What acid-base abnormalities are seen in congestive heart failure?

Respiratory alkalosis (due to hyperventilation from hypoxemia)

Metabolic acidosis (poor tissue perfusion resulting in anaerobic metabolism

Metabolic alkalosis (excessive diuretic use and hypovolemia)

Respiratory acidosis (rare except in severe congestive heart failure, when after prolonged hyperventilation, there is respiratory muscle fatigue and elevation of PCOz

In acromegaly, what associated cardiac diseases may be seen?

Coexisting cardiovascular diseases are common in acromegaly and are the most common cause of death in untreated acromegalic individuals. Evidence for cardiac enlargement, hypertrophy, diastolic filling abnormalities, congestive heart failure, arrhythmias, myocardiopathy, arterial hypertension, aortic and mitral valve disease, and advanced atherosclerotic diseases (including coronary artery disease) are seen. Diabetes mellitus with associated hyperinsulinism contributes to the increased atherosclerotic occurrence, morbidity, and mortality.

What hemodynamic changes are seen in hyperthyroidism?

Patients with hyperthyroidism have a high cardiac output state, characterized by increased stroke volume and increased pulse rate. There is a decreased peripheral vascular resistance, increased blood volume, increased pulse pressure, and a hyperdynamic precordium, resulting from increasing cardiac contractility.

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