Cardiomyopathy is a disease of the heart muscle where it loses its ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart to become enlarged and weakened. Hypertrophic cardiomyopathy causes thickening of the heart muscle. Restrictive cardiomyopathy stiffens the heart and impairs its ability to fill with blood. Diagnostic tests include echocardiograms, electrocardiograms, and cardiac catheterization. Treatment involves medications, device implantation, or transplantation depending on severity.
Raynaud's disease is a condition that causes narrowing of the small blood vessels (arterioles) in the fingers and toes in response to cold temperatures or stress. There are two main types: primary Raynaud's disease, which has no underlying cause, and secondary Raynaud's, which is caused by another condition like connective tissue disease, injury, or exposure to vibrating tools. Symptoms include numbness, pain, and color changes in the skin from blanching to blue or red. Diagnosis involves examining the extremities for color changes and reduced sensation in response to cold. Treatment focuses on lifestyle changes like avoiding smoking and stress as well as medications to dilate blood vessels.
A Holter monitor is a portable device worn for 24-48 hours that continuously records heart activity through electrodes placed on the skin. It is used to diagnose conditions like valvular heart disease, CAD, arrhythmias, and pacemaker malfunctions. Proper nursing management during the procedure includes documenting attachment/removal times, encouraging activity logging, and avoiding interference. Risks are generally low but may include skin irritation.
Rheumatic heart disease is a chronic condition that results from rheumatic fever and is characterized by inflammation and deformity of the heart valves. It occurs when a strep throat infection causes rheumatic fever, which leads to permanent damage of the heart valves. Symptoms include chest pain, fatigue, palpitations, and shortness of breath. Treatment involves rest, maintaining nutrition, hygiene practices to prevent infection, and long-term antibiotic therapy to prevent relapse.
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening conditions. The diagnosis is challenging due to the heterogeneity of symptoms but can involve electrocardiogram, cardiac biomarkers, echocardiogram, cardiac MRI and endomyocardial biopsy. About half of acute cases resolve in 2-4 weeks but some develop heart failure or arrhythmias. Treatment focuses on supporting heart function and managing symptoms while the disease runs its course.
This document discusses various types of cardiomyopathies:
- Dilated cardiomyopathy is caused by an unknown etiology and results in left ventricular dilatation and systolic dysfunction. It is a common cause of heart failure.
- Hypertrophic cardiomyopathy involves abnormal thickening of the heart muscle and can lead to outflow obstruction. It is a common cause of sudden death in young athletes.
- Restrictive cardiomyopathy causes stiff ventricles and impaired ventricular filling due to disorders like amyloidosis. It presents with symptoms of right and left heart failure.
- Other rare types discussed include arrhythmogenic right ventricular dysplasia and obliterative cardiomyopathy. Diagnosis involves imaging and endomyocardial biopsy
Raynaud's disease is a condition characterized by episodic vasoconstriction of the small arteries in the hands and feet in response to cold or stress. It most commonly affects women ages 16-40. Episodes cause color changes from pale to blue to red as blood flow is reduced and restored. Risk factors include cold exposure, vibratory machinery use, smoking, emotional distress, and autoimmune diseases. Diagnosis involves patient history and physical exam looking for color changes. Treatment focuses on avoiding triggers through lifestyle changes, calcium channel blockers, and topical nitroglycerin.
The document discusses myocarditis, which is an inflammation of the heart muscle (myocardium). It provides classifications of myocarditis including Lieberman's clinicopathological classification and pathological classifications such as lymphocytic, eosinophilic, granulomatous, and neutrophilic myocarditis. Etiologies including infectious, drug-induced, hypersensitivity reactions, and immunological causes are described. Diagnostic evaluations and management options for myocarditis are also outlined.
Cardiomyopathy is a disease of the heart muscle where it loses its ability to pump blood effectively. The main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart to become enlarged and weakened. Hypertrophic cardiomyopathy causes thickening of the heart muscle. Restrictive cardiomyopathy stiffens the heart and impairs its ability to fill with blood. Diagnostic tests include echocardiograms, electrocardiograms, and cardiac catheterization. Treatment involves medications, device implantation, or transplantation depending on severity.
Raynaud's disease is a condition that causes narrowing of the small blood vessels (arterioles) in the fingers and toes in response to cold temperatures or stress. There are two main types: primary Raynaud's disease, which has no underlying cause, and secondary Raynaud's, which is caused by another condition like connective tissue disease, injury, or exposure to vibrating tools. Symptoms include numbness, pain, and color changes in the skin from blanching to blue or red. Diagnosis involves examining the extremities for color changes and reduced sensation in response to cold. Treatment focuses on lifestyle changes like avoiding smoking and stress as well as medications to dilate blood vessels.
A Holter monitor is a portable device worn for 24-48 hours that continuously records heart activity through electrodes placed on the skin. It is used to diagnose conditions like valvular heart disease, CAD, arrhythmias, and pacemaker malfunctions. Proper nursing management during the procedure includes documenting attachment/removal times, encouraging activity logging, and avoiding interference. Risks are generally low but may include skin irritation.
Rheumatic heart disease is a chronic condition that results from rheumatic fever and is characterized by inflammation and deformity of the heart valves. It occurs when a strep throat infection causes rheumatic fever, which leads to permanent damage of the heart valves. Symptoms include chest pain, fatigue, palpitations, and shortness of breath. Treatment involves rest, maintaining nutrition, hygiene practices to prevent infection, and long-term antibiotic therapy to prevent relapse.
Myocarditis is an inflammatory disease of the heart muscle that can be caused by infectious or non-infectious triggers. It has a variable clinical presentation ranging from mild symptoms to life-threatening conditions. The diagnosis is challenging due to the heterogeneity of symptoms but can involve electrocardiogram, cardiac biomarkers, echocardiogram, cardiac MRI and endomyocardial biopsy. About half of acute cases resolve in 2-4 weeks but some develop heart failure or arrhythmias. Treatment focuses on supporting heart function and managing symptoms while the disease runs its course.
This document discusses various types of cardiomyopathies:
- Dilated cardiomyopathy is caused by an unknown etiology and results in left ventricular dilatation and systolic dysfunction. It is a common cause of heart failure.
- Hypertrophic cardiomyopathy involves abnormal thickening of the heart muscle and can lead to outflow obstruction. It is a common cause of sudden death in young athletes.
- Restrictive cardiomyopathy causes stiff ventricles and impaired ventricular filling due to disorders like amyloidosis. It presents with symptoms of right and left heart failure.
- Other rare types discussed include arrhythmogenic right ventricular dysplasia and obliterative cardiomyopathy. Diagnosis involves imaging and endomyocardial biopsy
Raynaud's disease is a condition characterized by episodic vasoconstriction of the small arteries in the hands and feet in response to cold or stress. It most commonly affects women ages 16-40. Episodes cause color changes from pale to blue to red as blood flow is reduced and restored. Risk factors include cold exposure, vibratory machinery use, smoking, emotional distress, and autoimmune diseases. Diagnosis involves patient history and physical exam looking for color changes. Treatment focuses on avoiding triggers through lifestyle changes, calcium channel blockers, and topical nitroglycerin.
The document discusses myocarditis, which is an inflammation of the heart muscle (myocardium). It provides classifications of myocarditis including Lieberman's clinicopathological classification and pathological classifications such as lymphocytic, eosinophilic, granulomatous, and neutrophilic myocarditis. Etiologies including infectious, drug-induced, hypersensitivity reactions, and immunological causes are described. Diagnostic evaluations and management options for myocarditis are also outlined.
This document discusses pulmonary thromboembolism (PE), which occurs when a blood clot blocks the pulmonary artery or its branches in the lungs. PE is usually caused by deep vein thrombosis, where a clot breaks off and travels to the lungs. Symptoms include dyspnea, chest pain, and coughing. Risk factors include prolonged immobilization, recent surgery or trauma, oral contraceptive use, pregnancy, and inherited or acquired hypercoagulable states. Diagnosis involves chest x-ray, ventilation-perfusion scanning, and pulmonary angiography to detect clots in the pulmonary arteries.
The document discusses pericardial disease and acute pericarditis. Acute pericarditis is defined as inflammation of the pericardium lasting less than 2 weeks. Common causes include viral or bacterial infections, tuberculosis, renal failure and idiopathic. Clinical features include chest pain relieved by sitting forward and pericardial rub. Investigations include EKG showing PR depression and ST elevation, echocardiogram detecting pericardial fluid, and pericardiocentesis if suspicion of infection or tamponade. Treatment involves NSAIDs or colchicine and complications can include recurrent pericarditis or constriction.
Cardiomyopathy refers to diseases of the heart muscle that weaken the heart's ability to pump blood effectively. The three main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy causes the left ventricle to enlarge and weaken, impairing its ability to pump blood. Causes include viral infections, toxins, genetic factors, and hypertension. Symptoms include fatigue, shortness of breath, and fluid retention. Diagnosis involves echocardiograms, electrocardiograms, and cardiac catheterization. Treatment focuses on managing symptoms through medications, lifestyle changes, and potentially surgery or transplantation.
This document discusses aortic regurgitation (AR), which occurs when the aortic valve does not close properly, allowing blood to flow backward into the left ventricle. It can be caused by damage to the aortic valve leaflets or distortion of the aorta. Common causes include rheumatic heart disease, bicuspid aortic valves, hypertension, and Marfan syndrome. Over time, the left ventricle must work harder to compensate for the backflow of blood, which can lead to enlarged and weakened heart muscles. Symptoms may include palpitations, chest pain, and shortness of breath. Diagnosis involves listening for an early diastolic murmur and confirming the diagnosis with echocardiogram
Pericarditis is inflammation of the pericardial sac surrounding the heart that causes chest pain. It can be caused by viruses, bacteria, fungi, uremia, myocardial infarction, or autoimmune disorders. Symptoms include chest pain worsened by deep breathing or lying down, fever, and potential heart failure from fluid buildup or tamponade. Diagnosis involves patient history, physical exam for rubs, ECG changes, imaging like echocardiogram, and labs. Treatment focuses on identifying and treating the underlying cause with rest, drainage procedures, antibiotics, anti-inflammatories, and steroids along with pain management and monitoring for complications like cardiac tamponade.
Cardiogenic shock is a condition of diminished cardiac output that severely impairs cardiac perfusion. In this condition in which the heart suddenly can't pump enough blood to meet the body's needs.
This document discusses chronic coronary syndrome (CCS), previously known as stable coronary artery disease. It defines CCS and outlines the six entities it can be classified into. It discusses the natural history, pathophysiology, risk factors, diagnosis and management of CCS. Key changes from 2013 guidelines include exercise stress testing now recommended for assessing symptoms and risk rather than diagnosis, and several new second-line treatment options for angina added based on heart rate, blood pressure and tolerance. Invasive testing guidelines were also updated.
This document provides information about a seminar on aortic dissection presented by Monika Devi. It discusses the introduction, types, causes, symptoms, risk factors, diagnosis, treatment, complications and prevention of aortic dissection. The two main types are Type A, which involves the ascending aorta, and Type B, which only involves the descending aorta. Causes include high blood pressure, genetic conditions like Marfan syndrome, and traumatic injury. Symptoms can include chest pain and symptoms of a stroke. Treatment depends on the type but may involve medications to lower blood pressure or surgery to repair the tear in the aorta. Complications can include death, organ damage or stroke if not properly treated.
Cardiac arrest refers to the sudden cessation of cardiac activity and can lead to death if not treated. It is usually caused by conditions that disrupt the heart's electrical system such as coronary artery disease or structural heart abnormalities. Risk factors include a family history of sudden cardiac death, previous heart issues, and lifestyle factors like smoking and obesity. Diagnosis involves evaluating the patient's history, ECG, echocardiogram, and blood work. Treatment includes CPR, defibrillation, cardiac catheterization, bypass surgery, and medication to control arrhythmias and heart disease. Nursing care focuses on monitoring the patient's condition, providing oxygen, and educating on preventing future cardiac events.
An aneurysm is a localized bulging or ballooning of the wall of an artery. It occurs when the arterial wall weakens, causing it to widen abnormally. The two main types are saccular aneurysms, which are spherical bulges, and fusiform aneurysms, which elongate a portion of the artery. Aneurysms can enlarge over time and rupture, causing life-threatening hemorrhage. Risk factors include atherosclerosis, infection, smoking, hypertension, and genetic conditions. Diagnosis involves physical exam and imaging tests. Treatment depends on the location and size of the aneurysm but may involve open or endovascular surgical repair to prevent rupture.
Persistent truncus arteriosus (or patent truncus arteriosus), also known as Common arterial trunk, is a rare form of congenital heart disease that presents at birth. In this condition, the embryological structure known as the truncus arteriosus fails to properly divide into the pulmonary trunk and aorta. This results in one arterial trunk arising from the heart and providing mixed blood to the coronary arteries, pulmonary arteries, and systemic circulation
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
This document discusses the assessment, investigation, and treatment of chronic stable angina. It defines chronic stable angina as chest pain or discomfort that is reproducibly associated with exertion or stress and relieved by rest. The document outlines how to evaluate patients presenting with chest pain through history, physical exam, risk factor assessment, and probability estimation models. It recommends initial tests like ECG, cardiac biomarkers, and stress testing. Treatment focuses on lifestyle changes, medications like aspirin, beta-blockers, calcium channel blockers, and revascularization if needed. Regular patient follow up and education are also emphasized.
This document discusses pulmonary thromboembolism (PE), which refers to blood clots (thrombi) traveling from deep veins to the lungs. Most clots originate in the lower extremities. Risk factors include inherited conditions, surgery, trauma, immobilization, cancer and pregnancy. PE can cause hypoxemia and pulmonary hypertension. Diagnosis involves clinical assessment, D-dimer testing, chest imaging like CT pulmonary angiogram (gold standard), ventilation-perfusion scanning and echocardiogram. Treatment aims to relieve symptoms and prevent complications like right heart strain.
Atrial septal defect (ASD) is an abnormal opening between the right and left atria that allows blood to pass from the left to the right atrium. There are three main types of ASDs that differ in their location within the atrial septum. Untreated ASDs can lead to volume overload of the right ventricle and elevated pulmonary artery pressures over time. While small defects may be asymptomatic, children with ASDs can experience fatigue, infections, and poor weight gain. Diagnosis involves auscultation, chest X-ray, ECG, echocardiogram and cardiac catheterization. Surgical closure of the defect is usually recommended in childhood to prevent long-term complications like congest
An aortic aneurysm is a localized sac or dilation formed at a weak point in the aortic wall. They most commonly occur in the abdominal aorta and can be caused by conditions like hypertension, atherosclerosis, and smoking. Aortic aneurysms are classified as either saccular or fusiform based on their shape and size. Untreated aneurysms risk rupture, which can cause massive hemorrhage and death. Surgical treatment involves replacing the diseased aortic segment with a synthetic graft to prevent rupture.
This document outlines the assessment and management of a patient named Melvin Pious presenting with chest pain. It details obtaining a history and physical exam, monitoring vital signs and performing an ECG and cardiac marker tests. Immediate interventions include oxygen, aspirin, nitroglycerine and morphine. Further medical interventions may include thrombolytic therapy within 30 minutes or primary percutaneous coronary intervention within 90 minutes. Laboratory tests and imaging are also ordered to evaluate the patient's condition.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
A ventricular septal defect (VSD) is a hole in the septum separating the left and right ventricles of the heart. VSDs are the most common type of congenital heart defect, occurring in about 2 out of every 1000 live births. They can range from small to large in size. Echocardiography is the primary way to diagnose a VSD and determine its location and size. Small VSDs may close on their own, but larger defects often require surgery to repair.
Raynaud's phenomenon is characterized by episodic vasospasm and ischemia of the extremities in response to cold or stress. Attacks typically involve color changes from white to blue to red. Primary Raynaud's has no known cause, while secondary Raynaud's is associated with underlying conditions like scleroderma. Nifedipine is currently the only drug approved for treatment, though research continues on therapies like topical nitroglycerin and rho kinase inhibitors to promote vasodilation.
Raynaud's disease is a condition that causes some areas of the body like fingers and toes to feel numb and cool in response to cold temperatures or stress. It is caused by narrowing of small blood vessels. Women are more likely than men to have it. Symptoms include changes in color and sensation in the fingers and toes. Diagnosis involves tests like a cold stimulation test and exams to check for autoimmune diseases. Lifestyle changes like avoiding smoking and stress can help prevent attacks. Medications may also be used to treat it if severe. Complications can include sores and tissue damage if not properly managed.
This document discusses pulmonary thromboembolism (PE), which occurs when a blood clot blocks the pulmonary artery or its branches in the lungs. PE is usually caused by deep vein thrombosis, where a clot breaks off and travels to the lungs. Symptoms include dyspnea, chest pain, and coughing. Risk factors include prolonged immobilization, recent surgery or trauma, oral contraceptive use, pregnancy, and inherited or acquired hypercoagulable states. Diagnosis involves chest x-ray, ventilation-perfusion scanning, and pulmonary angiography to detect clots in the pulmonary arteries.
The document discusses pericardial disease and acute pericarditis. Acute pericarditis is defined as inflammation of the pericardium lasting less than 2 weeks. Common causes include viral or bacterial infections, tuberculosis, renal failure and idiopathic. Clinical features include chest pain relieved by sitting forward and pericardial rub. Investigations include EKG showing PR depression and ST elevation, echocardiogram detecting pericardial fluid, and pericardiocentesis if suspicion of infection or tamponade. Treatment involves NSAIDs or colchicine and complications can include recurrent pericarditis or constriction.
Cardiomyopathy refers to diseases of the heart muscle that weaken the heart's ability to pump blood effectively. The three main types are dilated, hypertrophic, and restrictive cardiomyopathy. Dilated cardiomyopathy causes the left ventricle to enlarge and weaken, impairing its ability to pump blood. Causes include viral infections, toxins, genetic factors, and hypertension. Symptoms include fatigue, shortness of breath, and fluid retention. Diagnosis involves echocardiograms, electrocardiograms, and cardiac catheterization. Treatment focuses on managing symptoms through medications, lifestyle changes, and potentially surgery or transplantation.
This document discusses aortic regurgitation (AR), which occurs when the aortic valve does not close properly, allowing blood to flow backward into the left ventricle. It can be caused by damage to the aortic valve leaflets or distortion of the aorta. Common causes include rheumatic heart disease, bicuspid aortic valves, hypertension, and Marfan syndrome. Over time, the left ventricle must work harder to compensate for the backflow of blood, which can lead to enlarged and weakened heart muscles. Symptoms may include palpitations, chest pain, and shortness of breath. Diagnosis involves listening for an early diastolic murmur and confirming the diagnosis with echocardiogram
Pericarditis is inflammation of the pericardial sac surrounding the heart that causes chest pain. It can be caused by viruses, bacteria, fungi, uremia, myocardial infarction, or autoimmune disorders. Symptoms include chest pain worsened by deep breathing or lying down, fever, and potential heart failure from fluid buildup or tamponade. Diagnosis involves patient history, physical exam for rubs, ECG changes, imaging like echocardiogram, and labs. Treatment focuses on identifying and treating the underlying cause with rest, drainage procedures, antibiotics, anti-inflammatories, and steroids along with pain management and monitoring for complications like cardiac tamponade.
Cardiogenic shock is a condition of diminished cardiac output that severely impairs cardiac perfusion. In this condition in which the heart suddenly can't pump enough blood to meet the body's needs.
This document discusses chronic coronary syndrome (CCS), previously known as stable coronary artery disease. It defines CCS and outlines the six entities it can be classified into. It discusses the natural history, pathophysiology, risk factors, diagnosis and management of CCS. Key changes from 2013 guidelines include exercise stress testing now recommended for assessing symptoms and risk rather than diagnosis, and several new second-line treatment options for angina added based on heart rate, blood pressure and tolerance. Invasive testing guidelines were also updated.
This document provides information about a seminar on aortic dissection presented by Monika Devi. It discusses the introduction, types, causes, symptoms, risk factors, diagnosis, treatment, complications and prevention of aortic dissection. The two main types are Type A, which involves the ascending aorta, and Type B, which only involves the descending aorta. Causes include high blood pressure, genetic conditions like Marfan syndrome, and traumatic injury. Symptoms can include chest pain and symptoms of a stroke. Treatment depends on the type but may involve medications to lower blood pressure or surgery to repair the tear in the aorta. Complications can include death, organ damage or stroke if not properly treated.
Cardiac arrest refers to the sudden cessation of cardiac activity and can lead to death if not treated. It is usually caused by conditions that disrupt the heart's electrical system such as coronary artery disease or structural heart abnormalities. Risk factors include a family history of sudden cardiac death, previous heart issues, and lifestyle factors like smoking and obesity. Diagnosis involves evaluating the patient's history, ECG, echocardiogram, and blood work. Treatment includes CPR, defibrillation, cardiac catheterization, bypass surgery, and medication to control arrhythmias and heart disease. Nursing care focuses on monitoring the patient's condition, providing oxygen, and educating on preventing future cardiac events.
An aneurysm is a localized bulging or ballooning of the wall of an artery. It occurs when the arterial wall weakens, causing it to widen abnormally. The two main types are saccular aneurysms, which are spherical bulges, and fusiform aneurysms, which elongate a portion of the artery. Aneurysms can enlarge over time and rupture, causing life-threatening hemorrhage. Risk factors include atherosclerosis, infection, smoking, hypertension, and genetic conditions. Diagnosis involves physical exam and imaging tests. Treatment depends on the location and size of the aneurysm but may involve open or endovascular surgical repair to prevent rupture.
Persistent truncus arteriosus (or patent truncus arteriosus), also known as Common arterial trunk, is a rare form of congenital heart disease that presents at birth. In this condition, the embryological structure known as the truncus arteriosus fails to properly divide into the pulmonary trunk and aorta. This results in one arterial trunk arising from the heart and providing mixed blood to the coronary arteries, pulmonary arteries, and systemic circulation
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
This document discusses the assessment, investigation, and treatment of chronic stable angina. It defines chronic stable angina as chest pain or discomfort that is reproducibly associated with exertion or stress and relieved by rest. The document outlines how to evaluate patients presenting with chest pain through history, physical exam, risk factor assessment, and probability estimation models. It recommends initial tests like ECG, cardiac biomarkers, and stress testing. Treatment focuses on lifestyle changes, medications like aspirin, beta-blockers, calcium channel blockers, and revascularization if needed. Regular patient follow up and education are also emphasized.
This document discusses pulmonary thromboembolism (PE), which refers to blood clots (thrombi) traveling from deep veins to the lungs. Most clots originate in the lower extremities. Risk factors include inherited conditions, surgery, trauma, immobilization, cancer and pregnancy. PE can cause hypoxemia and pulmonary hypertension. Diagnosis involves clinical assessment, D-dimer testing, chest imaging like CT pulmonary angiogram (gold standard), ventilation-perfusion scanning and echocardiogram. Treatment aims to relieve symptoms and prevent complications like right heart strain.
Atrial septal defect (ASD) is an abnormal opening between the right and left atria that allows blood to pass from the left to the right atrium. There are three main types of ASDs that differ in their location within the atrial septum. Untreated ASDs can lead to volume overload of the right ventricle and elevated pulmonary artery pressures over time. While small defects may be asymptomatic, children with ASDs can experience fatigue, infections, and poor weight gain. Diagnosis involves auscultation, chest X-ray, ECG, echocardiogram and cardiac catheterization. Surgical closure of the defect is usually recommended in childhood to prevent long-term complications like congest
An aortic aneurysm is a localized sac or dilation formed at a weak point in the aortic wall. They most commonly occur in the abdominal aorta and can be caused by conditions like hypertension, atherosclerosis, and smoking. Aortic aneurysms are classified as either saccular or fusiform based on their shape and size. Untreated aneurysms risk rupture, which can cause massive hemorrhage and death. Surgical treatment involves replacing the diseased aortic segment with a synthetic graft to prevent rupture.
This document outlines the assessment and management of a patient named Melvin Pious presenting with chest pain. It details obtaining a history and physical exam, monitoring vital signs and performing an ECG and cardiac marker tests. Immediate interventions include oxygen, aspirin, nitroglycerine and morphine. Further medical interventions may include thrombolytic therapy within 30 minutes or primary percutaneous coronary intervention within 90 minutes. Laboratory tests and imaging are also ordered to evaluate the patient's condition.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
A ventricular septal defect (VSD) is a hole in the septum separating the left and right ventricles of the heart. VSDs are the most common type of congenital heart defect, occurring in about 2 out of every 1000 live births. They can range from small to large in size. Echocardiography is the primary way to diagnose a VSD and determine its location and size. Small VSDs may close on their own, but larger defects often require surgery to repair.
Raynaud's phenomenon is characterized by episodic vasospasm and ischemia of the extremities in response to cold or stress. Attacks typically involve color changes from white to blue to red. Primary Raynaud's has no known cause, while secondary Raynaud's is associated with underlying conditions like scleroderma. Nifedipine is currently the only drug approved for treatment, though research continues on therapies like topical nitroglycerin and rho kinase inhibitors to promote vasodilation.
Raynaud's disease is a condition that causes some areas of the body like fingers and toes to feel numb and cool in response to cold temperatures or stress. It is caused by narrowing of small blood vessels. Women are more likely than men to have it. Symptoms include changes in color and sensation in the fingers and toes. Diagnosis involves tests like a cold stimulation test and exams to check for autoimmune diseases. Lifestyle changes like avoiding smoking and stress can help prevent attacks. Medications may also be used to treat it if severe. Complications can include sores and tissue damage if not properly managed.
Raynaud's syndrome, also called Raynaud's phenomenon, is a condition that causes some areas of the body, such as fingers and toes, to feel numb and cool in response to cold temperatures or stress. It is caused by narrowing of small blood vessels. There are two main types: primary Raynaud's has no identified cause, while secondary Raynaud's is caused by an underlying condition like connective tissue disease. Symptoms include discolored, painful skin on fingers/toes. Treatment focuses on avoiding triggers and may include vasodilator drugs.
Syncope is a common medical problem that causes a brief loss of consciousness. It affects 15-39% of the general population annually. The main causes are vasovagal, orthostatic hypotension, cardiac issues, and unknown. Evaluation involves ruling out other conditions through history, exam, ECG and basic tests. If no cause is found, tilt table testing may be used. Treatment focuses on addressing the underlying cause, with beta-blockers and volume expanders sometimes used for vasovagal syncope. Prognosis depends on any cardiac issues found.
This document provides information about Raynaud's disease. It begins with an introduction that defines Raynaud's as a rare disorder affecting the arteries that causes vasospasm and reduced blood flow to the fingers and toes. It then covers the classification of Raynaud's disease into primary and secondary types. The causes, risk factors, pathophysiology, clinical manifestations, diagnostic evaluations, treatment options including medications and surgery, complications, health education, and nursing care plans are all discussed in detail.
The document discusses electrocardiography and rheumatic fever. It provides details on:
1) The components and intervals of an electrocardiogram (ECG) waveform
2) The Jones criteria for diagnosing rheumatic fever, which involves certain major and minor clinical manifestations
3) Treatment for rheumatic fever involves antibiotics, anti-inflammatory drugs, and in cases of cardiac involvement, corticosteroids. Secondary prevention relies on long-term antibiotics.
This document discusses acute rheumatic fever, which is triggered by an immune response to streptococcal infection and causes inflammation in connective tissues including the heart, joints, and skin. Key points include:
- It commonly affects children ages 5-15 and is characterized by fever, joint pain, and sometimes heart complications.
- The heart issues are due to cross-reactivity between streptococcal and heart proteins, leading to conditions like rheumatic carditis.
- Diagnosis is based on symptoms and evidence of prior streptococcal infection. Treatment focuses on antibiotics, aspirin or steroids to reduce inflammation, and long-term antibiotic prophylaxis to prevent future attacks.
The document defines hypertension and discusses changes made to definitions in guidelines from 2003 and 2017. It also covers the epidemiology of hypertension, risk factors, mechanisms, etiologies (essential vs. secondary), diagnosis, evaluation, target organ damage, clinical presentation, and patient workup. The summary provides an overview of key points:
1. The document defines normal, prehypertension, stage 1 and 2 hypertension based on guidelines from 2003 and 2017.
2. Hypertension is the most prevalent risk factor for cardiovascular disease, affecting about 30% of people over 18 and 50% over 60.
3. Patient evaluation for hypertension includes history, exam, and tests to define blood pressure levels, identify risk factors,
Rheumatic fever is an inflammatory disease that occurs as a delayed reaction to a Group A streptococcal throat infection. It most commonly affects children between 5-18 years old. The main manifestations include arthritis, carditis, chorea, and less commonly subcutaneous nodules and erythema marginatum. It is diagnosed using the revised Jones criteria which requires evidence of a preceding streptococcal infection and either two major manifestations or one major and two minor manifestations. Treatment involves primary prevention through antibiotic treatment of streptococcal infections, anti-inflammatory treatment such as aspirin for arthritis and steroids for carditis, supportive management of complications, and long-term secondary prevention through antibiotic prophylaxis.
Raynaud’s phenomenon is a peculiar vascular sign. It may be primary which is best described as Raynaud’s disease or secondary. Secondary Raynaud’s phenomenon is due to connective tissue disorders or occupational in origin. Identifying the type is essential for treatment. Associated clinical features and laboratory tests help in making the distinction. The paper discusses the essential practice points related to the phenomenon.
The patient, a 50-year-old female, presented with headache, vomiting, breathlessness and decreased urine output. She had a history of rheumatic heart disease for 4 years and was on warfarin therapy. Investigation revealed subdural hematoma which resolved after stopping warfarin. The final diagnosis was rheumatic heart disease with severe mitral stenosis, pulmonary hypertension, congestive cardiac failure, atrial fibrillation and warfarin-induced acute subdural hematoma.
Raynaud's disease is a rare disorder characterized by vasospasm of the arteries, reducing blood flow to the fingers and toes and causing them to temporarily turn pale or blue. It can be primary or secondary to other conditions. Primary Raynaud's has no known cause, while secondary Raynaud's is associated with diseases like scleroderma or connective tissue diseases. Episodes are typically triggered by cold temperatures or stress. Treatment focuses on lifestyle changes and medications to dilate blood vessels. Nursing care involves assessing circulation, providing warm compresses, administering vasodilating medications, educating on self-care activities, and addressing anxiety.
1) Rheumatic fever is an autoimmune disease that can occur as a delayed complication of untreated Group A streptococcal pharyngitis, with a latent period of 1-3 weeks.
2) It commonly affects children between 5-15 years of age and can involve the heart, joints, skin, and brain. The heart is involved in approximately 50-60% of cases (carditis).
3) Treatment involves bed rest, antibiotics to eradicate streptococci, anti-inflammatory drugs like aspirin for arthritis and carditis, corticosteroids for moderate to severe carditis, and long-term antibiotic prophylaxis to prevent recurrences.
Raynaud's disease is a condition characterized by spasm of the arteries, especially in the fingers, typically brought on by cold or vibration. It causes episodes where the affected areas turn white, then blue, then red as feeling returns. There are two main types - primary Raynaud's, which has no known cause, and secondary Raynaud's, which results from an underlying condition like connective tissue disorders. Diagnosis involves tests to distinguish between the types and check for underlying causes. Treatment focuses on avoiding triggers, managing any underlying conditions, and medications like calcium channel blockers or vasodilators to improve blood flow.
This document discusses valvular heart disease and rheumatic heart disease. It describes how valves can become narrowed or fail to close adequately, leading to regurgitation. Doppler echocardiography is useful for assessing valvular disease. Rheumatic fever is triggered by streptococcal infection and causes inflammation of the heart valves, most commonly affecting the mitral valve and causing mitral stenosis over time. Chronic rheumatic heart disease develops in at least half of rheumatic fever patients and causes progressive fibrosis and calcification of the valves.
The document summarizes principles of electrocardiography and rheumatic fever. It discusses:
1. The electrocardiogram represents electrical activity of the heart during the cardiac cycle, starting from the SA node through the ventricles. Standard ECG analysis examines heart rate, rhythm, intervals and abnormalities.
2. Rheumatic fever is caused by untreated streptococcal infection and can lead to heart damage. It is diagnosed using Jones Criteria involving major criteria of carditis, arthritis, chorea and minor criteria including fever and joint pain. Treatment involves antibiotics and anti-inflammatories.
3. Mitral stenosis is most often caused by rheumatic heart disease involving thickened,
Seminar on buergers disease and raynauds diseaseUma Binoy
Raynaud's disease and thromboangitis obliterans (Buerger's disease) are caused by reduced blood flow to the extremities. Raynaud's disease involves intermittent vasoconstriction of arteries in fingers and toes in response to cold or stress, causing discoloration and pain. Buerger's disease causes inflammation and blood clots in lower extremity arteries and veins, which can lead to gangrene if untreated. Both diseases require lifestyle modifications like avoiding cold and tobacco to prevent attacks and progression. Treatment involves medications to improve circulation, surgery to relieve symptoms, and amputation in severe cases of Buerger's disease.
Raynaud's phenomenon is a condition that causes reduced blood flow to the extremities, such as fingers and toes, in response to cold or stress. It has two main types: primary Raynaud's, which has no known cause, and secondary Raynaud's, which is caused by an underlying condition like scleroderma or injury. Symptoms include discoloration of the skin and pain or numbness. Management involves lifestyle changes to avoid triggers, medications to dilate blood vessels, and in severe cases, surgery. Nursing care focuses on education to prevent attacks and maintaining proper circulation and tissue oxygenation.
Acute rheumatic fever is an autoimmune disorder triggered by Group A streptococcal infection that causes inflammation in the heart, joints, brain, and skin. It most commonly affects children ages 5-15. Symptoms include fever, joint pain, and heart complications. Diagnosis involves evidence of a prior streptococcal infection and either two major symptoms or one major and two minor symptoms. Long-term antibiotic prophylaxis is needed to prevent recurrence and further heart damage. Without treatment, acute rheumatic fever can lead to rheumatic heart disease.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. INTRODUCTION
a medical condition in which spasm of arteries cause
episodes of reduced blood flow. Typically, the fingers, and
less commonly the toes, are involved. Rarely, the nose,
ears, or lips are affected.
3. 1. RP is considered primary if these symptoms occur
alone without evidence of any associated disorder
2. secondary RP refers to the presence of the disorder in
association with a related illness, such as systemic
lupus erythematosus and systemic sclerosis (SSc;
scleroderma)
4. EPIDEMIOLOGY
estimates of the prevalence of
RP have ranged from 3 to 20
percent in women and 3 to
14 percent in men.
RP is more common among
young women, younger age
groups, and family
members of patients with RP
5. Primary Raynaud phenomenon
is term to describe those patients without a
definable cause for their vascular events
usually has an age of onset between 15 and 30 years of
age, is more common in women, and may occur in
multiple family members
while primary RP often begins in the teenage years,
careful assessment for secondary causes is most
important
6. There is a reported increase in prevalence of RP among
patients with fibromyalgia syndrome
Similarly, there are several surveys that support an
association of migraine headaches and RP
7. Secondary Raynaud phenomenon
Secondary RP refers to those patients with RP in
whom an associated disease or cause may underlie the
attacks:
Diseases commonly associated with RP include
autoimmune rheumatic diseases such as systemic
sclerosis (SSc; scleroderma), systemic lupus
erythematosus, mixed connective tissue disease,
Sjögren's syndrome and
dermatomyositis/polymyositis.
8. Various drugs or toxins can also
precipitate or exacerbate RP such
as amphetamines and
chemotherapeutic agents
(especially cisplatin and
bleomycin)
Occupational and environmental
causes of RP include vascular
trauma (eg,injury to the distal
ulnar artery in the hypothenar
hammer syndrome) the use of
vibrating tools frostbite and
carpal tunnel syndrome
9. Hypothyroidism may predispose to RP, and
improvement of cold induced vasospasm may occur
with thyroid hormone replacement. Vasculitis may
cause ischemic digits, but the absence of preceding
cold-induced and reversible color changes help
distinguish this from true RP.
10. CLINICAL MANIFESTATIONS
With both primary and secondary RP, a typical episode
is characterized by the sudden onset of cold fingers
(or toes) in association with sharply demarcated color
changes of skin pallor (white attack) due to constricted
blood flow, followed by cyanotic skin (blue attack)
which indicates tissue hypoxia
With rewarming, the ischemic phase (white or blue
attack) usually lasts for 15 to 20 minutes. The skin
subsequently blushes upon recovery, thereby resulting
in the erythema of reperfusion.
11.
12. A Raynaud attack typically begins in a single finger
and then spreads to other digits symmetrically in
both hands
The index, middle, and ring finger are the most
frequently involved digits, while the thumb is often
spared entirely.
so , Involvement of the thumb may indicate a
secondary cause of RP
13. Livedo reticularis
During a cold response, patients with RP may exhibit
livedo reticularis; this is a violaceous mottling or
reticular pattern of the skin of the arms and legs,
sometimes with regular unbroken circles. In those
with primary RP, this finding is benign and completely
reversible with rewarming
14. By comparison, nonreversible livedo reticularis may
be observed in patients with vasculitis, occlusive
vascular disease (eg, due to atheroemboli or
thrombosis), or antiphospholipid syndrome.
These cutaneous changes may also be associated with
irregular broken circles.
15. EVALUATION AND DIAGNOSIS
Our evaluation begins with the following three
screening questions for RP :
● Are your fingers unusually sensitive to cold?
●Do your fingers change color when they are exposed to
cold temperatures?
●Do your fingers turn white, blue, or both?
We diagnose RP if the patient has a positive response to
all three questions
16. Nailfold capillary microscopy
Nailfold capillary microscopy is
performed by dropping oil on
the periungual area and
examining with an
ophthalmoscope set at diopter
40 or with a dissecting
microscope.
Nailfold capillaroscopy is
the method most
commonly used in
clinical practice to help
distinguish patients with
primary RP from those
with secondary RP.
17. Enlarged or distorted capillary loops and/or
dropout or loss of loops suggest an underlying
(or an increased likelihood of developing)
autoimmune rheumatic disease
If the enlargement is associated with loss of
capillaries, then the patient is more likely to have
or develop SSc
18. Every patient with a diagnosis of RP should be
carefully evaluated to distinguish primary RP from the
secondary disorder.
We diagnose primary RP if the results of a thorough
history and physical examination, including nailfold
capillary microscopy, do not suggest secondary RP.
There is typically no need for further specialized
testing among such patients
19. Patients with a moderate or high clinical suspicion of a
secondary cause of RP may have the following clinical
features:
• Later age of onset (greater than 40 years)
• History of a known precipitant
• Male gender
• Painful severe events with tissue sign of ischemia (ulceration)
• Asymmetric attacks
• RP associated with signs or symptoms of another disease
• Abnormal nailfold capillaries
• Abnormal laboratory parameters suggesting vascular disease or an
autoimmune disorder
•RP associated with ischemic signs or symptoms proximal to the
fingers (such as the hand or arm) or toes (foot or limb)
20. There are several conditions and disorders that can mimic
RP including:
excessive cold sensitivity
external compression of blood vessels
peripheral neuropathy
complex regional pain syndrome
occlusive vascular disease
acrocyanosis
acute idiopathic blue finger
erythromelalgia
21. Initial treatment of the Raynaud phenomenon
The goals of therapy in patients with the Raynaud
phenomenon (RP) are to improve quality of life and to
prevent ischemic tissue injury. At least a moderate
reduction in the intensity of attacks and the
prevention of digital ulcers or tissue injury are
achievable in most patients. However, abolishing cold
sensitivity and eliminating all Raynaud events is not
likely with available treatment options, particularly in
patients with secondary RP
22. We advise that all patients should be educated
regarding both the potential causes of a Raynaud
attack and the general measures to help prevent and
terminate an episode. Patients with primary RP are
unlikely to develop damaging digital ischemia and
thus are considered good candidates for
nonpharmacologic therapies
23. General measures that help to prevent or diminish the
severity of attacks of RP include:
●Avoidance of cold exposure, especially sudden changes
such as walking into the frozen food section of a grocery
store.
●Use of strategies to keep the whole body warm,
including dressing warmly (eg,with thermal underwear,
layered clothing, and a heat-conserving hat).
●Use of strategies to keep the digits of the hands and
feet warm (eg, winteer gloves, chemical hand warmers,
and heavy wool stockings).
●Knowledge of methods to help terminate an attack of RP.
These include placing the hands under warm water or
in a warm place (such as the axilla) or rotating arms in a
whirling or windmill pattern. Rubbing the hands
together can help.
24. ● Avoidance of rapidly changing temperatures, such as occurs when
quickly moving from a hot environment (90ºF) into an air-conditioned
room (70ºF).
● Avoiding sitting motionless in cool breezes or in humid cold air is
also recommended.
● Avoidance of smoking is advised since regular smokers are sensitized to
the vasoconstrictive properties of cigarettes.
●Avoidance of sympathomimetic drugs (such as decongestants,
amphetamines, diet pills, herbs containing ephedra), which is generally
recommended, although studies evaluating the degree of the impact of
over-the-counter preparations (such as cold medications) have not been
performed .
● Avoidance of agents used to treat attention deficit hyperactivity disorder
(methylphenidate and dextroamphetamine) is recommended.
25. ●Avoidance of some of the medications used for migraine
headaches, including serotonin agonists (eg, sumatriptan) or
caffeine plus ergotamine.
● Avoidance of repeated trauma to the fingertips by all
patients with RP and avoidance of vibrating tools by patients
with vibration-induced RP .
● Control or limitation of emotional stress, because the
thermoregulatory vessels are constricted by increased
sympathetic tone. Stress plus cold exposure is an especially
potent trigger for RP
26. Pharmacotherapy
We recommend use of the slow-release or long-acting
preparations of the dihydropyridine calcium channel
blockers (CCBs)
Effective doses of nifedipine range from 30 to 180
mg/day, and effective doses of amlodipine range
from 5 to 20 mg/day
start with the lowest dose and gradually increase, if
needed, depending upon the response
Some experts feel that amlodipine may be better
tolerated in patients with low blood pressure at
baseline
27. The major side effects associated with the dihydropyridines
include headache, dizziness, flushing, tachycardia,
and edema.
Maximal doses of the calcium channel blocker (eg,
amlodipine 15 to 20 mg/day) may lead to significant
edema
Alternative therapies may be required in patients in whom
CCBs are contraindicated or are poorly tolerated at low
doses (eg, patients with severe gastrointestinal
dysmotility, severe pulmonary artery hypertension,
significant cardiac disease with edema, and low blood
pressure).
28. ● A phosphodiesterase-5 inhibitor, such as sildenafil
● Topical nitrates
●An alternative oral agent, such as losartan or fluoxetine
● Local injection of botulinum toxin type A is also an
option