• Archive for August, 2013

    Constrictive Pericarditis:

    by  • 29/08/2013 • Cardiology

     Cases either due to TB or classed as idiopathic. May be due to fungal, parasitic, viral, bacterial, asbestos, RT…  p/c: Kussmaul breathing (deep sighing), raised JVP on inspiration, atrial y-wave with rapid descent (prominent diastolic collapse of JVP), pericardial knock in 50%, hepatomegaly, ascites, fatigue, peripheral oedema, friction rub, tight sack heart...

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    Congenital Heart Disease

    by  • 29/08/2013 • Cardiology

    Occurs in 1% of live births. Overall male predominance. Aetiology Aetiology of congenital cardiac disease is often unknown, but recognised associations include:  Maternal prenatal rubella infection – persistant ductus arteriosis and pulmonary valvular and arterial stenosis  Maternal alcohol abuse – foetal alcohol syndrome (FAS) = septal defects  Maternal drug treatment and...

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    Restrictive Cardiomyopathy

    by  • 27/08/2013 • Cardiology

    Definition Some cardiomyopathies do not present with muscular hypertrophy or ventricular dilatation. Instead, the ventricular filling is restricted, resulting in symptoms and signs of heart failure. Dilatation of the atria and thrombus formation commonly occur. Conditions associated: (linked to fibrotic infiltration and therefore restriction of expansion) o Amyloidosis o Sarcoidosis o Loeffler’s endocarditis (eosinophillic...

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    Dilated Cardiomyopathy

    by  • 24/08/2013 • Cardiology

    Definition Characterised by dilatation and impaired systolic function of the left and/or right ventricle. Rule out: abnormal loading conditions (hypertension, valve disease) and coronary disease. Must have NORMAL valves and coronaries to qualify. Presentation o Congestive heart failure and therefore symptoms are of left and/or right heart failure. o Syncope due to ventricular arrhythmia...

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    Hypertrophic Cardiomyopathy

    by  • 23/08/2013 • Cardiology

    Definition Characterised by variable myocardial hypertrophy, most commonly involving the interventricular septum and disorganisation of cardiac myocytes and myofibrils. 25% patients have left ventricular outflow tract obstruction due to combined effects of: o Hypertrophy o Systolic anterior motion of the anterior mitral valve leaflet o Rapid ventricular ejection   Symptoms similar to aortic stenosis...

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    Cardiomyopathy

    by  • 21/08/2013 • Cardiology

    Definition Cardiomyopathy = disease of the heart muscle Diseases are classified on predominant clinical presentations: o Dilated cardiomyopathy – ventricular dilatation o Hypertrophic cardiomyopathy – myocardial hypertrophy of interventricular septum and ventricular walls   o Restrictive cardiomyopathy – impaired ventricular filling o Arrhythmogenic right ventricular cardiomyopathy – prominent right ventricular involvement with a high...

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    Diastolic Dysfunction

    by  • 20/08/2013 • Cardiology

    Stiff ventricle = inadequate filling = reduced SV/CO and increased end diastolic volume (inefficient)! Heart failure caused by diastolic dysfunction is generally described as the failure of the ventricle to adequately relax and typically denotes a stiffer ventricular wall. This causes inadequate filling of the ventricle, and therefore results in an inadequate stroke volume....

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    Systolic Dysfunction

    by  • 18/08/2013 • Cardiology

    o decreased ejection fraction (less than 45%). o inadequate stroke volume, resulting in inadequate cardiac output. o Because the ventricle is inadequately emptied, ventricular end-diastolic pressure and volumes increase. o This is transmitted to the atrium. On the left side of the heart, the increased pressure is transmitted to the pulmonary vasculature, and the...

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    Heart Failure

    by  • 17/08/2013 • Cardiology

    Definition Occurs when the heart is unable to maintain sufficient cardiac output to meet demands of the body (in essence left ventricular systolic dysfunction = LVSD) Low output cardiac failure = congestive heart failure (‘pump failure’). High output cardiac failure = when the body’s requirements for oxygen and nutrients are increased, and demand outstrips...

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    Secondary causes of hypertension

    by  • 15/08/2013 • Cardiology

    Definition Where blood pressure elevation is the result of a specific and potentially treatable cause. Incidence 10% of hypertension cases. Aetiology – cause, risk factors  Renal disease (80% of secondary hypertension) – impair volume regulation and/or activate the renin-angiotensin-aldosterone system. Sodium and water retention, but there can be inappropriate elevation of plasma renin...

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