• 제목/요약/키워드: Arrhythmias cardiac

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수면 무호흡증후군의 내과적 치료 (Medical Treatment of Sleep Apnea Syndrome)

  • 문화식;최영미
    • 수면정신생리
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    • 제3권2호
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    • pp.77-89
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    • 1996
  • Data collected to date indicate that sleep apnea syndrome is a risk factor in the development of cardiovascular dysfunction such as systemic hypertension, cardiac arrhythmias, pulmonary hypertension, right heart failure, angina, myocardial infarction, and stroke. Several reports suggest that untreated patients with sleep apnea syndrome have a higher long-term mortality than treated patients and than normal subjects. But there are many controversies concerning the treatment of sleep apnea syndrome, and there is no universally accepted standard for effective treatment. We reviewed the current approaches and options in the medical treatment of sleep apnea syndrome.

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선천성 좌심방 류 -1례 보고- (Congenital Aneurysm of The Left Atrium -A Case Report-)

  • 홍남기;정태은;이정철;한승세;이동협
    • Journal of Chest Surgery
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    • 제33권9호
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    • pp.752-755
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    • 2000
  • Isolated congenital aneurysm of the left atrium with intact pericardium is a rate anomaly, which usually presents with arrhythmia, cerebral embolism or abnormalities on routine chest X-ray. Surgery is indicated in most cases to eliminate a potential source of systemic emboli and arrhythmias. A 42-year-old woman having cervical cancer, she was suspected of having a left atrial aneurysm on review of chest X-ray and confirmed by echocardiography and cardiac catheterization. Surgical resection of Left atrial aneurysm was achieved without complication using median sternotomy with cardiopulmonary bypass. The postoperative course was uneventful.

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Reversal of Doxorubicin-induced Cardiotoxicity by Using Phytotherapy: A Review

  • Hosseini, Azar;Sahebkar, Amirhossein
    • 대한약침학회지
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    • 제20권4호
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    • pp.243-256
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    • 2017
  • Doxorubicin as a chemotherapeutic drug is widely used for the treatment of patients with cancer. However, clinical use of this drug is hampered by its cardiotoxicity, which is manifested as electrocardiographic abnormalities, arrhythmias, irreversible degenerative cardiomyopathy and congestive heart failure. The precise mechanisms underlying the cardiotoxicity of doxorubicin are not clear, but impairment of calcium homeostasis, generation of iron complexes, production of oxygen radicals, mitochondrial dysfunction and cell membrane damage have been suggested as potential etiologic factors. Compounds that can neutralize the toxic effect of doxorubicin on cardiac cells without reducing the drug's antitumor activity are needed. In recent years, numerous studies have shown that herbal medicines and bioactive phytochemicals can serve as effective add-on therapies to reduce the cardiotoxic effects of doxorubicin. This review describes different phytochemicals and herbal products that have been shown to counterbalance doxorubicin-induced cardiotoxicity.

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver;Raman, Sainath;Suen, Jacky Y.;Cho, Hwa Jin;Fraser, John F.
    • Clinical and Experimental Pediatrics
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    • 제64권5호
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    • pp.188-195
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    • 2021
  • Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

우심실에 발생하여 우심방을 침범한 원발성 비호지킨씨 림프종 -1예 보고- (Primary Non-Hodgkin's Lymphoma in Right Ventricle with Right Atrial Invasion -Report of 1 case-)

  • 박기성;안욱수;이섭;권오춘;고무성;전상훈
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.376-381
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    • 2004
  • 원발성 심장 림프종은 원발성 심장 종양의 1.3%를 차지하는 드문 악성 종양으로, 절외성 림프종(Extronodal Lymphoma)의 한 형태로 심장 및 심장막에 발생한다. 급격히 진행하는 심부전, 부정맥, 심낭 삼출 및 심장 압전 등의 증상이 나타난다. 원발성 심장 림프종의 진단은 심초음파 및 흉부 단층촬영 및 자기공명영상 등이 이용되며, 종양에 대한 경정맥하 조직 생검과 심낭 삼출액의 세포학적 및 면역생화학 검사로 확진할 수 있다 원발성 심장 림프종은 진단이 지연되거나, 진단 시 이미 장기 내침범으로 인한 진행된 단계로 예후가 불량하다 따라서 조기 진단과 완전한 심장 종양의 절제가 필요하며, 수술 후 생존율 개선을 위해 적극적인 전신 항암 요법 및 방사선 요법이 보강요법으로 시행되어야 한다. 본 증례에서는 우심실 유입로와 방실구에 종괴의 광범위한 침윤이 있었고, 우심방 내로 침범이 되어 있어 수술적 절제가 불가능하였다. 종괴의 조직생검으로 확진 후 항암요법 및 방사선요법으로 증상의 개선 및 종괴의 크기 감소 소견을 보였다. 저자들은 우심실에서 발생하여 우심방을 침범한 원발성 심장 비호지킨써 림프종을 경험하였으며 그 조기 결과를 문헌고찰과 함께 보고한다.

Electrocardiographic characteristics of significant factors of detected atrial fibrillation using WEMS

  • 김민수;김윤년;조영창
    • 한국산업정보학회논문지
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    • 제20권6호
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    • pp.37-46
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    • 2015
  • The wireless electrocardiographic monitoring system(WDMS) is designed to be long term monitoring for the early detection of cardiac disorders. The current version of the WDMS can identify two types of cardiac rhythms in real-time, such as atrial fibrillation(AF) and normal sinus rhythm(NSR), which are very important to track cardiac-rhythm disorders. In this study, we proposed the analysis method to discriminate the characteristics statistically evaluated in both time and frequency domains between AF and NSR using various parameters in the heart rate variability(HRV). And we applied various ECG detection methods (e.g., difference operation method) and compared the results with those of the discrete wavelet transform(DWT) method. From the statistically results, we found that the parameters such as STD RR, STD HR, RMSSD, NN50, pNN50, RR Trian, and TNN(p<0.05) are significantly different between the AF and NSR patients in time domain. On the other hand, the frequency domain analysis results showed a significant difference in VLF power($ms^2$), LF power($ms^2$), HF power($ms^2$), VLF(%), LF(%), and HF(%). In particular, the parameters such as STD RR, RMSSD, NN50, pNN50, VLF power, LF power and HF power were considered as the most useful parameters in both AF and NSR patient groups. Our proposed method can be efficiently applied to early detection of abnormal conditions and prevent the such abnormals from becoming serious.

hERG 칼륨채널 활성도 변화에 따른 31종 한약처방의 심장독성 평가 (Cardiotoxicity assessment of 31 herbal formulae by activity of hERG potassium channel in HEK 293 cells)

  • 하혜경;진성은;이시온;김동현;서창섭;신현규
    • 대한한의학회지
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    • 제43권1호
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    • pp.33-41
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    • 2022
  • Objectives: Drug-induced blockade of the human ether-à-go-go related gene (hERG) potassium ion channel causes acquired long QT syndrome, which is known to cause cardiac arrhythmias and be fatal. To establish safety evidence of herbal formulae, we evaluated the effects of 31 herbal formulae on hERG channel activity. Methods: The current through hERG channel was measured by changing the membrane voltage before and after treatment with 31 herbal formulae in HEK 293 cell overexpressing hERG channel using a whole-cell patch clamp system. The current-voltage curves and the activity curves were fitted, and the hERG activity and 50% inhibitory concentration (IC50) according to each herbal formula were calculated. Results: Chokyungjongok-tang, Oncheong-eum, and Cheongsangbangpung-tang strongly inhibited the hERG activity, with IC50 values of 67.67, 141.2, and 296.3 ㎍/mL, respectively. Yeonkyopaedok-san, Eunkyo-san, Ukgan-san gajinphibanha, Daegunjoong-tang (except Oryzae gluten), Insamyangyoung-tang, Banhahubak-tang, SokyungHwalhyul-tang, Jodeung-san, Hyeonggaeyeongyo-tang, and Bangkeehwangkee-tang weakly inhibited hERG activity, with IC50 values ranging from 400 to 1000 ㎍/mL. The other 18 herbal formulae showed very weak hERG activity inhibition of less than 50% at the highest concentration (1000 ㎍/mL). Conclusion: This study provided safety information on cardiotoxicity by cardiac arrhythmia risk assessment of herbal formulae, and is expected to be a reference data for predicting the safety and risk of herbal formulae.

Change of Blood Magnesium Level in Diabetes Patients Undergoing Off-pump Coronary Artery Bypass Grafting

  • Seo, Si-Young;Moon, Seong-Min;Hyun, Kyung-Yae;Kim, Chong-Rak;Choi, Seok-Cheol
    • 대한의생명과학회지
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    • 제15권3호
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    • pp.207-215
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    • 2009
  • We carried out this study to investigate differences of physiological variables between patients with (DM group) and without type II diabetes mellitus (Non-DM group) undergoing off-pump coronary artery bypass grafting (OPCABG). Postoperative $Mg^{++}$ and $Ca^{++}$ levels were lower, whereas $Na^+$ level was higher in DM group than those in Non-DM group. ICU (intensive care unit) stay time in DM group was longer than that of Non-DM group. Postoperative platelet counts tended to decrease, whereas C-reactive protein (CRP) and cardiac troponin-I (cTNI) levels tended to increase in DM group compared with Non-DM group. Postoperative albumin level was lower, while blood urea nitrogen (BUN) and creatinine levels were greater in DM group than those in Non-DM group. DM group had higher incidence of post-operative arrhythmias than Non-DM group. These results reveal that type II DM patients undergoing OPCAB may have higher incidences of postoperative hypomagnesemia, hypocalcemia and arrhythmias, and increases of CRP, cTNI, BUN, and creatinine levels than in Non-DM patients undergoing OPCAB. The perioperative check and control (supplement) of $Mg^{++}$ levels should be considered in cardiovascular surgery combined with DM.

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10,150 J의 심장조율동과 치료적 저체온법으로 소생한 중증 초오 중독 환자 1례 (A Case of Successful Resuscitation of 10,150 J Shocks and Therapeutic Hypothermia on Aconitine-induced Cardiovascular Collapse)

  • 문형준;이정원;김기환;정동길;김종호;김영기;이현정
    • 대한임상독성학회지
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    • 제12권2호
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    • pp.97-101
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    • 2014
  • Aconitine, found in the Aconitum species, is highly extremely toxic, and has been known to cause fatal cardiac arrhythmias and cardiovascular collapse. Although several reports have described treatment of aconitine intoxication, management strategy for the patient in a hemodynamically compromised state who experienced cardiopulmonary collapse is unknown. We report here on a case of a successful cardiopulmonary resuscitation and therapeutic hypothermia in an aconitine-induced cardiovascular collapsed patient. A 73-year-old male who presented with nausea, vomiting, chest discomfort, and drowsy mental state after eating an herbal decoction made from aconite roots was admitted to the emergency department. He showed hemodynamic compromise with monomorphic ventricular tachycardia resistant to amiodarone and lidocaine. After 3 minutes on admission, he collapsed, and cardiopulmonary resuscitation was initiated. We treated him with repeated cardioversion/defibrillation of 51 times, 10,150 joules and cardiopulmonary resuscitation of 12 times, 69 minutes for 14 hours and therapeutic hypothermia for 36 hours. He recovered fully in 7 days.

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수면과 관련된 호흡장애가 심혈관계의 기능 변화에 미치는 영향 (Influence of Sleep-Related Breathing Disorders on Changes of Cardiovascular Function)

  • 문화식
    • 수면정신생리
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    • 제4권2호
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    • pp.129-139
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    • 1997
  • 수면 무호흡을 포함한 다양한 원인의 수면과 관련된 호흡장애를 동반한 환자들에서는 여러가지 심혈관계 기능부전이 초래되어 이들 환자의 임상경과에 중대한 영향을 미친다. 수면 무호흡증후군, 특히 폐쇄성 수면 무호흡증후군은 수면장애의 여러 가지 원인 중 임상영역에서 가장 흔히 볼수 있는 질환으로 전신성 고혈압, 심부정맥, 폐동맥 고혈압 및 우심실 부전, 협심증 및 심근경색증, 뇌졸증등의 발병률이 정상인에 비하여 현저히 높은 것으로 알려져 있다. 폐쇄성 수면 무호흡과 달리 중추성 수면 무호흡은 수면중에 호흡중추를 불안정하게 하는 다양한 원인에 의해 발생하며 역시 심혈관계의 기능에 영향을 미칠 수 있다. 수면중에 환기장애가 더욱 악화될 수 있는 호흡기계 질환이 있는 환자들은 수면 무호흡증후군과 달리 만성적인 저산소증과 고탄산증이 동반되며 이로 인해 심부정맥, 폐동맥 고혈압, 우심실 부전(폐성심) 등의 심혈관계 이상이 초래될 수 있다. 따라서 수면 무호흡을 포함한 수면과 관련된 호홉 장애의 진단과 치료에 있어서는 호흡기계 질환에 대한 정확한 평가와 더불어 동반될 수 있는 심혈관계의 기능부전에 대한 정밀한 분석이 반드시 필요하며, 이들 자료를 바탕으로 기관절개술, 기계적 호흡, 지속적 양압공급치료, 적절한 산소요법 등의 적극적이고도 효과적인 치료법을 적용함으로서 심혈관계 합병증의 발생과 이로 인한 사망률을 감소시킬 수 있을 것으로 생각된다.

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