Baroreflex Dysfunction

Baroreflexes play both an adaptive and a homeostatic role, maintaining blood pressure, heart rate, and blood volume within the normal range. Defects in baroreflexes have diverse manifestations and causes. The assessment and management of baroreflex dysfunction are reviewed.

Cytokinesis, Beta-Blockers, and Congenital Heart Disease

Cardiomyocytes in persons with tetralogy of Fallot and pulmonary stenosis have activated beta-adrenergic–receptor signaling. A recent study in human cells and in mice suggests that administration of beta-blockers represents an experimental strategy for the treatment of infants and children with tetralogy of Fallot.

Skin Discoloration from Amiodarone

An 81-year-old man with atrial fibrillation who was being treated with amiodarone presented to the ED after a fall. Physical examination revealed blue and gray discoloration of his nose, cheeks, and forehead. This discoloration is associated with amiodarone.

Treating Addiction as a Terminal Disease

Ms. A. had a history of opioid use longer than her adulthood and had been through inpatient rehabilitation, methadone maintenance, and buprenorphine treatment programs without lasting success. Now she had endocarditis, and she wanted only to be discharged to hospice.