Cardiac abnormalities dysfunction

Cardiac conditions in which prophylaxis is recommended include presence of prosthetic valves, prior infective endocarditis, congenital cardiac abnormalities, rheumatic heart disease or any other valvular dysfunction, hypertrophic... 

The IV administration of propafenone is accompanied by an increase in right atrial, pulmonary arterial, and pulmonary artery wedge pressures in addition to an increase in vascular resistance and a decrease in the cardiac index. A significant decrease in ejection fraction may be observed in patients with preexisting left ventricular dysfunction. In the absence of cardiac abnormalities, propafenone has no significant effects on cardiac function. 

Anthracyclines can cause the late complication of a cardiomyopathy, which can be irreversible and can proceed to congestive cardiac failure, ventricular dysfunction, conduction disturbances, or dysrhythmias several months or years after the end of treatment (3,4). Doxorubicin can cause abnormalities of right ventricular wall motion (5). A significant number of patients receiving anthracyclines develop cardiac autonomic dysfunction (6). 

Additional acute toxic symptoms involve cardiac abnormalities, liver dysfunction, and kidney inflammation. Agitated psychotic behavior can occur. For additional information, refer to Effects of Exposure to Toxic Gases-First Aid and Medical Treatment and Medical Management Guidelines for Acute Chemical Exposures [1,2]. 

Coma/lethargy Cardiac abnormality Liver dysfunction Hypotonia Glucose (B)... 

The only way to determine if a comatose patient has SE is by EEG. EEG monitoring should be used for patients who remain unconscious after initial antiepileptic treatment, and for those who received a long-acting paralytic agent or require prolonged therapy for RSE. Treatment should never be delayed while awaiting EEG results. An electrocardiogram (ECG) should be obtained to rule out cardiac dysfunction when hypotension or an abnormal heart rate is observed. 

Concomitant therapy Concomitant therapy with -blockers or digitalis is usually well tolerated, but the effects of coadministration cannot be predicted, especially in patients with left ventricular dysfunction or cardiac conduction abnormalities. 

Concomitant use of calcium channel blockers (atenolol) Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise when beta-blockers are administered with verapamil or diltiazem. Patients with preexisting conduction abnormalities or left ventricular dysfunction are particularly susceptible. Recent acute Ml (sotalol) Sotalol can be used safely and effectively in the long-term treatment of life-threatening ventricular arrhythmias following an Ml. However, experience in the use of sotalol to treat cardiac arrhythmias in the early phase of recovery from acute Ml is limited and at least at high initial doses is not reassuring. 

Ethanol readily passes across the placenta and into the fetal circulation. The fetal alcohol syndrome has three primary features microcephaly, prenatal growth deficiency, and short palpebral fissures Other characteristics include postnatal growth deficiency, fine motor dysfunction, cardiac defects, and anomalies of the external genitalia and inner ear. A definite risk of producing fetal abnormalities occurs when ethanol consumption by the mother exceeds 3 oz daily, the equivalent of about six drinks. 

A 68-year-old man was treated for a subcutaneous infection of the thigh by subcutaneous irrigation with povidone iodine (71). Toxic plasma and urinary iodine concentrations were associated with abnormalities of cardiac conduction, lactic acidosis, acute renal insufficiency, hypocalcemia, and thyroid dysfunction. 

S100B Overexpression Female specific hyperactivity, lack of habituation to novelty, reduced T-maze spontaneous alternation rate, abnormal exploratory behavior Enhanced astrocytosis and neurite proliferation Impaired learning and memory, increased dendrite density, enhanced age-related loss of dendrites Inhibitory effect on cardiac hypertrophy Increased susceptibility to hypoxia-ischemia Increased apoptosis after myocardial infarction Enhanced neuroinflammation and neuronal dysfunction induced by amyloid-(3... 

Depression and Diabetes Mellitus. Patients with chronic medical illness have a high prevalence of major depressive disorder [59], Depression may be three times more prevalent in the diabetic population when compared with its occurrence in nondiabetic individuals [60], In addition, microalbuminuria, hypertension, and hyperinsulinemia are another three independent risk factors for cardiac disease in non-insulin-dependent diabetes mellitus (NIDDM) [61], Nosadini et al. showed that peripheral insulin resistance, hypertension, microalbuminuria, and lipid abnormalities are associated with NIDDM [61], Further, Helkala et al. determined that cognitive and memory dysfunction are associated with NIDDM and explored the disease s relationship with depression, metabolic control, and serum lipids. The results showed that the NIDDM patients had impaired control of their learning processes [62], Obviously, future research examining the causal relationship of depression to the onset on diabetes and the effect of depression on the natural course of diabetes is needed [60]. 

Systemic features Possible visceral fibrosis CREST, pulmonary hypertension, major organ dysfunction CNS and cardiac involvement Flematologic abnormalities, hypergamma- globulinemia Myalgia, neuropathy, ingestion of L-tryptophan... 

In patients with colic, the most relevant clinical sign of hypokalemia is reduced intestinal motility (Geimari 1998, Schaer 1999). However, the association between h) okalemia and ileus in the horse remains undetermined. Other clinical signs include muscle weakness, lethargy and inability to concentrate urine (Schaer 1999). Cardiac conduction abnormalities are rare except in severe hypokalemia and in pre-existing cardiac dysfunction (Gennari 1998). The effect of potassium on acid-base status is small and need not be considered clinically (Corley Marr 1998). 

Accumulation of the parent drug and resultant QT prolongation may occur following a overdose, a drug interaction that limits metabolism of terfenadine (e.g., concomitant administration with erythromycin or other macrolide antibiotic or with the azole derivatives ketoconazole or itraconazole), or significant hepatic dysfunction that limits metabolism of terfenadine. Patients with preexisting cardiac disease or those with electrolyte abnormalities are also at increased risk for cardiac toxicity. 

Studies of chronic exposure of those working in dry cleaning plants have reported some CNS effects, some liver function abnormalities, renal dysfunction, and some definite central and peripheral neurotoxicity. Other effects from chronic exposure to PERC include cardiac arrhythmias, reduced color perception, impaired memory, peripheral neuropathy, impaired vision, confusion, disorientation, fatigue, personality changes, and agitation. 

Patients in hemodynamic subset I have a cardiac index and PAOP within generally acceptable ranges and have the lowest mortality of any subset. These patients do not need immediate specific interventions other than maximizing oral therapy and monitoring. It should be emphasized that patients with significant left ventricular dysfunction still may present in subset I because normal compensatory mechanisms and/or appropriate drug therapy at least partially may correct an otherwise abnormal hemodynamic profile. 

In dilated cardiomyopathy, the cardinal feature is dilatation of the ventricles. Systohc fnnction is abnormal, leading to a decreased cardiac ontpnt. Inpatients with hypertrophic cardiomyopathy (HCM), the ventricnlar cavity is not dilated, and the ventricnlar mnscle mass is increased. Ventricnlar cavity size is normal or decreased, and systolic function often is preserved. Patients with HCM may have an obstructive or nonobstructive form. Patients with restrictive cardiomyopathy have inadequate ventricular comphance causing diastolic dysfunction owing to endocardial and/or myocardial disease. The chnical presentation is similar to that of constrictive pericarditis. 

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