Oxygen Carrying Capacity

Bleeding associated with uterine leiomyoma is a common complication for many women. Sustained bleeding reduces the oxygen-carrying capacity of hemoglobin. However, a hemoglobin value below 2.0 g/dL due to bleeding is not common. Such a low level compensatively increases sympathetic tone and can lead to stress-induced cardiomyopathy and congestive heart failure. We report a case of severe anemia (1.4 g/dL of hemoglobin) with acute heart failure due to myoma-related bleeding.Â Â

Download Full-text

A case of progressive congestive heart failure secondary to severe anemia in a patient presenting with uterine hemorrhage

Resuscitation ◽

10.1016/s0300-9572(99)00085-4 ◽

1999 ◽

Vol 42 (1) ◽

pp. 69-72 ◽

Cited By ~ 1

Author(s):

Soichiro Yamashita ◽

Naoki Matsumiya ◽

Takeo Fujii ◽

Hiroshi Yamaguchi

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Severe Anemia ◽

Uterine Hemorrhage

Download Full-text

Abstract 3702: Anemia as an Independent Predictor of Perioperative and Long Term Cardiovascular Outcome in Patients Scheduled for Elective Vascular Surgery

Circulation ◽

10.1161/circ.116.suppl_16.ii_841-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Martin Dunkelgrun ◽

Sanne Hoeks ◽

Dustin Goei ◽

Gijs Welten ◽

Radosav Vidakovic ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Renal Failure ◽

Vascular Surgery ◽

Cox Regression ◽

Severe Anemia ◽

Cardiac Events ◽

Cox Regression Analysis ◽

Failure Data ◽

Anemia Group

BACKGROUND: Anemia has been shown to be an independent risk factor for adverse cardiac outcome in various populations. This study evaluated the predictive value of anemia in patients scheduled for elective vascular surgery. METHODS: In total, 1211 patients (76% male, age 68 ± 11 yrs) were enrolled. Anemia was defined as serum hemoglobin < 13 g/dL for men and < 12 g/dL for women, as defined by WHO. Anemia was divided into tertiles to compare mild, moderate and severe anemia with non-anemic patients. Outcome measures were 30-day and 5-year cardiac events (CE) (cardiac death or myocardial infarction). Mean follow up was 3.4 ± 3.2 years. Multivariable linear and Cox regression analysis was used, adjusting for age, sex, type of surgery and baseline characteristics, including angina, myocardial infarction, heart failure, diabetes and renal failure. Data are presented as HRs, with 95% confidence intervals. RESULTS: In total, 74 (6%) patients experienced a 30-day CE and 199 (16%) a 5-year CE. Anemia was present in 399 (33%) patients, of which 133 were mild, 133 moderate, and 133 severe anemia. The presence of anemia was associated with renal failure, diabetes and heart failure. CE free survival at 30 days and 5 years was worse for patients with anemia (Figure ). After adjustment for all clinical risk factors, the 30-day HRs for a CE per anemia group were; mild 1.8, 1.0 – 4.1, moderate 2.9, 1.4 – 6.2, and severe 7.6, 4.1–13.1, and 5-year HRs for CE per anemia group were; mild 2.2, 1.3–3.8, moderate 3.6, 2.4 –5.6, and severe 6.6, 4.6 –9.6. CONCLUSION: The presence and severity of preoperative anemia are significant predictors of 30-day and 5-year cardiac events in patients undergoing elective vascular surgery.

Download Full-text

The product of eGFR and hemoglobin may help predict mortality in systolic heart failure patients without severe anemia and renal failure

Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology ◽

10.5543/tkda.2012.01496 ◽

2012 ◽

Vol 40 (1) ◽

pp. 9-15

Author(s):

Mehmet Birhan Yilmaz

Keyword(s):

Heart Failure ◽

Renal Failure ◽

Systolic Heart Failure ◽

Severe Anemia ◽

Heart Failure Patients

Download Full-text

Mitochondria in Cardiomyopathy: Alterations in Size, Number and Internal Structures

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100100378 ◽

1968 ◽

Vol 26 ◽

pp. 126-127

Author(s):

George Hug ◽

William K. Schubert

Keyword(s):

Heart Failure ◽

Biochemical Analysis ◽

Left Ventricular ◽

Size Number ◽

Internal Structures ◽

Left Ventricular Outflow ◽

Chest X Ray ◽

Myocardial Fibers ◽

Muscle Biopsies ◽

Needle Liver Biopsy

A white boy six months of age was hospitalized with respiratory distress and congestive heart failure. Control of the heart failure was achieved but marked cardiomegaly, moderate hepatomegaly, and minimal muscular weakness persisted.At birth a chest x-ray had been taken because of rapid breathing and jaundice and showed the heart to be of normal size. Clinical studies included: EKG which showed biventricular hypertrophy, needle liver biopsy which showed toxic hepatitis, and cardiac catheterization which showed no obstruction to left ventricular outflow. Liver and muscle biopsies revealed no biochemical or histological evidence of type II glycogexiosis (Pompe's disease). At thoracotomy, 14 milligrams of left ventricular muscle were removed. Total phosphorylase activity in the biopsy specimen was normal by biochemical analysis as was the degree of phosphorylase activation. By light microscopy, vacuoles and fine granules were seen in practically all myocardial fibers. The fibers were not hypertrophic. The endocardium was not thickened excluding endocardial fibroelastosis. Based on these findings, the diagnosis of idiopathic non-obstructive cardiomyopathy was made.

Download Full-text

Localization of endothelial nitric oxide synthase in the normal and failing human atrial myocardium

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100166397 ◽

1996 ◽

Vol 54 ◽

pp. 786-787

Author(s):

Chi-Ming Wei ◽

Margarita Bracamonte ◽

Shi-Wen Jiang ◽

Richard C. Daly ◽

Christopher G.A. McGregor ◽

...

Keyword(s):

Nitric Oxide ◽

Heart Failure ◽

Nitric Oxide Synthase ◽

Endothelial Nitric Oxide Synthase ◽

Cardiac Tissues ◽

Mammalian Tissues ◽

End Stage Heart Failure ◽

End Stage ◽

Oxide Synthase ◽

Endothelial Nitric Oxide

Nitric oxide (NO) is a potent endothelium-derived relaxing factor which also may modulate cardiomyocyte inotropism and growth via increasing cGMP. While endothelial nitric oxide synthase (eNOS) isoforms have been detected in non-human mammalian tissues, expression and localization of eNOS in the normal and failing human myocardium are poorly defined. Therefore, the present study was designed to investigate eNOS in human cardiac tissues in the presence and absence of congestive heart failure (CHF).Normal and failing atrial tissue were obtained from six cardiac donors and six end-stage heart failure patients undergoing primary cardiac transplantation. ENOS protein expression and localization was investigated utilizing Western blot analysis and immunohistochemical staining with the polyclonal rabbit antibody to eNOS (Transduction Laboratories, Lexington, Kentucky).

Download Full-text