Aortic stenosis
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Aortic stenosis is the abnormal narrowing of the aortic valve opening. It can be caused by congenital heart defects, calcification of the valve, or rheumatic fever. Symptoms include chest pain, fainting, fatigue, and heart failure. Diagnosis involves echocardiogram, ECG, chest x-ray and cardiac catheterization. Treatment depends on severity and includes medications, balloon valvuloplasty, transcatheter aortic valve replacement, surgical aortic valve replacement, and lifestyle changes like quitting smoking.
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This document summarizes a clinical case report of a 79-year-old female patient admitted for heart failure with acute exacerbation likely due to infection. Key details include:
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- She is treated with antibiotics, diuretics, and other heart failure medications. Her symptoms improve with treatment and she is discharged with medications including valsartan and furosemide.
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This document discusses heart failure, including:
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- Common symptoms include fatigue, shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and Cheyne-Stokes respiration.
- Echocardiography, cardiac MRI, biopsy and BNP levels are important for diagnosis and evaluating the etiology and severity of heart failure.
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Diastolic dysfunction is common among elderly patients with diabetes and is a major cause of hospitalization. It involves abnormalities in left ventricular relaxation and filling during diastole. Aging and diabetes can both independently increase the risk of diastolic dysfunction through mechanisms like increased collagen deposition, oxidative stress, and impaired calcium handling. Non-invasive imaging like tissue Doppler imaging can help diagnose diastolic dysfunction in addition to clinical criteria. Current management focuses on controlling risk factors, but further research is still needed to determine the best treatment strategies.
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An overweight middle-aged man presented with acute shortness of breath, elevated blood pressure, coarse lung sounds, low oxygen saturation, and leg swelling. His initial evaluation found signs of severe congestive heart failure including pulmonary edema. Further assessment is needed to determine the underlying cause, guide treatment, and classify the type and severity of heart failure.
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This document discusses heart failure, including its increasing prevalence globally, definitions, classifications, management, and new strategies. Some key points:
- Heart failure prevalence is increasing worldwide and mortality remains high, around 50% within 5 years of diagnosis.
- The universal definition characterizes heart failure as a clinical syndrome caused by structural or functional cardiac abnormalities, accompanied by typical symptoms and signs.
- Management focuses on guideline-directed medical therapies (GDMT) including ACE inhibitors, ARBs, beta-blockers, and MRAs, though utilization remains suboptimal.
- The PARADIGM-HF trial showed the ARNI drug sacubitril/valsartan reduced cardiovascular death and heart failure
SURGICAL MANAGEMENT OF HEART FAILURE
This document discusses various surgical options for treating heart failure, including:
- Coronary artery revascularization to improve blood flow in ischemic cardiomyopathy.
- Valve surgery like mitral valve repair to address functional mitral regurgitation and reduce ventricular volume overload.
- Left ventricular reconstruction to remove scar tissue, restore a more elliptical chamber shape, and decrease wall stress.
- Passive cardiac support devices like the CorCap that provide external diastolic support to facilitate reverse remodeling.
- Mechanical circulatory support options for short-term support like IABP or long-term support like left ventricular assist devices as a bridge to transplant.
- Cardiac transplantation as the gold
Heart failure – an update [autosaved]
The document discusses congestive cardiac failure (heart failure) and its management. It provides details on:
- The high prevalence and mortality of heart failure.
- Current medical therapies including ACE inhibitors, beta-blockers, and aldosterone antagonists that have been shown to improve survival.
- Device therapies like cardiac resynchronization therapy and implantable cardioverter defibrillators that treat symptoms and reduce mortality.
- The benefits of multidisciplinary and integrated care approaches including telehealth monitoring in improving outcomes for heart failure patients.
Diastolic heart failure
Diastolic heart failure occurs when the ventricles become stiff and cannot relax fully during diastole. This prevents full ventricular filling and blood backs up in the organs. Around half of heart failure patients have diastolic heart failure. Diagnosis relies on echocardiogram showing diastolic dysfunction. Treatment focuses on controlling hypertension, volume overload, and other causes through medications like ACE inhibitors, diuretics and beta blockers.
Central aortic pressure in management hypertension 2
This document discusses the importance of measuring central aortic pressure and arterial stiffness in managing hypertension. It notes that arterial stiffness increases with age and can be detected earlier than other types of target organ damage to help prevent cardiovascular disease. Measuring pulse wave velocity is identified as the gold standard for assessing arterial stiffness. The document presents several case studies showing how evaluating arterial stiffness in addition to brachial blood pressure can modify treatment approaches and help achieve better cardiovascular outcomes for patients with hypertension.
Ueda2016 symposium - central aortic pressure in management hypertension state...
Ueda2016 symposium - central aortic pressure in management hypertension state of the art -ashraf okba
Management of stemi at emergency dept
1) Management of ST elevation myocardial infarction (STEMI) at the emergency department is critical as time lost is myocardial lost. The goal is to achieve door-to-needle time of 30 minutes to administer reperfusion therapy like streptokinase.
2) Reperfusion therapy within 30 minutes of arrival at the emergency department can reduce myocardial damage and mortality from STEMI. Hospitals should have a plan to minimize delays and ensure thrombolytic drugs are readily available.
3) Absolute contraindications for thrombolytic therapy include recent bleeding, stroke or surgery. Relative contraindications include uncontrolled high blood pressure and use of anticoagulants. Hospitals need ongoing evaluation to meet time targets for reperfusion therapy.
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This document discusses nausea and vomiting, including its definition, causes, pathophysiology, clinical presentation, and treatment. It describes the epidemiology of nausea and vomiting, noting it is most common in those aged 15-24 and less common in other ages. Treatment involves both non-pharmacological approaches like rest and rehydration as well as a variety of antiemetic drugs depending on the underlying cause, including 5-HT3 antagonists, D2 antagonists, antihistamines, and corticosteroids. The choice of antiemetic considers factors like the situation of motion sickness, pregnancy, postoperative nausea and vomiting, and cytotoxic chemotherapy.
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DNB Pediatrics OSCE CME (Command Hospital, Pune)
Tuberculosis of the spine is the likely diagnosis here. The incubation period is usually 2 years. The commonest site is the thoracolumbar area which is an area of maximum stress and has valveless venous drainage.
1
This document discusses pathology and methods in general and clinical pathology. It provides definitions of disease and death as basic notions in pathology. It also classifies pathogenic factors and discusses mechanisms of cellular injury, including depletion of ATP, damage to mitochondria, influx of calcium, accumulation of reactive oxygen species, and defects in membrane permeability. Autopsy and biopsy methods used in pathology are described.
My grevis
Myasthenia Gravis is an autoimmune disorder characterized by weakness of skeletal muscles that worsens with exertion and improves with rest. It results from antibodies directed against acetylcholine receptors at the neuromuscular junction, reducing their numbers. Clinically it presents with fluctuating weakness of extraocular muscles, facial muscles, bulbar muscles, limbs and respiratory muscles. Diagnosis involves testing for acetylcholine receptor antibodies, repetitive nerve stimulation, edrophonium testing and imaging to identify thymomas. Treatment includes acetylcholinesterase inhibitors, immunomodulators like prednisone, plasmapheresis and thymectomy.
Lecture section...Myasthenia Gravis
Myasthenia Gravis is an autoimmune neuromuscular disorder characterized by weakness of skeletal muscles that worsens with exertion and improves with rest. It results from antibodies directed against acetylcholine receptors at the neuromuscular junction, reducing their numbers and impairing signal transmission from nerves to muscles. Diagnosis involves testing for antibodies, electrodiagnostic studies like repetitive nerve stimulation and single fiber EMG, and response to medications like edrophonium. Treatment focuses on acetylcholinesterase inhibitors, immunomodulators like corticosteroids, plasmapheresis, and thymectomy in cases involving thymoma.
Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease that causes inflammation, swelling, and pain in the joints. It affects approximately 1% of the world's population and 0.92% of the adult population in India. There are two main types - seropositive RA, where the body produces immune reactions to normal tissue, and seronegative RA, where tests for rheumatoid factor and anti-CCP antibodies are negative. Risk factors include age 40-60, family history, smoking, obesity, and female sex. Diagnosis involves evaluating symptoms, x-rays of affected joints, and blood tests for rheumatoid factor and anti-CCP antibodies. Treatment includes non-pharmacological therapies as well as drugs like
Vascular Tone cardiovascular disease presentation
LO1
Understand biochemical and physiological processes of cardiovascular disease.
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Identify molecular, cellular and systemic processes that drugs use to mimic, enhance, or inhibit
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Rationalize potential therapeutic applications and toxic effects for drugs based on
pharmacological classification/properties.
Disorders of the Adrenal Glands 2011
This document discusses disorders of the adrenal glands. It provides objectives and describes the anatomy and physiology of the adrenal glands. It discusses various adrenal disorders including Cushing's syndrome, Cushing's disease, Conn's disease/hyperaldosteronism, Addison's disease, adrenal crisis, and pheochromocytoma. It describes the signs, symptoms, diagnostic workup, and treatment for each condition.
final_rheumatoid_arthritis.ppt
Rheumatoid arthritis is an autoimmune disease that causes inflammation of the joints. It commonly affects the small joints in the hands and feet first. Symptoms include pain, swelling, and stiffness of the joints, with morning stiffness lasting over an hour. It can lead to long-term joint damage, resulting in disability. Diagnosis is based on symptoms, physical exam, blood tests for rheumatoid factor and anti-CCP antibodies, and x-rays. Treatment involves medications like NSAIDs for pain relief, DMARDs like methotrexate to reduce disease activity and progression, and biological DMARDs for those with inadequate response to conventional DMARDS. The goals of treatment are to reduce joint damage, prevent disability, and
Similar to Aortic stenosis (20)
Rheumatoid Arthritis for Medical and Pharmacy Students
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Thực hành giải phẫu bệnh cho sinh viên y 3
Bài này Ân soạn theo hướng dẫn của Thầy Trần Minh Thông.
Tài liệu phần lớn là Ân lấy từ 2 cuốn thực hành Giải phẫu bệnh của Đại học Y Dược và Đại học y khoa Phạm Ngọc Thạch.
P/s: Có một bản mục lục kèm theo các bạn nhớ download về để tiện tìm kiếm.
CAD presentation
The document discusses coronary artery disease and angina. It defines coronary artery disease as a narrowing of the coronary arteries due to plaque buildup, reducing blood flow to the heart. It describes the different types of angina like stable angina brought on by exertion and unstable angina, a form of acute coronary syndrome. It provides details on symptoms, classifications of angina severity, and differences between angina and a heart attack.
Heart failure
Heart failure occurs when the heart muscle is damaged and weakens, affecting its ability to pump blood. The most common causes are coronary heart disease and high blood pressure. Symptoms include fatigue, shortness of breath, swelling, and coughing. Heart failure is classified based on onset (acute or chronic), which side of the heart is affected (left or right), and whether systolic or diastolic function is impaired. Management involves reducing workload on the heart, inducing diuresis, and treating the underlying cause with medications, device-based therapies, surgery, or transplant if needed. Lifestyle changes and cardiac rehabilitation are also important aspects of management.
Proton therapy
This presentation provides an overview of proton therapy, including its definition, history, mechanism, and applications. Proton therapy uses a beam of protons to treat cancerous tumors. It was first suggested in 1941 and the first treatment occurred in 1954. Proton therapy offers advantages over other treatments by depositing most of the radiation dose within the tumor and minimizing exposure of surrounding healthy tissue. Common applications include brain tumors and tumors located near critical organs. While proton therapy is effective, the equipment required is very expensive to build and operate.
Hiv aids
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Pharmacology in CAD
This document discusses medications used to treat coronary artery disease. Nitroglycerin, beta-blockers, calcium channel blockers, aspirin, and other antiplatelet drugs are mentioned. Nitroglycerin works to open blood vessels and reduce the heart's need for oxygen. Beta-blockers reduce heart rate, blood pressure, and the heart's oxygen needs. Calcium channel blockers are also used to treat coronary artery disease. Aspirin and additional antiplatelet drugs help prevent blood clots.
Coronary artery disease
- Coronary artery disease (CAD) involves the narrowing of the coronary arteries due to atherosclerosis.
- It is usually caused by risk factors like smoking, high cholesterol, hypertension, and diabetes.
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Aortic stenosis
- 2. Đinh Trần Xuân Trường Nguyễn Ngọc Tú Quỳnh Trần Thanh Tuấn Trần Triển Ngô Trung Huỳnh Trọng Ân Huỳnh An Khang Đỗ Nhật Minh Trực Nguyễn Hoàng Phi Yến Members
- 3. 1. Anatomy and Physiology 2. Pathophysiology 3. Signs and Symptoms 4. Pharmacology 5. Investigation 6. Management 7. Discussion Layout
- 6. The abnormal narrowing of the aortic valve Anatomy and Physiology
- 7. Congenital heart defect : 50% of cases Aortic valve calcification : 30 -40% of cases Rheumatic fever : less than 10% of cases Pathophysiology
- 8. Congenital heart defect One leaflet (unicuspid) Two leaflets (bicuspid 27 - 50%) Four leaflets (quadricuspid) Pathophysiology
- 10. The buildup of calcium deposits narrow the valve (30-40% of cases). Aortic valve calcification Pathophysiology
- 11. Streptococcus Pyogenes Pathophysiology Rheumatic fever : less than 10% of cases
- 12. Streptococcus infection Strep bacterium present M protein (virulence factor) on cell surface. Immune response to strep antigens Buildup of fibrotic connective tissue in valves. Fibrous thickening/calcification of valves leaflets fusion of commissures Aortic Stenosis Inflammatory response
- 13. In infants and children: • Become easily tired with exertion (in mild cases) • Serious breathing problems that develop within days or weeks of birth (in severe cases) Symptoms
- 14. Symptoms Failure to gain weight Poor feeding
- 15. Symptoms ASC (Aortic Stenosis Complications) The early : Angina More seriously : Syncope Finally : Congestive Heart Failure Sudden Death
- 16. Symptoms Angina
- 17. Fainting Weakness Dizziness with exertion activity Symptoms Syncope
- 18. • Breathing problems when exercising • Becoming easily tired • Fatigue Symptoms Congestive Heart Failure (Shortness of Breath)
- 19. Normal Heart Sound Aortic Stenosis Heart Sound Signs
- 20. Signs
- 22. Pharmacology Beta-Adrenergic Receptor Blockers Cardiac Glycoside Loop Diuretics Angiotensin-converting Enzyme (ace) Inhibitor Opioid Analgesics
- 23. Dichloroisoprenaline - first beta blocker Propranolol - first beta blocker There are three types of beta receptors : Β1 receptors are located in the heart, eye, and kidneys. β2 receptors are found in the lungs, gastrointestinal tract, liver, uterus, blood vessels, and skeletal muscle. Β3 receptors are located in fat cells. Pharmacology Beta – Adrenergic Receptor Blockers
- 24. Pharmacology Beta – Adrenergic Receptor Blockers
- 28. Pharmacology Angiotensin – converting Enzyme (ACE) Inhibitor
- 30. Pharmacology Opioid Analgesics Common and short term Itch Nausea Vomiting Constipation Drowsiness Dry mouth Other Opioid dependence Dizziness Decreased sex drive Impaired sexual function Decreased testosterone levels Depression Immunodeficiency Opioid-induced abnormal pain sensitivity Irregular menstruation Increased risk of falls Slowed breathing
- 32. Pharmacology Echocardiogram Degree of AS Mean gradient (mmHg) Aortic valve area (cm2) Mild < 25 > 1.5 Moderate 25 – 40 1.0 – 1.5 Severe > 40 < 1.0 Critical > 70 < 0.6
- 33. Figure 1.Transesophageal echocardiograms of a normal aortic valve. (A) Axial view. (B) Horizontal four-chamber view. Pharmacology Echocardiogram
- 34. Figure 2.Transesophageal echocardiograms of severe aortic stenosis. (A) The axial view shows diffusely thickened leaflets with a restricted opening motion. (B) The horizontal four-chamber view shows the resultant severe left ventricular hypertrophy and left atrial enlargement. Pharmacology Echocardiogram
- 35. Pharmacology Other tests for aortic valve stenosis ECG Chest X-ray Cardiac catheterization Exercise tests Computerized tomography (CT) Magnetic resonance imaging (MRI)
- 36. Monitoring Hospitalization Lifestyle patterns Should stop smoking and be tested for high cholesterol. Dental health - Good oral and dental hygiene Management
- 37. Severity of aortic valve stenosis How often you should have an echocardiogram MILD Every 3 to 5 years MODERATE Every 1 to 2 years SEVERE Every 6 to 12 months Management
- 39. Management Transcatheter aortic valve replacement
- 42. Discussion