Heart and vessels
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Amiodarone is a highly effective antiarrhythmic agent. Unfortunately amiodarone-induced pulmonary toxicity is described for medium-long term therapy. We describe a case of a 65-year-old man admitted to our department for breathlessness and with a history of recurrent episodes of atrial fibrillation for which he had been receiving amiodarone (200 mg/day) since 2008. ⋯ Indications for use of ECMO have expanded considerably. To our knowledge this is the first successful, reported article of a veno-venous ECMO used to treat amiodarone-induced toxicity in an adult. In patients with severe but potentially reversible pulmonary toxicity caused by amiodarone, extracorporeal life support can maintain pulmonary function and vital organ perfusion at the expense of low morbidity, while allowing time for drug clearance.
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Arterial stiffness is associated with increased cardiovascular risk. Pulse wave velocity (PWV) and augmentation index (AIx) are non-invasive markers for assessment of arterial stiffness. Increased arterial stiffness is associated with atherosclerosis in patients with psoriasis. ⋯ PWV and AIx were significantly higher in patients with psoriasis. Assessment of arterial stiffness parameters may be useful for early detection of cardiovascular deterioration in psoriasis patients with normal cardiac functions. Novel inflammatory biomarkers such as NLR may elucidate the mechanism of vascular dysfunction in such patients.