Cardiovascular system complications

It is usually presumed that smooth muscle cells have only one kind of activity, contraction, and that the only alternative to contractile activity is a kind of estivating resting state (Figure 11). The actual situation is of course more complicated. For example, smooth muscles synthesize extracellular filament protein. They also proliferate, particularly in the cardiovascular system. Both of these processes require a considerable amount of control of the cellular economy. 

The primary goals of treatment are correction of the intraabdominal disease processes or injuries that have caused infection and drainage of collections of purulent material (abscess). A secondary objective is to resolve the infection without major organ system complications (e.g., pulmonary, hepatic, cardiovascular, or renal failure) or adverse drug effects. Ideally, the patient should be discharged from the hospital with full function for self-care and routine daily activities. 

Systemic complications may include cardiovascular, renal, pulmonary, metabolic, hemorrhagic, and CNS abnormalities. 

A complication of diabetes where painful nerve damage can affect the limbs (especially causing ulcers in the feet if the patient has poor blood circulation), intestinal and cardiovascular system. 

One of the most serious aspects of the thromboembolic complications now widely acknowledged as being associated with HRT is that their emergence coincides with the development of the conclusion that the role of HRT in reducing the risk of coronary heart disease is at best unproven. A form of treatment that was originally viewed as potentially beneficial to the cardiovascular system is at present on balance perhaps harmful (33). 

Because of the general ability of many of the drugs previously described to produce CNS excitation, some of the primary side effects are nervousness, restlessness, and anxiety. Because these agents also tend to stimulate the cardiovascular system, prolonged or excessive use may also lead to complications such as hypertension, arrhythmias, and even cardiac arrest. When used to treat bronchospasm, prolonged administration via inhalation may also cause some degree of bronchial irritation with some agents. 

Embryonic lethality before development of a functional cardiovascular system die before E9.5 due to retardation of growth TM+/- mice develop normal without thrombotic complications (Christie et al. 1999 Healy et al. 1995,1998 Weiler-Guettler et al. 1998). 

Macrovascular complications are related to the cardiovascular system. His blood pressure and cholesterol are being controlled. 

Local complications in severe AP may include acute fluid collection, pancreatic necrosis, abscess, pseudocyst formation, and pancreatic ascites. Systemic complications may include cardiovascular, renal, pulmonary, metabolic, hemorrhagic, and CNS abnormalities. 

In patients who are predisposed to adverse cardiovascular events, the use of tropicamide either alone or in combination with 2.5% phenylephrine provides satisfactory mydriasis while minimizing the risks of systemic complications. In addition, the use of low concentrations of drug, single applications, eyelid closure, and nasolacrimal occlusion minimizes adverse reactions in susceptible patients. Thus the combination solution made by mixing equal amounts of 1% tropicamide and 2.5% phenylephrine as previously described may have the added benefit of reducing the chances of an adverse reaction even further. 

For the respiratory tract, inhalation can cause spasms, inflammation and edema of the larynx and bronchi, dyspnea, cyanosis, pneumonia, and pulmonary edema. Serious symptoms, such as pulmonary edema and asphyxiation, may not be observed for hours after overexposure. Occasionally, cardiac failure occurs as a complication of severe pulmonary edema. With regards to the cardiovascular system, diphosgene can cause rapid heartbeat and hypotension. Gastrointestinal exposure may cause nausea and vomiting in patients and may be fatal. 

Vigorous fluid resuscitation and support of respiratory, renal, cardiovascular, and hepatobiliary function may limit systemic complications. " However, there is no proven method to prevent these complications. While hemoconcentration (decreased intravascular volume) is strongly associated with pancreatic necrosis, it is not clear whether aggressive fluid resuscitation alone during the first 24 hours can prevent pancreatic necrosis." Procedures such as ERCP, hypothermia, nasogastric suction, pancreatic irradiation, peritoneal lavage, and thoracic duct drainage remain unproven. ... 

Yet treatment of diabetes today is far from complete. In spite of insulin, cardiovascular, renal, eye, and nervous system complications still occur. In spite of sulfonylureas, many primary and secondary failures occur and there is yet no oral insulin substitute for the juvenile or labile diabetic. 

Cardiovascular diseases and complications are the leading cause of death in the United States, which creates a large demand for biomaterials suitable for cardiovascular implantable devices. In general, in order for a biomaterial to be usable in a certain organ system in the human body, the material must be compatible with that system over the device s entire service life period. For a cardiovascular system, this includes compatibility with the patient s blood, especially with respect to immune responses and hemostatic/thrombotic responses and compatibility with blood vessels, if the device is in contact with them. 

In order to analyze the functional coupling between the heart and the blood vessels, we will use a model in which the cardiovascular system has been reduced to its simplest components (Levy, 1979 Berne and Levy, 1981). The model consists of a pump, an elastic arterial system, a peripheral resistance (/ ), and an elastic venous system (Figure 1). The relative ease of analysis of the interactions among the components of this simplified model permits the elucidation of certain basic principles. For many purposes the model is much too simple and potentially misleading. For such purposes, more complicated models must be used, such as those developed by Grodins and his coworkers (1959,1960), Sagawa (1972), and Guyton et al. (1973). 

Arrhythmias. The first solution to cardiovascular problems arising from arrhythmias came about as a result of a complication caused by open-heart surgery. During procedures to correct congenital defects in children s hearts, the electrical conduction system often became impaired, and until it healed, the heart could not contract sufficiently without outside electrical stimulation. A system that plugged into a wall outlet was considered adequate until an electrical storm knocked out power, lea ding to the development of the first battery-powered external pacemaker. 

Pulmonary hypertension develops late in the course of COPD, usually after the development of severe hypoxemia. It is the most common cardiovascular complication of COPD and can result in cor pulmonale, or right-sided heart failure. Hypoxemia plays the primary role in the development of pulmonary hypertension by causing vasoconstriction of the pulmonary arteries and by promoting vessel wall remodeling. Destruction of the pulmonary capillary bed by emphysema further contributes by increasing the pressure required to perfuse the pulmonary vascular bed. Cor pulmonale is associated with venous stasis and thrombosis that may result in pulmonary embolism. Another important systemic effect is the progressive loss of skeletal muscle mass, which contributes to exercise limitations and declining health status. 

NSAIDs are associated with gastrointestinal, renal, hepatic, and central nervous system toxicity and may increase blood pressure. NSAIDs that are selective for the cyclooxygenase-2 (COX-2) isozyme are less likely to cause gastrointestinal complications but may increase the risk of cardiovascular events. They are no more effective than nonselective NSAIDs. Selective agents should be reserved for patients at high risk of gastrointestinal complications and low risk for cardiovascular events. 

Patients predicted to follow a severe course require treatment of any cardiovascular, respiratory, renal, and metabolic complications. Aggressive fluid resuscitation is essential to correct intravascular volume depletion and maintain blood pressure. IV colloids may be required because fluid losses are rich in protein. Drotrecogin alfa may benefit patients with pancreatitis and systemic inflammatory response syndrome. IV potassium, calcium, and magnesium are used to correct deficiency states. Insulin is used to treat hyperglycemia. Patients with necrotizing pancreatitis may require antibiotics and surgical intervention. 

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