Abstract Takotsubo cardiomyopathy is one of the acquired cardiomyopathies which occurs due to physical or emotional stress. Its most common manifestations are chest pain, dyspnea but may be accompanied with myalgia, abdominal symptoms, palpitations syncope or presyncope. These symptoms can vary from mild to severe forms. It mimics myocardial infarction as greater than 80% of patients with takotsubo cardiomyopathy have ST segment elevation on electrocardiogram, followed by diffuse deep T-wave inversion and QT prolongation. Ventriculography often shows transient hypo kinesis of left ventricular apex but cardiac catheterization shows no coronary artery disease and it resolves completely within days to weeks. Electrocardiographic and echocardiographic disturbances are seen with reduced LVEF and normal angiography. In this report, we present a case of 67 years old lady who was scheduled for right breast lumpectomy and underwent stress cardiomyopathy due to anesthesia effects. Case description will further illustrate the patient, procedure and anesthetic management.
New Recommendations: The American Academy of Pediatrics released its now aging circumcision policy statement on March 1, 1999. The AAP withdrew its previous recommendation for neonatal circumcision but stated that, if a circumcision is to be done, analgesia should be used. The AAP says the ring block method is the most effective. Furthermore the AAP states that all methods reduce but do not eliminate pain. CIRP has more information about the last AAP statement . The Council on Scientific Affairs of the American Medical Association calls for parents to be given very full information on non-circumcision, circumcision, and especially about pain and pain control so that parents may make informed choices about circumcision and the use of pain control if a boy is to be circumcised. 93
Excela Health School of Anesthesia is a graduate level institution that provides education in the art and science of nurse anesthesia. Our primary goal is to provide students with the knowledge and skills needed to develop as competent and safe quality anesthesia practitioners. We strive to assimilate new members into our profession through mentoring, serving as role models. We seek to provide quality experiences that enhance the learning experience through clinical hours as well as simulation experiences. We strive to produce the highest quality professionals to serve as future generations of nurse anesthetists.