Therapeutic approach in cardio-respiratory emergencies

Introduction: The involvement of the heart in respira-tory disorders aggravates disease progression and pro-gnosis, modifying the therapeutic approach. The main etiologic substrate of rhythm disorders in bronchial ob-structive syndrome is represented by hypoxic pulmo-nary vasoconstriction. Pharmacological strategies aim at supporting vital functions, diminishing symptoms, controlling risk factors, improving the quality of life and preventing future complications.
Methods: We present the case of a 67-year-old patient diagnosed with persistent atrial fibrillation and GOLD stage 3 COPD in a previous assessment, neglect the-rapeutically, hospitalized in a particularly serious con-dition with decompensated heart failure and bronchial asthma on the background of therapeutic incompliance and chronic consumption of ethanol, at a person with multiple chronic conditions.
Results: The investigations performed objectified chro-nic bronchitis affection and severe obstruction, coexis-ting with cardiac stasis by mixed cardiac, atherosclero-tic, ethanolic, and chronic hepatic lesions with hypers-plenism. Dynamic electrocardiographic monitoring re-vealed atrial fibrillation with AV ≈ 160/min alternating with unsupported ventricular tachycardia and frequent polymorphic ventricular extrasystoles systemized in doublets, expression of instability of coronary ische-mia. Under sustained treatment, the control of the acu-te bronchial infestation process and the improvement of the heart condition was achieved, with reinstallation of the sinus rhythm on the 13th day of hospitalization. Concomitantly, the patient associates chronic kidney disease with ischemic nephropathy.
Conclusions: Cardio-respiratory disorders have com-mon pathophysiological mechanisms, which are based on the inflammatory process and endothelial dysfunc-tion. Patients with chronic lung disease require regular cardiac screening even in the absence of symptoms. Es-tablishing therapeutic behavior is a permanent challen-ge and requires a multidisciplinary approach.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)