1/257. Crack-cocaine-associated aortic dissection in early pregnancy--a case report.Even though uncommon in pregnancy, aortic dissection is a potentially catastrophic vascular complication, occurring mainly in the late stages of pregnancy. Vascular events, including aortic dissection are recognized complications of crack-cocaine use. The authors report a case of aortic dissection in early pregnancy related to crack-cocaine use. They believe that the combined effects of pregnancy and crack cocaine on the vasculature create the requisite milieu potentiating such catastrophic events as aortic dissection. This paper reviews the possible underlying pathophysiologic mechanisms and the available diagnostic, therapeutic, and management options.- - - - - - - - - - ranking = 1keywords = vas (Clic here for more details about this article) |
2/257. Focal aneurysmal dilatation of subchorionic vessels simulating chorioangioma.Subchorionic vascular aneurysms of the placenta are rare lesions and may present confusion with chorioangioma or focal mesenchymal dysplasia on sonography. To our knowledge, the findings of placental aneurysms have not been reported in the ultrasound literature. We present a case with detailed sonographic evaluation, including spectral and color Doppler and pathological analysis, that was mistaken for chorioangioma prenatally. knowledge of this benign entity may allow the sonologist to recommend conservative management in similar cases.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
3/257. Severe cardiac dysrhythmia in patients using bromocriptine postpartum.Used worldwide since 1980 for the prevention of breast engorgement in the puerperium, in 1994 bromocriptine mesylate was withdrawn from the American market as an agent suitable for ablactation. The relevant recommendation of the food and Drug Administration rested on case reports that described severe vasospastic reactions among users of the drug. Some patients so affected suffered stroke, intracranial bleeding, cerebral edema, convulsions, myocardial infarction, and puerperal psychosis. More recently, it has been suggested that the side effects of the drug may also include circulatory collapse secondary to cardiac dysrhythmia. This report describes two additional cases in this category. The antepartum clinical evaluation of these women suggested that they were predisposed to arrhythmias.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
4/257. Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension.The use of nitric oxide as an agent to reduce pulmonary artery pressure in a pregnancy complicated by pulmonary hypertension is reported for the first time. This therapy can reduce pulmonary vascular resistance and therefore potentially enable the right ventricle to better compensate for the physiologic changes of pregnancy.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
5/257. Epidural analgesia in an obstetric patient with Klippel-Trenaunay syndrome.We describe the use of epidural analgesia for vaginal delivery of a parturient with Klippel-Trenaunay syndrome in whom the use of repeated magnetic resonance imaging during her obstetric care allowed us to see deep haemangiomata. This also allowed the safe sitting of an epidural catheter at L1-2 to provide analgesia for labour and delivery. Klippel-Trenaunay syndrome and the anaesthetic implications of the congenital vascular abnormalities and potential coagulopathy are discussed.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
6/257. methamphetamine-related stroke: four cases.Amphetamine use in certain parts of the united states has risen dramatically. methamphetamine, the most-common illicitly abused type of amphetamine, can be inhaled, injected intravenously, or smoked. It is a potent sympathomimetic that may lead to vascular events including myocardial infarction and stroke. Because of the demographics of drug use, these potentially devastating events usually occur in relatively young patients. The pathophysiology of stroke related to amphetamine use is multifactorial. Elevation in blood pressure, vasculitis, or other vascular toxicity are postulated as major mechanisms. Four cases of stroke associated with the use of methamphetamine, all occurring in patients ranging in age from 29-45 years, are described. methamphetamine use appears to be a risk factor for the development of stroke. The rise in methamphetamine use will undoubtedly result in increased Emergency Department admissions with clinical presentations very similar to those of cocaine intoxication.- - - - - - - - - - ranking = 2keywords = vas (Clic here for more details about this article) |
7/257. The location of chronic pregnancy hypertension on the vasoconstriction-volume spectrum: working hypothesis.OBJECTIVE: The purpose of this study was to examine whether volume loading is a factor in chronic pregnancy hypertension. STUDY DESIGN: Five patients with chronic hypertension performed home self-monitoring daily with a noninvasive pressure transducer from a fingertip. Determinants of mean arterial pressure were computed from the pressure data and a concurrent electrocardiogram. For this study blood pressure and rapid ejection time, which is an empiric indicator of arterial compliance, were evaluated during antihypertensive therapy. Data were transmitted by facsimile to the hospital. RESULTS: One patient with hypertension who was admitted to the study at 10 weeks' gestation became normotensive with a diuretic (furosemide) alone. Medication was discontinued at 23 weeks' gestation. This patient remained normotensive until delivery at 41 weeks' gestation. blood pressure was controlled with furosemide combined with nifedipine and labetolol in the other 4 cases. Three patients were studied with concurrent blood pressure and rapid ejection time measurements made before and after antihypertensive medication. All 3 showed decreases in these measurements with medication. CONCLUSION: Both volume excess and vasoconstriction should be considered in the pathogenesis of chronic pregnancy hypertension.- - - - - - - - - - ranking = 3keywords = vas (Clic here for more details about this article) |
8/257. Ruptured splenic artery aneurysm during pregnancy: a rare case with both maternal and fetal survival.The rupture of a splenic artery aneurysm during pregnancy has been reported. In this particular case uterine rupture was suspected; however, an aneurysm was diagnosed after cesarean delivery. After resection of the aneurysm, splenic artery revascularization was performed by reanastomosis. In conclusion, early diagnosis and 2-stage rupture increase the likelihood of survival.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
9/257. heart transplantation for peripartum cardiomyopathy: a report of three cases and a literature review.Peripartum cardiomyopathy is a devastating medical condition and carries a mortality of up to 60% with medical treatment. The authors describe their experience of successful outcome of three cases with heart transplantation and review the literature. The importance of performance of endomyocardial biopsy for all peripartum cardiomyopathy patients is emphasized. It is recommended that heart transplantation should only be offered to myocarditis negative patients.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
10/257. Spontaneous dissections of all three coronary arteries in a 33-week-pregnant woman.The clinical course and angiographic follow-up of a woman with spontaneous coronary dissections in all three coronary arteries during the third trimester of pregnancy is described. Mother and child survived and subsequent clinical course was uneventful. At 6-month follow-up, dissections in the right and circumflex coronary artery had healed completely. At the site of the dissection in the LAD, an aneurysm had formed. This is to our knowledge the first report of antepartum and antemortem diagnosis of pregnancy related coronary dissections in all three coronary arteries. Cathet. Cardiovasc. Intervent. 48:207-210, 1999.- - - - - - - - - - ranking = 0.5keywords = vas (Clic here for more details about this article) |
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