Vidyalakshimi, U (2021) Acute Pulmonary Edema: Etiological Spectrum, Clinical Profile, In-Hospital Management and Outcome at a Tertiary Care Hospital in South India. Masters thesis, Stanley Medical College, Chennai.
Full text not available from this repository.Abstract
INTRODUCTION: Acute Pulmonary Edema represents the most dramatic medical emergency, following cardiogenic shock, which requires immediate hospitalization and early and rigorous management. If not treated promptly, it can be life threatening and has a high mortality. The prevalence of acute pulmonary edema is previously estimated to be around 40% amongst the various acute heart failure with a mortality rate as high as 14%. The one year and six year mortality rates are further alarming with an estimates of 50% and 85% respectively. The current study aims to investigate the etiology, clinical profile, treatment given and outcome of acute pulmonary edema in a tertiary hospital in South India, which will help in assessing the burden of the disease and the mortality associated with it and help us in establishing adequate infrastructure necessary for management of the acute episodes and in providing better healthcare. OBJECTIVES: 1. To determine the etiology and the precipitating factors of acute cardiogenic pulmonary edema. 2. To analyse the following investigatory findings of the study population: TLC, DC, RFT, ECG, Chest X-ray, Echo and to establish their correlation with APE. 3. To evaluate the outcome associated with the disease. MATERIALS AND METHODS: This is an observational type of study where 161 patients admitted with acute pulmonary edema in a medical emergency unit in Government Stanley Medical College and Hospital were enrolled in the study. The study was conducted over a period of one year. Data regarding the clinical presentation, investigations and in-hospital management were collected and analysed. RESULTS: Amongst the 161 participants enrolled, the majority were males (70.8%) and predominantly belonging to the 50-75 years age group. Breathlessness followed by chest pain were the most common presenting symptoms. The most common precipitating factors include hypertension (31.7%) and acute coronary syndrome (29.8%) and the predominant predisposing factor was left ventricular systolic dysfunction. The mortality rate in APE patients in this study was 14.9%, with lower presenting blood pressure, oxygen saturation, LV ejection fraction and certain precipitating factors like arrhythmias and ACS serving as independent risk factors. CONCLUSION: Hypertension and acute coronary syndrome are implicated as a precipitant in majority of patients with APE. Clinical characteristics and investigation findings may help in reducing mortality by identifying high-risk APE patients early. Also, the recurrence of APE can be minimized by understanding the precipitating factors and initiating measures to overcome the challenges.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 201811079 |
| Uncontrolled Keywords: | Acute pulmonary edema, precipitating factors, outcome. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 May 2021 09:11 |
| Last Modified: | 30 Oct 2021 13:05 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15799 |
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