Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patient was an-85-year-old man with hypertension and hyperlipidemia. The patient had a history of faintness on standing. He visited our hospital after experiencing chest oppression and pre-syncope in 2015. Brain magnetic resonance imaging and echocardiography did not detect any structural brain or heart disease. Ischemic heart disease was suspected based on the myocardial scintigraphy findings, but coronary angiography revealed no unusual findings. Holter electrocardiography did not reveal the reason for his symptoms. Because he had experienced 2-second sinus arrest rather than faintness or pre-syncope during the Holter monitoring (not an indication for the implantation of a pacemaker), we implanted a loop recorder to detect the cause of pre-syncope.The loop recorder required that he or his family to manually send the telemetry monitoring data, but he and his wife did not understand how to do it. After the loop recorder failed to reveal the cause of his symptoms, he was hospitalized for its extraction. When we manually checked the loop recorder data on the day of hospitalization, sinus arrest of >3 seconds was detected 271 times; the maximum sinus arrest was 4 seconds. Sinus arrest was confirmed to be cause of his symptoms. His symptoms completely disappeared after the implantation of a permanent pacemaker.Although faintness is not rare in elderly people, it can be difficult to diagnose. An implantable loop recorder was useful for diagnosing pre-syncope; however, in the present case, it was difficult for the elderly patient and his wife to perform telemetry monitoring.
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PMID:The implantation of a loop recorder to detect the cause of pre-syncope in an 85-year-old man. 2788 30

Patients with valvular heart disease (VHD) should be treated for diabetes, hypertension, and hyperlipidemia. They also should receive therapy for left ventricular dysfunction, undergo interval echocardiography, and participate in aerobic exercise. Valve replacement should be considered for patients with aortic stenosis (AS) and syncope, presyncope, heart failure, angina, or severe AS with left ventricular dysfunction. Valve replacement is performed with open or transcatheter procedures; the latter are preferred for patients with high surgical risk. Patients with chronic aortic regurgitation (AR) should undergo open surgical replacement if they are symptomatic or are asymptomatic but have severe regurgitation and left ventricular dysfunction. No transcatheter procedures currently are approved for AR. Patients with mitral stenosis (MS) should receive drugs for heart rate control and anticoagulation if they have atrial fibrillation. Invasive treatment involves valve replacement or percutaneous commissurotomy. Management of severe chronic mitral regurgitation consists of valve replacement or, for patients with high surgical risk, a percutaneous transcatheter procedure that clips the mitral leaflets together. When severe, tricuspid regurgitation can be managed with valve replacement. Pregnant patients with VHD require special management. Women with severe AS or MS should avoid becoming pregnant until VHD is managed definitively.
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PMID:Valvular Heart Disease in Adults: Management of Native Valve Disease. 2867 5

Clinical manifestations of acute myocardial infarction can be more than just chest pain. Patients can present with dyspnea, fatigue, heart burn, diaphoresis, syncope, and abdominal pain to name a few. Our patient was a 74-year-old male with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and COPD due to chronic tobacco use, who presented with persistent hiccups for 4 days and no other complaints. Coincidently, he was found to have a diabetic foot ulcer with sepsis and acute kidney injury and hence was admitted to the hospital. A routine 12-lead EKG was done, and he was found to have an inferior wall ST elevation myocardial infarction. He underwent diagnostic catheterization which demonstrated 100% right coronary artery occlusion and a thallium viability study which confirmed nonviable myocardium; hence, he did not undergo percutaneous coronary intervention. Elderly patients who present with persistent hiccups should be investigated for an underlying cardiac etiology.
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PMID:Persistent Hiccups as the Only Presenting Symptom of ST Elevation Myocardial Infarction. 2971 52


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