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Peripartum and Dilated Cardiomyopathies - Prevalence, Risk Factors and Treatment (Paperback)
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Peripartum and Dilated Cardiomyopathies - Prevalence, Risk Factors and Treatment (Paperback)
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In this compilation, the authors discuss peripartum cardiomyopathy
(PPCM), a rare but serious form of heart failure affecting women in
the last month of pregnancy or early postpartum. It is diagnosed by
documented left ventricular systolic dysfunction in the absence of
another demonstrable cause in a previously healthy woman. Prognosis
is variable and appears to be positively related to reversal of
ventricular dysfunction. Prompt diagnosis with institution of
intense therapy by a multidisciplinary team is a prerequisite for
improved outcome. Pharmacotherapy remains the mainstay of treatment
for PPCM, and the management strategy is broadly aligned with
established guidelines for cardiac failure. Nevertheless,
individually tailored therapy is often required for treatment of
clinical sequelae, as well as for the management of delivery. At
present, we lack the understanding to be able to effectively risk
stratify patients and identify those susceptible to disease
progression. As such, further research into this area is crucial in
order to develop an understanding of which women are at greatest
long-term risk, as well as to more effectively manage the
condition. The authors also discuss idiopathic dilated
cardiomyopathy (DCM), the second most frequent cause of heart
failure and is associated with a survival rate of less than 50% at
10 years. The diagnosis is clinical and established by the presence
of both left ventricle enlargement and systolic dysfunction. MRI
has been increasingly applied to the evaluation of cardiovascular
disease and has become the first-line imaging modality in the
assessment of many types of congenital and acquired cardiovascular
disorders; it could be used for global analysis of ventricular
structure and function, myocardial mass and viability. It is
nowadays the gold standard for assessing RV systolic function and
is being increasingly used in this regard. Additionally, more than
40 genes have been identified as causative gene associated with
hereditary DCM. A genetic diagnosis can confirm a hereditary DCM
clinical diagnosis and it can help predict disease risks for family
members before the onset of symptoms. Thus, finding predictors of
DCM is of great significance as this may help doctors take
precautions as soon as possible and is beneficial for long-term
outcomes.
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