Peripheral nervous system

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Brugada Syndrome?

💡 Overview
Brugada Syndrome is a genetic disorder affecting the heart's electrical system.
It increases the risk of sudden cardiac death due to arrhythmias.
It often presents without any structural abnormalities in the heart.

🧬 Genetic Basis
The syndrome is primarily linked to mutations in the SCN5A gene.
This gene is responsible for the sodium channels in heart cells.
Mutations impair the flow of sodium ions, leading to abnormal electrical signals.

⚡ Symptoms
Many individuals with Brugada Syndrome are asymptomatic.
Symptoms, if present, include fainting, seizures, or sudden cardiac arrest.
These episodes often occur during sleep or at rest.

🔍 Diagnosis
Diagnosis is made through an electrocardiogram (ECG) showing characteristic patterns.
These patterns may not always be present, requiring additional testing.
Genetic testing can also confirm the diagnosis.

💊 Management
The primary treatment is the implantation of a cardioverter-defibrillator (ICD).
Lifestyle modifications, such as avoiding fever and certain medications, are important.
Antiarrhythmic drugs may be used in some cases.

🏃 Prognosis
With proper management, many patients can lead normal lives.
However, there is a lifelong risk of cardiac events, especially without an ICD.

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Resistant Hypertension?

💡 Definition
Resistant hypertension is high blood pressure that remains uncontrolled despite the use of at least three antihypertensive medications at optimal doses.
One of these medications should be a diuretic.

🔍 Causes
Primary causes can include poor medication adherence, suboptimal treatment, or secondary causes like obstructive sleep apnea.
Lifestyle factors like excessive salt intake or obesity can also contribute.

📊 Diagnosis
To diagnose resistant hypertension, healthcare providers must rule out pseudoresistance.
This involves checking for white coat hypertension, incorrect blood pressure measurements, or poor medication adherence.

💊 Treatment
Treatment includes optimizing the current medication regimen.
Adding a mineralocorticoid receptor antagonist (like spironolactone) may help.
Lifestyle changes such as weight loss, reduced salt intake, and regular physical activity are essential.

⚠️ Secondary Hypertension
Common causes of secondary hypertension include chronic kidney disease, primary aldosteronism, and thyroid disorders.
Addressing the underlying cause is crucial in managing resistant hypertension.

📅 Monitoring
Frequent blood pressure monitoring is necessary to evaluate the effectiveness of treatment.
Ambulatory or home blood pressure monitoring can provide a more accurate assessment than clinic readings.

🧠 Complications
If left untreated, resistant hypertension can lead to serious complications such as stroke, heart attack, and kidney failure.
Early and effective management is vital to prevent these outcomes.

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Dr ELSAYED ELMURR,MD

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