scholarly journals Anaesthetic Management of a Patient with Dermatomyositis and Valvular Heart Disease

2013 ◽  
Vol 10 (2) ◽  
pp. 100-102
Author(s):  
GS Shrestha ◽  
D Aryal
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Anaesthetic Management ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Spinal Epidural

Dermatomyositis is an idiopathic inflammatory myopathy with involvement of muscle, skin and other organs. Valvular heart disease increases the risk of perioperative adverse cardiac events. Only a little information is available about the anaesthetic management of a patient with dermatomyositis and valvular heart disease. Here we considered combined spinal-epidural technique for total abdominal hysterectomy, minimizing the risk of delayed recovery from muscle relaxants, aspiration pneumonitis, arrhythmias and cardiac failure. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 100-102 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7355

Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves

Heart ◽  
2019 ◽  
Vol 105 (18) ◽  
pp. 1432-1436 ◽  
Author(s):  
Aaqib H Malik ◽  
Srikanth Yandrapalli ◽  
Wilbert S Aronow ◽  
Julio A Panza ◽  
Howard A Cooper
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Major Bleeding ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Cardiac Events ◽  
Increased Risk ◽  
Randomised Controlled

ObjectiveCurrent guidelines endorse the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF). However, little is known about their safety and efficacy in valvular heart disease (VHD). Similarly, there is a paucity of data regarding NOACs use in patients with a bioprosthetic heart valve (BPHV). We, therefore, performed a network meta-analysis in the subgroups of VHD and meta-analysis in patients with a BPHV.MethodsPubMed, Cochrane and Embase were searched for randomised controlled trials. Summary effects were estimated by the random-effects model. The outcomes of interest were a stroke or systemic embolisation (SSE), myocardial infarction (MI), all-cause mortality, major adverse cardiac events, major bleeding and intracranial haemorrhage (ICH).ResultsIn patients with VHD, rivaroxaban was associated with more ICH and major bleeding than other NOACs, while edoxaban 30 mg was associated with least major bleeding. Data combining all NOACs showed a significant reduction in SSE, MI and ICH (0.70, [0.57 to 0.85; p<0.001]; 0.70 [0.50 to 0.99; p<0.002]; and 0.46 [0.24 to 0.86; p<0.01], respectively). Analysis of 280 patients with AF and a BPHV showed similar outcomes with NOACs and warfarin.ConclusionsNOACs performed better than warfarin for a reduction in SSE, MI and ICH in patients with VHD. Individually NOACs performed similarly to each other except for an increased risk of ICH and major bleeding with rivaroxaban and a reduced risk of major bleeding with edoxaban 30 mg. In patients with a BPHV, results with NOACs seem similar to those with warfarin and this needs to be further explored in larger studies.

scholarly journals PERIOPERATIVE MANAGEMENT OF PATENT DUCTUS ARTERIOSIS WITH EISENMENGERS SYNDROME WITH SEVERE PULMONARY HYPERTENSION POSTED FOR NON-CARDIAC SURGERY.

2020 ◽  
pp. 1-3
Author(s):  
S.V. Padma Priya ◽  
Mrunalini Mrunalini
Keyword(s):  
Perioperative Management ◽  
Early Adulthood ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Anaesthetic Management ◽  
Pulmonary Artery Hypertension ◽  
Definition Of ◽  
Patent Ductus Arteriosis ◽  
High Pulmonary Vascular Resistance

Victor Eisenmenger's initial definition of Eisenmengers syndrome was redefined by Wood as 'the presence of high pulmonary vascular resistance associated with pulmonary artery hypertension at or close to systemic pressure associated with a reversed or bi-directional shunt at the aortopulmonary, interatrial or interventricular level'. Survival beyond 50 years is unusual, but patients may lead a relatively active and productive life in early adulthood and will therefore present from time to time for noncardiac surgery. Though theoretical risks of anaesthesia are considerable patients are known to do well with a variety of techniques, if pathophysiology of the disease is well understood.We describe the anaesthetic management of the patient with Eisenmengers syndrome with abnormal uterine bleeding with multiple fibroids.She underwent a total abdominal hysterectomy after pre-operative stabilization.Anaesthetizing such a decompensated patient is an anaesthetic challenge.

scholarly journals Perinatal outcomes in pregnant women with heart disease: Hospital General León experience

2018 ◽  
Vol 8 (1) ◽  
pp. 54
Author(s):  
Edgar Ruiz Treviño ◽  
Gabriela Tecayehuatl Delgado ◽  
Junior Joel Araiza Navarro
Keyword(s):  
Heart Disease ◽  
Perinatal Outcomes ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
Fetal Mortality ◽  
Outpatient Basis ◽  
Cardiac Events ◽  
Maternal Risk ◽  
Adverse Cardiac Events ◽  
Disease Hospital

Background: Pregnancies in patients with heart disease are often complicated. The prevalence in our country is at 0.1 to 4%. An increase in the morbidity and mortality of pregnant patients with heart disease was observed, so it is recommended to evaluate the maternal risk with the WHO Classification. The objective of the study was to determine adverse outcomes; cardiac, obstetric and fetal/neonatal.Methods: We retrospectively studied all pregnancies of women with heart disease that were presented on an outpatient basis in the period of 4 years at the General Hospital of León and maternal, obstetric and fetal/ neonatal outcomes were reviewed.Results: In our study population, no maternal or fetal mortality was observed. Of 16 pregnancies of patients with heart disease were complicated by adverse cardiac events (2 of 16), obstetric (9 of 16), fetal/ neonatal (6 of 16). Hospitalization was required during the pregnancy of 11 patients. WHO class IV was the only group in which there were adverse cardiac events. 12 pregnancies were interrupted abdominally. Low fetal growth curve was observed in 6 of the 16 patients.Conclusions: Pregnancies in patients with heart disease have a high risk of cardiac, obstetric and fetal / neonatal complications. Therefore, preconceptionally counseling and specialized multidisciplinary management should be offered to reduce perinatal morbidity and mortality.

Perioperative cardiothoracic surgical management

2010 ◽  
pp. 257-276
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Coronary Artery Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Cardiac Arrhythmias ◽  
Perioperative Management ◽  
Perioperative Risk ◽  
Cardiac Patients ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Artery Disease

Perioperative management of cardiac patients undergoing non-cardiac surgery 258 Risk stratification of cardiac patients undergoing non-cardiac surgery 260 Management of cardiac conditions associated with increased perioperative risk 262 Perioperative management of patients undergoing cardiac surgery 272 Pre-existing CVD is associated with a significant increase in morbidity and mortality in patients undergoing non-cardiac surgery. Coronary artery disease accounts for the vast majority of adverse cardiac events associated with non-cardiac surgery. Other conditions associated with increased perioperative risk include HF, valvular heart disease, and cardiac arrhythmias....

scholarly journals Efficacy and safety of combined spinal: Epidural versus epidural technique for labor analgesia in parturients with rheumatic valvular heart disease

2013 ◽  
Vol 27 (2) ◽  
pp. 80
Author(s):  
Babita Ghai ◽  
Ram Krishnamoorthy ◽  
Vanita Suri ◽  
Rajesh Vijayvergiya ◽  
Jyotsna Wig ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Labor Analgesia ◽  
Efficacy And Safety ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

scholarly journals Sedation in a patient with William Syndrome without supravalvular aortic stenosis and normal QT: Challenge still remains

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Roma Sharma ◽  
Habib Md Reazaul Karim ◽  
Omer Mohammed Mujahid ◽  
Rahul Kanjilal
Keyword(s):  
Cardiovascular Diseases ◽  
Sudden Death ◽  
Learning Difficulties ◽  
Anaesthetic Management ◽  
Personality Characteristics ◽  
Cardiac Events ◽  
Genetic Condition ◽  
Adverse Cardiac Events ◽  
William Syndrome ◽  
Elastin Gene

William Syndrome (WS) is a rare genetic condition related to deletion of elastin gene resulting in distinctive facies, cardiovascular diseases, learning difficulties, developmental delay, unique personality characteristics, endocrine involvement, etc.1 Although successful anaesthesia is reported, literature review indicate significant major adverse cardiac events (MACE) including sudden death, as frequent.2 So anaesthetic management of these patients has proved to be challenging. The cardiovascular abnormality, corrected QT, and cardio-depressant actions of anaesthetic drugs need critical considerations.

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