- Cardiovascular autonomic profile in women with constitutional hypotension. [Journal Article]
- JHJ Hypertens 2018 May 16
- CONCLUSIONS: We conclude that the cardiovascular autonomic control in women with CHT is characterized by a low sympathetic vascular tone and increased baroreceptor sensitivity. Also, it seems that these women have a compensated primary hypovolemia, which warrants further investigation.
- Cardiovascular responses to isometric handgrip exercise in young patients with recurrent vasovagal syncope. [Journal Article]
- ANAuton Neurosci 2018; 212:23-27
- CONCLUSIONS: In VVS patients, the pattern of individual CO and TPR changes to IGH is different from healthy subjects. VVS patients may present an abnormal regulation of cardiovascular responses to IHG, with preserved cardiovagal and cardiac sympathetic function.
- [Fitness to drive with cardiovascular diseases : Current guidelines of the German Federal Highway Research Institute]. [Journal Article]
- HERZHerz 2018 May 17
- The general rules for participation in road traffic are specified in the German Driving License Regulations (FeV). The assessment of fitness to drive motor vehicles is, in addition to Annex 4 of the ...
The general rules for participation in road traffic are specified in the German Driving License Regulations (FeV). The assessment of fitness to drive motor vehicles is, in addition to Annex 4 of the FeV, governed by the guidelines of the German Federal Highway Research Institute, which implements the requirements of the European Union in Germany. By anchoring the assessment guidelines on fitness to drive in the FeV (Annex 4) and the publication in the Traffic Journal, the guidelines have a normative character. On 28 December 2016 the 11th amendment of the FeV came into force with the newly revised Chapter 3.4 on "Cardiovascular diseases". For a physician there is a duty to inform the patient about the lack or loss of driving ability. This information must be documented. Taking into account the current state of knowledge, this article describes the preconditions as to when a person has limited or is permanently unfit to drive because of cardiac arrhythmia, for patients with implantable defibrillators, syncope, coronary heart disease, heart failure, cardiomyopathy, heart valve diseases and arterial hypertension.
- Recognition of Sympathetic Crashing Acute Pulmonary Edema (SCAPE) and use of high-dose nitroglycerin infusion. [Journal Article]
- AJAm J Emerg Med 2018 May 10
- Sympathetic Crashing Acute Pulmonary Edema (SCAPE), or flash pulmonary edema, is the extreme end of the acute pulmonary edema spectrum. A sympathetic surge occurs as a result of decreased systemic pe...
Sympathetic Crashing Acute Pulmonary Edema (SCAPE), or flash pulmonary edema, is the extreme end of the acute pulmonary edema spectrum. A sympathetic surge occurs as a result of decreased systemic perfusion resulting in further increases in afterload, causing the patient to decompensate. Patients can decompensate quickly, therefore patients require rapid interventions. The use of high-dose nitroglycerin (HDN) has been a topic of interest as it is believed to achieve preload and afterload reduction. However, its use continues to be controversial due to concerns of drug induced hypotension, syncope or paresthesia. Although there are Free Open Access Medical Education (FOAM) based podcasts as well as few studies to suggest the use of HDN, the evidence is limited by statistical flaws, incomplete dosing parameters and inconsistent methods of administration. In order to address these limitations, a protocol at our ED was created to ensure the safe and effective use of HDN. Here, we present a case of HDN use for the management of SCAPE based on this protocol.
- Arrhythmogenic right ventricular cardiomyopathy in Boxer dogs: the diagnosis as a link to the human disease. [Journal Article]
- AMActa Myol 2017; 36(3):135-150
- CONCLUSIONS: We suggest the diagnosis of ARVC in Boxer dogs requires two out of the three following criteria: presence of ≥ 100 VPCs, presence of couplets or R-on-T-phenomenon on a 24 h-ECG. This results in a uniform phenotype similar to that described in human ACM and may result in the adoption of the term ACM for this analogous condition in Boxer dogs.
- On the Road Again After Vasovagal Syncope? [Editorial]
- JCJACC Clin Electrophysiol 2016; 2(2):209-211
- Prospective Assessment of the Risk of Vasovagal Syncope During Driving. [Journal Article]
- JCJACC Clin Electrophysiol 2016; 2(2):203-208
- CONCLUSIONS: The estimated risk of serious harm or death was <0.0035% per person-year in highly symptomatic patients, less than the risk of serious harm or death in the general population. (A Randomized Clinical Trial of Fludrocortisone for Vasovagal Syncope: The Second Prevention of Syncope Trial [POST II]; NCT00118482).
- Left Ventricular Ejection Fraction and Fractional Shortening are Useful for the Prediction of the Therapeutic Response to Metoprolol in Children with Vasovagal Syncope. [Journal Article]
- PCPediatr Cardiol 2018 May 16
- The objective of this manuscript was to explore if left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) could predict the efficacy of metoprolol therapy on vaso...
The objective of this manuscript was to explore if left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) could predict the efficacy of metoprolol therapy on vasovagal syncope (VVS) in children. Forty-nine children, including 30 with VVS and 19 gender- and age-matched healthy controls, were included in the study. Metoprolol was prescribed to the VVS subjects. The clinical data were obtained during follow-up at 2 and 6 months. The results showed that LVEF and LVFS of responders were significantly higher than those of non-responders both at the 2-month follow-up (LVEF: 72.5 ± 3.2% vs. 64.6 ± 3.4%; LVFS: 40.9 ± 2.3% vs. 34.9 ± 2.9%), and at the 6-month follow-up (LVEF: 72.8 ± 2.8% vs. 65.5 ± 4.6%; LVFS: 41.1 ± 1.9% vs. 35.8 ± 3.6%). The receiver operating characteristic curve (ROC) analysis demonstrated that 70.5% as a cutoff value of baseline LVEF yielded a sensitivity of 80% and a specificity of 100% in predicting the therapeutic effectiveness of metoprolol at 2 months. For baseline LVFS, 38.5% as a cutoff value yielded a sensitivity of 90% and a specificity of 90%. At the 6-month follow-up, the ROC analysis demonstrated that 70.5% as a cutoff value of baseline LVEF yielded a sensitivity of 81.3% and a specificity of 88.9% in the prediction of metoprolol efficacy. For baseline LVFS, 37.5% as a cutoff value yielded a sensitivity of 93.8% and a specificity of 66.7%. In conclusion, baseline LVEF and LVFS might be useful predictors of the efficacy of β-blocker therapy on VVS in children.
- [Long-term follow-up of psychogenic pseudosyncope]. [Journal Article]
- TPTijdschr Psychiatr 2018; 60(5):297-305
- CONCLUSIONS: After communicating the diagnosis of PPS, attack frequency decreased and health care use shifted toward mental care. Low quality of life underlines the fact that PPS is a serious condition. Improvement of quality of life probably requires both a longer treatment and longer follow-up.
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- Syncope and autonomic failure in a middle-aged man. [Journal Article]
- IEIntern Emerg Med 2018 May 15