Cardiac abnormalities mortality

Medical Complications Amenorrhea Lanugo High mortality Dental cavities Electrolyte imbalances Electrolyte imbalances Dental cavities Callous on hands/fingers Enlarged parotid and salivary glands Cardiac abnormalities... 

Withdrawal delirium (delirium tremens), which usually appears 1 to 4 days after abstinence and peaks at about 72 to 96 hours. The mortality rate may be as high as 15% if serious complicating medical problems are also present. Clinical signs and symptoms include profound confusion, illusions, delusions, vivid hallucinations, agitation, insomnia, and autonomic hyperactivity. Death results from infection, cardiac arrhythmias, fluid and electrolyte abnormalities, or suicide (e.g., in response to hallucinations, illusions, or delusions). 

Several disease states can result from abnormal blood clots. For example, strokes were mentioned previously. However, the most common and deadliest thrombotic disease is myocardial infarction (MI). Atherosclerosis has long been associated with reduced cardiac function and elevated mortality due to rupture of atherosclerotic plaques. The rupture of an atherosclerotic plaque usually results not only in blockage due to the plaque itself but also in the immediate formation of an occlusive blood clot, which results in an MI. Immediately after the initiation of an MI, a zone of necrosis begins to develop around the area as ischemia proceeds. It is during this early phase of ischemia (several hours) that therapeutic intervention not only can be life-saving but also can minimize the amount of necrotic heart tissue formed. 

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. 

The heart is sometimes affected by rheumatoid arthritis. Rheumatoid arthritis is associated with an increased risk of cardiovascular mortality. This risk appears to be higher in those with more active inflammation and is reduced with treatment, particularly with methotrexate. Pericarditis may occur, resulting in the accumulation of fluid. Although many patients show evidence of previous pericarditis at autopsy, the development of clinically evident pericarditis with tamponade is a rare complication. Cardiac conduction abnormalities and aortic valve incompetence, caused by aortic root dilatation, may occur. Myocarditis is a rare complication of rheumatoid arthritis. 

Early trials of SAECG showed that an abnormal test was associated with an increased risk of VT, SCD, and total mortality (59). SAECG had a low PPV in these trials, but a high NPV of between 81 and 89%. However, few of these patients were treated with contemporary therapy, making their relevance in current risk stratification paradigms less clear. A more recent trial of 1925 patients with ischemic cardiomyopathy and NSVT found that a filtered QRS duration >114 msec independently predicted the primary end point of arrhythmic death or cardiac arrest (58). However, the five-year rate of the primary end point was 28% versus 17% in patients with an abnormal test versus a normal test (P = 0.0001), revealing the limited PPV and NPV of SAECG to risk stratify these patients. The predictive value of the test was enhanced when it was combined with a low LVEF. 

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