Congestive heart failure cardiac arrhythmias

Keywords Hypertension Benign prostatic hyperplasia Congestive heart failure Cardiac arrhythmia Adrenoceptor B4 Adrenoceptor... 

Bigger, J.T., Jr., Why patients with congestive heart failure die arrhythmias and sudden cardiac death. Circulation, 1987. 75(5 Pt 2) p. IV28-35. 

Cardiovascular—congestive heart failure, decrease or increase in blood pressure, and cardiac arrhythmias... 

Occurs when the volume of extracellular fluid is significantly diminished. Examples include hemorrhage, fluid loss caused by burns, diarrhea, vomiting, or excess diuresis Occurs when the heart is unable to deliver an adequate cardiac output to maintain perfusion to the vital organs. Examples include as the result of an acute myocardial infarction, ventricular arrhythmias, congestive heart failure (CHF), or severe cardiomyopathy. 

High risk Has unstable or symptomatic angina, despite treatment Has uncontrolled hypertension Has severe congestive heart failure (NYHA class III or IV) Had a recent myocardial infarction or stroke within past 2 weeks Has moderate or severe valvular heart disease Has high-risk cardiac arrhythmias Has obstructive hypertrophic cardiomyopalhy Phosphodiesterase inhibitor is contraindicated sexual intercourse should be deferred... 

Vasopressin vla Human cDNA Hypertension, congestive heart failure, hyponatremia, coagulation, cardiac arrhythmia, learning, memory, Alzheimer s disease, obesity Vasoconstriction, cell proliferation, stimulation of platelet aggregation, stimulation of hepatic glycogenesis, steroid secretion, neuroprotection... 

Norepinephrine NE transporter Human cDNA Depression, Alzheimer s disease, epilepsy, anxiety, attention deficit hyperactivity, angina, asthma, cardiac arrhythmia, cardiac hypertrophy, congestive heart failure, myocardial ischemia, hypertension, artherosclerosis, narcolepsy, orthostatic hypotension, prostatic hyperplasia, rhinitis, diabetes, diarrhea, glaucoma, impotence, obesity, opiate withdrawal pain, Raynaud s disease, preterm labor pain Modulation of norepinephrine concentration in the neuronal synaptic clefts, neuroprotection... 

Cardiac glycosides are drags used in the treatment of congestive heart failure or cardiac arrhythmia, by inhibiting the Na+/K+ pump. This inhibition increases the amount of Ca + ions available for contraction and improves cardiac output and reduces distention of the heart. Cardiac glycosides are extracted from plant material. 

Most of the indications for -blockers concern the -adrenoceptor. This subtype is predominantly present in the heart, mediating all typical cardiac effects like positive inotropy, chronotropy and dro-motropy. The main indications are hypertension, ischemic heart disease, cardiac arrhythmias and some forms of congestive heart failure. The mechanism by which -blocker, when administered chronically, can reduce the blood pressure is not completely understood yet. Most probably several mechanisms. 

Fluid overload occurs commonly in patients with renal failure, often in the absence of associated heart disease. If salt and water intake is not controlled in the patient who is oliguric or anaemic, plasma volume and symptoms of congestive heart failure ensue. Hypertension and coronary heart disease with increasing age contributes to the congestive heart failure. Diuretics like loop-diuretics or metolazone may be of value. Digitalis should be used with caution in patients on dialysis as cardiac arrhythmias may ensue in patients receiving dialysis in the presence of hypokalemia. 

The 3-receptor blocking agents have widespread and important uses in the management of cardiac arrhythmias, angina pectoris, and hypertension. Their uses in these conditions are reviewed in Chapters 16, 17, and 20, respectively. Even though acute administration of 3-blockers can precipitate congestive heart failure in patients who are largely dependent on enhanced sym-... 

Myocardial cell membrane ATPase, the enzyme present in heart muscle, is the site of action of the cardiac steroid glycosides, which have a specific action on the heart muscle. These drugs increase the force of contraction of the muscle (positive inotropic effect) as well as its conductivity and automaticity. They are also valuable in treating congestive heart failure, in which the circulatory needs of organs are no longer satisfied, and heart arrhythmias, in which the rhythm of the cardiac contractions is upset. The effect of the drug is that the force of contraction increases and the heart rate is slowed (chronotropic effect). Consequently, the cardiac output is elevated while the size of the heart decreases. 

This anthracycline-type anticancer drug is very effective against various solid cancers but unfortunately is also cardiotoxic. It causes a dose-dependent cardiomyopathy (degeneration of the cardiac muscle), which leads to arrhythmias and congestive heart failure. 

Adverse Side Effects. Dizziness, drowsiness, ataxia, blurred vision, anemia, water retention (because of abnormal antidiuretic hormone [ADH] release), cardiac arrhythmias, and congestive heart failure can occur with use of these drugs. 

Glycosides of the gitoxigenin series are less active than the corresponding members of the digitoxigenin-derived series. Digitoxin is the only compound routinely used as a drug, and it is employed in congestive heart failure and treatment of cardiac arrhythmias, particularly atrial fibrillation. 

When the heart can no longer pump an adequate supply of blood to meet the metabolic needs of the tissues or in relation to venous return, cardiac failure may ensue. The causes of cardiac failure are complex, but stem from mechanical abnormalities (e.g., pericardial tamponade), myocardial failure (e.g., cardiomyopathy and inflammation), and arrhythmias. In high-output failure, the cardiac output, which may be normal or even higher than normal, is not sufficient to meet the metabolic requirement of the body. Cardiac failure may predispose a patient to congestive heart failure, which is a state of circulatory congestion. Toxic injury, caused by agents such as doxorubicin, the alkaloid emetine in ipecac syrup, cocaine, or ethyl alcohol, is another way by which the functional integrity of the heart may also be compromised. 

Adverse effects Thiazide diuretics induce hypokalemia and hyperuricemia in 70% of patients, and hyperglycemia in 10% of patients. Serum potassium levels should be monitored closely in patients who are predisposed to cardiac arrhythmias (particularly individuals with left ventricular hypertrophy, ischemic heart disease, or chronic congestive heart failure) and who are concurrently being treated with both thiazide diuretics and digitalis glycosides (see p. 160). Diuretics should be avoided in the treatment of hypertensive diabetics or patients with hyperlipidemia. 

Burger AJ, Horton DP, LeJemtel T, Ghali JK, Torre G, Dennish G, Koren M, Dinerman J, Silver M, Cheng ML, Elkayam U Prospective Randomized Evaluation of Cardiac Ectopy with Dobutamine or Natrecor Therapy. Effect of nesiritide (B-type natriuretic peptide) and dobutamine on ventricular arrhythmias in the treatment of patients with acutely decompensated congestive heart failure the PRECEDENT study. Am Heart J 2002 144(6) 1102-8. 

Plants Chemicals that provide medicinal properties are extracted from plants for example, leaves from the foxglove plant are used to produce digitalis, which is used to treat congestive heart failure and cardiac arrhythmias. 

Cardiovascular disease mortality, accounting for 50% of all deaths in ESRD, is defined by death caused by arrhythmias, cardiomyopathy, cardiac arrest, myocardial infarction, atherosclerotic heart disease, and pulmonary edema. Patients with ESRD should be considered in the highest risk group for subsequent cardiovascular events. Among dialysis patients, the prevalence of congestive heart failure is approximately 40%. Both coronary artery disease and LVH are risk factors for the development of heart failure. In practice, it is difficult to determine whether cardiac failure reflects left ventricular dysfunction or extracellular fluid volume overload. 

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