[CICTD]
[Contact]
Cardiovascular diseases in CICTDsQuestions asked to Prof Duprez, cardiologist UZ Gent, in reference to his lecture on 13 June 1998 for the CIB-league, department Oost-Vlaanderen. |
| What is the meaning of a high concentration of triglyceride in the blood? |
|---|
| Triglycerides are part of the fats in the blood, but are not as dangerous as the real cholesterol. A high concentration of triglycerides may be caused by the intake of certain drugs, alcohol consumption, or it may be a familial characteristic. For determining the triglyceride concentration, it is important to take account of the moment of taking the blood sample. Eating cheese and wine or a bar of chocolate the evening before, will not influence your cholesterol level, but it leads to an increase in the triglyceride concentration. An elevated level of triglycerides is also seen in case of a nephrotic renal syndrome, thyroid problems and in a deregulation of diabetes. The triglyceride concentration should normally be less than 200 mg per dl. |
| What is the meaning of a cloudy blood sample? |
| When the triglyceride concentration is elevated, the blood plasma looks like cream. Hence the term 'cloudy' blood sample.
|
| Can Raynauds phenomenon occur in the chronic fatigue syndrome? |
| In case of the chronic fatigue syndrome the CRP or sedimention rate must be normal. Raynaud may occur together with it, but a patient with Raynaud complaining of chronic fatigue should be examined for connective tissue diseases, or in case of an infectious pathology, it has to be clear whether it is the primary or secondary Raynaud. Some young girls starve themselves, use diuretic pills, and do not eat salt to meet the perfect beauty ideal. As a result, they suffer from a low blood pressure, a higher pulse, they are tired, underfed and have blue hands and toes. If they are told that they have to put on at least 10 kg in weight, they get angry and try to find a doctor who will cure their cold fingers, although this is a normal physiological reaction of the body.
|
| Can Sjogren with lung problems be the cause of cardiac arrhythmia? |
| In this case, the pressure in the pulmonary blood vessels may be elevated. In the arteries the pressure is 120/80 mm Hg, in the lungs the pressure is 16/8 mm Hg. As the pressure in the lungs is very low, the wall of the right ventricle is only 4 to 5 mm. The left ventricular wall is 8 to 10 mm. The occurrence of Sjogrens Syndrome together with lung problems results in a pressure overload of the right ventricle. Even in case of a small pressure rise in the pulmonary arteries from e.g. 16/8 to 30/10 mm Hg, the right ventricle is distended. The pacemaker, located in the right atrium of our heart, will be dilated and causes cardiac arrhythmias, extra systolic beats or atrial fibrillation. |
| How can we decrease a blood pressure of 140-100 mmHg ? |
|
If this blood pressure persists for 6 months, some questions should be answered like: "Am I overweight? Do I smoke? Is there a family factor? Do I take prescription drugs like corticosteroids or anti-inflammatory drugs which increase blood pressure? Do I abuse nose drops?" If all these answers are negative, you can proceed with a low-salt diet or start with anti-hypertensives. |
| Can an elevated pulse rate (130 / bpm at rest) be caused by lupus or by the intake of corticosteroids? |
| It is not directly related to lupus. By taking corticosteroids water and salt will be retained, so that the cardiovascular system has to deal with extra volume. To circulate this extra fluid the body reacts with a higher pulse rate. Patients with chronic rheumatic diseases are likely to have a lower haematocrit, just like people with renal insufficiency have a lower concentration of red blood cells, which results in a higher pulse rate to maintain the blood pressure. |
| What are the symptoms if there is fluid around the heart ? |
|
In case of a pericard tamponade the heart is compressed, which results in shortness of breath, a weak pulse rate and a low blood pressure. The patient complains about pain when breathing in.
|
| What is the cause of spontaneous blue bruises ? |
| One possibility could be that, in a very thin skin the capillaries are situated just beneath the skin. Another possibility is that due to the use of corticosteroids the capillary walls have become very fragile, so they are damaged more easily and form blue bruises
. |
| Is there a correlation between thin skin and blood supply to the skin ? |
|
Actually not. It could be due to the natural ageing process. In case of scleroderma one could say there is a correlation.
|
| Is the formation of oedema in the hands and feet in the morning caused by heart failure? |
|
Oedema caused by heart failure should fade away in the morning given the complete fluid resorption at night due to the horizontal position of the body. Oedema in the hands and feet can be caused by inflammation of the smaller joints.
|
| Can you give an explanation for the pressure under the sternum (breastbone) when one rises in the morning? |
|
The reason for this may be a small epigastric hernia with some gastric acid overflow in the oesophagus.
|
| Can Raynauds phenomenon occur in healthy people ? |
| In the Scandinavian countries the primary Raynauds phenomenon occurs in one out of three women. Probably there is also a hormonal influence as the blood circulation in the fingers fluctuates with 50% within a cycle in the fertile period of a woman.
|
| Is there a correlation between contractions of the toes and calves and blood pressure disorders? |
|
If it occurs during walking or strolling, it is linked with the blood pressure in the arteries of the legs. If it worsens during standing up, it has to do with the joints. Using diuretic medication may also be the cause, as the sodium balance in the body is disturbed. The potassium level becomes too low and contractions occur. This problem can be avoided by eating bananas, mushrooms and strawberries. The contractions may also be caused by restless legs, but then there is magnesium deficit.
 Lecture of Prof Duprez concerning cardiovascular diseases in chronic connective tissue diseases.
Back to Articles
|