What is Kawasaki? Perhaps, your first thought was this is a vehicle. No, I will be discussing about Kawasaki Disease. This is a rare vasculitis, which is inflammation of a blood vessel. This disease may be rare, but is serious. This disease strikes children under the age of five. There is no known cause of Kawasaki, but it is not contagious. “Over 4,000 children develop it each year. 80% of patients are under the age of five.”
What are some of the symptoms? One of the first symptoms is that the patient’s begin with a high fever lasting more than five days. Reports have also said that there will be red eyes, lips and mouth, their tongue will be like a strawberry color, swollen hands and feet and swollen lymph nodes. This disorder affects the mucous membranes, walls of the blood vessels and the heart. The most important aspect of the disease is the heart’s involvement.” This disease can cause inflammation of blood vessels in the coronary arteries, which can lead to aneurysms. Kawasaki is the leading cause of acquired heart disease in children.”
How can this be diagnosed? With early detection and recognition and treatment full recovery can be expected. “However, 2% of patients die from complications of the coronary blood vessels. Patients who have had Kawasaki should have an echocardiogram every 1-2 years to screen for heart problems.”
Immediate treatment is critical to avoid permanent damage to the coronary arteries and heart. “Standard treatment includes high doses of
A recent systematic review of observational data (6 studies) found that the total mortality rate in angina patients was 2.8% to 6.6% per annum(121). At present it is thought that stable angina does not cause permanent myocardial damage. However prompt diagnosis and treatment is important to prevent further complications. Initiation of pharmacological intervention has been shown to retard plaque disease progression and to stabilise the surface endothelium(131).
Diagnostic test would include, CBC with differential, ESR, platelet count, CRP, liver transaminases, gamma-glutamyltransferase (GGT), and urinalysis. CRP will be elevated but ESR is sometime normal. Blood, urine, cerebrospinal fluid, and group A beta-hemolytic streptococcus pharyngeal cultures may be collected to identify other sources of fever. Diagnostic test would be done to confirm or rule out the diagnosis of Kawasaki disease (Burns, Dunn, Brady, Starr & Blosser, 2013).
In the evaluation of patients with chest pain, the preliminary ECG is a more clear-cut tool for early risk stratification with more recent recommendations indicating that ECG should be performed as early as possible, within 10 minutes of ED admittance. Early indicators associated with MI or ischemic complication such as ST segment elevation or depression allows rapid treatment aligning with the indicated complication. While the ECG may reveal significant indicators in certain situations, in other circumstances findings may be limited due to low diagnostic sensitivity
Next we have Cardiac tamponade [which is caused by blunt or penetrating trauma or a few medical conditions such as cancer or autoimmune dieses] which is a serious condition where the blood accumulates in the pericardial sac [the sack around the heart]. While there is no definitive treatment on a basic level and ALS provider can relieve fluid with a needle in a risky but necessary procedure the last form of cardiogenic shock is a pulmonary embolism. A pulmonary embolism is when there is a blood clot blocking the flow of the pulmonary veins leading to obstructive shock and causing heart failure. Interesting enough to mention is the fact that one of the more common causes to cardiogenic shock is damage to the heart muscle however just because you have a heart attack does not necessarily mean you have had caridogenic
Once occluded, these arteries cannot deliver oxygenated blood to the cardiac tissues, which leads to cardiac ischemia and infarction. The death of cardiac muscle can be so great that it is fatal, or it can be within a spectrum of morbidity that limits an individual’s ability to perform activities of daily life and decreases one’s quality of life. CHD is prevented by healthy habits, such as good nutritional intake, a minimum of 150 minutes of moderate physical activity per week, stress management, and consistent screenings (LCMHS, 2016). These interventions can also be used during any stage of the disease, for they can reduce the progression of the disease as well as improve the effectiveness of medications and other provider-ordered
This is a contagious bacterial disease that is transmitted through the air(respiratory) or by person-to-person contact, and is often accompanied by fever and delirium, headache, weakness, and cough. If not treated early enough, the recipient may go into septic shock and die. Antibiotics are effective in the treatment of this type of disease.
Coronary artery disease remains number one killer of the western civilization despite 40 years of aggressive drug and surgical interventions (Esselstyn). Usually, pharmaceutical drugs, such as statin, are given to try to slow the progression, but may provide uncomfortable side effects. In fact, the majority of patients discontinue statins within 1 year of treatment initiation (Maningat). Furthermore, surgery is performed to circumvent clogged arteries and literally bypass the symptoms. In the last year, 500,000 coronary bypass procedures were performed (Swaminathan et al). However, these surgeries can have significant risks, including the potential to cause further heart damage, stroke, and brain dysfunction. Thus, it is evident that these way of treatments may not be enough on its own, and that getting to the
Indications can be any combination of the following manifestations: fever, ulcers, hepatitis, encephalitis, seizures, coma, and vision trouble from retinitis to blindness. Among other symptoms or signs as internal organs are attacked are the less common but possible emergence of the evidence of activity of this virus including splenomegaly, anemia, or lymphadenopathy (Fagerberg et. al., 2013).
Once Kawasaki Disease has been diagnosed, beginning treatment is critical to be started fast. The child will be admitted to the hospital to be under constant observation and receive intravenous therapy. Intravenous immunoglobulin (IVIG) and aspirin are the most important treatments to begin. Intravenous immunoglobulin, specifically Gammagard for Kawasaki disease, is classified as a biologic response modifier (med book) it is used as an unlabeled use that research has shown to reduce fever and the risk of heart problems by providing additional antibodies to fight disease-carrying organisms (Kawasaki disease - Treatment). IVIG is most effective in the first 10 days of the disease. It has been reported that approximately 20% of children do not respond to the initial dose IVIG, and require either another dose or other experimental medication to try and obtain the same effects (Kawasaki Disease Clinic). Aspirin is given during the acute
A 32-year old nurse who has rheumatic fever as a child noticed a persistent tachycardia and light-headedness. Upon examination, chest x rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation. There was also mild pulmonary congestion. Cardiac evaluation resulted in the following information:
Our body system is not immune to pathological deficiencies. There exist numerous identified pathologies which compromise the regular functioning of a heart, but all heart-related pathologies are narrowed to a single condition known as Acute Coronary Syndrome (ACS). This is the term properly used in reference to the different identified clinical entities threatening the cardiovascular system. ACS is the result of the progressive or complete sudden blocking of the arteries or veins; this prevents an appropriate blood flow through the circulatory system, and as a consequence, the body is unable to receive enough oxygen and nutrients to meet its daily necessities.
The common causes of this disease is Epstein-Barr, and other viruses that may pop up. Some of the symptoms that come with mono is fever, sore throat, headaches, muscle weakness, night sweats etc. The prevalence rate of this disease is over 95% worldwide, only 50% of children become seropositive for EBV between the ages 1and 15 years old in socioeconomic groups or developed countries.
The goal of medical management is to minimized myocardial damage, preserve myocardial function, and prevent complications. These goals are achieved by reperfusing the area by emergency use of Percutaneous Transluminal Coronary Angioplasty (PTCA) or thrombolytic medication. Minimizing myocardial damage is also accomplished by reducing myocardial oxygen demand and increasing oxygen supply with medications, oxygen administration, and bed rest.
Cardiogenic shock, according to Werden et al. (2012), is the most common cause of death from an acute myocardial infarction (AMI) and has a chance of mortality from thirty percent to eighty percent. Infarction-related cardiogenic shock (ICS) complicates approximately five to ten percent of acute myocardial infarctions (AMI) and remains the leading cause of death in patients hospitalized from an AMI (Kolte et al., 2014). Kolte et al. (2014) also states that the incidence of cardiogenic shock is higher in patients over the age of seventy-five, and has higher prevalence in women, Caucasians, Asians, and Pacific islanders. This paper will discuss the pathophysiology, clinical manifestations, tools used to diagnose, and therapeutic management of cardiogenic shock.
The high risk patients are those who are I danger of severe complications such as death due to the severity of symptoms in which they are hemodynamically unstable. Low risk patients usually have different treatment regimens from high risk patients as they are not in any immediate danger. Van der Hulle, T. (2015, August 19). When it comes to high risk patients they are usually given thrombolytic therapy to resolve the blood clot obstruction in the pulmonary artery. Because thrombolytic can thin the blood so easily they are only ever used in life threatening situations because it can cause major bleeding. There are alternatives to thrombolytic therapy if a patient isn’t able to use that treatment. There is surgical embolectomy in which the embolus is surgically removed. Low risk patients are patients who are hemodynamically stable. The treatments for low risk patients are usually blood thinners such as Coumadin (Warfarin) to help thin the blood so that the clot can be dissolved. Although it runs the risk problems such as death from blood loss due to the inhibited ability for the blood to clot. It is recommended that patients adhere to the plan of care and take the drugs as prescribed to prevent the reoccurrence of another embolism which could lead to even worse complications such as organ damage or even death. Low risk patients are