Dengue: cardiac patients have a higher risk of complications
Now, what can happen when they settle in patients with heart disease?
As cardiovascular diseases are presented in several ways. So we can try to differentiate patients according to the way their disease interacts with one of these hemorrhagic fever pictures:
Patients using antiplatelet drugs or anticoagulants
People who have ever had a heart attack or have had
stent As well as those at high risk of heart attack (diabetics, among others), are advised to use aspirin and in some cases other medicines that disrupt platelet function. Some examples are clopidogrel, presugrel, ticlopidine. The function of these is to make that in case of rupture of fat plaque inside the coronary artery (which precedes the infarction) the platelets do not agglomerate and close the coronary completely. The effect of these drugs on platelets can be as high as seven days. Other people also need to use anticoagulants to prevent clots in the heart or prosthetic valves, such as those with arterial fibrillation, deep vein thrombosis, pulmonary embolism, or arrhythmia that allows clots to form in the left atrium and can reach the brain. These anticoagulants have a much greater effect on coagulation, which as an adverse effect leaves the person much more prone to bleeding. In summary, many people with heart disease need to use anticoagulants - that is, medicines that make coagulation difficult. and make them more prone to bleeding - during their treatment. This, combined with dengue, which may increase the risk of bleeding, is a dangerous factor for the patient.
Dengue and cardiovascular problems
When dengue reduces platelets, or the possibility of increased bleeding was facilitated by anticoagulants , the person is at risk of bleeding. Generally, platelets below 100,000 suggest caution with the use of antiplatelet agents. Below 70,000 have rare indications of medication maintenance. Thus, monitoring of platelets and the investigation and evaluation of any bleeding is more important in these patients than in the majority.
In addition, care should be taken to know when to restart medications (as platelets rise). The patient can not be unprotected at this time, as many cases of infarction require percutaneous (angioplasty) or cardiac surgery, which are at increased risk if they are done at that time.
Patients with heart failure
Heart failure can be systolic or diastolic, and in both the restriction of fluid is important part of the treatment. This is because excess fluids accumulate in the lungs and legs, as well as belly and other soft parts of the body. With this, the heart can not push the blood forward with enough force. Many medications can not be absorbed by intestinal loop edema. Usually they are on high doses of diuretics and stable through a delicate balance between the fluids that enter and leave the body. The patient already knows how much salt can ingest and small variations come with warmer days for example.
At a time of infection or inflammation, the body accelerates the heart rate and divert liquids from within the blood vessels to the skin during the fever. And this can unbalance the patient's condition. Heart failure may decompensate kidney function by reducing blood pressure, which may lead to fluid leakage and soft tissue edema causing swelling throughout the body.
Inflammation can serve as a cradle for bacterial infections, sometimes already resistant for multiple hospitalizations.
Vaccines and early diagnosis are the best opportunity for people at greater risk in case of contagion. In case of suspected dengue fever, it is interesting to have an early diagnosis, even if presumptive, and rigorous follow-up to avoid complications.
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