Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Tidsskr. Nor. Laegeforen. · Sep 1990
Review[Treatment of heart failure with angiotensin converting enzyme inhibitors].
Stimulation of the renin angiotensin system, catecholamines and antidiuretic hormone causes prominent vasoconstriction in severe heart failure. Angiotensin converting enzyme inhibitors reverse these effects, and thus ameliorate cardiac function and reduce mortality in severe heart failure. Angiotensin II is an important regulator of renal function in diseases with renal hypoperfusion, and treatment with angiotensin converting enzyme inhibitors may cause a serious decrease in glomerular filtration and hyperkalemia. Asymptomatic heart failure, acute heart failure and acute myocardial infarction are areas where angiotensin converting enzyme inhibitors may prove beneficial in the future.
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Tidsskr. Nor. Laegeforen. · Sep 1990
Case Reports[Lung shock in connection with acute myocardial infarction. Adult respiratory distress syndrome, ARDS].
We describe the case of 42 year-old male patient who developed adult respiratory distress syndrome (ARDS) during an acute myocardial infarction. He was treated with positive pressure ventilation for 23 days. Chest X-ray showed multiple, bilateral infiltrates for several weeks. ⋯ The therapeutic consequences involve positive pressure ventilation with increased inspired oxygen concentration and positive end-expiratory pressure. ARDS in patients with impaired myocardial function can be difficult to recognize. It is an alternative diagnosis to pneumonia and ordinary heart failure when patients are seen to be suffering serious hypoxemia.