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Orthostatic Hypotension Predicts The Early Morbidity And Mortality In Patients With Ischemic Heart Disease In Coronary Care Unit

Author: dr. Safaa Ali Khudhair د. صفاء علي خضير
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2009 Volume: 3 Issue: 1 Pages: 33-39
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACTBackground: The mechanism by which the orthostatic hypotension and cardiac autonomic neuropathy increase cardiovascular morbidity and mortality remain to be settled. Some studies found exercise intolerance in patients with cardiac autonomic neuropathy with a reduced response in heart rate and blood pressure and decreased cardiac output during exercise. An association between cardiac autonomic neuropathy and QT prolongation has been shown.Objective: To asses the role of the orthostatic hypotension in the development of the early cardiovascular complications in the patients of the coronary care unit.Patients and method: In this a prospective observational follow up study, (50) patients with ischemic heart diseases were included. Blood pressure was measured with the standard mercury sphygmomanometer, the measurement in supine position was taken after at least 15 minutes of rest and the measurement in standing position was taken at the third minutes of standing, the orthostatic hypotension is said to be present when there was a sustained drop in systolic (≥ 20 mmHg) or diastolic (≥ 10 mmHg) blood pressure at the third minute of standing up.Results: Out of twenty two patients with orthostatic hypotension fifteen patients developed cardiovascular complications and out of twenty eight patients without orthostatic hypotension five patients developed cardiovascular complications, this association is statistically significant Conclusion: Orthostatic hypotension can be used as a prognostic marker for the development of early adverse outcomes in patients with acute coronary syndrome, thus it can be useful tool to screen the high risk patients in the coronary care unit.


Article
Cardiovascular Autonomic Impairment in Parkinson Disease

Authors: Asma'a Khalaf Hamod --- Ali Musa Ja'afer --- Abdul Kareem Kadim AL- Khazraji --- Isra'a Fayiq Ja'afer --- et al.
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2015 Volume: 8 Issue: 1 Pages: 1-7
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor dysfunction and several non-motor features. Dysautonomia is a significant non-motor feature as well as a neuropsychiatric symptom.Objective: To assess cardiovascular autonomic function in Parkinson patients.Patients and Methods: Samples were collected from Al Kadhimiya teaching hospital and Baquba teaching hospital in a period lasts from 1st January to 1st November 2013. Cardiovascular autonomic function had been tested in 44 Parkinson patients with autonomic dysfunction, 23 Parkinson patients without autonomic dysfunction and 25 healthy matched controls; using Valsalva maneuver, 30:15 ratio, and effect of posture on blood pressure.Results: The most frequent dysautonomic symptoms in parkinson disease were fainting and dizziness (postural hypotension) with a frequency of 26.8% with a P-value 0.015. The comparison between valsalva levels in three groups of study population was significant (P- value 0.04). The comparison between 30:15 ratio in three groups of study population was not significant statistically (P-value 0.344).Conclusion: Cardiovascular autonomic dysfunction is a common non-motor symptom associated with Parkinson's disease. It may precede the development of the cardinal motor symptoms in PD, making cardiovascular dysfunction an attractive target for early detection and potential neuroprotective strategies for PD. Valsalva maneuver and effect of changes in posture on blood pressure are affecting tests in cardiovascular autonomic study.

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