Intravenous nitroglycerin in acute myocardial infarction

Vasodilator therapy has been shown to improve ventricular function in patients with left ventricular failure complicating acute myocardial infarction. Sublingual nitroglycerin also improves ventricular function in these patients but its effects are transient and variable. Infusion of intravenous nitroglycerin in 12 patients with acute infarction resulted in a decrease in left ventricular fill…

Hemodynamic effects of isosorbide dinitrate vs nitroglycerin in patients with…

The hemodynamic response to nitroglycerin administration, to sublingual or oral administration of isosorbide dinitrate, or to a placebo was evaluated and compared in 37 patients with unstable angina pectoris under resting, pain-free conditions. Patients with congestive heart failure were not included in this study. Serial measurements of mean arterial Mood pressnre (MAP), pulmonary arter…

Clinical and Circulatory Effects of Isosorbide Dinitrate ; Comparison with Ni…

In order to resolve current controversies on isosorbide dinitrate (ISDN), we employed a particularly sensitive testing protocol to evaluate effects of sublingual ISDN and nitroglycerin on the exercise capacity of patients with angina. Ten minutes after ISDN 21 of 23 patients exercised longer (average 2.7 minutes, P < 0.001) than after placebo. Benefit was evident in only a minority of patients …

Peripartum Cardiomyopathy

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Treatment of right heart failure: is there a solution to the problem?

Right heart function is a significant determinant of outcomes across a variety of aetiologies of rightrnventricular (RV) dysfunction. Right heart failure syndrome is characterised by the inability of the rightrnventricle to generate sufficient stroke volume. Management often requires simultaneous execution ofrnmultiple strategies to optimise RV preload, contractility and afterload, while mainta…

Peripartum Cardiomyopathy: Review of the Literature

Peripartum cardiomyopathy (PPCM) is a rare but serious form of cardiac failure affecting women in the last months of pregnancy or early puerperium. Clinical presentation of PPCM is similar to that of systolic heart failure from any cause, and it can sometimes be complicated by a high incidence of thromboembolism

European Stroke Organization Guidelines for the Management of Intracranial A…

Intracranial aneurysm with and without sub-arachnoid haemorrhage (SAH) is a relevant health problem: The overall incidence is about 9 per 100,000 with a wide range, in some countries up to 20 per 100,000. Mortality rate with conservative treatment within the first months is 50–60%.

Cerebrospinal Fluid Analysis

Lumbar puncture is frequently performed in primary care. Properly interpreted tests can make cerebrospinal fluid (CSF) a key tool in the diagnosis of a variety of diseases. Proper evaluation of CSF depends on knowing which tests to order, normal ranges for the patient’s age, and the test’s limitations. Protein level, opening pressure, and CSF-to-serum glucose ratio vary with age.

Pressure gradient vs. flow relationships to characterize the physiology of a …

Pressure loss vs. flow curves offer a fundamental fluid dynamic synthesis for describing aortic valve pathophysiology. Severe AS does not consistently behave like an orifice (as suggested by Gorlin) or a resistor, whereas TAVI devices behave like a pure resistor. During peak dobutamine, the ratio of aortic to left ventricular pressures during systolic ejection provides a ‘fractional flow r…

Trends in long-term prognosis after acute coronary syndrome

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