RESUMO
The discipline of perioperative medicine is assuming greater importance as increasing numbers of older patients with medical comorbidity undergo complex surgical procedures. If patient outcomes and use of limited hospital resources are to be optimized, physicians with skills and interest in perioperative risk assessment and therapeutic intervention are needed. This systematic review attempts to provide an evidence-based update in several key areas in the management of the perioperative patient.
Assuntos
Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Doenças Cardiovasculares/cirurgia , Medicina Baseada em Evidências/tendências , Humanos , Assistência Perioperatória/tendências , Guias de Prática Clínica como Assunto/normas , Fatores de RiscoRESUMO
We present a case of acute pulmonary oedema as the first presentation of autoimmune cardiomyopathy in primary antiphospholipid antibody syndrome in a patient who had no previous cardiac history. Five days of methylprednisolone at 500 mg/day followed by 100 mg/day for 10 days and then a weaning course of oral prednisone resulted in effective resolution of the acute diffuse cardiomyopathy. Her cardiac status became clinically and echocardiographically normal. We illustrate the effectiveness of immunosuppressive therapy as an adjunct to standard anti-failure measures in such presentations and we outline the association between antiphospholipid antibodies and cardiac dysfunction.