Presentation
We describe patterns of presentation and outcomes of patients with methamphetamine use who present with NOMI to a single institution. [ncbi.nlm.nih.gov]
Entire Body System
- Coronary Atherosclerosis
The Role of Coronary Atherosclerosis It was very important that these investigators provided IVUS evidence of coronary atherosclerosis in all patients tested, confirming our findings from the Women’s Ischemia Syndrome Evaluation (WISE) IVUS substudy.10 [ahajournals.org]
This test can determine if you have a buildup of calcium in your coronary arteries — a sign of coronary atherosclerosis. The heart arteries can also be seen using CT scanning (coronary CT angiogram). [mayoclinic.org]
These underlying conditions are macrovascular diseases, obstructive coronary atherosclerosis, and microvascular disease. [vpjournal.net]
- Lower Extremity Pain
METHODS: A 14-year old boy presented with worsening right lower extremity pain and ulcerative lesions of his foot. Laboratory analysis revealed a diagnosis of APS. [ncbi.nlm.nih.gov]
Respiratoric
- Dyspnea
RESULTS: A total of five women enrolled of which four completed the trial, while one was withdrawn by the investigators after developing dyspnea 1 week after treatment. Her symptoms resolved after cessation of the study medication. [ncbi.nlm.nih.gov]
Typical angina was more prevalent in the oCAD group (85% versus 64%; P<0.001) whereas the INOCA subjects had more limiting dyspnea (New York Heart Association classification III/IV 54% versus 37%; OR, 2.0 [1.3–3.0]; P=0.001). [ahajournals.org]
If the patient is becoming hypoxic or has dyspnea due to fluid resuscitation, apply oxygen via nasal cannula or non-rebreather mask. Consider intubation if their breathing gets worse. [cdemcurriculum.com]
It further suggests cardiac stress testing in a variety of clinical situations in which clinicians are concerned about ongoing CAD.2 Cardiac stress tests should be performed in diabetic patients with angina or anginal equivalent symptoms, including dyspnea [clinical.diabetesjournals.org]
Cardiovascular
- Chest Pain
“These findings suggest that even though there may not be as much plaque, many women may have chest pain that limits their daily activities. We have medicines that can improve chest pain from heart disease. [healio.com]
Sweating Fatigue When to see a doctor Get emergency help if you have severe chest pain or chest pain that doesn't go away. [mayoclinic.org]
- Hypotension
Although the collateral blood supply to the stomach is protective, systemic hypotension or occlusion of the main arteries, as in the case of our patient, may result in gastric ischemia. [ncbi.nlm.nih.gov]
For cases of CMI, hypotension should be avoided as much as possible. This needs to be stressed at the time of sign out and if there is a risk for hypotension, the overnight physician may need to monitor pressures. B. Anticipated Length of Stay. [clinicaladvisor.com]
Two large bore IV’s with crystalloid fluids wide open are necessary in patients who are hypotensive. [cdemcurriculum.com]
- Left Ventricular Dysfunction
ventricular dysfunction, or those who are symptomatic. [opmed.doximity.com]
Of note, in the subset of patients with left ventricular dysfunction, a substudy of the Surgical Treatment for Ischemic Heart Failure (STICH) trial also demonstrated that inducible myocardial ischemia did not identify patients with worse prognosis or [jamanetwork.com]
Other causes include severe left ventricular dysfunction resulting in a low ejection fraction, paradoxical embolus from the venous system due to a shunt through a septal defect such as an aneurysm or patent foramen ovale, or vessel-to-vessel atheroembolism [clevelandclinicmeded.com]
Neurologic
- Confusion
Phase 1 Severe abdominal pain Blood in stools Phase 2 Widespread abdominal and belly pain Decreased bowel motility and abdominal bloating Phase 3 Shock Dehydration Low blood pressure Rapid heart rate Confusion If you or a loved one has any of these symptoms [susquehannahealth.org]
Symptoms of stroke are Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) Sudden confusion, trouble speaking or understanding speech Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss [medlineplus.gov]
Therefore; may cause life-threatening problems such as heart attacks or strokes and symptoms such as speech difficulties, confusion, weakness in arms and legs. [healthandmedicine.net]
The signs of a stroke are: Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion Sudden trouble speaking Sudden trouble seeing in one or both eyes Sudden trouble walking Sudden dizziness, loss of balance [cedars-sinai.edu]
Lacunes may be confused with other empty spaces, such as enlarged perivascular Virchow-Robin spaces (VRS). The VRS are extensions of the subarachnoid space that accompany vessels entering the brain parenchyma. [radiologyassistant.nl]
- Seizure
Sustained severe hypoglycemia, and seizures lasting 1-2 hours also cause permanent brain damage. Pure hypoxia in clinical settings is unusual. [neuropathology-web.org]
Seizures in the first 24 hours of life can also indicate the possibility of hypoxic-ischemic encephalopathy. There are three levels of hypoxic-ischemic encephalopathy: mild, moderate, and severe. [cerebralpalsy.org]
Seizures can also occur at the onset of ischemic or hemorrhagic strokes. [clevelandclinicmeded.com]
[…] t breathe without assistance Cooling the baby’s brain or body to reverse brain hypoxia caused by high temperatures Hyperbaric oxygen treatment in cases where HIE is caused by carbon monoxide intoxication General anesthesia and medications to control seizures [birthinjuryguide.org]
- Irritability
These solutions will cause pain and/or irritation. </p> <h3>Direct pressure </h3> <p>Before you try to stop the bleeding, clean your hands to reduce the risk of infection. [aboutkidshealth.ca]
In addition, pressure builds up in surrounding tissues and irritation and swelling occur, which can lead to further brain damage. Hemorrhagic strokes are divided into 2 main categories, including the following: Intracerebral hemorrhage. [hopkinsmedicine.org]
Workup
We report a case of a 50 year old woman presenting with digital ischemia, whose diagnostic workup led to an invasive breast cancer, with significant improvement of digital ischemia after a successful treatment of the neoplasm. [ncbi.nlm.nih.gov]
Further workup may include referral to a geneticist for evaluation of potential genetic or metabolic causes of stroke in these populations. [clevelandclinicmeded.com]
Serum
- Dyslipidemia
There were notable differences in baseline characteristics including smoking, dyslipidemia, and inducible ischemia on exercise treadmill testing. [ahajournals.org]
< 50 mg/dL or treatment of dyslipidemia, obesity (especially central obesity), poor nutrition, low physical activity, family history of premature CVD occurring in a first-degree relative in men aged < 55 years or women aged < 65 years, the metabolic syndrome [vpjournal.net]
In patients with dyslipidemia, recommendations state that those with known coronary disease and patients at high-risk for coronary disease be treated with lifestyle measures and a statin, even in the presence of a normal LDL (Class I, Level A evidence [clevelandclinicmeded.com]
Intensive standardized risk factor reduction, including 1 ) treatment of hyperglycemia, hypertension, dyslipidemia, and microalbuminuria; 2 ) secondary prevention of cardiovascular disease with aspirin; and 3 ) behavioral modification, resulted in significant [care.diabetesjournals.org]
Other ECG Findings
- Ischemic Changes
Because these intestinal ischemic changes can progress, it is difficult to make a definitive determination intraoperatively as to whether resection of damaged intestine is required. [ncbi.nlm.nih.gov]
Despite this high risk, the results of this study suggest that, in patients with stable CAD, documented ischemia observed by ischemic changes during EST was not associated with different 10-year cardiovascular outcomes and worsening of ventricular function [jamanetwork.com]
- Abnormal ECG
After a markedly abnormal ECG showing high voltage R waves and deep, inverted T waves on precordial leads, an echocardiographic study is performed, suggesting non-obstructive hypertrophic cardiomyopathy (HCM). [scmr.org]
ADA recommendations include cardiac stress testing for these patients, as well as for those with proteinuria and microalbuminuria, peripheral vascular disease, carotid occlusive disease, or abnormal ECG, and for those who have been sedentary and are about [clinical.diabetesjournals.org]
Treatment
The underlying pathogenic mechanisms remain unknown and it can be the first manifestation, occur after the diagnosis or during treatment. [ncbi.nlm.nih.gov]
Prognosis
These results showed that an increase in SPP of ≥ 20 mmHg after bypass surgery was associated with better limb prognosis. [ncbi.nlm.nih.gov]
The extent of ischemia and its quantification is also relevant in view of the very poor prognosis of left main and 3-vessel disease, which influences this negative prognosis through the presence of extensive ischemia. [revespcardiol.org]
Etiology
Spontaneous subclavian artery dissection is a rare etiology. Spontaneous artery dissection causing brain ischemia is rare in all ischemic strokes. [ncbi.nlm.nih.gov]
Epidemiology
We present a short review of the literature, discussing epidemiology, pathophysiology, clinical presentations, diagnosis and management of NOMI. NOMI is a rare disease with a difficult diagnosis. [ncbi.nlm.nih.gov]
It provides biological plausibility to support epidemiology studies that show ultrafine particles are especially potent in causing adverse cardiac outcomes. [cfpub.epa.gov]
Contents Critical limb ischemia: definition, epidemiology and economic impact History of diagnosis and treatment of critical limb ischemia Diabetes mellitus, diabetic foot and amputations: the magnitude of the problem Arterial mapping by Duplex scanning [minervamedica.it]
Silent myocardial ischemia: Epidemiology, diagnosis, treatment, and prognosis. https://www.uptodate.com/contents/search. Accessed Jan. 31, 2019. Jameson JL, et al., eds. Chest discomfort. In: Harrison's Principles of Internal Medicine. 20th ed. [mayoclinic.org]
Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016;37:3232-45. DOIPubMed 4. Center for Disease Control and Prevention. Women and heart disease fact sheet. [vpjournal.net]
Pathophysiology
This study reviews the role of ALDH2 in modulating the pathways involved in the pathophysiology of IRI associated with oxidative stress, autophagy and apoptosis. [ncbi.nlm.nih.gov]
Prevention
The effects of statins on stroke prevention and treatment as well as on apoptotic mediators are also considered. [dx.doi.org]
The management for preventing the delayed cerebral ischemia is clinically difficult because of its multifactorial nature. [ncbi.nlm.nih.gov]
Prevention The same lifestyle habits that can help treat myocardial ischemia can also help prevent it from developing in the first place. [mayoclinic.org]