Minerva cardioangiologica
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Minerva cardioangiologica · Mar 1999
Review[Critical ischemia in elderly patients. Evaluation of the effect of two different methods of Iloprost therapy on the efficacy, tolerance, modification of quality of life and self-sufficiency].
The use of Iloprost in the treatment of critical leg ischemia in very old patients can lead to tolerability problems, related to the drug used and to the kind of patient treated. The aim of this study was to evaluate the impact of this therapy on the activities of daily living and on the quality of life of the patient together with its efficacy and tolerability. ⋯ Iloprost can be used in the treatment of critical leg ischemia even for very old patients with good tolerability and effectiveness. In the double daily administration no relevant side effect was observed. This approach is to be preferred also in terms of cost-effectiveness.
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The authors report the case of a 77-year-old woman suffering from ischemic cardiopathy, arterial hypertension and NID diabetes mellitus who was hospitalised for diabetic retinopathy. Following the topical administration of a drop of phenylephrine in the right eye, in preparation for fluoroangiography, she suffered an attack of angina pectoris. This event was clearly identified by a ECG carried out at the time which highlighted the sublevelling of the ST tract in the precordial derivations V2-V5, and by ecocardiographic imaging that showed septo-apical, anterior-apical and anterior-median transient segmentary hypokinesia. This case underlines the need for prudence and emphasises the need to regard patients suffering from ischemic cardiopathy as high-risk when undergoing diagnostic tests, in particular if these involve the use of vasoactive drugs.