ACUTE LEFT HEART FAILURE: MANAGEMENT
Written by Dr.ChrisMANAGEMENT: ACUTE LEFT HEART FAILURE
An soon as a diagnosis of acute LHF is made, prompt and effective measures should be instituted to:-(i) lower the venous return and thereby decrease pulmonary congestion; (ii) improve myocardial function; and (iii) clear the air passages.
SPECIFIC MEASURES
(1) Posture. The patient should be made to sit in a chair, or cardiac bed […]
Tags: diuresis, furosemide, pulmonary oedema
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Clinical Manifestations: BACTERAEMI SHOCK
Written by Dr.ChrisClinical Manifestations: BACTERAEMI SHOCK: Clinically, patients reveal features of both bacteraemia and shock. The former include high fever with chills, nausea, vomiting and marked prostration. When shock supervenes hypotension develops with tachycardia, tachypnoea and oliguria. As the “shock syndrome” progresses oliguria and hypotension worsen, mental confusion develops, and extremities become pale and cold. Finally, circulatory […]
Tags: Cardiac Arrhythmias, pulmonary oedema, tachycardia, tachypnoea
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Thrombotic Stroke
Written by Dr.ChrisThrombotic Stroke: This usually results from occlusion in either a large cerebral artery (e.g., middle cerebral) or in small penetrating vessels arising from the anterior, middle or posterior cerebral arteries or basilar artery. In the latter event, lacunar infarcts varying in size from 0.5-10 mm may occur in the region of putamen, thalamus, internal capsule […]
Tags: consciousness, distress syndrome, headache, hiccup, hypoxaemia, oedema, pulmonary oedema, pupillary abnormalities, vomiting
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Measures to Reduce Cerebral Oedema
Written by Dr.ChrisMeasures to Reduce Cerebral Oedema: A certain degree of cerebral oedema is invariably present and therefore, decongestive measures are urgently indicated in all such cases. Of the various drugs available for this purpose (see section on “Thrombotic Stroke”), furosemide is the most useful since it will also help in controlling the blood pressure. Corticosteroids are […]
Tags: distress syndrome, hypoxaemia, oedema, pulmonary oedema
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ADULT RESPIRATORY DISTRESS SYNDROME: GENERAL MEASURES
Written by Dr.ChrisADULT RESPIRATORY DISTRESS SYNDROME: GENERAL MEASURES: Throughout the course of the disease which may stretch over 4-8 weeks certain general measures should be instituted to help recovery. For this purpose, a five point protocol has been defined as follows:
(1) Exercise—respiratory and whole body; (2) Nutrition—attain anabolism by adequate caloric intake; (3) Fluid administration—maintain optimally dry […]
Tags: distress syndrome, hypoxaemia, oedema, pulmonary oedema
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Clinical Features:Adult Respiratory Distress Syndrome
Written by Dr.ChrisClinical Features: From the foregoing account it will be clear that ARDS is a serious complication which can develop during the course of a number of clinical disorders. Unexplained tachycardia, laboured breathing or appearance of cyanosis in such cases should warrant a closer scrutiny. Clinically, the course of ARDS progresses through four stages.
Stage I. Following […]
Tags: distress syndrome, hypoxaemia, oedema, pulmonary oedema
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PATHOPHYSIOLOGY OF ADULT RESPIRATORY DISTRESS SYNDROME
Written by Dr.ChrisPATHOPHYSIOLOGY OF ADULT RESPIRATORY DISTRESS SYNDROME: The increase in extravascular pulmonary fluid and collapse of lung units results in a number of functional abnormalities: (a) progressive hypoxaemia due initially to ventilation-perfusion imbalance and later to shunt hypoxaemia because of blood traversing without oxygenation through capillaries in areas of lung collapse; (b) progressive decrease in functional […]
Tags: distress syndrome, hypoxaemia, oedema, pulmonary oedema
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ADULT RESPIRATORY DISTRESS SYNDROME
Written by Dr.ChrisADULT RESPIRATORY DISTRESS SYNDROME: Adult respiratory distress syndrome (ARDS) can be defined as an acute respiratory disorder of diverse etiologies which result in damage to alveolar capillary membrane (without any preexisting lung disease). The syndrome is associated with increased extravascular fluid in the lungs (non-cardiac pulmonary oedema), and is characterized by severe arterial hypoxaemia. It […]
Tags: distress syndrome, hypoxaemia, oedema, pulmonary oedema
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Treatment : Cardiogenic Shock
Written by D C MorganThe treatment of a case of well-developed cardiogenic shock is extremely difficult and often unsuccessful. Every attempt must therefore be made to prevent it by limiting the extent of necrosis during the period of evolution of infarction (for details, see section on “Acute Myocardial Infarction”). Other preventive mea¬sures will include prompt detection and control of […]
Tags: heart attack, myocardial infarction, pulmonary embolism, pulmonary oedema, Renal Failure, treatement
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Cardiogenic shock
Written by D C MorganEtiology. Cardiogenic shock is one of the most dreaded cardi¬ovascular emergencies, carrying a mortality of 50-80 -percent. It is most frequently the result of acute myocardial infarction but may also occur in cases of massive pulmonary embolism, acute cardiac tamponade, tension pneumothorax and in severe left heart failure. The description that follows refers primarily to […]
Tags: heart attack, myocardial infarction, pulmonary embolism, pulmonary oedema, Renal Failure, tachy
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Treatment of Acute Pulmonary Oedema
Written by D C MorganAn soon as a diagnosis of acute LHF is made, prompt and effec tive measures should be instituted to:-(i) lower the venous return and thereby decrease pulmonary congestion; (ii) improve myoc ardial function; and (iii) clear the air passages.
SPECIFIC MEASURES
(1) Posture. The patient should be made to sit in a chair, or cardiac bed may be […]
Tags: acute left heart failure treatment, Cardiac Failure, heart attack, LHF, pulmonary oedema
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Acute Pulmonary Oedema
Written by D C MorganAcute Pulmonary Oedema Clinical Features. In a well developed attack the history and appearance of the patient are characteristic. Most of the attacks come during sleep, especially at night, unless there are particular precipitating factors as mentioned above.
The patient is suddenly awakened from his sleep by cough and a feeling of suffocation: he has […]
Tags: Cardiac Failure, cyanosis, heart attack, LHF, pulmonary oedema
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ACUTE LEFT HEART FAILURE
Written by D C MorganACUTE LEFT HEART FAILURE
Etiology. Of all the medical emergencies acute left heart failure (LHF) associated with pulmonary oedema is, perhaps, the most dramatic. It may develop suddenly in known cardiac patients without any past history of breathlessness or may result from acute intensification of pre-existing LHF.
Any disease on the left side of the circulation, […]
Tags: ACUTE LEFT HEART FAILURE, Cardiac Failure, heart attack, LHF, pulmonary oedema
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