RESUMO
Spontaneous dissection of the vessels of the neck is one of the main causes of ischemic stroke in young patients under 45 years of age. According to morphological studies, dissection of the vessels of the neck can be based on dysplastic changes in the arterial wall in arteriopathies, Marfan syndrome, Ehlers-Danlos syndrome, undifferentiated connective tissue dysplasia. The article presents a case of spontaneous dissection of the internal carotid artery in a 30-year-old patient with clinical manifestations of undifferentiated connective tissue dysplasia and carriage of homozygous variants of candidate genes: 4G/4G of the PAI-1 (-675, 4G/5G), T/T of the MTHFR C677T, 5A/5A of the MMP-3 (-1171 5A/6A) and A/A of the MMP-9 (8202A/G).
Assuntos
Dissecação da Artéria Carótida Interna/genética , Tecido Conjuntivo/patologia , Adulto , Homozigoto , Humanos , Metaloproteinase 3 da Matriz/genética , Metaloproteinase 9 da Matriz/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Acidente Vascular Cerebral/etiologiaRESUMO
In order to evaluate the effectiveness mildronate in rehabilitative treatment in connective tissue dysplasia examined 240 patients (24,41 ± 7,62 years, 130 men). All patients were treated with 5 ml of mildronate 10% intravenously for 10 days, then 1 capsule (250 mg), 2 times per day for 4 months. The therapy showed a significant decrease in asthenic complaints, reducing the incidence of violations repolarization I (p<0.05) and II infarction (p<0.05), a significant increase in end-diastolic volume (p<0.05), stroke volume (p<0.05), left ventricular ejection fraction (p<0.05) by echocardiography, increased exercise tolerance with the normalization of reaction to physical stress on a dystonic normotonichesky, improved quality of life. During the treatment was not recorded adverse events in patients receiving the drug. Portability mildronate majority of patients described as good to very good (average 8.67 points).
Assuntos
Doenças do Tecido Conjuntivo/complicações , Cardiopatias , Metilidrazinas , Adulto , Astenia/tratamento farmacológico , Astenia/etiologia , Fármacos Cardiovasculares/administração & dosagem , Fármacos Cardiovasculares/efeitos adversos , Vias de Administração de Medicamentos , Monitoramento de Medicamentos , Tolerância ao Exercício/efeitos dos fármacos , Feminino , Cardiopatias/diagnóstico , Cardiopatias/tratamento farmacológico , Cardiopatias/etiologia , Cardiopatias/fisiopatologia , Testes de Função Cardíaca/efeitos dos fármacos , Testes de Função Cardíaca/métodos , Humanos , Masculino , Metilidrazinas/administração & dosagem , Metilidrazinas/efeitos adversos , Contração Miocárdica/efeitos dos fármacos , Resultado do TratamentoRESUMO
To assess the efficacy and safety of bisoprolol to monitor heart rate (HR) in young patients with connective tissue dysplasia (CTD) examined 58 patients (22,3 + 3,47 years, 38 men). Bisoprolol drug was administered at an initial dose of 1.25 mg/day, with a further increase to 2.5 mg/day in 2 weeks, etc. to achieve the level of heart rate 59-69 beats/min. Average effective dose was 7.27 ± 2.08 mg/day. Target heart rate,improvement of health and the pumping function of the heart, reducing the activation of the sympathetic nervous system and of anxiety achieved the absolute majority of patients. During treatment unit observed transient manifestations of general weakness, headache, episodes of vertigo in the selection of the dose, cases of bradycardia and hypotension pathological registered for the time of ingestion. Thus, the use of mandatory bisoprolol gradual careful titration, starting with 1.25 mg/day as a means to control the heart rate in young patients with CTD with sinus tachycardia, the manifestations of autonomic nervous system dysfunction, safely and effectively in relation to adverse orthostatic reactions.