There was 93.3% survival in patients receiving ILE for drug-induced cardiovascular collapse. Clinically significant adverse effects were uncommon. We suggest ILE administration for the treatment of cardiogenic shock due to CCB and BB overdose.
SummaryPulmonary embolism (PE) is a potentially life-threatening condition and the fact that 90% of PE originate from lower limb veins highlights the significance of early detection and treatment of deep vein thrombosis.1) Massive/high risk PE involving circulatory collapse or systemic arterial hypotension is associated with an early mortality rate of approximately 50%, in part from right ventricular (RV) failure.2) Intermediate risk/submassive PE, on the other hand, is defined as PE-related RV dysfunction, troponin and/or B-type natriuretic peptide elevation despite normal arterial pressure.
3)Without prompt treatment, patients with intermediate risk PE may progress to the massive category with a potentially fatal outcome. In patients with PE and right ventricular dysfunction (RVD), in hospital mortality ranges from 5% to 17%, significantly higher than in patients without RVD. 4,5) (Int Heart J 2016; 57: 91-95)
Toxication caused by pesticides is a serious health problem in our country. Organophosphates are the leading cause of pesticide toxications in our country, as they are worldwide. These compounds lead to acetylcholine deposition by blocking acetylcholine esterase enzyme, causing muscarinic, nicotinic and central nervous symptoms due to continuous stimulation of the receptors. Mortality occurs in the early period due to acute cholinergic crisis or later in patients with intermediate syndrome. Death is caused by heart conduction disturbances and respiratory failure during the acute cholinergic crisis period, whereas it is due to respiratory failure in patients with an intermediate syndrome. Management of patients with pesticide poisoning should start by providing adequate respiratory and circulatory support followed by antidotes and other medical therapies. In this review, we have aimed to explain the properties and mechanisms of action of organophosphate compounds;with causes of mortality in the poisoning of these compounds and recent approaches for management of toxication. (JAEM 2012; 11: 176-82)
Significant left main coronary artery (LMCA) disease and total occlusion of the LMCA are very important cardiovascular emergencies and indicate an urgent need for invasive treatment strategies. Furthermore, a significantly higher risk of catheter-based procedural complications in these patients must be taken into consideration. All of these facts are important issues in estimating significant LMCA disease using electrocardiography (ECG) findings, the fastest and easiest method for the diagnosis and evaluation of acute coronary syndrome. We present here a case report of a 52-year-old man admitted to our emergency department with anterior myocardial infarction complicated by cardiogenic shock. There were Q waves and ST elevations in leads V1-V6, D1, aVL and aVR, as well as marked ST depressions in the inferior leads with right bundle branch block (RBBB) and left anterior fascicular block (LAFB) on the ECG. The left main coronary artery (LMCA) was totally occluded with no antegrade or retrograde coronary flow on coronary angiography.
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