Cardiopulmonary disorders

PPHN is associated with diverse cardiopulmonary disorders, including asphyxia, sepsis, meconium aspiration syndrome, congenital diaphragmatic hernia, respiratory distress syndrome, lung hypoplasia, and others, or can... 

Mustard burns may leave areas of hypopig-mentation or hyperpigmentation, sometimes with scarring. Individuals who survive an acute, single mustard exposure with few or no systemic or infectious complications appear to recover fully. Previous cardiopulmonary disorders, severe or inadequately treated bronchitis or pneumonitis, a prior history of smoking, and advanced age all appear to contribute to long-term chronic bronchitis there is no definitive way to determine whether these conditions are the result of aging,... 

Infants and children may require long-term ventilatory support due to three categories of diseases that may impair the ventilatory balance increased respiratory load (due to intrinsic cardiopulmonary disorders, upper airway abnormalities, or skeletal deformities), ventilatory muscle weakness [due to neuromuscular diseases (NMD) or spinal cord injury], or failure of neurological control of ventilation (with central hypoventilation syndrome being the most common presentation) (Fig. 1). 

Dysrhythmias seem to be the most likely cause of sudden death from cocaine, but cardiac conduction disorders are more common in patients with acute cocaine toxicity. Severe cocaine toxicity also causes acidemia and cardiac dysfunction (96). Four patients developed seizures, psychomotor agitation, and cardiopulmonary arrest two of these are briefly summarized here. 

Discordance between total and free magnesium measurements has been reported in selected patient populations, including those with cardiovascular disorders, diabetes meUitus, alcoholism, migraine headaches, asthma, renal transplants, head trauma, and in pregnant women. Interferences, such as that from thiocyanate, in measurement of fr ee magnesium may explain some of these discrepencies. Free magnesium determinations may be helpfiil in others of these disorders and in critically ill patients and during cardiopulmonary bypass, preeclampsia, neonatal distress, and therapy with a number of... 

A. Check blood pressure and pulse rate and rhythm. Perform cardiopulmonary resuscitation (CPR) if there is no pulse and perform advanced cardiac life support (ACLS) for arrhythmias and shock. Note that some ACLS drugs may be ineffective or dangerous in patients with dmg- or poison-induced cardiac disorders. For example, procainamide is contraindicated in patients with tricyclic antidepressant overdose, and atropine and isoproterenol are ineffective in patients with beta-blocker poisoning. 

These disorders include hypertensive disease, ischemic heart disease, other forms of heart disease, and cerebrovascular disease. As with cancer, the specific contribution of occupational factors to the causation of CVD has been debated, but there is agreement that some workplace factors contribute to or cause CVD (see Smith and Sainfort 1990 for a detailed discussion of psychosocial factors and their contribution). Four main occupational sources of CVD causation are agents that affect cardiopulmonary capacity, chemicals, noise, and psychosocial stress. 

Pre-Employment Examination In addition to the standard preemployment examination protocol, special attention should be given to the cardiopulmonary system. Work at high altitudes places greater demands on the circulatory and respiratory systems. For example, medical conditions such as early chronic obstructive pulmonary disease and asthma are more disabling at altitude. Workers with blood disorders (such as sickle ceU anemia, anemia, or polycythemia) wiU find working at high altitudes much more difficult. Medical professionals should be consulted to establish the appropriate medical protocols for the preemployment examinations. 

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