Sustained-release calcium channel blocker (CCB SR) overdoses are potentially life-threatening ingestions. These patients may not become hemodynamically unstable until many hours after ingestion. On theoretical grounds, some have suggested that whole bowel irrigation (WBI) with polyethylene glycol electrolyte lavage solution may be of value in the management of these cases. We report two cases with poor outcome (including one fatality) that were complicated by the use of WBI. Both cases were treated with WBI beginning before and continuing after developing hypotension. WBI should be avoided in the setting of the hemodynamically unstable CCB SR overdose.
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http://dx.doi.org/10.1016/j.jemermed.2007.11.100 | DOI Listing |
Pak J Med Sci
January 2025
Muhammad Ali Mumtaz, MD FACS. Tahir Heart Institute, Fazl-e-Omar Hospital, Chenab Nagar, District Chiniot, Pakistan.
Infective endocarditis used to frequently cause mortality in subjects having PDA before the advent of antibiotics and surgical ligation. It has been documented that clinically silent PDAs may cause infective complications of heart valves. We present case of an 18-years-old male who presented with palpitations and fever to our emergency department.
View Article and Find Full Text PDFAME Case Rep
November 2024
Department of Orthopaedic Surgery, Sugita Genpaku Memorial Obama Municipal Hospital, Fukui, Japan.
Background: Open pelvic fractures are rare but represent a serious clinical problem with high mortality rates. Acute mortality is often associated with hemorrhage, whereas delayed mortality is most often associated with sepsis and multiple organ failure. We report a case of Wang's classification of type II open pelvic ring fracture with hemorrhagic shock and septic shock from gas gangrene.
View Article and Find Full Text PDFAME Case Rep
November 2024
Department of Cardiology, Wellstar Medical College of Georgia Health, Augusta, GA, USA.
Background: In cases of electrical storm, identifying the etiology is essential, as patients with reversible causes do not benefit from implantable cardioverter defibrillator (ICD). Given the diversity of pharmacologic and nonpharmacologic management tools available for hemodynamically unstable patients in electrical storm, all must be considered and tailored to each individual patient.
Case Description: This report describes a 36-year-old female without prior cardiac history who presented in ventricular fibrillation (VF) electrical storm.
Acta Med Indones
October 2024
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia - Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
Increased thrombotic events that occur in up to one-third of patients with COVID-19 are predominantly pulmonary emboli (PE), which are associated with higher severity and increased mortality. Acute PE should therefore be one of the main differential diagnoses among patients with hemodynamic instability. Early treatment of such a condition with systemic thrombolysis remains the first line of treatment especially in patients with COVID-19, which hinders further invasive intervention.
View Article and Find Full Text PDFJ Cardiovasc Dev Dis
December 2024
Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Bronx, NY 10467, USA.
The use of extracorporeal membrane oxygenation (ECMO) has emerged as a rescue intervention for hemodynamically unstable patients and prophylactic intraprocedural hemodynamic support in the cardiac catheterization laboratory. The prompt initiation of ECMO provides immediate hemodynamic support and allows for the completion of bridging and/or life-saving interventions. However, there are no clinical practice guidelines for the use of extracorporeal support in this area.
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