Valvular defects. Lectures from Pathological Physiology. Study materials from Pathological Physiology, 2017/2018 Oliver Rácz, Eva Sedláková
|
|
- Gwendoline Henderson
- 5 years ago
- Views:
Transcription
1 Valvular defects Lectures from Pathological Physiology Study materials from Pathological Physiology, 2017/2018 Oliver Rácz, Eva Sedláková
2 Valvular dysfunction - introduction Stenosis block of flow; regurgitation backward flow For pathological physiology the hemodynamics is the most important. It helps to understand heart failure also in other diseases. Symptoms. auscultation (murmurs), USG see internal propedeutics. In the past mostly a consequence of rheumatic fever, today this is changing: degenerative processes of valves hereditary causes ( mitral valve prolapse, pulmonary, stenosis) inflammation secondary dilatation (cardiomyopathies, papillary muscle dysfunction) 4 5 Mitral stenosis years after febris rheumatica From 1 st symptoms to decompensation: 5 10 years Often in combination with other valvular defects (aortic insufficiency) 25 years after f. rh 33 % NYHA III, 50 % NYHA IV Narrowing of the ostium from 4 6 to 1 cm 2 and less 6 2
3 Mitral stenosis Pressure gradient between left atrium and ventricle first only during exercise, later also in rest Left ventricle is intact not involved in compesation Postcapillary pulmonary hypertension. Over 30 mmhg danger of pulmonary oedema Overload of right ventricle Symptoms of left heart failure without dysfunction of left ventricle 3 typical complications atrial fibrillation, thrombus formation and the danger of embolisation 7 Grades of mitral stenosis norm mild middle severe Area of ostium (cm 2 ) < 1 gradient (mm Hg) < > 20 Pressure t 1/2 (ms) < >
4 An old solution TODAY EARLY VALVULOPLASTIC INTERVENTION THROUGH CATHETRIZATION 10 A short diversion towards atrial fibrillation A common dysrythmic condition Different forms paroxysmal, recurrent, etc... and according to hemodynamics (with or without tachycardia) Dg. also without ECG pulsus irregularis et inaequalis - why? In the past mitral stenosis Today age, sex (m > w) 60 y. cca 1 %, 80 y. up to 6 % Thyreotoxicosis Cardiac disease in general
5 Atrial fibrillation Management: According ro rythm, cardiac frequency, risk of embolisation Pharmacological cardioversion Electrical cardioversion and modern methods Surgical ablation Catheter Ablation Suppression of AF by pacing Internal Atrial cardioverter/defibrillators Dissolution of blood clots and monitoring of coagulation!!! 13 Mitral regurgation Hemodynamics Regurgitation from LV back into left atrium during systole. Volume overload of LV (to get 5 liters into circulation the heart pumps 7-8 and more). Excentric hypertrophy of LV compensates the hemodynamic disorder. Symptoms (except murmurs, ECG and X ray) are similar to stenosis (left heart failure, pulmonary oedema, complications)
6 Mitral valve prolapse Classic description: Valve prolapse with acute regurgitation after necrosis of papillary muscles or as a part of inherited diseases of collagen (m. Marfan, Ehlers-Danlos) RARE New view: Small regurgitation due to mitral valve prolapse visible on USG usually without hemodynamic consequences and symptoms. COMMON AD disease? Altered histological structure of valves? Increased risk of sudden death? 16 Prolaps, new data (2009) Prevalence cca 2,4 % Familiar type, AD, degeneration of valves and annulus fibrosus (young women) Marfan and other connective tissue diseases CHD and other pathological conditions of the heart Increased risk of infectiousus endocarditis and arrhytmias Migraine??!! 17 Valvular Causes Aortic stenosis Hereditary (also cardiomyopathy) 1 % of population has bicuspidal aortic valve Degeneration, calcification Postrheumatic In addition to valvular also Subvalvular see hypertrophic cardiomyopathy Supravalvular coarctation of aorta 18 6
7 Aortic stenosis Hemodynamics Pressure gradient between LV and aorta Pressure overload of LV (as in hypertension) Concentric hypertrophy, well compensated for a long time, diastolic dysfunction. Finally decompensation and left heart failure Pulsus parvus et tardus insufficient perfusion of tissues, especially of heart muscle
8 Grades of aortal stenosis Norm mild middle severe Area of ostium (cm 2 ) 2-3 > 1,5 1,0-1,5 < 1,0 gradient (mm Hg) 0 < > Aortic insufficiency Mostly postrheumatic Hemodynamics: Regurgitation in diastole, volume overload of LV. High systolic and low diastolic pressure disadvantegous for heart muscle perfusion. Pulsus celer et altus 23 Overview of hemodynamics of valvular defects Disorder Timing Overload Notes M.Sten. A V Diastole not of LV! fibrillation embolisatio n M.Ins. A V Systole volume exercise Ao. Sten. V Ao Systole pressure pulsus! Ao. Ins V Ao Diastole volume pulsus! 24 8
9 The forgotten ventricle* Often as a victim alebo bystander of overall pathological cardiac or pulmonalry conditions USG inverstigation is more complicated Some anatomical, histological and functional specifics (valves, papillar muscles, trabeculisation of the apical part and contraction) *Šimková a Kaldarárová, Kardiológia pre prax, 8, 2010, The forgotten ventricle etiology of pathological conditions Pressure overload stenosis of a. pulmonalis, pulmonary HT, pulmonary embolism (acute!) Volume overload atrial septum defect, tricuspidal regurgitation Dysfunction of the myocard - MI, cardiomyopathies Obstruction of inflow tricuspidal stenosis, tamponade, constrictive pericarditis Abusus of some drugs cocaine, amphetamine 26 Tricuspidal regurgitation* Common secondary condition in valvular diseases of the left ventricle, in congenital defects and in left ventricle failure Primary in inf. endocarditis (i.v. drug users), danger of septic pulmonary embolisation Prolaps together with the left side Ebstein anomaly *Chňupa P, Kardiológia pre prax 8, 2010,
The 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 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 informationPathological physiology of cardiovascular system Congenital heart diseases
Pathological physiology of cardiovascular system Congenital heart diseases Rácz Oliver, Sedláková Eva Institute of Pathological Physiology, Medical School, P.J. Šafárik University Oliver Rácz, Eva Sedláková
More informationMitral Valve Disease. Prof. Sirchak Yelizaveta Stepanovna
Mitral Valve Disease Prof. Sirchak Yelizaveta Stepanovna Fall 2008 Mitral Valve Stenosis Lecture Outline Mitral Stenosis Mitral Regurgitation Etiology Pathophysiology Clinical features Diagnostic testing
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 informationCase # 1. Page: 8. DUKE: Adams
Case # 1 Page: 8 1. The cardiac output in this patient is reduced because of: O a) tamponade physiology O b) restrictive physiology O c) coronary artery disease O d) left bundle branch block Page: 8 1.
More informationAdult Echocardiography Examination Content Outline
Adult Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 Anatomy and Physiology Pathology Clinical Care and Safety Measurement Techniques, Maneuvers,
More informationValvular Heart Disease
Valvular Heart Disease MITRAL STENOSIS Pathophysiology rheumatic fever. calcific degeneration, malignant carcinoid disease, congenital mitral stenosis. SLE. The increased pressure gradient across the mitral
More informationValvular Heart Disease. Dr. HANAN ALBACKR
Valvular Heart Disease Dr. HANAN ALBACKR Valvular Heart Disease Format for this lecture IMPORTANT CLINICAL INFO know for boards, tests and clinical practice Spectrum of VHD Aortic Valve Mitral Valve Tricuspid
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 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 informationFor more information about how to cite these materials visit
Author: Michael Shea, M.D., 2008 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/
More informationWhat Is Valvular Heart Disease? Heart valve disease occurs when your heart's valves do not work the way they should.
What Is Valvular Heart Disease? Heart valve disease occurs when your heart's valves do not work the way they should. How Do Heart Valves Work? MAINTAIN ONE-WAY BLOOD FLOW THROUGH YOUR HEART The four heart
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 informationRhythm Disorders 2017 TazKai LLC and NRSNG.com
Rhythm Disorders 1. Outline the conduction system of the heart. 2. What do the different portions of the EKG represent? 3. Define the following terms: a. Automaticity b. Conductivity c. Excitability d.
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 informationpulmonary valve on, 107 pulmonary valve vegetations on, 113
INDEX Adriamycin-induced cardiomyopathy, 176 Amyloidosis, 160-161 echocardiographic abnormalities in, 160 intra-mural tumors similar to, 294 myocardial involvement in, 160-161 two-dimensional echocardiography
More information8/31/2016. Mitraclip in Matthew Johnson, MD
Mitraclip in 2016 Matthew Johnson, MD 1 Abnormal Valve Function Valve Stenosis Obstruction to valve flow during that phase of the cardiac cycle when the valve is normally open. Hemodynamic hallmark - pressure
More informationCongenital heart disease. By Dr Saima Ali Professor of pediatrics
Congenital heart disease By Dr Saima Ali Professor of pediatrics What is the most striking clinical finding in this child? Learning objectives By the end of this lecture, final year student should be able
More informationCongenital Heart Disease Cases
Congenital Heart Disease Cases Sabrina Phillips, MD FACC FASE Mayo Clinic Congenital Heart Disease Center 2013 MFMER slide-1 No Disclosures 2013 MFMER slide-2 1 CASE 1 2013 MFMER slide-3 63 year old Woman
More informationAnaesthesia for non-cardiac surgery in patients left ventricular outflow tract obstruction (LVOTO)
Anaesthesia for non-cardiac surgery in patients left ventricular outflow tract obstruction (LVOTO) Dr. Siân Jaggar Consultant Anaesthetist Royal Brompton Hospital London UK Congenital Cardiac Services
More informationMyocardial 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 informationThe Causes of Heart Failure
The Causes of Heart Failure Andy Birchall HFSN Right heart failure LVSD - HFREF Valve regurgitation or stenosis Dropsy CCF congestive cardiac failure Cor pulmonale Pulmonary hypertension HFPEF LVF Definitions
More informationAortic Valve Lesions
Version 1.0 Valvular Heart Disease 25/03/2012 Aortic Stenosis Aortic Valve Lesions General Most common isolated affected valve, esp elderly 4M:1F Unrecognised can be important cause of anaesthetic & obstetric
More informationPROSTHETIC VALVE BOARD REVIEW
PROSTHETIC VALVE BOARD REVIEW The correct answer D This two chamber view shows a porcine mitral prosthesis with the typical appearance of the struts although the leaflets are not well seen. The valve
More informationSudden cardiac death: Primary and secondary prevention
Sudden cardiac death: Primary and secondary prevention By Kai Chi Chan Penultimate Year Medical Student St George s University of London at UNic Sheba Medical Centre Definition Sudden cardiac arrest (SCA)
More informationMitral Valve Disease, When to Intervene
Mitral Valve Disease, When to Intervene Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Current ACC/AHA guideline Stages
More informationTSDA Boot Camp September 13-16, Introduction to Aortic Valve Surgery. George L. Hicks, Jr., MD
TSDA Boot Camp September 13-16, 2018 Introduction to Aortic Valve Surgery George L. Hicks, Jr., MD Aortic Valve Pathology and Treatment Valvular Aortic Stenosis in Adults Average Course (Post mortem data)
More informationMITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT. Irene Frantzis P year, SGUL Sheba Medical Center
MITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT Irene Frantzis P year, SGUL Sheba Medical Center MITRAL VALVE DISEASE Mitral Valve Regurgitation Mitral Valve Stenosis Mitral Valve Prolapse MITRAL REGURGITATION
More informationClinical Indications for Echocardiography
Clinical Indications for Echocardiography Echocardiography is widely utilised and potential applications are increasing with advances in technology. The aim of this document is two-fold: 1) To define clinical
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 informationRegurgitant Lesions. Bicol Hospital, Legazpi City, Philippines July Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA
Regurgitant Lesions Bicol Hospital, Legazpi City, Philippines July 2016 Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA Aortic Insufficiency Valve anatomy and function LVOT and
More informationUptofate Study Summary
CONGENITAL HEART DISEASE Uptofate Study Summary Acyanotic Atrial septal defect Ventricular septal defect Patent foramen ovale Patent ductus arteriosus Aortic coartation Pulmonary stenosis Cyanotic Tetralogy
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 informationValvular Heart Disease Mitral Stenosis
Valvular Heart Disease Mitral Stenosis A 75 year old woman with loud first heart sound and mid-diastolic murmur Chronic dyspnea Class 2/4 Fatigue Recent orthopnea/pnd Nocturnal palpitation Pedal edema
More informationDetailed Order Request Checklists for Cardiology
Next Generation Solutions Detailed Order Request Checklists for Cardiology 8600 West Bryn Mawr Avenue South Tower Suite 800 Chicago, IL 60631 www.aimspecialtyhealth.com Appropriate.Safe.Affordable 2018
More informationEjection across stenotic aortic valve requires a systolic pressure gradient between the LV and aorta. This places a pressure load on the LV.
Valvular Heart Disease Etiology General Principles Cellular and molecular mechanism of valve damage Structural pathology Functional pathology - stenosis/regurgitation Loading conditions - pressure/volume
More informationReview of Cardiac Mechanics & Pharmacology 10/23/2016. Brent Dunworth, CRNA, MSN, MBA 1. Learning Objectives
Brent Dunworth, CRNA, MSN, MBA Associate Director of Advanced Practice Division Chief, Nurse Anesthesia Vanderbilt University Medical Center Nashville, Tennessee Learning Objectives Review the principles
More informationHISTORY. Question: How do you interpret the patient s history? CHIEF COMPLAINT: Dyspnea of two days duration. PRESENT ILLNESS: 45-year-old man.
HISTORY 45-year-old man. CHIEF COMPLAINT: Dyspnea of two days duration. PRESENT ILLNESS: His dyspnea began suddenly and has been associated with orthopnea, but no chest pain. For two months he has felt
More informationLong-Term Recurrence of Atrial Fibrillation After Mitral Valve Replacement and Left Atrial Ablation (Reasons and Mechanisms)
March 2002 27 Long-Term Recurrence of Atrial Fibrillation After Mitral Valve Replacement and Left Atrial Ablation (Reasons and Mechanisms) A.V. EVTUSHENKO, V.M. SHIPULIN, I.V. ANTONCHENKO, S.V. POPOV,
More informationMITRAL STENOSIS. Joanne Cusack
MITRAL STENOSIS Joanne Cusack BSE Breakdown Recognition of rheumatic mitral stenosis Qualitative description of valve and sub-valve calcification and fibrosis Measurement of orifice area by planimetry
More informationDISCLOSURE. Echocardiography in Systemic Diseases: Questions. Relevant Financial Relationship(s) None. Off Label Usage None 5/7/2018
Echocardiography in Systemic Diseases: Questions Sunil Mankad, MD, FACC, FCCP, FASE Associate Professor of Medicine Mayo Clinic College of Medicine Director, Transesophageal Echocardiography Associate
More informationEjection across stenotic aortic valve requires a systolic pressure gradient between the LV and aorta. This places a pressure load on the LV.
Valvular Heart Disease General Principles Etiology Cellular and molecular mechanism of valve damage Structural pathology Functional pathology - stenosis/regurgitation Loading conditions - pressure/volume
More informationEchocardiography in Adult Congenital Heart Disease
Echocardiography in Adult Congenital Heart Disease Michael Vogel Kinderherz-Praxis München CHD missed in childhood Subsequent lesions after repaired CHD Follow-up of cyanotic heart disease CHD missed in
More informationVALVULAR HEART DISEASE
VALVULAR HEART DISEASE Stenosis: failure of a valve to open completely, obstructing forward flow. - almost always due to a chronic process (e.g., calcification or valve scarring). Insufficiency : failure
More informationEtiology of Valvular Heart Disease in the 21 st Century
Etiology of Valvular Heart Disease in the 21 st Century Genetic and Molecular Mechanisms Harisios Boudoulas, MD, Dr, Dr Hon. Professor, Academician (ant. mem.) The Ohio State University, USA Biomedical
More informationClinical significance of cardiac murmurs: Get the sound and rhythm!
Clinical significance of cardiac murmurs: Get the sound and rhythm! Prof. dr. Gunther van Loon, DVM, PhD, Ass Member ECVDI, Dip ECEIM Dept. of Large Animal Internal Medicine Ghent University, Belgium Murmurs
More informationI (312) Mitral Regurgitation What Should You Know?
Mitral Regurgitation What Should You Know? Table of Contents What is Mitral Regurgitation? 3 What are the Symptoms? 4 What are the risks? 5 Who Gets Mitral Regurgitation? 6 Diagnosing Mitral Regurgitation
More informationMiscellaneous Cardiology Topics pregnancy - congenital - myocarditis - pericardial disease. Pregnancy and Cardiovascular Disease MCQ
Miscellaneous Cardiology Topics pregnancy - congenital - myocarditis - pericardial disease Maan Jokhadar, MD, FACC Emory Center for Advanced Heart Failure Therapy Emory Adult Congenital Heart Center Pregnancy
More informationHeart Valve disease: MR. AS tough patient When to echo, When to refer, What s new
Heart Valve disease: MR. AS tough patient When to echo, When to refer, What s new B. Sonnenberg UAH Cardiology CME Day 5 May 2015 Disclosures Speaker s or Advisory Boards: none Research grants: none (co-investigator
More informationDegenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention
Degenerative Mitral Regurgitation: Etiology and Natural History of Disease and Triggers for Intervention John N. Hamaty D.O. FACC, FACOI November 17 th 2017 I have no financial disclosures Primary Mitral
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 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 informationPediatric Echocardiography Examination Content Outline
Pediatric Echocardiography Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 Anatomy and Physiology Normal Anatomy and Physiology 10% 2 Abnormal Pathology and Pathophysiology
More informationDOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES
THORAXCENTRE DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES J. Roelandt DOPPLER HEMODYNAMICS Intracardiac pressures and pressure gradients Volumetric measurement
More informationUptofate Study Summary
CARDIOLOGY: Valvulopathies Aortic Stenosis 1. Aetiology is age dependant - Age > 70: Senile calcification (50%), rheumatic (25%), biscupid (25%) - Age < 70: Bicuspid (75%), rheumatic (25%) - Note: Rheumatic
More informationTricuspid and Pulmonic Valve Disease
Chapter 31 Tricuspid and Pulmonic Valve Disease David A. Tate Acquired disease of the right-sided cardiac valves is much less common than disease of the leftsided counterparts, possibly because of the
More informationHISTORY. Question: What category of heart disease is suggested by the fact that a murmur was heard at birth?
HISTORY 23-year-old man. CHIEF COMPLAINT: Decreasing exercise tolerance of several years duration. PRESENT ILLNESS: The patient is the product of an uncomplicated term pregnancy. A heart murmur was discovered
More informationValvular Heart Disease
GP Update Refresher 18 th January 2018 Valvular Heart Disease Dr. Alexander Lyon Senior Lecturer and Consultant Cardiologist Clinical Lead in Cardio-Oncology Royal Brompton Hospital, London UK President
More informationPregnancy and Heart Disease. Alexandra A Frogoudaki Adult Congenital Heart Clinic ATTIKON University Hospital
Pregnancy and Heart Disease Alexandra A Frogoudaki Adult Congenital Heart Clinic ATTIKON University Hospital Pregnancy is not a state Hemodynamic changes During pregnancy Estrogens 1. Renin 2.
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 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 informationCoronary Anomalies & Hemodynamic Identification
Coronary Anomalies & Hemodynamic Identification David Stultz, MD Cardiology Fellow, PGY 6 May 2, 2006 Anomaly #1 Anomaly #2 Anomaly #3 Figure 18-27 Anomalous origin of the left circumflex artery.
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 informationHISTORY. Question: What category of heart disease is suggested by this history? CHIEF COMPLAINT: Heart murmur present since early infancy.
HISTORY 18-year-old man. CHIEF COMPLAINT: Heart murmur present since early infancy. PRESENT ILLNESS: Although normal at birth, a heart murmur was heard at the six week check-up and has persisted since
More informationWorldwide rheumatic fever is the most common cause of valve disease. In industrialized areas, valvular disease of old age predominates
Michael Sumners DO Epidemiology Worldwide rheumatic fever is the most common cause of valve disease In industrialized areas, valvular disease of old age predominates Calcific aortic stenosis Functional
More informationSemiology of the Heart in the 21 st century
Semiology of the Heart in the 21 st century Workshop Rodrigo Salgado Dept of Radiology Antwerp University Hospital - Belgium Question The cardiothoracic index a. Is something I always mention, because
More informationComprehensive Cardiology: Matters of the Heart Class III SARAH BEANLANDS RN BSCN MSC
Comprehensive Cardiology: Matters of the Heart Class III SARAH BEANLANDS RN BSCN MSC Overview ACS continued Heart Failure Valvular Disorders and Endocarditis Diagnosis Nuclear stress test- stable angina
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 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 informationHemodynamic Monitoring
Perform Procedure And Interpret Results Hemodynamic Monitoring Tracheal Tube Cuff Pressure Dean R. Hess PhD RRT FAARC Hemodynamic Monitoring Cardiac Rate and Rhythm Arterial Blood Pressure Central Venous
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 informationASCeXAM / ReASCE. Practice Board Exam Questions. Tuesday Morning
ASCeXAM / ReASCE Practice Board Exam Questions Tuesday Morning Congenital Heart Disease in Adults Congenital Heart Disease Cases Diastolic Function Pericardial Disease Congenital Heart Disease Cases Michael
More informationEVALUATION OF PREGNANT PATIENTS WITH HEART DISEASE. Karen Stout, MD University of Washington Seattle Children s Seattle, WA
EVALUATION OF PREGNANT PATIENTS WITH HEART DISEASE Karen Stout, MD University of Washington Seattle Children s Seattle, WA CASE PRESENTATION 24 year old woman with aortic regurgitation referred for evaluation
More informationIdiopathic Hypertrophic Subaortic Stenosis and Mitral Stenosis
CASE REPORTS Idiopathic Hypertrophic Subaortic Stenosis and Mitral Stenosis Martin J. Nathan, M.D., Roman W. DeSanctis, M.D., Mortimer J. Buckley, M.D., Charles A. Sanders, M.D., and W. Gerald Austen,
More informationSee below for descriptions of the waveform
The internal jugular vein (IJV) connects to the right atrium without any intervening valves. The pulsation of the right atrium therefore causes the column of blood in the IJV to rise and fall this is called
More informationAdel Hasanin Ahmed 1
Adel Hasanin Ahmed 1 PERICARDIAL DISEASE The pericardial effusion ends anteriorly to the descending aorta and is best visualised in the PLAX. PSAX is actually very useful sometimes for looking at posterior
More informationDisclosures. ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech
Disclosures ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech Speaker s fee Edwards Lifesciences Sanofi-Aventis Decision Making in Patients with Multivalvular
More informationWhen to implant an ICD in systemic right ventricle?
When to implant an ICD in systemic right ventricle? Département de rythmologie et de stimulation cardiaque Nicolas Combes n.combes@clinique-pasteur.com Pôle de cardiologie pédiatrique et congénitale Risk
More informationReview of Cardiac Imaging Modalities in the Renal Patient. George Youssef
Review of Cardiac Imaging Modalities in the Renal Patient George Youssef ECHO Left ventricular hypertrophy (LVH) assessment Diastolic dysfunction Stress ECHO Cardiac CT angiography Echocardiography - positives
More informationHow to Assess and Treat Obstructive Lesions
How to Assess and Treat Obstructive Lesions Erwin Oechslin, MD, FESC, FRCPC, Director, Congenital Cardiac Centre for Adults Peter Munk Cardiac Centre University Health Network/Toronto General Hospital
More informationMore History. Organization. Maternal Cardiac Disease: a historical perspective. The Parturient with Cardiac Disease 9/21/2012
The Parturient with Cardiac Disease Pamela Flood M.D. Professor of Anesthesia and Perioperative Care Obstetrics, Gynecology and Reproductive Sciences University of California, San Francisco Maternal Cardiac
More information7. Echocardiography Appropriate Use Criteria (by Indication)
Criteria for Echocardiography 1133 7. Echocardiography Criteria (by ) Table 1. TTE for General Evaluation of Cardiac Structure and Function Suspected Cardiac Etiology General With TTE 1. Symptoms or conditions
More informationEAE RECOMMENDATIONS FOR TRANSESOPHAGEAL ECHO. Cardiac Sources of Embolism. Luigi P. Badano, MD, FESC
EAE RECOMMENDATIONS FOR TRANSESOPHAGEAL ECHO. Cardiac Sources of Embolism Luigi P. Badano, MD, FESC Background Stroke is the 3 cause of death in several industrial countries; Embolism accounts for 15-30%
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 informationCardiovascular Disease
Cardiovascular Disease Certification Examination Blueprints Blueprint for the Full-Day, Multiple-Choice Questions Component of the Exam: Purpose of the exam The exam is designed to evaluate the knowledge,
More informationValvular heart disease : Role of medication ( drug and intervention ) Pol.Col.Dr.Kasem Ratanasumawong
Valvular heart disease : Role of medication ( drug and intervention ) Pol.Col.Dr.Kasem Ratanasumawong Management of valvular heart disease Accurate diagnosis and disease severity Prevention and treatment
More informationHigh Yield Associations Cardio for Step 1. Amanda Krauss, Adee Elhamdani
High Yield Associations Cardio for Step 1 Amanda Krauss, Adee Elhamdani EKGs Irregularly irregular with no p waves and inconsistent RR intervals High Yield new onset MC risk factors Regular PP intervals
More informationBy Dickens ATURWANAHO & ORIBA DAN LANGOYA MAKchs, MBchB CONGENTAL HEART DISEASE
By Dickens ATURWANAHO & ORIBA DAN LANGOYA MAKchs, MBchB CONGENTAL HEART DISEASE Introduction CHDs are abnormalities of the heart or great vessels that are present at birth. Common type of heart disease
More informationPathophysiology: Heart Failure
Pathophysiology: Heart Failure Mat Maurer, MD Irving Assistant Professor of Medicine Outline Definitions and Classifications Epidemiology Muscle and Chamber Function Pathophysiology Heart Failure: Definitions
More informationHeart failure congestive heart failure, or CHF
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,
More informationPre-participation Screening for the Prevention of sudden Cardiac Death in Young Athletes. Thomas W. Allen, DO, MPH
Pre-participation Screening for the Prevention of sudden Cardiac Death in Young Athletes Thomas W. Allen, DO, MPH Cardiovascular disorders are the leading cause of sudden death in young athletes accounting
More informationCongenital Heart Defects
Normal Heart Congenital Heart Defects 1. Patent Ductus Arteriosus The ductus arteriosus connects the main pulmonary artery to the aorta. In utero, it allows the blood leaving the right ventricle to bypass
More informationIndex. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A ACHD. See Adult congenital heart disease (ACHD) Adult congenital heart disease (ACHD), 503 512 across life span prevalence of, 504 506
More informationValve Disease Board Review Questions
Valve Disease Board Review Questions Dennis A. Tighe, MD, FASE University of Massachusetts Medical School Worcester, MA Case 1 History A 61 year-old man Presents to hospital with worsening shortness of
More informationCASE REPORT: DOUBLE ORIFICE MITRAL VALVE WITH CLEFT IN ANTERIOR LEAFLET OF DOMINANT VALVE IN AN AFRO-CARIBBEAN
CASE REPORT: DOUBLE ORIFICE MITL VAE WITH CLEFT IN ANTERIOR LEAFLET OF DOMINANT VAE IN AN AFRO-CARIBBEAN Disclosure: No potential conflict of interest. Received: 27.08.13 Accepted: 23.06.14 Citation: EMJ
More informationValvular Heart Disease
Valvular Heart Disease B K Singh, MD, FACC Disclosures: None 1 CARDIAC CYCLE S2 S2=A2P2 S1=M1T1 S4 S1 S3 2 JVP Carotid S1 Slitting of S2 S3 S4 Ejection click Opening snap Dynamic Auscultation What is the
More informationHEART FAILURE. Study day November 2018 Sarah Briggs
HEART FAILURE Study day November 2018 Sarah Briggs Overview and Introduction This course is an introduction and overview of heart failure. Normal heart function and basic pathophysiology of heart failure
More informationECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT
ECHOCARDIOGRAPHIC APPROACH TO CONGENITAL HEART DISEASE: THE UNOPERATED ADULT Karen Stout, MD, FACC Divisions of Cardiology University of Washington Medical Center Seattle Children s Hospital NO DISCLOSURES
More information