Patients undergoing WBH showed typical signs of hyperdynamic circulation without impairment of left ventricle which could be monitored excellently by TEE. We recommend using TEE especially in patients with an increased cardiac risk.
Myocardial ischemia is a major complication in the perioperative period, mostly in patients with high cardiac risks. After non-cardiac surgery myocardial infarction was observed in 5.6% of patients with coronary heart disease, the rate in patients with no cardiac diseases was 0.1-0.7%. We present the case of a 21-year-old ASA I male patient who underwent surgery to reconstruct the cruciate ligament of the knee. General anaesthesia was performed in combination with a femoral nerve block. After surgery the patient suffered from myocardial infarctions on the day of surgery and the 6th day after surgery. After resuscitation, thrombolysis and percutaneous transluminal coronary angioplasty (PTCA), an intraaortic balloon pump had to be temporarily implanted due to persistent cardiogenic shock.
Intoxications with tricyclic antidepressants are often life threatening situations. In consequence of interference with many organ systems specific treatment consists in transportation to hospital under cardiopulmonary monitoring by physicians. The multiple possibilities of complications require the following treatments: continuous monitoring of the cardiovascular system, gastrolavage, application of carbon through a nasogastric tube, intubation and controlled ventilation in case of coma and continuous stand by for defibrillation. Additionally patients with stable parameters should be monitored in intensive care units because often there are no precursors of cardiac or pulmonary complications. We report the case of a 49-year old women with ingestion of 2500 mg of amitriptyline who suffered from multiple cardiac arrhythmias with following cardiac arrests and who required multiple defibrillations and resuscitation.
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