Deutsche medizinische Wochenschrift
-
Dtsch. Med. Wochenschr. · Mar 2021
Case Reports[Unusual presentation of late reactivated tuberculosis in immunosenescence after nine decades latency].
Tuberculosis is an often underestimated infectious disease which can lead to manifest infections even after years of latency. Pulmonary manifestations are by far the most frequent, although any other organ can be equally affected. ⋯ Tuberculosis, primary or reactivated, should always be considered as a potential cause of unclear infections; especially in patients with anticipated immunosenescence.
-
Dtsch. Med. Wochenschr. · Mar 2021
Review[Symptom control in heart failure patients - how to handle GFR decrease and hyperkalaemia].
For heart failure patients with reduced ejection fraction, optimised medication improves symptom control and reduces mortality. Substances influencing the renin-angiotensin-aldosteron-system, so-called RAAS-inhibitors, are the cornerstone of heart failure treatment. This article summarises a consensus between experts in cardiology and in nephrology on a pragmatic approach to manage a drop in glomerular filtration rate and incident hyperkalaemia - the two most common reasons for reducing or discontinuing heart failure medication.
-
Dtsch. Med. Wochenschr. · Mar 2021
Review[Embolic stroke of undetermined source (ESUS) - Classification of a new stroke entity].
Embolic stroke of undetermined source (ESUS) represents a subpopulation of cryptogenic strokes defined by its embolic stroke pattern on imaging and if after a carefully performed diagnostic evaluation, a specific, well recognized cause of stroke has not been identified. This review article analyses the basics of the ESUS concept and provides an overview of the evidence from recent cohort studies. The definition, aetiology and diagnosis of ESUS are reassessed. Targeted diagnostics in ESUS patients can reduce the number of cryptogenic strokes by making a specific diagnosis.
-
Dtsch. Med. Wochenschr. · Mar 2021
Case Reports[Taxus poisoning: an unusual cause of acute heart failure].
Taxines are the active, poisonous constituents in yew plants (Taxus spp.) and can result in life-threatening cardiac toxicity. Rapid elimination of yew plant material and administration of active charcoal can limit absorption of toxins. ⋯ Therapeutic interventions such as utilization of digoxin immune fab, hemodialysis and temporary cardiac pacing may be utilized. Extracorporeal life support should be considered for severe cases.
-
The heart is closely connected with the endocrine system. On the one hand, the heart is an endocrine organ itself and produces several hormones like atrial and brain natriuretic peptides. On the other hand, cardiac structures are targets of many hormones like catecholamines, thyroid hormones, and corticosteroids. ⋯ In this article, we describe three instructive clinical cases of patients with hormonal disorders that mimicked cardiovascular disease. Furthermore, we shortly discuss useful diagnostic and treatment algorithms. All cases emphasize the value of interdisciplinary management of patients with cardiac symptoms.