cardiovascular-agents and Neuromuscular-Diseases

Cardiovascular complications are common and varied in neuromuscular diseases. Knowledge of the complications specific to each disease is essential for appropriate screening for cardiovascular disease. Appropriate treatment of complications varies between neuromuscular diseases and draws primarily on experience from patients without neuromuscular disease. This article details the known cardiovascular complications and treatments for some of the major neuromuscular diseases.

Topics: Cardiovascular Agents; Cardiovascular Diseases; Echocardiography; Electrocardiography; Humans; Neuromuscular Diseases; Oxygen Inhalation Therapy; Physical and Rehabilitation Medicine

There is a fascinating and exceedingly important area of medicine that most of us have not been exposed to at any level of our medical training. This relatively new area is termed chronobiology; that is, how time-related events shape our daily biologic responses and apply to any aspect of medicine with regard to altering pathophysiology and treatment response. For example, normally occurring circadian (daily cycles, approximately 24 hours) events, such as nadirs in epinephrine and cortisol levels that occur in the body around 10 PM to 4 AM and elevated histamine and other mediator levels that occur between midnight and 4 AM, play a major role in the worsening of asthma during the night. In fact, this nocturnal exacerbation occurs in the majority of asthmatic patients. Because all biologic functions, including those of cells, organs, and the entire body, have circadian, ultradian (less than 22 hours), or infradian (greater than 26 hours) rhythms, understanding the pathophysiology and treatment of disease needs to be viewed with these changes in mind. Biologic rhythms are ingrained, and although they can be changed over time by changing the wake-sleep cycle, these alterations occur over days. However, sleep itself can adversely affect the pathophysiology of disease. The non-light/dark influence of biologic rhythms was first described in 1729 by the French astronomer Jean-Jacques de Mairan. Previously, it was presumed that the small red flowers of the plant Kalanchoe bloss feldiuna opened in the day because of the sunlight and closed at night because of the darkness. When de Mairan placed the plant in total darkness, the opening and closing of the flowers still occurred on its intrinsic circadian basis. It is intriguing to think about how the time of day governs the pathophysiology of disease. On awakening in the morning, heart rate and blood pressure briskly increase, as do platelet aggregability and other clotting factors. This can be linked to the acrophase (peak event) of heart attacks. During the afternoon we hit our best mental and physical performance, which explains why most of us state that "I am not a morning person." Even the tolerance for alcohol varies over the 24-hour cycle, with best tolerance around 5 pm (i.e. "Doctor, I only have a couple of highballs before dinner"). Thus, all biologic functions, from those of the cell, the tissue, the organs, and the entire body, run on a cycle of altering activity and function.(ABSTRACT TRUNCATED AT 400 W

Topics: Arthritis; Autonomic Nervous System Diseases; Cardiovascular Agents; Cardiovascular Diseases; Chronobiology Phenomena; Circadian Rhythm; Endocrine System Diseases; Female; Gastrointestinal Diseases; Hematologic Diseases; Humans; Hypersensitivity; Kidney Diseases; Male; Nervous System Diseases; Neuromuscular Diseases; Phototherapy; Respiratory Physiological Phenomena; Respiratory Tract Diseases; Sleep; Sleep Apnea Syndromes

Topics: Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Anticonvulsants; Antineoplastic Agents; Autonomic Nervous System Diseases; Cardiovascular Agents; Cranial Nerve Diseases; Environmental Pollutants; Humans; Nerve Degeneration; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nerves; Polyneuropathies; Psychotropic Drugs; Risk; Sensation

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Neurology; Neuromuscular Diseases

Topics: Cardiovascular Agents; Dihydro-beta-Erythroidine; Humans; Muscle Relaxants, Central; Neuromuscular Blockade; Neuromuscular Diseases

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Neuromuscular Blockade; Neuromuscular Diseases; Neuromuscular Junction

Topics: Animals; Carbon Dioxide; Cardiovascular Agents; Cats; Humans; Muscle Relaxants, Central; Neuromuscular Blockade; Neuromuscular Diseases; Neuromuscular Junction

Topics: Cardiovascular Agents; Muscle Relaxants, Central; Musculoskeletal Diseases; Neuromuscular Diseases; Thiamine

Topics: Cardiovascular Agents; Humans; Muscle Relaxants, Central; Neuromuscular Blockade; Neuromuscular Diseases