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| http://dx.doi.org/10.21037/atm.2018.06.07 | DOI Listing |
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Sepsis-induced cardiogenic shock: controversies and evidence gaps in diagnosis and management.
J Intensive Care
January 2025
Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA.
Sepsis often leads to vasoplegia and a hyperdynamic cardiac state, with treatment focused on restoring vascular tone. However, sepsis can also cause reversible myocardial dysfunction, particularly in the elderly with pre-existing heart conditions. The Surviving Sepsis Campaign Guidelines recommend using dobutamine with norepinephrine or epinephrine alone for patients with septic shock with cardiac dysfunction and persistent hypoperfusion despite adequate fluid resuscitation and stable blood pressure.
View Article and Find Full Text PDFAmyloidosis and the Syncopal Enigma.
J Prim Care Community Health
December 2024
Mayo Clinic, Rochester, MN, USA.
Background: Syncope is a common presenting complaint in the outpatient setting and requires a thoughtful and meticulous approach to history-taking skills. This is crucial in discerning cardiac versus non-cardiac etiologies, underscoring the pivotal role of healthcare professionals in the diagnostic process.
Case Report: This is a case of a 76-year-old male who presented to the primary care clinic following an episode of syncope with abrupt loss of consciousness.
Prevalence of Coronary Microvascular Dysfunction and Epicardial Spasm in Patients With Angina and Myocardial Bridge.
J Soc Cardiovasc Angiogr Interv
September 2024
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington.
Article Synopsis
- Myocardial bridges (MB) are common vascular abnormalities but only a fraction relate to chest pain (angina); this study aimed to investigate coexisting conditions that might cause symptoms in patients with MB.
- Conducted at the University of Chicago, the study included 30 patients with MB experiencing chest pain, testing for various types of coronary spasm and coronary microvascular dysfunction using specific medical tests.
- Findings revealed that 60% had endothelium-independent coronary microvascular dysfunction, 29% had microvascular spasm, and 37% had epicardial spasm, with most patients showing at least one of these abnormalities regardless of whether the MB was deemed hemodynamically significant.
Hemodynamic management of acute kidney injury.
Curr Opin Crit Care
December 2024
Department of Anesthesiology, Intensive Care & Perioperative Medicine, Assistance Publique Hôpitaux de Paris. Paris Saclay University, Paris, France.
Purpose Of Review: To discuss the role of hemodynamic management in critically ill patients with acute kidney injury.
Recent Findings: Acute kidney injury (AKI) may be associated with persistent alterations in renal perfusion, even when cardiac output and blood pressure are preserved. The effects of interventions aiming at increasing renal perfusion are best evaluated by renal Doppler or contrast enhance ultrasound.
Norepinephrine triggers glutamatergic long-term potentiation in hypothalamic paraventricular nucleus magnocellular neuroendocrine cells through postsynaptic β1-AR/PKA signaling pathway in rats.
Korean J Physiol Pharmacol
November 2024
Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji 133002, China.
Norepinephrine (NE) modulates synaptic transmission and long-term plasticity through distinct subtype adrenergic receptor (AR)-mediated-intracellular signaling cascades. However, the role of NE modulates glutamatergic long-term potentiation (LTP) in the hypothalamic paraventricular nucleus (PVN) magnocellular neuroendocrine cells (MNCs) is unclear. We here investigate the effect of NE on high frequency stimulation (HFS)-induced glutamatergic LTP in rat hypothalamic PVN MNCs , by whole-cell patch-clamp recording, biocytin staining and pharmacological methods.
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