The circadian effects on major cardiovascular and cerebrovascular diseases result in increased vulnerability to myocardial ischemia, cerebral ischemia, and myocardial dysfunction during the early hours of the morning after awakening and rising. asthma inhalers
A comprehensive approach to treatment in patients with cardiovascular disorders must take into consideration the chronobiology of the cardiovascular system and its relevance to the underlying disease process that affects the cardiovascular system. The interaction between endogenous and exogenous daily rhythms can moderate cardiovascular morbidity and mortality. The capacity to adapt to temporal changes in the environment may well be a factor in the survival of the species.
This is the second of a two-part series, in which a third case is presented to permit elaboration on additional aspects of circadian influence in cardiovascular disease.
A 53-year-old banker was brought to the emergency room after experiencing a syncopal episode during an early morning meeting at his office. At the scene fire rescue personnel found the patient alert and lying on the floor. He complained of light-headedness and a burning sensation in the epigastrium. Vital signs by paramedics revealed a regular heart rate of 40 beats/minute, blood pressure of 85/65 mm Hg, and respirations of 16/minute. His skin was clammy, the lung fields were clear. Examination of the heart revealed an S, variable in intensity and no heart murmurs.
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