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Brief observation| Volume 118, ISSUE 5, P548-551, May 2005

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Anemia and ischemia: Myocardial injury in patients with gastrointestinal bleeding

DOI:https://doi.org/10.1016/j.amjmed.2005.01.026
Anemia and ischemia: Myocardial injury in patients with gastrointestinal bleeding
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      Acute gastrointestinal bleeding can produce hypovolemia, hypotension, and diminished oxygen-carrying capacity, causing myocardial ischemia and necrosis. Activation of the sympathetic nervous system can further increase myocardial oxygen demand and worsen ischemia. These processes would be expected to be most important in patients with obstructive coronary artery disease, a group that is also at risk for gastrointestinal bleeding.
      • Bhatti N.
      • Amoateng-Adjepongg Y.
      • Qamar A.
      • Manthous C.A.
      Myocardial infarction in critically ill patients presenting with gastrointestinal hemorrhage retrospective analysis of risks and outcomes.
      Chest. 1998; 114: 1137-1142
      , 
      • Emenike E.
      • Srivastava S.
      • Amoateng-Adjepongg Y.
      • et al.
      Myocardial infarction complicating gastrointestinal hemorrhage.
      Mayo Clin Proc. 1999; 74: 235-241
      Studies examining the relationship between gastrointestinal bleeding and myocardial ischemia suggest that the prevalence of acute myocardial infarction in patients with gastrointestinal hemorrhage ranges from 1 to 14%.
      • Bhatti N.
      • Amoateng-Adjepongg Y.
      • Qamar A.
      • Manthous C.A.
      Myocardial infarction in critically ill patients presenting with gastrointestinal hemorrhage retrospective analysis of risks and outcomes.
      Chest. 1998; 114: 1137-1142
      , 
      • Emenike E.
      • Srivastava S.
      • Amoateng-Adjepongg Y.
      • et al.
      Myocardial infarction complicating gastrointestinal hemorrhage.
      Mayo Clin Proc. 1999; 74: 235-241
      , 
      • Cappell M.S.
      A study of the syndrome of simultaneous acute upper gastrointestinal bleeding and myocardial infarction in 36 patients.
      Am J Gastroenterol. 1995; 90: 1444-1449
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      DOI: https://doi.org/10.1016/j.amjmed.2005.01.026

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      © 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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