SlideShare a Scribd company logo
1 of 36
CCU Case Conference
Chief Complaint ,[object Object]
History of Present Illness ,[object Object],[object Object]
Past Medical History ,[object Object],[object Object],[object Object]
[object Object]
 
South Asians and CV risk
Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Assessment 8.5 8.5 – 10.5 Calcium (mg/dl) 136 70 - 110 Glucose (mg/dl) 1.5 0.6 – 1.5 Creatinine (mg/dl) 20 8 – 25 Urea nitrogen (mg/dl) 22 23.0 – 31.9 Carbon dioxide (mmol/liter) 102 100 – 108 Chloride (mmol/liter) 5.4 3.4 – 4.8 Potassium (mmol/liter) 137 135 – 145 Sodium (mmol/liter) CHEMISTRY ON ADMISSION REFERENCE RANGE TEST
Laboratory Assessment 0 2-8 Bands 1.1 11.3 – 13.3 INR 13.9 22.1 – 35.1 Partial-thromboplastin time (sec) 269 150,000 – 300,000 Platelet Count (per mm 3 ) 11 4 – 11 Monocytes 15 22 – 44 Lymphocytes 74 40 – 70 Neutrophils Differential Count (%) 15.0 4,500 – 11,000 White-cell count (per mm 3 ) 41.3 41.0 – 53.0 Hematocrit (%) 13.9 13.5 – 17.5 Hemoglobin (g/dl) HEMATOLOGY ON ADMISSION REFERENCE RANGE TEST
Laboratory Assessment ,[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
 
 
Hospital Course ,[object Object],[object Object]
Hospital Course ,[object Object],[object Object]
Hospital Course ,[object Object]
 
 
 
 
 
 
Hospital Course ,[object Object]
 
 
Post – operative course ,[object Object],[object Object]
Post – operative course ,[object Object]
Ventricular Septal Rupture ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1  Birnbaum, NEJM 2002 2  Crenshaw, Circulation 2000
The Evolution of an MI 7 - 10 d 3 - 4 d 30 m - 4 h 10 - 14 d 2 -8 wk Dense collagenous scar  >2 mo  Increased collagen deposition, with decreased cellularity  2–8 wk  Well-established granulation tissue with new blood vessels and collagen deposition  10–14 days  Well-developed phagocytosis of dead cells; early formation of fibrovascular granulation tissue at margins  7–10 days  Beginning disintegration of dead myofibers, with dying neutrophils; early phagocytosis of dead cells by macrophages at infarct border  3–7 days  Coagulation necrosis, with loss of nuclei and striations; brisk interstitial infiltrate of neutrophils  1 to 3 days Ongoing coagulation necrosis; myocyte hypereosinophilia; marginal contraction band necrosis; early neutrophilic infiltrate  12 to 24 hrs Early coagulation necrosis; edema; hemorrhage  4 to 12 hrs Variable waviness of fibers at border  30 min to 4 hrs Relaxation of myofibrils; glycogen loss; mitochondrial swelling  0 to 30 min Morphological Changes Time
[object Object],[object Object],[object Object]

More Related Content

What's hot

Churg strauss syndrome nephropathy
Churg strauss syndrome nephropathyChurg strauss syndrome nephropathy
Churg strauss syndrome nephropathyVishal Ramteke
 
Dr. Burke Product Power Point
Dr. Burke Product Power PointDr. Burke Product Power Point
Dr. Burke Product Power PointRobbie Warren
 
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISRESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISULVAN OZAD
 
Sepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac DysfunctionSepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac Dysfunctionshivabirdi
 
Vte path and rx
Vte path and rx Vte path and rx
Vte path and rx derosaMSKCC
 
Mangement of sepsis and septic shock
Mangement of sepsis and septic shockMangement of sepsis and septic shock
Mangement of sepsis and septic shockhamida Esahli
 
An approach to myocardial biopsy interpretation
An approach to myocardial biopsy interpretationAn approach to myocardial biopsy interpretation
An approach to myocardial biopsy interpretationSaurav Singh
 
Hcm 2013 congresso finale1
  Hcm 2013 congresso finale1  Hcm 2013 congresso finale1
Hcm 2013 congresso finale1Pietro Giuliano
 
Seminario Biologia Molecular
Seminario Biologia Molecular Seminario Biologia Molecular
Seminario Biologia Molecular Miguel Saavedra
 
Debate endomyocardial biopsy aldia
Debate endomyocardial biopsy aldiaDebate endomyocardial biopsy aldia
Debate endomyocardial biopsy aldiadrucsamal
 
Brugada syndrome
Brugada syndromeBrugada syndrome
Brugada syndromeMamata rai
 
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-Yusuke Ebana
 

What's hot (16)

Churg strauss syndrome nephropathy
Churg strauss syndrome nephropathyChurg strauss syndrome nephropathy
Churg strauss syndrome nephropathy
 
Dr. Burke Product Power Point
Dr. Burke Product Power PointDr. Burke Product Power Point
Dr. Burke Product Power Point
 
Chronic Allograft Injury
Chronic Allograft InjuryChronic Allograft Injury
Chronic Allograft Injury
 
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSISRESPIRATORY ASPECT OF CYSTIC FIBROSIS
RESPIRATORY ASPECT OF CYSTIC FIBROSIS
 
Sepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac DysfunctionSepsis-Induced Cardiac Dysfunction
Sepsis-Induced Cardiac Dysfunction
 
Vte path and rx
Vte path and rx Vte path and rx
Vte path and rx
 
Mangement of sepsis and septic shock
Mangement of sepsis and septic shockMangement of sepsis and septic shock
Mangement of sepsis and septic shock
 
Sepsis & Septic Shock
Sepsis & Septic ShockSepsis & Septic Shock
Sepsis & Septic Shock
 
Bruguda syndrome
Bruguda syndromeBruguda syndrome
Bruguda syndrome
 
An approach to myocardial biopsy interpretation
An approach to myocardial biopsy interpretationAn approach to myocardial biopsy interpretation
An approach to myocardial biopsy interpretation
 
Hcm 2013 congresso finale1
  Hcm 2013 congresso finale1  Hcm 2013 congresso finale1
Hcm 2013 congresso finale1
 
Seminario Biologia Molecular
Seminario Biologia Molecular Seminario Biologia Molecular
Seminario Biologia Molecular
 
Hcc2
Hcc2Hcc2
Hcc2
 
Debate endomyocardial biopsy aldia
Debate endomyocardial biopsy aldiaDebate endomyocardial biopsy aldia
Debate endomyocardial biopsy aldia
 
Brugada syndrome
Brugada syndromeBrugada syndrome
Brugada syndrome
 
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-
Genetic basis of inherited arrhythmia syndome -From monogenic to polygenic-
 

Viewers also liked

Indipendenza energetica e indipendenza economica
Indipendenza energetica e indipendenza economicaIndipendenza energetica e indipendenza economica
Indipendenza energetica e indipendenza economicaComitato Energia Felice
 
Maschera3u
Maschera3uMaschera3u
Maschera3uANiMALA
 
10 cittĂ  della salute
10 cittĂ  della salute10 cittĂ  della salute
10 cittĂ  della saluteComune Udine
 
Nonsembravanovembre stefano ventura rimini_9maggio11
Nonsembravanovembre stefano ventura rimini_9maggio11Nonsembravanovembre stefano ventura rimini_9maggio11
Nonsembravanovembre stefano ventura rimini_9maggio11Stefano Ventura
 
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...Comitato Energia Felice
 

Viewers also liked (7)

Indipendenza energetica e indipendenza economica
Indipendenza energetica e indipendenza economicaIndipendenza energetica e indipendenza economica
Indipendenza energetica e indipendenza economica
 
Maschera3u
Maschera3uMaschera3u
Maschera3u
 
Daniele Muriano
Daniele MurianoDaniele Muriano
Daniele Muriano
 
206 convenzione sulla maternitĂ 
206   convenzione sulla maternitĂ 206   convenzione sulla maternitĂ 
206 convenzione sulla maternitĂ 
 
10 cittĂ  della salute
10 cittĂ  della salute10 cittĂ  della salute
10 cittĂ  della salute
 
Nonsembravanovembre stefano ventura rimini_9maggio11
Nonsembravanovembre stefano ventura rimini_9maggio11Nonsembravanovembre stefano ventura rimini_9maggio11
Nonsembravanovembre stefano ventura rimini_9maggio11
 
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...
L'imperativo della riduzione delle emissioni climalteranti: motivazioni scien...
 

Similar to VSR again

Epidural abcess a case presentation
Epidural abcess a case presentationEpidural abcess a case presentation
Epidural abcess a case presentationRamy Mostafa
 
Epidural abcess a case presentation
Epidural abcess a case presentationEpidural abcess a case presentation
Epidural abcess a case presentationRamy Mostafa
 
Cerebral Fat Embolism in ICU
Cerebral Fat Embolism in ICU Cerebral Fat Embolism in ICU
Cerebral Fat Embolism in ICU Dr.Tarek Sabry
 
Pulmonary Embolism.pptx
Pulmonary Embolism.pptxPulmonary Embolism.pptx
Pulmonary Embolism.pptxDrSwarupDas1
 
Fellows Conference
Fellows ConferenceFellows Conference
Fellows Conferencecallroom
 
Bleeding in paediatric surgery - case presentations
Bleeding in paediatric surgery - case presentationsBleeding in paediatric surgery - case presentations
Bleeding in paediatric surgery - case presentationsscanFOAM
 
Ultrasound assisted thrombolysis for vte turkish experience
Ultrasound assisted thrombolysis for vte turkish experienceUltrasound assisted thrombolysis for vte turkish experience
Ultrasound assisted thrombolysis for vte turkish experienceuvcd
 
Acute radiation syndrome - handout
Acute radiation syndrome - handoutAcute radiation syndrome - handout
Acute radiation syndrome - handoutFarooq Khan
 
papillary thyroid carcinoma ppt
papillary thyroid carcinoma pptpapillary thyroid carcinoma ppt
papillary thyroid carcinoma pptDr Tarique Ahmed Maka
 
July 2013 audit presentation ga and lrti
July 2013 audit presentation ga and lrtiJuly 2013 audit presentation ga and lrti
July 2013 audit presentation ga and lrtinolife
 
Ca Papillary(Thyroid Gland)
Ca Papillary(Thyroid Gland)Ca Papillary(Thyroid Gland)
Ca Papillary(Thyroid Gland)DRASIMSHAHZAD1
 
Puerperial sepsis
Puerperial sepsisPuerperial sepsis
Puerperial sepsisDR MUKESH SAH
 

Similar to VSR again (20)

CPC
CPCCPC
CPC
 
Dvt work up
Dvt work upDvt work up
Dvt work up
 
Epidural abcess a case presentation
Epidural abcess a case presentationEpidural abcess a case presentation
Epidural abcess a case presentation
 
Epidural abcess a case presentation
Epidural abcess a case presentationEpidural abcess a case presentation
Epidural abcess a case presentation
 
Cerebral Fat Embolism in ICU
Cerebral Fat Embolism in ICU Cerebral Fat Embolism in ICU
Cerebral Fat Embolism in ICU
 
Pulmonary Embolism.pptx
Pulmonary Embolism.pptxPulmonary Embolism.pptx
Pulmonary Embolism.pptx
 
Fellows Conference
Fellows ConferenceFellows Conference
Fellows Conference
 
Bleeding in paediatric surgery - case presentations
Bleeding in paediatric surgery - case presentationsBleeding in paediatric surgery - case presentations
Bleeding in paediatric surgery - case presentations
 
Ultrasound assisted thrombolysis for vte turkish experience
Ultrasound assisted thrombolysis for vte turkish experienceUltrasound assisted thrombolysis for vte turkish experience
Ultrasound assisted thrombolysis for vte turkish experience
 
Acute radiation syndrome - handout
Acute radiation syndrome - handoutAcute radiation syndrome - handout
Acute radiation syndrome - handout
 
papillary thyroid carcinoma ppt
papillary thyroid carcinoma pptpapillary thyroid carcinoma ppt
papillary thyroid carcinoma ppt
 
Moeez
Moeez Moeez
Moeez
 
July 2013 audit presentation ga and lrti
July 2013 audit presentation ga and lrtiJuly 2013 audit presentation ga and lrti
July 2013 audit presentation ga and lrti
 
Case discussion
Case discussionCase discussion
Case discussion
 
Ca Papillary(Thyroid Gland)
Ca Papillary(Thyroid Gland)Ca Papillary(Thyroid Gland)
Ca Papillary(Thyroid Gland)
 
Copd in ICU
Copd in ICUCopd in ICU
Copd in ICU
 
Mortality Meet Presentation by Dr. Saumya Agarwal
Mortality Meet Presentation by Dr. Saumya Agarwal Mortality Meet Presentation by Dr. Saumya Agarwal
Mortality Meet Presentation by Dr. Saumya Agarwal
 
Puerperial sepsis
Puerperial sepsisPuerperial sepsis
Puerperial sepsis
 
Cbp on vt (1)
Cbp on vt (1)Cbp on vt (1)
Cbp on vt (1)
 
Fat embolism
Fat embolismFat embolism
Fat embolism
 

More from callroom

ppt6
ppt6ppt6
ppt6callroom
 
PPT5
PPT5PPT5
PPT5callroom
 
PPT2
PPT2PPT2
PPT2callroom
 
PPT1
PPT1PPT1
PPT1callroom
 
Test Presentation
Test PresentationTest Presentation
Test Presentationcallroom
 
Thyroid and the Heart
Thyroid and the HeartThyroid and the Heart
Thyroid and the Heartcallroom
 
Myocardial Viability - the STICH Trial NEJM May 2011
Myocardial Viability - the STICH Trial NEJM May 2011Myocardial Viability - the STICH Trial NEJM May 2011
Myocardial Viability - the STICH Trial NEJM May 2011callroom
 
Flail Leaflet
Flail LeafletFlail Leaflet
Flail Leafletcallroom
 
Fat versus Fit
Fat versus FitFat versus Fit
Fat versus Fitcallroom
 
Cardiac MR and viability
Cardiac MR and viabilityCardiac MR and viability
Cardiac MR and viabilitycallroom
 
Cardiac MR and viability
Cardiac MR and viabilityCardiac MR and viability
Cardiac MR and viabilitycallroom
 
LFT Review
LFT ReviewLFT Review
LFT Reviewcallroom
 
testing123
testing123testing123
testing123callroom
 
Hypertrophic Cardiomyopathy
Hypertrophic CardiomyopathyHypertrophic Cardiomyopathy
Hypertrophic Cardiomyopathycallroom
 
C. diff presentation
C. diff presentationC. diff presentation
C. diff presentationcallroom
 
test
testtest
testcallroom
 
Hemostasis and Thrombosis
Hemostasis and ThrombosisHemostasis and Thrombosis
Hemostasis and Thrombosiscallroom
 
qwqsqw
qwqsqwqwqsqw
qwqsqwcallroom
 

More from callroom (20)

ppt6
ppt6ppt6
ppt6
 
PPT5
PPT5PPT5
PPT5
 
PPT2
PPT2PPT2
PPT2
 
PPT1
PPT1PPT1
PPT1
 
Test Presentation
Test PresentationTest Presentation
Test Presentation
 
Thyroid and the Heart
Thyroid and the HeartThyroid and the Heart
Thyroid and the Heart
 
Myocardial Viability - the STICH Trial NEJM May 2011
Myocardial Viability - the STICH Trial NEJM May 2011Myocardial Viability - the STICH Trial NEJM May 2011
Myocardial Viability - the STICH Trial NEJM May 2011
 
Flail Leaflet
Flail LeafletFlail Leaflet
Flail Leaflet
 
Fat versus Fit
Fat versus FitFat versus Fit
Fat versus Fit
 
Cardiac MR and viability
Cardiac MR and viabilityCardiac MR and viability
Cardiac MR and viability
 
Cardiac MR and viability
Cardiac MR and viabilityCardiac MR and viability
Cardiac MR and viability
 
LFT Review
LFT ReviewLFT Review
LFT Review
 
testing123
testing123testing123
testing123
 
Hypertrophic Cardiomyopathy
Hypertrophic CardiomyopathyHypertrophic Cardiomyopathy
Hypertrophic Cardiomyopathy
 
C. diff presentation
C. diff presentationC. diff presentation
C. diff presentation
 
test
testtest
test
 
Hemostasis and Thrombosis
Hemostasis and ThrombosisHemostasis and Thrombosis
Hemostasis and Thrombosis
 
 
 
qwqsqw
qwqsqwqwqsqw
qwqsqw
 

Recently uploaded

Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...amritaverma53
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationMedicoseAcademics
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesMedicoseAcademics
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableSteve Davis
 
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...Rashmi Entertainment
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Janvi Singh
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxSwetaba Besh
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryJyoti singh
 
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...TanyaAhuja34
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Janvi Singh
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana GuptaLifecare Centre
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Availablesoniyagrag336
 
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...call girls hydrabad
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Dipal Arora
 

Recently uploaded (20)

Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
Call Girl in Chennai | Whatsapp No 📞 7427069034 📞 VIP Escorts Service Availab...
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Difference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac MusclesDifference Between Skeletal Smooth and Cardiac Muscles
Difference Between Skeletal Smooth and Cardiac Muscles
 
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Wayanad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
❤️ Chandigarh Call Girls☎️98151-579OO☎️ Call Girl service in Chandigarh ☎️ Ch...
 
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
Call Girls Service Jaipur {9521753030 } ❤️VVIP BHAWNA Call Girl in Jaipur Raj...
 
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kathua Just Call 8250077686 Top Class Call Girl Service Available
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
(RIYA)🎄Airhostess Call Girl Jaipur Call Now 8445551418 Premium Collection Of ...
 
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
Lucknow Call Girls Service { 9984666624 } ❤️VVIP ROCKY Call Girl in Lucknow U...
 
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service AvailableLucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
Lucknow Call Girls Just Call 👉👉8630512678 Top Class Call Girl Service Available
 
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
 
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
Bhawanipatna Call Girls 📞9332606886 Call Girls in Bhawanipatna Escorts servic...
 

VSR again

  • 2.
  • 3.
  • 4.
  • 5.
  • 8.
  • 9. Laboratory Assessment 8.5 8.5 – 10.5 Calcium (mg/dl) 136 70 - 110 Glucose (mg/dl) 1.5 0.6 – 1.5 Creatinine (mg/dl) 20 8 – 25 Urea nitrogen (mg/dl) 22 23.0 – 31.9 Carbon dioxide (mmol/liter) 102 100 – 108 Chloride (mmol/liter) 5.4 3.4 – 4.8 Potassium (mmol/liter) 137 135 – 145 Sodium (mmol/liter) CHEMISTRY ON ADMISSION REFERENCE RANGE TEST
  • 10. Laboratory Assessment 0 2-8 Bands 1.1 11.3 – 13.3 INR 13.9 22.1 – 35.1 Partial-thromboplastin time (sec) 269 150,000 – 300,000 Platelet Count (per mm 3 ) 11 4 – 11 Monocytes 15 22 – 44 Lymphocytes 74 40 – 70 Neutrophils Differential Count (%) 15.0 4,500 – 11,000 White-cell count (per mm 3 ) 41.3 41.0 – 53.0 Hematocrit (%) 13.9 13.5 – 17.5 Hemoglobin (g/dl) HEMATOLOGY ON ADMISSION REFERENCE RANGE TEST
  • 11.
  • 12.  
  • 13.  
  • 14.  
  • 15.  
  • 16.  
  • 17.  
  • 18.  
  • 19.  
  • 20.
  • 21.
  • 22.
  • 23.  
  • 24.  
  • 25.  
  • 26.  
  • 27.  
  • 28.  
  • 29.
  • 30.  
  • 31.  
  • 32.
  • 33.
  • 34.
  • 35. The Evolution of an MI 7 - 10 d 3 - 4 d 30 m - 4 h 10 - 14 d 2 -8 wk Dense collagenous scar >2 mo Increased collagen deposition, with decreased cellularity 2–8 wk Well-established granulation tissue with new blood vessels and collagen deposition 10–14 days Well-developed phagocytosis of dead cells; early formation of fibrovascular granulation tissue at margins 7–10 days Beginning disintegration of dead myofibers, with dying neutrophils; early phagocytosis of dead cells by macrophages at infarct border 3–7 days Coagulation necrosis, with loss of nuclei and striations; brisk interstitial infiltrate of neutrophils 1 to 3 days Ongoing coagulation necrosis; myocyte hypereosinophilia; marginal contraction band necrosis; early neutrophilic infiltrate 12 to 24 hrs Early coagulation necrosis; edema; hemorrhage 4 to 12 hrs Variable waviness of fibers at border 30 min to 4 hrs Relaxation of myofibrils; glycogen loss; mitochondrial swelling 0 to 30 min Morphological Changes Time
  • 36.

Editor's Notes

  1. 4 main risk factors associated w/ increased risk is smoking, high Apo protein, history of hypertension, and diabetes. In this study they also found that the rates of fruit and vegetable consumption were quite lower