Pregnancy with normal course is probably not a predictor of future cardiovascular disease (CVD). Pregnancy-induced changes in cardiovascular system (CVS) develop primarily to meet the increase metabolic demands of the mother and fetus. Despite the increased workload of the heart during gestation and labor, the healthy woman has no impairment of cardiac reserve.Epidemiologic studies show that the risk of coronary artery disease is much lower in premenopausal women compared with age matched men, but the risk differential disappears in postmenopausal females. A body of research suggests that hormonal differences between pre-and postmenopause contribute to the cardioprotection for premenopausal women. The reproductive hormones primarily estrogen modulates cardiovascular function through several mechanisms such as stress-induced activation of hypothalamic pituitary-axis and sympathetic adrenomedullary system. Also, lactation is associated with a lower prevalence of hypertension, diabetes, hyperlipidemia, and CVD.Hence, pregnancy is a normal physiologic state in a women's life and may not be predictive of future CVD lest it is complicated by some adverse events. Yes-It Is a PredictorSince times immemorial, there had been a gender bias as regards to risk prediction tools. Pregnancy is a special part of women's life and pregnancy-related complications can be a The present debate is an effort to study that besides the common risk factors such as gestational hypertension, gestational diabetes, and preeclampsia, preterm delivery, assisted reproductive technology-related pregnancy events, and arrhythmias also have a bearing on future cardiovascular risk of a woman. The awareness in the medical community especially obstetricians, physicians, and cardiologists may play a pivotal role in detecting these complications and appropriate follow-up.
Funding Acknowledgements Type of funding sources: None. Introduction SARS-CoV-2 is 30 kb long, positive sense, single stranded and polyadenylated.(1)SARS-CoV-2 has tight interaction with the human ACE2 receptor binding domain, causing greater transmissibility.(2) SARS-CoV-2 viral particles have been seen by RT-PCR in cardiac tissue(3)supporting direct cardiotoxicity.Hyperinflammation leads to vascular inflammation, plaque instability, myocardial inflammation and suppression(4,5) The most common symptoms include breathlessness, fever, dry cough.(6,7) Aims This retrospective observational study included 120 positive patients tested by RT-PCR(kit used- Blackbio TruPCR Kilpest) or TrueNAT (kit used-chip based Covid-19 PCR by Molbio diagnostics)tests, admitted to CMC,Ludhiana over two years. 60 patients from first wave (March 2020-December 2020) and 60 patients from second wave (January 2021-May 2021). The aim is to study the clinical symptoms, the nature and outcome of patients who had CVS complications during hospital stay in first and second waves. Statistical analysis- Data were described in range; mean ±standard deviation (± SD),and frequencies.Kolmogorov-Smirnov test was used. Comparison of quantitative variables between the study groups was done using Student t-test and Mann Whitney U test.For comparing categorical data, Chi square (χ2) test was done and p value less than 0.05 was considered statistically significant. Results In 2020,35(58%) were males compared to 63%(38)in the second.The mean age was >50years in both the waves.In 2020,20(33%) had hypertension and 16(27%) patients in 2021.Diabetes accounted for 16(27%) in the first wave and 10(17%) in the second.14(23%) of the patients in first wave and 10(17%) of the patients in second wave had CAD.The most common symptom was breathlessness seen in 26(43%) patients of first and 32(53%) of second wave. Fever was seen in 26(43%) of patients in the first and 22 (37%) in the second.11(18%) of patients in both the years had cough.7(12%) patients last year and 11(18%) patients this year had sore throat.4(7%) patients of the first wave and 11(18%) patients of the second wave had chest pain.STEMI was seen in 13(22%) patients in the second wave. Unstable angina accounted for 17%(10) patients in the first wave.Arrhythmia accounted for 6(10%) patients in 2020 and 12(20%) patients in 2021.NSTEMI was seen in 6(10%) patients of the first wave and 2(3%) patients in the second wave.4(7%) patients last year presented in acute LVF.22(37%) patients having cardiovascular complications last year and 2(35%) patients this year died. 26 (43%) patients in both the years were discharged. Conclusions There was no statistical significance between the two waves.The outcome of patients with co morbidities was worse than the ones without them.Both the waves had almost equal number of mortalities.The guards should not be let down since the severity of both the waves was similar.Knowing about the disease, one can anticipate its nature and course in the times to come.
Perioperative complications of prolonged surgery and prone positioning are well known. Changing the position from prone to supine in an anesthetized patient can result in aspiration and airway obstruction. The drop-in oxygen saturation and hemodynamic changes are warning signs and can cause acute cardiac decompensation leading to diagnostic dilemma. We present a case where the patient had these changes after changing the position after spine surgery in prone position. A quick response from the treating anesthesiologist and active involvement of cardiologist helped in reaching the diagnosis and successful management of aspiration pneumonitis in this patient. We conclude that a quick response in investigations and multimodality approach helps in the management of such perioperative complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.