atrial-natriuretic-factor and Aortic-Dissection

A 49-year-old man had sudden chest pain and paralysis of the lower right limb. An acute aortic dissection was diagnosed in a computed tomography scan and the patient underwent an emergency operation. After the operation, myonephropathic metabolic syndrome developed, and human atrial natriuretic peptide was administered for 11 days until the volume of daily urine output reached at least 10,000 mL, which would facilitate limb salvage and the preservation of life without hemodialysis. This report documents that postoperative myonephropathic metabolic syndrome improved due to the strong diuretic action of human atrial natriuretic peptide without hemodialysis.

Topics: Acute Disease; Aortic Aneurysm, Thoracic; Aortic Dissection; Atrial Natriuretic Factor; Blood Vessel Prosthesis Implantation; Dose-Response Relationship, Drug; Follow-Up Studies; Humans; Infusions, Intravenous; Male; Metabolic Diseases; Middle Aged; Postoperative Complications; Radiography; Rhabdomyolysis; Syndrome

An 84-year-old woman was hospitalized in hemodynamic shock due to type A acute aortic dissection (AAD) complicated by pulseless tamponade. She was treated conservatively as her family refused emergency surgery. In spite of warning her family that lack of intervention may possibly lead to an early death, she gradually improved and went home without any further problems. Emergency surgery for octogenarians remains controversial, however. We report the first surviving, non-operative case of an octogenarian with pulseless shock due to aortic dissection.

Topics: Aged, 80 and over; Aortic Aneurysm; Aortic Dissection; Atrial Natriuretic Factor; Cardiac Tamponade; Cardiotonic Agents; Diuretics; Dopamine; Female; Humans; Norepinephrine; Pulse; Tomography, X-Ray Computed; Treatment Outcome; Treatment Refusal