Ilaria Botta, Jacques Devriendt, Jose Castro Rodriguez, Marielle Morissens, Andrew Carling, Leonel Barreto Gutierrez, Thierry Preseau, David De Bels, Patrick M. Honore and Sebastien Redant
effects than betamimetics. [ 1 , 2 , 3 , 4 , 5 ] Maternal serious adverse events have been described in case reports. [ 6 , 7 , 8 , 9 , 10 , 11 ] We present the case of a 21-year-old woman who developed a severe cardiogenic choc after the administration of nifedipine.
A 21-year-old Caucasian woman at 27 weeks of pregnancy was admitted to the obstetric department for pre-term labor. She received 10 mg of nifedipine 4 times in 1 h, according to the internal protocol. Shortly after, she brutally deteriorated with pulmonaryedema and hypoxemia
Abbas Aghabiklooei, Shahin Shadnia, Hossein Hassanian-Moghaddam and Nasim Zamani
9. Drudi FM, Poggi R, Trenta F, Manganaro F, Iannicelli E. [A case of the adult respiratory distress syndrome induced by a methadone overdose, in Italian]. Radiol Med 1997;94:393-6. PMID: 9465250
10. Schaaf JT, Spivack ML, Rath GS, Snider GL. Pulmonaryedema and adult respiratory distress syndrome following methadone abuse. Am Rev Respir Dis 1973;107:1047-51. PMID: 4740265
11. Martin M, Daoudal P, Bein C, Bazzi N, Bourscheid D, Floriot C. [Inhaled methadone-induced non cardiogenic pulmonaryedema with Acute Respiratory Distress
Gui-lin Yang, Ying-xia Liu, Mu-tong Fang, Yan-xia He, John Nunnari, Jing-jing Xie, Xiao-hua Le and Bo-ping Zhou
al. Clinical feature and risk factors of pulmonaryoedema after enterovirus-71-related hand, foot, and mouth disease. Lancet 1999; 354:1682-1686.
7. Chen HI, Liao JF, Kuo L, Ho ST. Centrogenic pulmonaryedema induced by cerebral compression in rats. Circ Res 1980; 47:366-373.
8. Kao SJ, Yang FL, Hsu YH, Chen HI. Mechanism of fulminant pulmonaryedema caused by enterovirus 71. Clin Infect Dis 2004;38(12):1784-1788.
9. Chan LG, Parashar UD, Lye MS, Ong FG, Zaki SR, Alexander JP, et al. Deaths of children during an
Farhad Abtahi, Fernando Seoane and Kaj Lindecrantz
from the time-invariant impedance signal, all depending on the ratio between impedance estimation time and interference frequency. For wideband interferences, averaging will always reduce the effect of aliasing and the degree of attenuation will depend upon the width of the frequency distribution of the interference and on the averaging time.
Case Study – PulmonaryoedemaPulmonaryoedema is the accumulation of fluid in the alveoli and parenchyma of the lungs and transthoracic impedance spectroscopy (TIS) is a potential method for monitoring pulmonaryoedema
We present a case of probably unreported aortic stenosis evolution in a patient with primary antiphospholipid syndrome (APS). A female patient, 54 years old, with a history of recurrent deep venous thrombosis, an episode of pulmonary embolism and was positive for APS antibodies. She was kept on warfarin and aspirin. The patient was admitted with acute pulmonary edema and severe aortic stenosis. While preparing for aortic valve surgery, the patient developed acute stroke, and a week later developed concurrent acute ischemia of both lower limbs. Emergency surgery salvaged the lower limbs and follow up transthoracic echocardiography showed marked regression of the thickening of the aortic valve leaflets, only mild aortic stenosis and moderate aortic regurgitation. Aortic valve surgery was cancelled, and the patient was kept on warfarin and aspirin.
Development of severe aortic stenosis is uncommon in primary APS, and this scenario of spontaneous improvement from a severe to a mild aortic stenosis, is probably unreported before.
Lukas Piliponis, Gintarė Neverauskaitė-Piliponienė, Monika Kazlauskaitė, Pavel Kačnov, Sigita Glaveckaitė, Jūratė Barysienė and Saulius Ročka
Neurogenic stress cardiomyopathy (NSC) is defined as transient cardiac dysfunction occurring after primary brain injury, such as aneurysmal subarachnoid haemorrhage, and characterised by left ventricular systolic dysfunction with reduced ejection fraction and abnormalities of regional wall motion. It may also be suspected if elevated levels of cardiac biomarkers and ECG abnormalities are present. It is a reversible condition with favourable long-term prognosis if diagnosed and treated timely, however, NSC is associated with higher rates of early mortality and complications, including pulmonary oedema, cardiogenic shock, delayed cerebral ischaemia. Early diagnosis of the NSC is important in order to prevent these complications and reduce mortality. Management of the NSC is complicated and a multidisciplinary approach is usually required.
Sebastien Redant, Jacques Devriendt, Ilaria Botta, Rachid Attou, David De Bels, Patrick M. Honoré and Charalampos Pierrakos
The distinction between hydrostatic pulmonaryedema (HPE) and acute respiratory distress syndrome (ARDS) could be challenging in the management of acutely ill patients. The Berlin definition of acute respiratory distress syndrome (ARDS) stipulate that respiratory failure must not be explained by cardiac failure of fluid overload. The situation needs an objective assessment to exclude hydrostatic edema, if no risk factor is present. [ 1 ] The differential diagnosis is based on the evaluation of the left atrial pressure, which is considered as normal in ARDS