Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires
-
Can J Cardiovasc Nurs · Jan 2005
ReviewPalliative trajectory markers for end-stage heart failure. Or "oh Toto. This doesn't look like kancerous!".
Heart failure is a complex syndrome with a high morbidity and mortality rate. The Canadian mortality rate is between 25% and 40% annually. End-stage heart failure patients suffer from many debilitating symptoms. ⋯ This is difficult to determine due to the lack of tangible trajectory markers and the roller-coaster nature of the trajectory itself. These circumstances were the impetus for a review of the current literature and a clinical experience in a cardiac clinic within a major teaching hospital in Vancouver. The objective was to determine if clear palliative trajectory markers for heart failure existed and, if so, could they be used to produce a tool to assist health care professionals to accurately determine a timeline of six months or less.
-
Can J Cardiovasc Nurs · Jan 2005
Maternal cardiac autonomic function and fetal heart rate in preeclamptic compared to normotensive pregnancies.
Preeclampsia during pregnancy increases a woman's risk of cardiovascular disease in two ways. Women who develop preeclampsia are at increased risk for the development of hypertension and cardiovascular disease later in life. As well, fetal adaptations (e.g., growth restriction) may lead to the development of cardiovascular risk factors (e.g., obesity, increased cholesterol) in the offspring. Although atypical maternal cardiac autonomic function has been reported in preeclampsia, to date, its effects on fetal cardiac function have not been determined. ⋯ These findings serve to further our understanding of the cardiovascular pathophysiology of preeclampsia in both the mother and the fetus. Women who develop preeclampsia during pregnancy show atypical autonomic nervous system modulation of heart rate that is associated with a decrease in spontaneous fetal heart rate accelerations in late gestation. Implications for cardiovascular nursing practice include the monitoring of maternal cardiac autonomic function during pregnancy, especially during standing, as well as a need for continued surveillance of maternal cardiovascular function following pregnancy. The negative effect on fetal heart rate accelerations has implications for the interpretation of standardized obstetrical tests of fetal well-being.