Posts Tagged ‘ANGINA’

Accidents and Incidents hemodialysis

Monday, March 8th, 2010

A – Hypotension
Is found in 20 to 30% of the sessions.
There are several etiologies: An excessive decrease in the volume, inadequate peripheral vasoconstriction (diabetic patients for example), or cardiac function improperly or failed.
Clinical: Sudden fall in blood pressure, feeling sick (hot flashes, discomfort, tachycardia, possibly loss of consciousness). Yawning is often a precursor met.
What to do:

  • Reducing the speed of the pump blood ..
  • Last sloping patient.
  • Intake of saline (on prescription)
  • Eventually, put under O2 (depends on service protocols)

Prevention:

  • Never ultrafilter patients below its base weight.
  • Weight gain rigorous
  • Avoid taking anti-hypertensive before the dialysis session
  • Rate of Na in the dialysis at a concentration equal to or lower than the patient. (Reminder: the Na profile is a prescription)

B – angina
Aggravating factors: anemia, decrease in BP, in hyper-debit FAV
What to do:

  • Preventing nephrologist
  • UF minimum
  • Decreased blood flow
  • O2 nasal + scope
  • possibly following protocols, use nitroglycerin sub-lingual.
  • If the crisis continues, stopping hemodialysis, restitution, perform ECGs, biology (KPC / CPKMB / LDH etc. ….), transfer in a specialized

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ANGINA

Friday, November 21st, 2008

Definition

All chest pain event related to a “narrowing of the size” of one or more coronary arteries. The coronary arteries are the arteries that supply blood to the heart muscle.

Clinical Data

Clinical examination was unremarkable.
The resting ECG was completely normal except for a painful crisis.
Any interrogation can find angina:
with chest pain to left arm
to pain on exertion and rest
pain in 3 to 4 minutes,
took to heart in a vise.

Pathophysiology

Suffering infarction: ischemia is associated with a mismatch between needs and the oxygen supply of heart muscle:
is the input can not increase in proportion to needs: angina of effort
is in constant need, contributions are reduced: spastic angina.
The decrease in arterial size is secondary to a “collection” by atherosclerotic plaques. (more…)

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