Circulatory Health magazine

More documents

Recommendations

Info

It is Tuesday morning, 7:45 a.m. Nicolasa enters through the revolving door of the UMC Utrecht, together with her daughter-in-law Sharine. She's fifteen minutes late. "Traffic jam", she explains, "everything was deadlocked" and despite her cane she hurries to the Internal Medicine outpatient department. Sometimes she grimaces with pain, because she has had a blood pressure monitor around her arm for 24 hours, which still continues to pump up tightly. "I hardly slept because of it. It's great that it comes off soon." "It started with a headache and pain in my neck every day," Nicolasa remembers. "High blood pressure, my family doctor told me. I received medication, but my blood pressure remained at 170/100. Far too high. And after my accident, it got much higher still. I took six different drugs. Eventually, I was referred to the outpatient clinic for complicated hypertension." As Nicolasa was eligible for the comprehensive screening program, she first had to cut back her medication, to ensure untainted research results. Nicolasa: "On April 10, I had my first major medical, which looked at risk factors. This was called SMART. My blood and urine were tested, my waist and hip circumference were measured, an abdominal ultrasound was done, and an ECG. Today is the second major examination. For this, I had to start a 24-hour blood pressure measurement yesterday, and I also collected my urine over these 24 hours." Upon arrival at the outpatient department, she is greeted by nurse Marieke Pol, who helps her to her bed. "This study looks at the possibility of a hormonal disorder in the adrenal glands," Marieke explains to Nicolasa. "Or whether your adrenal glands produce too much of the hormone Aldosteron. This hormone regulates the salt and water metabolism in the body, and, as such, blood pressure. To measure this, you will be administered a total of two liters of saline solution through a drip. We will take blood samples and measure your blood pressure at specific intervals. Because Aldosteron is normally always produced when you move, we must take the measurements at rest. This means you will have to stay in bed for four hours." But first, Nicolasa has to take a 15-minute walk. "Immediately afterward, we will take a blood sample and measure your blood 8 Circulatory Health Magazine
pressure after this light exercise," says Marieke. The 24-hour sphygmomanometer finally comes off, and a drip needle is inserted. Nicolasa walks to the outpatient laboratory, where she hands in her urine sample and continues to the vascular medicine outpatient clinic to hand in the sphygmomanometer. Plus the log that she filled in yesterday, so that all blood pressures can be linked to her activity level. Back in the outpatient department, Nicolasa sits down on the edge of the bed. First, the blood pressure in her right arm is measured: 181/107. Marieke asks Nicolasa whether she recognizes this result. "Yes, that's normal," she whispers. Measuring the other arm hurts. And the cuff keeps pumping up. "That means the blood pressure is very high and it is automatically measured again," explains Marieke. She's right, the blood pressure peaks at 228/138. Marieke wants to take a blood sample through an IV needle, but that does not work. "We will take a separate sample." This, too, is not easy. "This often happens," says Marieke, "the blood vessels of people with high blood pressure are tougher and more difficult to prick." But Marieke is skillful and it's soon over, leaving Nicolasa to heave a sigh of relief. After this first blood pressure measurement and blood sampling, the saline solution in Nicolasa's IV is administered. She lies down for the next four hours. After a few weeks, all outcomes will be discussed with her. Circulatory Health Magazine 9
Page 1 and 2: Circulatory Health Magazine "I've n
Page 3 and 4: Contents 06 Promising research into
Page 5 and 6: Our heart's desire is… ...to give
Page 7: Nicolasa follows a comprehensive sc
Page 11 and 12: Heart-on-a-chip Willem Suyker, depa
Page 13 and 14: Social worker The social worker vis
Page 15 and 16: Flu? "Five years ago, I caught a ba
Page 17 and 18: after the professor who developed t
Page 19 and 20: Blood vessels An adult has 5 to 6 l
Page 21 and 22: Wealth of data in Utrecht Cardiovas
Page 23 and 24: "Not just for myself but for everyo
Page 25 and 26: UMC Utrecht discovers treatment for
Page 27 and 28: "How are you doing?," asks Gert Jan
Page 29 and 30: Elective programs for students Juli
Page 31 and 32: Four women talk about their heart "
Page 33 and 34: Forty-kilometer tandem ride for res
Page 35 and 36: ‘Combining forces’ "The strateg
Page 37 and 38: Senior university lecturer Kerstin
Page 39 and 40: Did you know that the cells in our
Page 41 and 42: "This is the healthcare of the futu
Page 43 and 44: A patch against a stroke? Every yea
Page 45 and 46: Clinical epidemiologist Ale Algra i
Page 47 and 48: U-Prevent Smart website about custo
Page 49 and 50: Imaging of heart failure Faster, mo
Page 51 and 52: Colophon Publication 2018 PUBLISHED

Circulatory Health magazine

Create successful ePaper yourself

Delete template?

Save as template?