Heart failure congestive heart failure, or CHF
|
|
- Iris Dawson
- 6 years ago
- Views:
Transcription
1 Heart failure Heart failure (also called congestive heart failure, or CHF) is a frequent end point of many of the conditions In the United States alone, CHF affects nearly 5 million individuals annually, necessitating >1 million hospitalizations, and contributes to death of 300,000 patients a year.
2 Most heart failure is the consequence of systolic dysfunction, the progressive deterioration of myocardial contractile function.
3 Causes of CHF 1-ischemic heart disease 2-hypertension. -in 20% to 50% of patients the heart contracts normally but relaxation is abnormal ("diastolic" failure ). -the patients with "diastolic" failure are generally older and more likely to be female with hypertension or diabetes mellitus.
4 3-valve failure (e.g., endocarditis) 4-normal hearts suddenly burdened with an abnormal load (e.g., fluid or pressure overload). 5-acute blood loss
5 As a compansation the heart dilates the ventricular wall tension increases which increases the oxygen requirements of an already compromised myocardium.
6 With time, the failing myocardium is no longer able to propel sufficient blood to meet the needs of the body, even at rest. At this point, patients enter a phase termed decompensated heart failure
7 Types of Heart failure: 1- predominantly the left side 2- predominantly the right side 3- both sides of the heart.
8 The most common causes of left-sided cardiac failure are: (1) IHD (ischemic heart disease) (2) systemic hypertension (3) mitral or aortic valve disease (4) primary diseases of the myocardium.
9 The most common cause of right-sided heart failure is: 1-left ventricular failure, with its associated pulmonary congestion and elevation in pulmonary arterial pressure. 2-Right-sided failure can also occur in the absence of left-sided heart failure in patients with intrinsic diseases of the lung parenchyma and/or pulmonary vasculature (cor pulmonale)
10 cor pulmonale can be caused by : a. primary pulmonic or tricuspid valve disease. b. congenital heart diseases, i.e., left-toright shunts
11 Clinical manifestations Left-Sided Heart Failure 1-Dyspnea (breathlessness) is usually the earliest and most significant complaint of patients in left-sided heart failure; 2-cough is also a common accompaniment of left heart failure due to fluid transudation into airspaces.
12 3-orthopnea (dyspnea when recumbent) -This occurs because of increased venous return from the lower extremities and by elevation of the diaphragm when in the supine position. -Orthopnea is typically relieved by sitting or standing, so that such patients usually sleep while sitting upright.
13 4-Paroxysmal nocturnal dyspnea is a particularly dramatic form of breathlessness awakening patients from sleep with attacks of extreme dyspnea bordering on suffocation.
14 5-cardiomegaly (enlarged heart ) 6-tachycardia (increase heart rate ) 7-third heart sound (S3), and fine rales at the lung bases, produced by respirations through edematous pulmonary alveoli.
15 8-mitral regurgitation and a systolic murmur. 9-atrial fibrillation irregular heartbeat.
16 Clinical manifestations Right-Sided Heart Failure 1-systemic and portal venous congestion 2-hepatic and splenic enlargement 3-peripheral edema 4-pleural effusion 5-ascites 6-cyanosis and acidosis
17 ISCHEMIC HEART DISEASE (IHD) IHD is also frequently called coronary artery disease (CAD) IHD is a generic designation for a group of related syndromes resulting from myocardial ischemiaan imbalance between cardiac blood supply (perfusion) and myocardial oxygen demand.
18 ischemia can result from: 1- increased demand (e.g., tachycardia or hypertension 2- diminished oxygen-carrying capacity (e.g., anemia, carbon monoxide poisoning), 3- reduction in coronary blood flow caused by obstructive atherosclerotic disease
19 There are four basic clinical syndromes of IHD: 1-Angina pectoris the ischemia causes pain but is insufficient to lead to death of myocardium
20 Types of angina : 1-stable angina (occurring reliably after certain levels of exertion) 2-variant angina or Prinzmetal angina ( due to vessel spasm ) 3-Unstable angina occurring with progressively less exertion or even at rest.
21 2-Acute myocardial infarction (MI) the severity or duration of ischemia is enough to cause cardiac muscle death 3-Chronic IHD progressive cardiac decompensation (heart failure) following MI 4-Sudden cardiac death (SCD) can result from a lethal arrhythmia following myocardial ischemia.
22 Epidemiology Nearly 500,000 Americans die of IHD annually After peaking in 1963, the overall death rate from IHD has fallen in the United States by approximately 50%. The decline can be attributed largely to the recognition of cardiac risk factors.
23 Risk factors: 1- smoking. 2- hypertension 3- diabetes. 4- lowering cholesterol levels.
24 Pathogenesis atherosclerotic occlusion of coronary arteries and new superimposed thrombosis and/or vasospasm
25
26 -lesion obstructing 70% to 75% or more of a vessel lumen-so-called critical stenosis angina only in the setting of increased demand -a fixed 90% stenosis can lead to inadequate coronary blood flow even at rest.
27 - Chronic coronary occlusion when a coronary artery develops atherosclerotic occlusion at a sufficiently slow rate, it may be able to stimulate collateral blood flow from other major epicardial vessels protection against MI even in the setting of a complete vascular occlusion. - acute coronary occlusions cannot spontaneously recruit collateral flow and will result in infarction
28 Clinical Features 1-severe, crushing substernal chest pain 2- discomfort that can radiate to the neck, jaw, epigastrium, or left arm. In contrast to the pain of angina pectoris, the pain of an MI typically lasts from 20 minutes to several hours and is not significantly relieved by nitroglycerin or rest.
29 3- MIs can be entirely asymptomatic in 10% to 15% of the cases (silent infarcts).
30 "silent" infarcts are particularly common in patients with: 1- underlying diabetes mellitus (with peripheral neuropathies) 2- in the elderly.
31 4- the pulse is generally rapid and weak 5- patients can be diaphoretic and nauseated particularly with posteriorwall MIs. 6- dyspnea is common and is caused by impaired myocardial contractility and dysfunction of the mitral valve apparatus, with resultant pulmonary congestion and edema.
32 7-With massive MIs (>40% of the left ventricle) cardiogenic shock develops.
33 Angina Pectoris Angina pectoris is intermittent chest pain caused by transient, reversible myocardial ischemia. There are three variants: 1-Typical or stable angina -is episodic chest pain associated with exertion or some other form of increased myocardial oxygen demand (e.g., tachycardia or hypertension due to fever, anxiety, fear). -the pain is classically described as a crushing or squeezing substernal sensation, -the pain can radiate down the left arm or to the left jaw (referred pain).
34 - Stable angina pectoris is usually associated with a fixed atherosclerotic narrowing ( 75%) of one or more coronary arteries. - With this degree of critical stenosis, the myocardial oxygen supply may be sufficient under basal conditions but cannot be adequately augmented to meet any increased requirements
35 - The pain is usually relieved by rest (reducing demand) or by administering agents such as nitroglycerin; - such drugs cause peripheral vasodilation and thus reduce venous blood delivered to the heart reducing cardiac work. - in larger doses, nitroglycerin also increases blood supply to the myocardium by direct coronary vasodilation
36 2-Prinzmetal, or variant angina Is angina occurring at rest due to coronary artery spasm. Although such spasms typically occur on or near an existing atherosclerotic plaque, completely normal vessels can be affected. The etiology is not clear. Prinzmetal angina typically responds promptly to the administration of vasodilators such as nitroglycerin or calcium channel blockers.
37 3-Unstable angina (also called crescendo angina) - is characterized by increasing frequency of pain, precipitated by progressively less exertion. - the episodes also tend to be more intense and longer lasting than stable angina. - unstable angina is associated with plaque disruption and superimposed partial thrombosis, distal embolization of the thrombus, and/or vasospasm.
38 - Unstable angina is the harbinger of more serious, potentially irreversible ischemia (due to complete luminal occlusion by thrombus) and is therefore sometimes called pre-infarction angina.
39 Myocardial Infarction MI, popularly called heart attack, is necrosis of heart muscle resulting from ischemia. Roughly 1.5 million people in the United States suffer an MI every year % die-half before they can reach the hospital. Lethal arrhythmia Sudden Cardiac Death Arrhythmias are caused by electrical abnormalities of the ischemic myocardium and conduction system.
40 The major underlying cause of IHD is atherosclerosis and therefore the frequency of MIs rises progressively with increasing age and presence of other risk factors such as hypertension, smoking, and diabetes
41 Acute occlusion of the proximal left anterior descending (LAD) artery is the cause of 40-50% of all MIs and typically results in infarction of the anterior wall of the left ventricle, the anterior 2/3 of the ventricular septum, and most of the heart apex
42 Approximately 10% of MIs occur in people younger than 40 years. 45% occur in people younger than age 65.
43 Blacks and whites are equally affected. Men are at significantly greater risk than women, although the gap progressively narrows with age. In general, women are remarkably protected against MI during their reproductive years. Nevertheless, menopause and declining estrogen production- is associated with exacerbation of coronary atherosclerosis
44 Electrocardiographic(ECG) abnormalities are important markers of MIs; these include 1-changes such as Q waves (indicating transmural infarcts), 2- ST-segment abnormalities 3-T-wave inversion (representing abnormalities in myocardial repolarization). 4-Arrhythmias caused by electrical abnormalities of the ischemic myocardium and conduction system are common, and indeed, SCD due to a lethal arrhythmia accounts for the vast majority of deaths occurring before hospitalization
45 Laboratory evaluation of MI is based on measuring the blood levels of intracellular macromolecules that leak out of injured myocardial cells through damaged cell membranes. these molecules include : 1-myoglobin. 2-cardiac troponins T and I (TnT, TnI), 3-creatine kinase (CK, and more specifically the myocardial-specific isoform, CK-MB), 4- lactate dehydrogenase, and many others.
46 Cardiac troponins T and I (TnT, TnI), are the best markers for acute MI. persistence of elevated troponin levels for approximately 10 days allows the diagnosis of acute MI long after CK-MB levels have returned to normal. TnI and TnT are not normally detectable in the circulation. After acute MI both troponins become detectable after 2 to 4 hours and peak at 48 hours. The level remains elevated for 7 to 10 days.
47 CK-MB is the second best marker after the cardiac-specific troponins. Since various forms of CK are found in brain, myocardium, and skeletal muscle, total CK activity is not a reliable marker of cardiac injury (i.e. it could come from skeletal muscle injury).
48 CK-MB isoform-principally derived from myocardium but also present at low levels in skeletal muscle is the more specific indicator of heart damage. CK-MB activity begins to rise within 2-4 hours of MI, peaks at hours, and returns to normal within approximately 72 hours.
49 cardiac troponin and CK-MB are equally sensitive at early stages of an MI. persistence of elevated troponin levels for approximately 10 days allows the diagnosis of acute MI long after CK-MB levels have returned to normal. With reperfusion, both troponin and CK-MB peaks occur earlier as a result of washout of the enzyme from the necrotic tissue.
50 Morphology 1- (<24 hr) coagulative necrosis and wavy fibers. Necrotic cells are separated by edema fluid. 2- (2-3-day) -old infarct Dense neutrophilic infiltrate 3- (7-10 days) complete removal of necrotic myocytes by phagocytic macrophages
51 4- up to 14 days Granulation tissue characterized by loose connective tissue and abundant capillaries. 5- several weeks Healed myocardial infarct consisting of a dense collagenous scar.
52 A-necrosis & edema B- dense neutrophilic infiltrate C-removal of necrotic myocutes D-granulation tissue formation E-collagenous scar
53 Consequences and Complications of MI 1-Unfortunately, 50% of the deaths associated with acute MI occur in individuals who never reach the hospital. patients generally die within 1 hour of symptom onset-usually as a result of arrhythmias.
54 Extraordinary progress has been made in patient outcomes subsequent to acute MI. Since the 1960s the in-hospital death rate has declined from approximately 30% to an overall rate of between 10% and 13%.
55 2- cardiogenic shock. occurs in 10-15% of patients after acute MI, generally with a large infarct (often >40% of the left ventricle). Cardiogenic shock has a nearly 70% mortality rate and accounts for two-thirds of in-hospital deaths.
56 3-Myocardial rupture 4-Pericarditis. 5-Infarct expansion 6-Ventricular aneurysm 7-Progressive late heart failure
57 Complications of myocardial rupture include: (1) rupture of the ventricular free wall, with hemopericardium and cardiac tamponade, which is usually fatal (2) rupture of the ventricular septum, leading to a new VSD and left-to-right shunt (3) papillary muscle rupture, resulting in severe mitral regurgitation
58 Rupture can occur at almost any time after MI but is most common 3 to 7 days after infarction. It is at this point in the healing process that lysis of the myocardial connective tissue is maximal and the granulation tissue has not deposited sufficient collagenous matrix to buttress the wall.
59 Risk factors for free-wall rupture include : 1-age older than 60 years 2-female gender 3-pre-existing hypertension
60 Factors that prevent rupture are: 1-lack of left ventricular hypertrophy 2-no previous MI (pre-existing scarring tends to prevent myocardial tearing).
61 4-Pericarditis. A fibrinous or hemorrhagic pericarditis usually develops within 2 to 3 days of a transmural MI and typically spontaneously resolves with time.
62 5-Infarct expansion. Because of the weakening of necrotic muscle, there may be disproportionate stretching, thinning, and dilation of the infarct region (especially with anteroseptal infarcts)
63 6-Mural thrombus. With any infarct, the combination of a local loss of contractility (causing stasis) with endocardial damage (causing a thrombogenic surface) can foster mural thrombosis and, potentially, thromboembolism
64 7-Ventricular aneurysm. A late complication, aneurysms of the ventricular wall most commonly result from a large transmural anteroseptal infarct that heals with the formation of thin scar tissue
65 Complications of ventricular aneurysms include : 1-mural thrombus 2-arrhythmias 3-heart failure
66 8-Papillary muscle dysfunction. dysfunction of a papillary muscle after MI occurs due to: 1- as a result of rupture. 2- postinfarct mitral regurgitation results from ischemic dysfunction of a papillary muscle and underlying myocardium 3- papillary muscle fibrosis and shortening 4- ventricular dilation.
67 9-Progressive late heart failure
68 Long-term prognosis after MI - depends on many factors: - 1- left ventricular function - 2- the severity of atherosclerotic narrowing of vessels perfusing the remaining viable myocardium.
69 Chronic Ischemic Heart Disease progressive heart failure as a consequence of ischemic myocardial damage. In most instances there is a history of MI. Chronic IHD usually results from postinfarction cardiac decompensation that follows exhaustion of the hypertrophy of the viable myocardium. In other cases severe obstructive CAD may be present without prior infarction, but with diffuse myocardial dysfunction.
70 Clinical Features : Chronic IHD is characterized by the development of severe, progressive heart failure, sometimes punctuated by episodes of angina or MI. Arrhythmias are common and, along with CHF
71 Sudden Cardiac Death (SCD) Affecting some 300,000 to 400,000 individuals annually in the United States, SCD is most commonly defined as unexpected death from cardiac causes either without symptoms or within 1 to 24 hours of symptom onset Coronary artery disease is the most common underlying cause In many adults SCD is the first clinical manifestation of IHD. With younger victims other nonatherosclerotic causes are more common:
72 Other causes 1-Congenital coronary arterial abnormalities 2-Aortic valve stenosis 3-Mitral valve prolapse 4-Myocarditis or sarcoidosis 5-Dilated or hypertrophic cardiomyopathy 5-Pulmonary hypertension 6-Hereditary or acquired abnormalities of the cardiac conduction system. 7-Isolated myocardial hypertrophy. 8-hypertensive 9-unknown cause.
Myocardial Infarction
Myocardial Infarction MI = heart attack Defined as necrosis of heart muscle resulting from ischemia. A very significant cause of death worldwide. of these deaths, 33% -50% die before they can reach the
More information1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI).
1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI). 5- cardiogenic shock (massive MIs >40% of the left ventricle)
More informationHeart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United
Heart disease remains the leading cause of morbidity and mortality in industrialized nations. It accounts for nearly 40% of all deaths in the United States, totaling about 750,000 individuals annually
More informationIschemic Heart Diseases. Dr. Nabila Hamdi MD, PhD
Ischemic Heart Diseases Dr. Nabila Hamdi MD, PhD ILOs Compare and contrast the different types of angina regarding their pathogenesis, clinical manifestations and evolution. Discuss myocardial infarct,
More informationMI Acute occlusion of the proximal left anterior descending (LAD) artery is the cause of 40% to 50% of all MIs. *
MI *33% -50% die before hospital lethal arrhythmia Sudden Cardiac Death. * Arrhythmias are caused by electrical abnormalities of the ischemic myocardium and conduction system. *Acute occlusion of the proximal
More informationIschemic heart disease
Ischemic heart disease Introduction In > 90% of cases: the cause is: reduced coronary blood flow secondary to: obstructive atherosclerotic vascular disease so most of the time it is called: coronary artery
More informationIschemic heart disease (IHD) Dr: Salah Ahmed
Ischemic heart disease (IHD) Dr: Salah Ahmed The coronaries: 1- Left anterior descending coronary artery: - supplies anterior portion of LV, anterior 2/3 of IVS - accounts for 40-50% of coronary artery
More informationIschemic Heart Disease
Ischemic Heart Disease Dr Rodney Itaki Lecturer Division of Pathology University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology General Consideration Results from partial
More informationCardiac Pathology 2: Heart Failure, Ischemic Heart Disease and other assorted stuff. Kris=ne Kra>s, M.D.
Cardiac Pathology 2: Heart Failure, Ischemic Heart Disease and other assorted stuff Kris=ne Kra>s, M.D. Cardiac Pathology Outline Blood Vessels Heart I Heart II Cardiac Pathology Outline Blood Vessels
More informationResults of Ischemic Heart Disease
Ischemic Heart Disease: Angina and Myocardial Infarction Ischemic heart disease; syndromes causing an imbalance between myocardial oxygen demand and supply (inadequate myocardial blood flow) related to
More informationPathophysiology of Cardiovascular System. Dr. Hemn Hassan Othman, PhD
Pathophysiology of Cardiovascular System Dr. Hemn Hassan Othman, PhD hemn.othman@univsul.edu.iq What is the circulatory system? The circulatory system carries blood and dissolved substances to and from
More informationChapter 14 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since.
1 2 3 4 5 Chapter 14 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since. Accounts for 1 of every 2.8 deaths Cardiovascular disease (CVD)
More informationCardiac Emergencies. A Review of Cardiac Compromise. Lawrence L. Lambert
Cardiac Emergencies A Review of Cardiac Compromise Lawrence L. Lambert 1 Cardiac Emergencies Objectives: Following successful completion of this training session, the student should be able to: 1. Describe
More informationCardiovascular Disorders Lecture 3 Coronar Artery Diseases
Cardiovascular Disorders Lecture 3 Coronar Artery Diseases By Prof. El Sayed Abdel Fattah Eid Lecturer of Internal Medicine Delta University Coronary Heart Diseases It is the leading cause of death in
More informationCardiac Pathology & Rehabilitation
Cardiac Pathology & Rehabilitation Which of the following best describes the physical activity performed in my leisure time? A. I perform vigorous physical activity 3X/week for 20 minutes each time B.
More informationCan be felt where an artery passes near the skin surface and over a
1 Chapter 14 Cardiovascular Emergencies 2 Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since. Accounts for 1 of every 2.8 deaths Cardiovascular disease (CVD) claimed
More informationCoronary Heart Disease. Raja Nursing Instructor RN, DCHN, Post RN. BSc.N
Coronary Heart Disease Raja Nursing Instructor RN, DCHN, Post RN. BSc.N 31/03/2016 Objectives Define coronary heart disease (CHD). Identify the causes and risk factors of CHD Discuss the pathophysiological
More informationSPECIAL PATHOPHYSIOLOGY CARDIO-VASCULAR SYSTEM
1. Myocardia lischemia is mainly a result of: 1.Coronary hypoxemia. 2. Coronary artery disease (CAD). 3. Acute coronaritis. 4. Coronary anemia. 5. Heart remodelling. SPECIAL PATHOPHYSIOLOGY CARDIO-VASCULAR
More information12 Lead EKG Chapter 4 Worksheet
Match the following using the word bank. 1. A form of arteriosclerosis in which the thickening and hardening of the vessels walls are caused by an accumulation of fatty deposits in the innermost lining
More informationBIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS. As. MARUSHCHAK M.I.
BIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS As. MARUSHCHAK M.I. Heart attack symptoms Acute MI Measurement of cardiac enzyme levels Measure cardiac enzyme levels at regular
More informationObjectives. Identify early signs and symptoms of Acute Coronary Syndrome Initiate proper protocol for ACS patient 10/2013 2
10/2013 1 Objectives Identify early signs and symptoms of Acute Coronary Syndrome Initiate proper protocol for ACS patient 10/2013 2 Purpose of this Education Module: Chest Pain Center Accreditation involves
More informationCommon Codes for ICD-10
Common Codes for ICD-10 Specialty: Cardiology *Always utilize more specific codes first. ABNORMALITIES OF HEART RHYTHM ICD-9-CM Codes: 427.81, 427.89, 785.0, 785.1, 785.3 R00.0 Tachycardia, unspecified
More informationHeart Disorders. Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8. Overview Heart Disorders Vascular Disorders
Cardiovascular Disorders (Part B-1) Module 5 -Chapter 8 Overview Heart Disorders Vascular Disorders Susie Turner, MD 1/7/13 Heart Disorders Coronary Artery Disease Cardiac Arrhythmias Congestive Heart
More informationChest Pain. Dr. Amitesh Aggarwal. Department of Medicine
Chest Pain Dr. Amitesh Aggarwal Department of Medicine BACKGROUND Approx 5% of all ED visits 15 % - AMI 25-30 % - Unstable angina 50-55 % - Other conditions Atypical presentations common 2% of patients
More informationPharmacology. Drugs affecting the Cardiovascular system (Antianginal Drugs)
Lecture 7 (year3) Dr Noor Al-Hasani Pharmacology University of Baghdad College of dentistry Drugs affecting the Cardiovascular system (Antianginal Drugs) Atherosclerotic disease of the coronary arteries,
More informationCORONARY ARTERY DISEASES
CORONARY ARTERY DISEASES It has been estimated that over one third of the population eventually will die of CAD, and 20% will develop symptoms when younger than age 60 years. ANATOMY OF THE CORONARY ARTERIES
More informationCor pulmonale. Dr hamid reza javadi
1 Cor pulmonale Dr hamid reza javadi 2 Definition Cor pulmonale ;pulmonary heart disease; is defined as dilation and hypertrophy of the right ventricle (RV) in response to diseases of the pulmonary vasculature
More informationImaging of Coronary Artery Disease: II
Acta Radiológica Portuguesa, Vol.XIX, nº 74, pág. 45-51, Abr.-Jun., 2007 Imaging of Coronary Artery Disease: II Jean Jeudy University of Maryland School of Medicine Department of Diagnostic Radiology Armed
More informationThe Cardiovascular System Part I: Heart Outline of class lecture After studying part I of this chapter you should be able to:
The Cardiovascular System Part I: Heart Outline of class lecture After studying part I of this chapter you should be able to: 1. Describe the functions of the heart 2. Describe the location of the heart,
More informationChapter 16 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since 1900.
1 2 3 4 5 6 Chapter 16 Cardiovascular Emergencies Cardiovascular Emergencies Cardiovascular disease has been leading killer of Americans since 1900. Accounts for of every 3 deaths Cardiovascular disease
More informationCardiovascular Disease
Cardiovascular Disease Session Guidelines This is a 15 minute webinar session for CNC physicians and staff CNC holds webinars on the 3 rd Wednesday of each month to address topics related to risk adjustment
More informationMYOCARDIALINFARCTION. By: Kendra Fischer
MYOCARDIALINFARCTION By: Kendra Fischer Outline Definition Epidemiology Clinical Aspects Treatment Effects of Exercise Exercise Testing Exercise Rx Summary and Conclusions References Break it down MYOCARDIAL
More informationCardiac Diseases. Dr.Sura Aldewachi Department of Pathology Ninavah College of Medicine
Cardiac Diseases Dr.Sura Aldewachi Department of Pathology Ninavah College of Medicine Heart Failure Heart failure generally is referred to as congestive heart failure (CHF). CHF is the common end point
More informationCardiovascular Disorders. Heart Disorders. Diagnostic Tests for CV Function. Bio 375. Pathophysiology
Cardiovascular Disorders Bio 375 Pathophysiology Heart Disorders Heart disease is ranked as a major cause of death in the U.S. Common heart diseases include: Congenital heart defects Hypertensive heart
More informationCardiology/Cardiothoracic
Cardiology/Cardiothoracic ICD-9-CM to ICD-10-CM Code Mapper 800-334-5724 www.contexomedia.com 2013 ICD-9-CM 272.0 Pure hypercholesterolemia 272.2 Mixed hyperlipidemia 272.4 Other and hyperlipidemia 278.00
More informationMyocardial infarction
CHAPTER-I CARDIOVASCULAR SYSTEM Myocardial infarction SUB: PHARMACOTHERAPEUTICS-I CODE:T0820006 Dr. Venugopal Pharm.D Assistant Professor Department of Pharm.D Kriahna Teja Pharmacy College,Tirupati. Definition
More informationAnatomy of the Heart and the. ICD-10 Codes
Anatomy of the Heart and the Diseases ICD-10 Codes Sharon J. Oliver CPC, CPMA, CPC-I All Rights Reserved 1 Anatomy of the Heart Pulmonary Tricuspid (AV) Valve Mitral Aortic Semilunar Valve Chordae Tendineae
More informationTHE FRAMINGHAM STUDY Protocol for data set vr_soe_2009_m_0522 CRITERIA FOR EVENTS. 1. Cardiovascular Disease
THE FRAMINGHAM STUDY Protocol for data set vr_soe_2009_m_0522 CRITERIA FOR EVENTS 1. Cardiovascular Disease Cardiovascular disease is considered to have developed if there was a definite manifestation
More information10. Definition of cardiovascular disease 10.1 Nosologic definitions Acute myocardial infarction: myocardial cell death due to prolonged ischaemia 62.
10. Definition of cardiovascular disease 10.1 Nosologic definitions Acute myocardial infarction: myocardial cell death due to prolonged ischaemia 62. Acute coronary syndrome: it is a big category which
More informationIschemic Heart Disease
Ischemic Heart Disease Definition: Ischemic heart disease (IHD) is a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium; it typically occurs when there
More informationBUSINESS. Articles? Grades Midterm Review session
BUSINESS Articles? Grades Midterm Review session REVIEW Cardiac cells Myogenic cells Properties of contractile cells CONDUCTION SYSTEM OF THE HEART Conduction pathway SA node (pacemaker) atrial depolarization
More informationAcute coronary syndromes
Acute coronary syndromes 1 Acute coronary syndromes Acute coronary syndromes results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus.
More informationCardiovascular Diseases and Diabetes
Cardiovascular Diseases and Diabetes LEARNING OBJECTIVES Ø Identify the components of the cardiovascular system and the various types of cardiovascular disease Ø Discuss ways of promoting cardiovascular
More informationDiagnosis and Management of Acute Myocardial Infarction
Diagnosis and Management of Acute Myocardial Infarction Acute Myocardial Infarction (AMI) occurs as a result of prolonged myocardial ischemia Atherosclerosis leads to endothelial rupture or erosion that
More informationCongestive Heart Failure Patient Profile. Patient Identity - Mr. Douglas - 72 year old man - No drugs, smokes, moderate social alcohol consumption
Congestive Heart Failure Patient Profile Patient Identity - Mr. Douglas - 72 year old man - No drugs, smokes, moderate social alcohol consumption Chief Complaint - SOB - When asked: Increasing difficulty
More informationHEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM
REVIEW DATE REVIEWER'S ID HEART AND SOUL STUDY OUTCOME EVENT - MORBIDITY REVIEW FORM : DISCHARGE DATE: RECORDS FROM: Hospitalization ER Please check all that may apply: Myocardial Infarction Pages 2, 3,
More informationAcute Myocardial Infarction
Acute Myocardial Infarction Hafeza Shaikh, DO, FACC, RPVI Lourdes Cardiology Services Asst.Program Director, Cardiology Fellowship Associate Professor, ROWAN-SOM Acute Myocardial Infarction Definition:
More informationHEART DISEASE HEART CONDITIONS, RISKS AND PROTECTION
Spotlight on Health 2017 HEART DISEASE HEART CONDITIONS, RISKS AND PROTECTION Heart disease is the leading cause of death for both men and women worldwide, accounting for over 17 million deaths per year.
More informationAcute Myocardial Infarction. Willis E. Godin D.O., FACC
Acute Myocardial Infarction Willis E. Godin D.O., FACC Acute Myocardial Infarction Definition: Decreased delivery of oxygen and nutrients to the myocardium Myocardial tissue necrosis causing irreparable
More information10/16/2014. CCRN Review - Cardiovascular. CCRN Review - Cardiovascular. CCRN Review - Cardiovascular
Hypertrophic (IHSS) Diagnosis Chest x ray cardiomegaly Electrocardiography LV hypertrophy, ST segment T was changes, Q waves in inferior & precordial leads Atrial & ventricular dysrhythmias Hypertrophic
More informationA DAYS CARDIOVASCULAR UNIT GUIDE DUE WEDNESDAY 4/12
A DAYS CARDIOVASCULAR UNIT GUIDE DUE WEDNESDAY 4/12 MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 3/20 - B 3/21 - A 3/22 - B 3/23 - A 3/24 - B 3/27 - A Dissection Ethics Debate 3/28 - B 3/29 - A Intro to Cardiovascular
More informationCardiomyopathy Consequences. function of the myocardium for any reason. This is a serious disease in which the heart muscle
Becki Simmons Cardiomyopathy Consequences Cardiomyopathy, which literally means "heart muscle disease," is the deterioration of the function of the myocardium for any reason. This is a serious disease
More informationPresenter: Steven Brust, HCS-D, HCS-H Product Manager, Home Health Coding Center
Presenter: Steven Brust, HCS-D, HCS-H Product Manager, Home Health Coding Center Pinpoint & properly assign the appropriate heart failure codes Left- vs. Right-sided Left ventricular failure (LVF) may
More informationHeart Failure Dr ahmed almutairi Assistant professor internal medicin dept
Heart Failure Dr ahmed almutairi Assistant professor internal medicin dept (MBBS)(SBMD) Introduction Epidemiology Pathophysiology diastolic/systolic Risk factors Signs and symptoms Classification of HF
More informationAcute coronary syndrome. Dr LM Murray Chemical Pathology Block SA
Acute coronary syndrome Dr LM Murray Chemical Pathology Block SA13-2014 Acute myocardial infarction (MI) MI is still the leading cause of death in many countries It is characterized by severe chest pain,
More informationHanna K. Al-Makhamreh, M.D., FACC Interventional Cardiologist
Hanna K. Al-Makhamreh, M.D., FACC Interventional Cardiologist Introduction. Basic Life Support (BLS). Advanced Cardiac Life Support (ACLS). Cardiovascular diseases (CVDs) are the number one cause of death
More informationCardiac Ischemia (is-kē-mē-uh)
Chapter 21 Cardiac Ischemia (is-kē-mē-uh) By: Alejandra & Lindsay I. Cardiac Ischemia =the most common cause of death in Western Culture ~35% of deaths. -Suddenly from acute coronary occlusion or fibrillation
More informationCoronary heart disease (CHD)
1 Coronary heart disease (CHD) 2 Institute of Pathological Physiology Martin Vokurka mvoku@lf1.cuni.cz Winter Semester 3 CORONARY CIRCULATION AND MYOCARDIAL METABOLISM 4 Blood flow: resting: 250 ml/min
More information10/8/2018. Lecture 9. Cardiovascular Health. Lecture Heart 2. Cardiovascular Health 3. Stroke 4. Contributing Factor
Lecture 9 Cardiovascular Health 1 Lecture 9 1. Heart 2. Cardiovascular Health 3. Stroke 4. Contributing Factor 1 The Heart Muscular Pump The Heart Receives blood low pressure then increases the pressure
More informationAcute Coronary Syndrome
ACUTE CORONOARY SYNDROME, ANGINA & ACUTE MYOCARDIAL INFARCTION Administrative Consultant Service 3/17 Acute Coronary Syndrome Acute Coronary Syndrome has evolved as a useful operational term to refer to
More informationCardiovascular System Notes: Heart Disease & Disorders
Cardiovascular System Notes: Heart Disease & Disorders Interesting Heart Facts The Electrocardiograph (ECG) was invented in 1902 by Willem Einthoven Dutch Physiologist. This test is still used to evaluate
More informationEchocardiography as a diagnostic and management tool in medical emergencies
Echocardiography as a diagnostic and management tool in medical emergencies Frank van der Heusen MD Department of Anesthesia and perioperative Care UCSF Medical Center Objective of this presentation Indications
More informationIschaemic heart disease. IInd Chair and Clinic of Cardiology
Ischaemic heart disease IInd Chair and Clinic of Cardiology Definition Syndrome due to chronic insufficient oxygen supply to myocardial cells Nomenclature: ischaemic heart disease (IHD), coronary artery
More informationCardiovascular manifestations of HIV
Cardiovascular manifestations of HIV Prabhakar Rajiah, MBBS, MD, FRCR Associate Professor of Radiology Associate Director, Cardiac CT and MRI University of Texas Southwestern Medical Center, Dallas, USA
More informationLecture 8 Cardiovascular Health Lecture 8 1. Introduction 2. Cardiovascular Health 3. Stroke 4. Contributing Factors
Lecture 8 Cardiovascular Health 1 Lecture 8 1. Introduction 2. Cardiovascular Health 3. Stroke 4. Contributing Factors 1 Human Health: What s Killing Us? Health in America Health is the U.S Average life
More informationHeart Failure. Cardiac Anatomy. Functions of the Heart. Cardiac Cycle/Hemodynamics. Determinants of Cardiac Output. Cardiac Output
Cardiac Anatomy Heart Failure Professor Qing ZHANG Department of Cardiology, West China Hospital www.blaufuss.org Cardiac Cycle/Hemodynamics Functions of the Heart Essential functions of the heart to cover
More informationUnit 1: Human Systems. The Circulatory System
Unit 1: Human Systems The Circulatory System nourish all cells with oxygen, glucose, amino acids and other nutrients and carry away carbon dioxide, urea and other wastes Purposes Transport chemical messengers
More informationCardiovascular Disease
Cardiovascular Disease Chapter 15 Introduction Cardiovascular disease (CVD) is the leading cause of death in the U.S. One American dies from CVD every 33 seconds Nearly half of all Americans will die from
More informationDiagnosis & Management of Heart Failure. Abena A. Osei-Wusu, M.D. Medical Fiesta
Diagnosis & Management of Heart Failure Abena A. Osei-Wusu, M.D. Medical Fiesta Learning Objectives: 1) Become familiar with pathogenesis of congestive heart failure. 2) Discuss clinical manifestations
More informationCMS Limitations Guide - Radiology Services
CMS Limitations Guide - Radiology Services Starting October 1, 2015, CMS will update their existing medical necessity limitations on tests and procedures to correspond to ICD-10 codes. This limitations
More informationBy the end of this session, the student should be able to:
Valvular Heart disease HVD By Dr. Ashraf Abdelfatah Deyab VHD- Objectives By the end of this session, the student should be able to: Define and classify valvular heart disease. Enlist the causes of acquired
More informationThe production of murmurs is due to 3 main factors:
Heart murmurs The production of murmurs is due to 3 main factors: high blood flow rate through normal or abnormal orifices forward flow through a narrowed or irregular orifice into a dilated vessel or
More informationA case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD
A case of post myocardial infarction ventricular septal rupture CHRISTOFOROS KOBOROZOS, MD NAVAL HOSPITAL OF ATHENS case presentation Female, 81yo Hx: diabetes mellitus, hypertension, chronic anaemia presented
More informationC1: Medical Standards for Safety Critical Workers with Cardiovascular Disorders
C1: Medical Standards for Safety Critical Workers with Cardiovascular Disorders GENERAL ISSUES REGARDING MEDICAL FITNESS-FOR-DUTY 1. These medical standards apply to Union Pacific Railroad (UPRR) employees
More information1 Functions of endothelial cells include all the following EXCEPT. 2 Response to vascular injury is characterised by
airns ase Hospital mergency epartment Part 1 FM MQs 1 Functions of endothelial cells include all the following XPT Formation of von-willebrand factor Formation of collagen and proteoglycans Formation of
More informationThe Cardiovascular System
The Cardiovascular System The Cardiovascular System A closed system of the heart and blood vessels The heart pumps blood Blood vessels allow blood to circulate to all parts of the body The function of
More informationLAB 4: THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM
LAB 4: THE MUSCLE AND CARDIOVASCULAR SYSTEM THE MUSCLE AND CARDIOVASCULAR SYSTEM The focus of this week s lab will be pathology of the cardiovascular system. The cardiovascular system is composed of the
More informationChapter 10. Learning Objectives. Learning Objectives 9/11/2012. Congestive Heart Failure
Chapter 10 Congestive Heart Failure Learning Objectives Explain concept of polypharmacy in treatment of congestive heart failure Explain function of diuretics Learning Objectives Discuss drugs used for
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationWHI Form Report of Cardiovascular Outcome Ver (For items 1-11, each question specifies mark one or mark all that apply.
WHI Form - Report of Cardiovascular Outcome Ver. 6. COMMENTS To be completed by Physician Adjudicator Date Completed: - - (M/D/Y) Adjudicator Code: OMB# 095-044 Exp: 4/06 -Affix label here- Clinical Center/ID:
More informationIndex of subjects. effect on ventricular tachycardia 30 treatment with 101, 116 boosterpump 80 Brockenbrough phenomenon 55, 125
145 Index of subjects A accessory pathways 3 amiodarone 4, 5, 6, 23, 30, 97, 102 angina pectoris 4, 24, 1l0, 137, 139, 140 angulation, of cavity 73, 74 aorta aortic flow velocity 2 aortic insufficiency
More informationLnformation Coverage Guidance
Lnformation Coverage Guidance Coverage Indications, Limitations, and/or Medical Necessity Abstract: B-type natriuretic peptide (BNP) is a cardiac neurohormone produced mainly in the left ventricle. It
More informationMWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient
MWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient In this CE we will discuss the patient presenting with an acute ST-Elevation Myocardial Infarction (STEMI) Definition: Myocardial
More informationAn aneurysm is a localized abnormal dilation of a blood vessel or the heart Types: 1-"true" aneurysm it involves all three layers of the arterial
An aneurysm is a localized abnormal dilation of a blood vessel or the heart Types: 1-"true" aneurysm it involves all three layers of the arterial wall (intima, media, and adventitia) or the attenuated
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acute coronary syndrome(s), anticoagulant therapy in, 706, 707 antiplatelet therapy in, 702 ß-blockers in, 703 cardiac biomarkers in,
More informationIn the name of GOD. Animal models of cardiovascular diseases: myocardial infarction & hypertension
In the name of GOD Animal models of cardiovascular diseases: myocardial infarction & hypertension 44 Presentation outline: Cardiovascular diseases Acute myocardial infarction Animal models for myocardial
More informationThe Value of Stress MRI in Evaluation of Myocardial Ischemia
The Value of Stress MRI in Evaluation of Myocardial Ischemia Dr. Saeed Al Sayari, MBBS, EBCR, MBA Department of Radiology and Nuclear Medicine Mafraq Hospital, Abu Dhabi United Arab Emirates Introduction
More informationPulmonary-Vascular Disease. Howard J. Sachs, MD.
Pulmonary-Vascular Disease Howard J. Sachs, MD www.12daysinmarch.com Dyspnea Cardiac Pulmonary CAD Pump Failure Chest Wall Airways Valve Disease Pericardial Disease Alveoli Interstitium Rhythm Disturbance
More informationThe production of murmurs is due to 3 main factors:
Heart murmurs The production of murmurs is due to 3 main factors: high blood flow rate through normal or abnormal orifices forward flow through a narrowed or irregular orifice into a dilated vessel or
More informationPyruvate + NADH + H + ==== Lactate + NAD +
1 UNIVERSITY OF PAPUA NEW GUINEA SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY PBL SEMINAR ANAEROBIC METABOLISM - An Overview
More informationHeart Disease. Signs and Symptoms
Heart Disease The term "heart disease" refers to several types of heart conditions. The most common type is coronary artery disease, which can cause heart attack, angina, heart failure, and arrhythmias.
More informationMyocardial Infarction: Left Ventricular Failure
CARDIOVASCULAR PHYSIOLOGY 93 Case 17 Myocardial Infarction: Left Ventricular Failure Marvin Zimmerman is a 52-year-old construction manager who is significantly overweight. Despite his physician's repeated
More informationChapter 14. Cardiovascular Emergencies
Chapter 14 Cardiovascular Emergencies Introduction (1 of 2) Cardiovascular disease has been leading killer of Americans since 1900. Accounts for 1 of every 2.8 deaths Introduction (2 of 2) EMS can help
More informationObjectives. Acute Coronary Syndromes; The Nuts and Bolts. Overview. Quick quiz.. How dose the plaque start?
Objectives Acute Coronary Syndromes; The Nuts and Bolts Michael P. Gulseth, Pharm. D., BCPS Pharmacotherapy II Spring 2006 Compare and contrast pathophysiology of unstable angina (UA), non-st segment elevation
More informationANGINA PECTORIS. angina pectoris is a symptom of myocardial ischemia in the absence of infarction
Pharmacology Ezra Levy, Pharm.D. ANGINA PECTORIS A. Definition angina pectoris is a symptom of myocardial ischemia in the absence of infarction angina usually implies severe chest pain or discomfort during
More informationDisorders of Cardiac Function
Disorders of Cardiac Function Objectives: Pericardial and endocardial disorders. Cardiomyopathies and cardiac arrhythmias. Valvular and congenital heart disorders. Coronary artery disease, myocardial ischemic
More information12 Lead ECG Interpretation
12 Lead ECG Interpretation Julie Zimmerman, MSN, RN, CNS, CCRN Significant increase in mortality for every 15 minutes of delay! N Engl J Med 2007;357:1631-1638 Who should get a 12-lead ECG? Also include
More informationHypertension Coronary artery disease
Hypertension Coronary artery disease 1 Problem Magnitude Hypertension( HTN) is the most common primary diagnosis. Worldwide prevalence estimates for HTN may be as much as 1 billion. Arterial hypertension
More informationImproving Transition of Care in Congestive Heart Failure. Mark J. Gloth, DO, MBA. Vice President, Chief Medical Officer HCR ManorCare
Improving Transition of Care in Congestive Heart Failure Mark J. Gloth, DO, MBA. Vice President, Chief Medical Officer HCR ManorCare Heart Failure Fastest growing clinical cardiac disease in the United
More information