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Pain Management 2019 & Internal Medicine 2019 International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X Page 34
JOINT EVENT
7th Edition of International Conference on
Pain Management
8th Edition of International Conference on
Internal Medicine &
Patient Care
&
March 25-26, 2019
Rome, Italy
Cardio renal syndrome: Case presentation
Katerina Ristoska
PZU Sistina Nefroplus, Macedonia
Background: Cardio renal syndrome (CRS) isused todescribe
clinical conditions in which cardial and renal dysfunction
co-exist. First were classified in 2008 and divided into
five subtypes. Its pathogenesis is not fully understood.
Additionally available therapeutic strategies are challenged
to manage this syndrome.
Case presentation: We report the case of 60-year-old diabetic
man, hypertronic, with adipositas permagna, previous
myocardial infarction (1998), LVH and diastolic dysfunction,
with implanted St. Jude’s prosthesis and the aneurysm of
ascending aorta. In 2013, he was diagnosed with bilateral
renal cysts, with a worsening of renal function, which was
characterized as chronic renal failure stage three (GFR39mL/
minaccording toMDRD formula), withalbuminuriaof 90mg/L
and an increased quotient albumin/creatinine of 164mg/dL.
Same year, after Enterococcus faecalis bacteremia, without
the development of endocarditis, he develop atrial thrombus,
which is resumed by conservative treatment. Due to the
development of Stanford B aortic dissection and aneurysmal
endoleak, with the tendency of aneurysm growth, was
performed the stenting with prosthesis of the thoraco-
abdominal transitionof theaortaandof truncuscoeliacus. He
is suffering from restrictive, moderate peripheral obstructive
ventilatory insufficiency, with the development of respiratory
acidosis, dependent on oxygen therapy and CPAPmask (SAP
syndrome). Infectiously affected by gastroenteritis and right-
side pneumonia he developed an acute decompensation
of chronic renal failure, with a worsening of heart failure,
develops pulmonary edema, with an increase in degradation
products, and commences hemodialysis three times a week.
In December 2016, during dialysis he developed VF with a
state of unconsciousness, which was treated with CPR with
electro shock therapy. After that he developed bradycardia,
AF and AV block third degree, therefore AICD was implanted.
In December 2017 he was diagnosed that stentprothese in
the thoracolumbar junction with supply of the celiac trunk
via a stent with a retrograde restoration of the truncus was
compromited and developed new atrial thrombus.
Conclusion: Since renal function is the singlemost important
factor in the outcomes of patents with heart failure,
the importance of early recognition, after adjusting the
differences in baseline data, etiology and severity of disease,
asmuch of early therapeutic strategy have impact of long life
outcomes.
Biography
Katerina Ristoska has completed her Graduation in Medical
Faculty, Skopje, Republic of Macedonia, where she also attend-
ed her specialization in internal medicine. Currently, she is the
Author and Coauthor of 57 publications at the international
congresses at home and abroad, as same in the several other
journals. She was Contributor on two multi-centric studies of
pharmaceutical company “Krka-Farma” DOOEL Skopje. She is
a Fellow of New Westminster College, Vancouver, British Co-
lumbia, Canada; Member of The Macedonian Association of
internal medicine, ESC, EAPCI, HFA, EACVI, EAPC and ACCA;
Member of ESC Council on Cardiovascular Nursing and Al-
lied Professions, ESC Council on Hypertension, ESC Council
on Valvular Heart Disease, the Member of Working Group on
Grown-up Congenital Heart Disease, the Member of Working
Group on Aorta & Peripheral vascular disease; Member of
ERA–EDTA Diabesity Group, ERA– EDTA EUREKA -MWorking
Group of European renal and Cardiovascular medicine, ERA -
EDTA CKD- MBD Working Group and an Accredited Examiner
of a doctor’s professional exam for obtaining a work license
and Editor-In-Chief in the International Journal of Medicine and
Healthcare and Section Editor in the Interdisciplinary Studies,
for Healthcare in International Journal Anglisticum.
Katerina Ristoska, Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-005