Cardiac tamponade
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Cardiac tamponade is a medical emergency caused by an accumulation of fluid in the pericardial space, which surrounds the heart. This increased fluid pressure restricts the heart's filling and reduces cardiac output. If untreated, cardiac tamponade is rapidly fatal. Diagnosis is made through physical exam findings, electrocardiogram, chest x-ray and echocardiogram. Pericardiocentesis, a procedure to drain the fluid via needle insertion, provides immediate relief and is lifesaving for cardiac tamponade. After the procedure, close monitoring is needed to watch for potential complications and recurrence of fluid buildup.
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to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/12/ecg-basics.html
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1. Right bundle branch block (RBBB) results from a defect in the heart's electrical conduction system where there is a delay or failure of impulses traveling down the right bundle branch.
2. This causes the right ventricle to depolarize more slowly than usual, resulting in a characteristic wide and notched QRS complex on ECG.
3. RBBB is generally not treated unless it progresses to heart block, in which case further testing may be needed.
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- Additional echocardiographic indices for evaluating pulmonary hemodynamics, such as right atrial pressure, pulmonary vascular resistance, and right ventricular function.
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Cardiovascular physiology
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1) The anatomy of the heart and circulation of blood through the heart.
2) Electrical conduction system of the heart and the cardiac cycle.
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to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/12/ecg-basics.html
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The document provides an outline for a lecture on basic electrocardiograms (ECGs). It discusses the history of ECGs, outlines the standardization of ECGs, and explains the reasons for performing ECGs. It also describes the 12-lead ECG system and proper electrode placement. Key aspects of ECG waves and rhythms are defined. Ten assessment points for ECGs are identified. Finally, the document categorizes cardiac rhythms according to the required intervention hierarchy.
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- Left bundle branch block (LBBB) is caused by conditions that damage the left bundle branch, such as hypertension, dilated cardiomyopathy, and ischemic heart disease.
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- The prognosis of LBBB depends on any underlying heart conditions, with LBBB increasing the risk of mortality. LBBB may resolve temporarily following a premature ventricular contraction due to resetting of the conduction system.
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The P wave is the first positive deflection on the ECG.
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This document discusses aortic stenosis, including its causes, symptoms, diagnosis, and treatment. It notes that aortic stenosis can be valvular, subvalvular, or supravalvular and can be caused by rheumatic fever, congenital defects, or age-related calcification. Common symptoms include chest pain, shortness of breath, fatigue, and murmurs. Diagnosis involves echocardiogram, EKG, chest X-ray and cardiac catheterization. Treatment options range from medication to manage symptoms, balloon valvuloplasty, or aortic valve replacement surgery.
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1. Right bundle branch block (RBBB) results from a defect in the heart's electrical conduction system where there is a delay or failure of impulses traveling down the right bundle branch.
2. This causes the right ventricle to depolarize more slowly than usual, resulting in a characteristic wide and notched QRS complex on ECG.
3. RBBB is generally not treated unless it progresses to heart block, in which case further testing may be needed.
EVALUATION OF PULMONARY HEMODYNAMICS AND ALTERATION IN DISEASE STATES
This document discusses pulmonary hemodynamics and how they can be evaluated using echocardiography. It provides details on:
- The anatomy and function of the pulmonary valve.
- How echocardiography can be used to estimate systolic, mean, and diastolic pulmonary artery pressures. Methods include measuring tricuspid regurgitant velocity to estimate systolic pressure and using pulmonary regurgitant velocity to estimate mean and diastolic pressures.
- Additional echocardiographic indices for evaluating pulmonary hemodynamics, such as right atrial pressure, pulmonary vascular resistance, and right ventricular function.
Indications and timing of intervention in congenital heart disease
Ventricular septal defect (VSD) is the most common congenital heart defect (excluding bicuspid
aortic valve); its prevalence varies from 3 to 5/1,000 live births.9,10 Clinical manifestations depend on the size of
the defect and the pulmonary and systemic vascular resistances. Some of the small and moderate sized VSDs
can close spontaneously. In the historic series of Dr. Paul Wood, 52% of patients with large VSD developed
irreversible pulmonary vascular disease with the onset in infancy in four-fifths of them.11 Commonest site of
VSD is perimembranous (80%), the other sites are outlet or sub-pulmonary (5%-7%), inlet (5%-8%), and
muscular (5%-20%).
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This document provides information on various congenital heart diseases. It discusses the signs, symptoms and treatments for conditions such as atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA), tetralogy of Fallot (TOF), pulmonary stenosis, coarctation of the aorta and Eisenmenger's syndrome. Some key points include that ASD, VSD and PDA cause left-to-right shunts which can lead to heart failure if untreated. TOF is the most common cyanotic heart defect and causes right-to-left shunting. Symptoms of cyanotic conditions include clubbing and central cyanosis. Surgical correction
Ventricular tachycardia
Ventricular tachycardia can occur due to various causes like acute myocardial infarction, chronic infarction, dilated cardiomyopathy, etc. It is classified as sustained, non-sustained, monomorphic, polymorphic, etc. based on characteristics. Diagnosis involves ECG, echocardiogram, and monitoring. Treatment depends on hemodynamic stability and includes electrical cardioversion, antiarrhythmic drugs like amiodarone, lidocaine, ablation, and ICD implantation in selected cases. Recurrence risk is high in structurally abnormal hearts and prevention involves controlling triggers, antiarrhythmics, and ICDs.
ECG interpretation
This document provides a template for systematically interpreting electrocardiograms (ECGs). It outlines 13 sections to analyze, including ECG type and recording, rate, rhythm and axis, P wave, PR interval, QRS complex, ST segment, T wave, and U wave. Additional features like delta waves are also addressed. Various abnormalities are defined and associated diagnoses are provided. The template aims to help clinicians make accurate ECG interpretations through a standardized approach.
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The cardiovascular system consists of the heart and blood vessels. The heart is hollow and located in the thorax, protected by the pericardium. It pumps blood through the circulatory system via contraction and relaxation in a cardiac cycle. Blood flow is regulated by arteries, veins and capillaries which allow for gas and nutrient exchange. Blood pressure and flow are influenced by many factors including the heart, blood properties and vessel dynamics.
Cardiovascular system
The cardiovascular system consists of the heart and blood vessels. The heart is hollow and located in the thorax, protected by the pericardium. It pumps blood through the circulatory system via contraction and relaxation. Blood flows from the heart through arteries, then capillaries where gas exchange occurs, and returns to the heart through veins, aided by valves. The heart's rhythm is regulated by electrical conduction pathways and nerves.
ARTERIAL PULSES.pptx
Clinical examination in cardiolgy starts with the examination of arterial pulse.
In this PowerPoint presentation we have discussed all about this important topic
Copy of cardio vascular system
This document provides an overview of the cardiovascular system including:
1. It describes the main components of the cardiovascular system which are the heart, blood vessels (arteries, veins, capillaries), and lymphatic vessels.
2. It explains the structure and features of arteries, veins, and capillaries. It notes key differences in their structure and function.
3. It outlines the internal and external features of the heart including the layers of the heart (endocardium, myocardium, pericardium), valves, chambers and openings.
lecture 2- 1 Cardiovascular.pptx
The document discusses cardiovascular anatomy and physiology. It describes the structures of the heart including the layers (pericardium, epicardial fat, myocardium, endocardium), chambers (left and right atria and ventricles), and valves. It also discusses the cardiac conduction system including the sinoatrial node, atrioventricular node, bundle of His, and Purkinje fibers. Hemodynamic monitoring techniques are covered such as intra-arterial blood pressure monitoring, central venous pressure monitoring, pulmonary artery pressure monitoring, and mixed venous oxygen saturation monitoring. Physical exam skills related to cardiovascular assessment are also outlined.
Circulatory system
The circulatory system consists of the heart, blood vessels, and blood. The heart is a muscular pump made of cardiac muscle tissue composed of four chambers. It pumps blood through two circuits - the pulmonary circuit to the lungs and systemic circuit to the body. Blood vessels include arteries, veins, and capillaries. Blood contains plasma, red blood cells, white blood cells, and platelets. The cardiovascular system is regulated through intrinsic factors like Starling's law of the heart and extrinsic neural and hormonal control.
Circulatory system
The circulatory system consists of the heart, blood vessels, and blood. The heart is a muscular pump made of cardiac muscle tissue composed of four chambers. It pumps blood through two circuits - the pulmonary circuit to the lungs and systemic circuit to the body. Blood vessels include arteries, veins, and capillaries. Blood contains plasma, red blood cells, white blood cells, and platelets. The cardiovascular system is regulated through intrinsic factors like Starling's law of the heart and extrinsic neural and hormonal control.
Circulatory system
The circulatory system consists of the heart, blood vessels, and blood. The heart is a muscular pump made of cardiac muscle tissue composed of four chambers. It pumps blood through two circuits - the pulmonary circuit to the lungs and systemic circuit to the body. Blood vessels include arteries, veins, and capillaries. Blood contains plasma, red blood cells, white blood cells, and platelets. The cardiovascular system is regulated through intrinsic factors like Starling's law of the heart and extrinsic neural and hormonal control.
vasospastic.pptx
This document discusses vasospastic disorders and gangrene. It provides details on physiology of arteries, blood components, blood pressure measurement, classifications of occlusive diseases, causes of chronic limb ischemia, and clinical signs of ischemic limbs. Arterial diseases can be investigated through tests like ankle brachial index which helps identify ischemia. Chronic ischemia can lead to complications like gangrene if not addressed.
The heart
excellent presentation with great visuals on heart, its basic structure, physiology and some of the pathology.
IVMS-CV-Cardiovascular Pathology
This PowerPoint presentation provides images and descriptions of normal heart anatomy and various cardiovascular pathologies. It begins with images of the normal heart structures, including the coronary arteries, myocardium, and valves. It then covers atherosclerotic cardiovascular disease, showing examples of atherosclerotic plaques, aneurysms, thrombi, and infarcts. Other sections address arterial dissection, infective endocarditis, pericarditis, and myocarditis. The presentation is intended to enable offline study of cardiovascular pathology images for medical licensing exam preparation.
IVMS-CV-Cardiovascular Pathology
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OPEN / DOWNLOAD FULL LIVE HYPERMEDIA PRESENTATION
http://www.scribd.com/doc/106694518/IVMS-CV-Cardiovascular-PathologyPresentation
Human Blood Vessels Anatomy Review pptxs
Here are the answers to the questions:
1. Sedentary people with elevated triglyceride levels who continue to eat fatty foods are likely to have a high level of peripheral resistance.
2. Veins have one-way valves to prevent backflow of blood.
3. Arteries are the thickest walled to withstand the high pressure of blood being pumped from the heart.
4. Arteries carry blood away from the heart.
5. When blood is pumped into the thin-walled vessels of the lungs, the pressure decreases which allows for gas exchange between the blood and lungs.
6. The carotid artery delivers blood to the brain.
7. The
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The document provides an overview of the major arteries of the head and neck, including their origins, courses, branches, and clinical significance. It discusses the common carotid artery, external carotid artery, internal carotid artery, and their branches such as the lingual, facial, occipital, and maxillary arteries. The summary highlights the arterial supply of the head and neck originating from branches of the aortic arch and their roles in supplying surrounding structures.
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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
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Cardiac tamponade
- 1. CARDIAC TAMPONADE Mohammed Niyas Group 4a Dept. of Surgery TSMU
- 3. PERICARDIUM - ANATOMY • Resilient Fibro-serous sac – envelops heart and great vessels •2 layers •Inner visceral layer – Serous Pericardium •Monolayer membrane of mesothelial cells, collagen & elastin fibres. •Over the heart, same as the Epicardium - contains the epicardial coronary arteries and veins, autonomic nerves, lymphatics, and a variable amount of adipose tissue. •Reflects over the great vessels - forms delicate inner lining of Fibrous Pericardium
- 4. •Outer parietal layer – Fibrous Pericardium •Acellular, mainly collagenous fibrous tissue, little elastin fibrils. •2 mm thick normally. Contains the epicardial coronary arteries and veins, autonomic nerves, lymphatics, variable amount of adipose tissue. •The junctions between the visceral and parietal pericardium lie along the great vessels - pericardial reflections - continuous along the pulmonary veins and vena cavae •Posterior to LA, midline cul-de-sac known as the Oblique Sinus. •Behind the great arteries, the Transverse Sinus forms a tunnel-like passageway.
- 5. •Between these 2 layers lies the Pericardial Space – 10-50 ml of fluid - ultrafiltrate of the plasma. •Intrapericardial •All 4 Chambers except posterior part of LA •Almost entire Ascending Aorta, Main Pulmonary Artery, all 4 Pulmonary Veins •In case of TAPVC, PV confluence is intrapericardial •Extrapericardial •Right and Left Pulmonary Artery •Ductus Arteriosus
- 6. • Only noncardiovascular macrostructure associated with the pericardium - the Phrenic Nerves, enveloped by parietal pericardium. • Drainage of pericardial fluid is via right lymphatic duct and thoracic duct.
- 7. DEFINITION “clinical syndrome caused by accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise” CARDIAC TAMPONADE
- 8. ↑ pericardial fluid Pressure onrt sideof heart ↓Venousreturn Poolingofblood inpulmonary capillaries ↓Strokevolume, ↓Cardiac output CardiacArrest Howmuch pericardial fluid is needed to impair diastolic filling ? PATHO-PHYSIOLOGY
- 10. ETIOLOGY: blood/ pus/serous • Physical trauma • Pericarditis (bact/TB/HIV) • Myocardial rupture • After heart surgery • Aortic dissection • Neoplastic • Hypothyroidism
- 11. CLINICAL SYMPTOMS • Breathlessness • Chest pain, • Abdominal pain, • Fatigue, • Fever, • Cough, • Palpitation, • Maybe in shock
- 12. PHYSICAL EXAMINATION • tachycardia, • distant or muffled heart sounds • jugular vein distension • falling BP, • paradoxical pulse (a drop in inspiratory BP by greater than 10 mmHg).
- 13. Beck's triad.(rapid accumulation of pericardial fluid) 1. Hypotension occurs because of decreased stroke volume 2. jugular-venous distension due to impaired venous return to the heart 3. muffled heart sounds due to fluid inside the pericardium
- 14. • complete blood count (CBC) • RFT,LFT • PT,INR • CKMB, TROP-T • ANA assay, • ESR • Rh FACTOR • HIV testing • Mantouxtest • Pericardial fluidC/S, AFB INVESTIGATIONS
- 15. ECG • sinus tachy ,low voltage QRS complexes , • electrical alterans,
- 16. CXR: large, globular heart, enlarge cardiac silhouette, water bottle shaped heart
- 17. ECHO: “diagnostic test of choice “
- 19. TREATMENT: Cardiac tamponade is a medical emergency Untreated, cardiac tamponade is rapidly and universally fatal Prompt diagnosis and treatment is the key. • O2 • Volume expansion • Bed rest • Inotropic drugs • Positive-pressure mechanical ventilation should be avoided • Pericardiocentesis: • A Swan-Ganz catheter can be left in place for continuous monitoring of hemodynamics • repeat ECHO and a repeat CXR within 24 hours.
- 20. APPROACH 1. Sub-xiphoid : A. Echo guided B. ECG guided C. Blind 2. Para-sternal PERICARDIOCENTESIS
- 24. AFTER CARE 1. Monitor vitals 2. Look out for complications 3. Repeat ECHO & CXR 4. If Pt still symptomatic then may require placement of catheter in the pericardial space or surgical creation of a pericardial window PERICARDIOCENTESIS
- 25. COMPLICATIONS 1. Cardiac arrhythmia 2. Pneumothorax 3. Pleural effusion 4. Myocardial injury 5. Peritoneal injury 6. Liver/stomach injury 7. Internal mammary artery injury 8. Diaphragmatic injury
- 26. RECURRENT TAMPONADE • Pericardial window • Sclerosing the pericardium • Pericardio-peritoneal shunt • Pericardiectomy
- 27. summary •Cardiac tamponade is a medical emergency, and if untreated, its rapidly and universally fatal •Prompt diagnosis and treatment is the key. •Pericardiocentesis is a life saving procedure in tamponade •Monitor vitals after the procedure to look for complications