Inspiratory fall in arterial blood pressure (Pa) during airway obstruction was ascribed to ventricular interdependence, afterload, and transmission of intrathoracic pressure swings. We have shown this effect significantly reduced in the elderly, but the underlying reasons remain unclear. Here we compare the results of inspiratory loading in young and older subjects with a mathematical model tha...

Peripheral artery disease (PAD) affects more than 200 million adults worldwide. Patients with lower extremity PAD have a heightened risk for cardiovascular events because of the systemic nature of atherosclerosis, and benefit from treatment with risk factor-modifying therapies. Limb symptoms in PAD include intermittent claudication and diminished walking ability. Arterial obstruction from ather...

It is uncommon in medicine for emerging data to completely transform a field, particularly in such a common disease state as atherosclerotic vascular disease. New evidence from multiple fronts has underscored the frequency and prognostic importance of atherosclerotic embolization in the microvasculature. Until recently, we have had limited access to diagnose microvascular obstruction in living ...

Once the diagnosis of pulmonary arterial hypertension is established, wheezing and chronic cough are rarely described during the course of the disease. The present study reports on two nonsmoking patients with severe pulmonary arterial hypertension, confirmed by right-heart catheterisation, who developed chronic cough, wheezing and irreversible obstructive lung disease masquerading as adult-ons...

The dynamic and static lung volumes, arterial blood-gas tensions, and single-breath carbonmonoxide transfer factor have been compared in 72 asthmatic and 45 bronchitic patients with airways obstruction of comparable severity to determine which measurements might be used to discriminate between the two diseases. The forced vital capacity, total lung capacity, arterial carbon-dioxide tension, and...

The possibility that venous blood could be withdrawn through a radial artery cannula when venous pressure is high was examined in 30 patients during cardiopulmonary bypass for coronary artery bypass operation. Progressive desaturation of radial artery blood occurred when venous pressure was equal to arterial pressure. Desaturation not only increased with duration of venous obstruction but also ...

We describe a rare intraaortic balloon pump (IABP) vascular complication as a result of malpositioning of the IABP. A 61-year-old man with unstable angina underwent emergency coronary artery bypass grafting soon after the insertion of an IABP. Postoperative hemodynamics were stable, but acute hepatic dysfunction occurred on the second postoperative day. Doppler echography revealed the absence o...

BACKGROUND Validated measures to assess the severity of airway obstruction in patients with obstructive airway disease are limited. Changes in the pulse oximeter plethysmograph waveform represent fluctuations in arterial flow. Analysis of these fluctuations might be useful clinically if they represent physiologic perturbations resulting from airway obstruction. We tested the hypothesis that the...

he mechanism of myocardial infarction and Tunexpected sudden cardiac death remains incompletely defined. The frequent absence of complete coronary arterial obstruction in both these conditions' has challenged the concept of arterial obstruction followed by infarction or sudden death or both. Several independent observations are herein developed into a working hypothesis for the pathogenesis of ...

The effects of the oral beta agonist pirbuterol on pulmonary haemodynamics and gas exchange were studied in nine patients with severe irreversible airflow obstruction and moderate arterial hypoxaemia. After administration of 15 mg pirbuterol pulmonary vascular resistance fell by 19% but cardiac output rose by 24%, so that pulmonary arterial pressure showed no significant change. Systemic arteri...