1/14. Peripartum cardiomyopathy--a case report.Peripartum cardiomyopathy in the form of congestive heart disease of unknown etiology appears relatively rarely during the last month of pregnancy or within 5 months after delivery, and it is potentially life-threatening. This case report describes a 34-year-old female, G4P1, at 36 weeks' gestation who was admitted for cesarean section under lumbar epidural anesthesia due to twin pregnancy. She had no past history of cardiovascular diseases. However, rapid onset of dyspnea at ward and acute cardiac failure developed 15 h after cesarean section. Peripartum cardiomyopathy was diagnosed. After a 7-day intensive treatment she was discharged. Since then she was symptom-free and her two babies were doing well during a period of one more years after discharge.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/14. Unusual pregnancy-related vascular emergency.Although rare, aneurysms are well-known pregnancy-related vascular diseases. They are influenced by hormonal, mechanical, and genetic factors and may be associated with high incidence of maternal and fetal mortality. We present a case of a pregnancy-related common iliac aneurysm, ruptured 5 days after delivery. The source of bleeding was recognized during the second emergency laparotomy for hemoperitoneum and retroperitoneal hematoma. The treatment consisted of excision and substitution of the common iliac artery (totally involved) by an autologous saphenous vein graft. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication that may occur during pregnancy or shortly after delivery.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
3/14. An autopsied case of Eisenmenger syndrome complicated by recurrent thromboembolic phenomena in postpartal period.dyspnea, back pain, edema, and cyanosis developed suddenly in a 23-year-old woman during the last trimester of her first pregnancy. Although she had been noticed to have the enlarged heart and exertional shortness of breath to a slight degree, she had been apparently in good condition without any significant heart murmurs. Clinically, recurrent episodes of disseminated intravascular coagulation, including pulmonary thrombosis, were thought to be superimposed to Eisenmenger syndrome associated with toxemia of pregnancy. Anticoagulant and fibrinolytic treatments were tried, but their effectiveness was limited by hemorrhagic diathesis. She died of respiratory and circulatory failure after delivery of a moribund baby. autopsy revealed eisenmenger complex (a defect in the membranous portion of the interventricular septum and pulmonary vascular disease) and many fresh hemmorrhages in both lungs with a lot of new and organized thrombi. Fresh thrombi were also seen in the heart, the pancreas and the kidneys. The high peripartal mortality in Eisenmenger syndrome could be attributed to pulmonary thrombosis, which may be related to DIC, as well as to peripartal changes in circulatory function.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
4/14. Peripartum cardiomyopathy with recovery in a patient with coincidental Eisenmenger ventricular septal defect.Severe pulmonary vascular disease was found during pregnancy in a 31 year old woman with a large ventricular septal defect. Three months after delivery peripartum cardiomyopathy with severe biventricular failure developed. This was a chance association. Recovery of ventricular function was slow but was complete two years later. There was no advance in the pulmonary vascular disease.- - - - - - - - - - ranking = 2keywords = vascular disease (Clic here for more details about this article) |
5/14. pregnancy and subarachnoid hemorrhage: a case report.Cerebrovascular diseases are rare in pregnancy and mostly caused by rupture of an arterial aneurysm. We present the case of a pregnant woman at 36 weeks of gestation who had a subarachnoid hemorrhage resulting from rupture of an unknown aneurysm, and who underwent a cesarean section and an endovascular treatment to embolize the aneurysm.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
6/14. Anesthetic and obstetric considerations in a parturient with Klippel-Trenaunay syndrome.PURPOSE: To explain the considerations governing the anesthetic management of pregnant patients with Klippel-Trenaunay syndrome (KTS). Klippel-Trenaunay syndrome is a congenital vascular disease characterized by cutaneous hemangiomas, venous varicosities, and limb hypertrophy; and is associated with both hemorrhagic and thrombotic complications. The importance of this diagnosis, including the presence of neuraxial vascular anomalies, is often under-appreciated by both obstetric and anesthesia providers. While regional anesthetic management of patients with KTS has been discussed by others, we present a case in which regional anesthesia presented an unwarranted risk to the patient. CLINICAL FEATURES: An obese, 18-yr-old parturient with a fetus in the breech position underwent Cesarean delivery at 35 weeks gestation secondary to evolving preeclampsia. Unfortunately, no neurovascular imaging of this patient's spine was available. The patient underwent an attempted external cephalic version, a failed obstetric induction, and, ultimately, a Cesarean delivery under general anesthesia. The resulting infant was without any stigmata of KTS. Both mother and infant did well during the course of their hospitalization, and were discharged home without incident. CONCLUSIONS: The posterior cutaneous hemangiomas of KTS may be associated with underlying epidural and subdural vascular malformations. Disruption of these vascular anomalies during regional anesthesia may lead to neuraxial hematoma formation, which may be further compounded by a consumptive coagulopathy observed in some cases of KTS. If neuraxial vascular anomalies cannot be ruled out radiographically, regional anesthesia should be avoided. Additionally, regardless of the anesthetic technique chosen, the coagulation profile of these patients should be verified for signs of coagulopathy.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
7/14. Pure word deafness.Two cases of pure word deafness, both with bilateral temporal lobe lesions due to cerebrovascular disease, are presented. This rare disorder is briefly discussed.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
8/14. Acute cardiogenic pulmonary edema and pregnancy: a ten-year experience.We reviewed the cardiac emergencies that occurred during or soon after pregnancy and required admission in an intensive care unit. The study sample consisted of 22248 pregnant women representing the whole obstetrical population collected from 3 hospitals over a ten-year period. Among the 88 patients admitted to our ICU during this decade, only 5 suffered from a specific cardiac disorder. Acute pulmonary edema was the common clinical presentation in the 4 cases reported. Despite the severity of cardiac involvement on admission none had previous evidence of heart disease that could have heralded acute left ventricular failure. From these observations it can be concluded that preexisting cardiovascular disease and circulatory changes related to pregnancy should no longer be regarded as the unique contributors to the development of severe heart failure during pregnancy.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
9/14. Vanishing cerebrovascular disease of pregnancy.A woman developed TIAs in the last days of her pregnancy. angiography revealed partial obstruction of the left middle cerebral artery. Following delivery and anticoagulation her symptoms abated. angiography 11 weeks later revealed resolution of the obstruction. We propose that this intrinsic vascular lesion was secondary to reversible intimal hyperplasia brought on by reproductive steroids.- - - - - - - - - - ranking = 4keywords = vascular disease (Clic here for more details about this article) |
10/14. Rapid development of nephrotic syndrome, hypertension, and hemolytic anemia early in pregnancy in patients with IDDM.In recent years, the prognosis for a successful pregnancy has greatly improved for women with insulin-dependent diabetes mellitus (IDDM) who are under good glycemic control and free of complications such as vascular disease and nephropathy. We report the rapid development of severe nephrotic syndrome, malignant hypertension, and microangiopathic hemolytic anemia during the first trimester of pregnancy in a 29-yr-old woman with IDDM of 18 yr duration. Our patient had no pregestational history of retinopathy or hypertension and only minimal proteinuria. Significant improvement in blood glucose levels had been achieved over the 6 mo before conception. kidney biopsy performed before the termination of pregnancy at 10 wk gestation revealed diabetic nephropathy. No other etiology for her renal disease could be found. An arteriole was noted to have entrapped red blood cell fragments and platelet thrombi, revealing the probable source of her hemolytic process. By 8 wk postpartum, her nephrotic syndrome and hemolysis had completely resolved. At 3 mo postgestation, the patient's hypertension was still present but less severe. Her serum creatinine has continued to decrease toward normal. This is the first report of a woman with IDDM in White's classification C who developed a toxemia-like syndrome during the first trimester of pregnancy, attributable to the underlying diabetic state.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
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