Prepared by MD, PhD., Associate Professor, Marta R. Gerasymchyk, pathophysiology department of Ivano-Frankivsk National Medical University, Ukraine.
For medical students
The American Heart Association (AHA) expert consensus panel proposed definition of cardiomyopathies is as follows: “Cardiomyopathies are a heterogeneous group of diseases of
the myocardium associated with mechanical and/or electrical dysfunction, which usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation, due to a variety of etiologies that frequently are genetic. Cardiomyopathies are either confined to the heart or are
part of generalized systemic disorders, and often lead to cardiovascular death or progressive heart failure–related disability.”
Prepared by MD, PhD., Associate Professor, Marta R. Gerasymchyk, pathophysiology department of Ivano-Frankivsk National Medical University, Ukraine.
For medical students
The American Heart Association (AHA) expert consensus panel proposed definition of cardiomyopathies is as follows: “Cardiomyopathies are a heterogeneous group of diseases of
the myocardium associated with mechanical and/or electrical dysfunction, which usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation, due to a variety of etiologies that frequently are genetic. Cardiomyopathies are either confined to the heart or are
part of generalized systemic disorders, and often lead to cardiovascular death or progressive heart failure–related disability.”
Dr Vivek Baliga - Diastolic heart failure - A complete overviewDr Vivek Baliga
In this presentation, Dr Vivek Baliga, Consultant Internal Medicine, discusses a common problem in medical practice that often confuses many - diastolic heart failure. Now a misnomer, it is referred to as heart failure with preserved ejection fraction. For patient articles - http://heartsense.in/author/dr-vivek-baliga-b/ . LinkedIn - https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125
Cardiovascular assessment and diagnostic proceduresANILKUMAR BR
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide.
According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease.
Based on the principle that the distal coronary pressure measured during vasodilation is directly proportional to maximum vasodilated perfusion.
FFR is defined as the ratio of maximum blood flow in a stenotic artery to maximum blood flow in the same artery if there were no stenosis.
FFR is simply calculated as a ratio of mean pressure distal to a stenosis (Pd) to the mean pressure proximal stenosis, that is the mean pressure in the aorta (Pa), during maximal hyperaemia.
Dr Vivek Baliga - Diastolic heart failure - A complete overviewDr Vivek Baliga
In this presentation, Dr Vivek Baliga, Consultant Internal Medicine, discusses a common problem in medical practice that often confuses many - diastolic heart failure. Now a misnomer, it is referred to as heart failure with preserved ejection fraction. For patient articles - http://heartsense.in/author/dr-vivek-baliga-b/ . LinkedIn - https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125
Cardiovascular assessment and diagnostic proceduresANILKUMAR BR
Cardiovascular disease is the leading killer for both men and women among all racial and ethnic groups in the world wide.
According to the Centers for Disease Control (CDC) studies among coronary heart disease (CAD) patients, 90% of patients have had prior exposure to at least one heart disease risk factor that contributed to their disease.
Based on the principle that the distal coronary pressure measured during vasodilation is directly proportional to maximum vasodilated perfusion.
FFR is defined as the ratio of maximum blood flow in a stenotic artery to maximum blood flow in the same artery if there were no stenosis.
FFR is simply calculated as a ratio of mean pressure distal to a stenosis (Pd) to the mean pressure proximal stenosis, that is the mean pressure in the aorta (Pa), during maximal hyperaemia.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
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In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
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Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
2. Contains
Conduction system of heart
Definition
Incidence of cardiac arrhythmias
Causes
Types
Clinical features
Investigation
Cardiac arrhythmias in athletes , football players
3. Introduction
THE term "cardiac arrhythmia" indicates that an
irregularity of heart-beat is present. Many
states of disordered heart-beat, however, are
associated with an entirely regular rhythm, for
example paroxysmal atrial tachycardia [1]
4. Conduction system of heart
The conducting system of the heart
consists of cardiac muscle cells and
conducting fibers (not nervous tissue)
that are specialized for initiating impulses
and conducting them rapidly through the
heart . They initiate the normal cardiac
cycle and coordinate the contractions of
cardiac chambers. Both atria contract
together, as do the ventricles, but atrial
contraction occurs first.
5. Normal Conduction Pathway
The normal impulse spreads from the sinoatrial node
through the atrial muscle at about 1,000 mm. per second
and produces the P wave of the electrocardiogram. Most of
the P-R interval is taken up by the impulse spreading
through the atrio-ventricular node, a structure with a long
refractory period, incapable of rapid conduction (22 mm.
per second). Once in the branches of the bundle of His and
Purkinje fibres the passage of the impulse is rapid (4,000
mm. per second). Contraction occurs as the impulse enters
the ventricular muscle and is followed by the resting state
.[1]
6.
7. Aetiology of Cardiac Arrhythmias
Any abnormal state affecting the myocardium and any process interfering with the
normal action of the valves of the heart may be responsible for an arrhythmia
In addition, many metabolic disturbances may present in this way, and in this
connection the Na+ and K+ interchange across the myocardial cell membrane, Ca+
+ and Mg+ -t + concentration are all of great importance.
Both atrial fibrillation and atrial flutter may occur in the absence of any recognisable
heart disease.
10. Atrial Fibrillation
This may occur as
1. As a paroxysmal rhythm
2. As an established rhythm.
It occurs most frequently in association with
• rheumatic heart disease
• Coronary artery disease
• Systemic hypertension
• Congenital heart disease [least common ]
• Pericardial disease is a numerically small but functionally important precipitating
cause of atrial fibrillation
11. Atrial Flutter
Like atrial fibrillation atrial flutter may occur in two forms, paroxysmal or
established.
It is far less common than atrial fibrillation
Atrial flutter is usually found in association with rheumatic heart disease, coronary
artery disease, thyrotoxicosis and systemic hypertension and is less frequently
encountered than atrial fibrillation in hearts that are otherwise normal. Atrial septal
defect, especially postoperative, is the commonest associated congenital heart
disease
12. Ventricular Tachycardia
This is uncommon
Although almost always associated with organic heart disease it infrequently does
occur in the absence of any recognised disease
The arrhythmia is rapid and the heart beat almost, but not quite reguilar. Cannon
waves may be seen in the neck.
13. Sinus arrhythmia
This is phasic alteration in heart rate in relation
of breathing . The HR increases in inspiration
and decreases in expiration
Significance – this is most common arrhythmia
it is normal phenomenon and is manifestation
of normal autonomic nervous activity .
14. Incidence and Risk Factors Associated With Cardiac Arrhythmias
During Rehabilitation After Coronary Artery Bypass Surgery
The incidence of significant arrhythmias in patients performing a program of cardiac
rehabilitation after CABG and to identify relevant prognostic factors.
cardiac arrhythmias represent a frequent and potentially serious problem in
patients undergoing an inpatient CRP after CABG surgery.
This finding suggests that the incidence of undetected arrhythmias in ambulatory
patients after CABG is high during the first month after surgery
15. Reduced Incidence of Cardiac Arrhythmias in Walkers and
Runners
no significant risk increase for self-reported cardiac arrhythmias associated with
running distance, exercise intensity, or marathon participation. Rhythm
abnormalities were based on self-report, precluding definitive categorization of the
nature of the rhythm disturbance.
However, even if the runners arrhythmias include sinus bradycardia due to running
itself, there was no increase in arrhythmias with greater running distance.
16. Arrhythmias and Adaptations of the Cardiac Conduction System in
Former National Football League Players
While several studies have associated long‐term participation in endurance‐type sports
with an increased risk of atrial fibrillation (AF), this is the first study associating
participation in strength‐type sports with AF.
The majority of former NFL athletes with AF were previously undiagnosed, rate
controlled, and asymptomatic, but 80% met indications for anticoagulation, highlighting
the need for a high level of clinical suspicion for occult AF in this group.
Sinus bradycardia and first‐degree atrioventricular block are typically benign findings in
former athletes, but more severe conduction abnormalities requiring cardiac pacing
also appear more prevalent in this population.