chronic constrictive pericarditis ideal short case presentation
•Download as PPTX, PDF•
1 like•88 views
A patient presented with chronic constrictive pericarditis, ascites, hepatomegaly, pedal edema, congestive cardiac failure, and was probably tubercular in etiology. An echocardiogram showed pericardial thickening, diastolic dysfunction of both ventricles, increased respiratory variation of early diastolic velocities, dilated and non-collapsible IVC, increased hepatic doppler flow reversal, elevated PA pressure, severe TR, and diastolic collapse of the RV. The echocardiogram confirmed the diagnosis of chronic constrictive pericarditis.
Report
Share
Report
Share
Recommended
Tricuspid valve stenosis
information about tricuspid valve stenosis, causes, pathophysiology, clinical manifeastition, investigation, physical examination, complication and treatment
Tricuspid pulmonary valves
This document provides an overview of tricuspid and pulmonary valve diseases. It discusses the anatomy of the right atrium, right ventricle, and tricuspid valve. It then covers tricuspid stenosis, including causes, chest X-ray findings, echocardiography findings, and severity assessment. Tricuspid regurgitation is also discussed, including causes, chest X-ray findings, and echocardiography findings. MRI and CT imaging of tricuspid valve disease is briefly mentioned. The document concludes by stating that Ebstein anomaly is a myopathy.
Penyakit jantung katup'13
1. Tetralogy of Fallot is a cyanotic congenital heart disease that consists of four anatomical features: ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.
2. Clinical manifestations include cyanosis, clubbing of fingers after 6 months of age, and cyanotic spells with breathlessness, fast breathing, weakness, seizures and coma.
3. Diagnosis is made based on clinical examination, chest x-ray, electrocardiogram and echocardiogram findings. Management involves prevention of dehydration and cyanotic spells with medications, and either palliative surgery such as Blalock-Taussig shunt or definitive total correction surgery.
Tricuspid atresia
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent, preventing blood flow from the right atrium to the right ventricle. It occurs in approximately 1-2.4% of congenital heart defects. Survival depends on the presence of an atrial septal defect to allow blood to bypass the right ventricle. Treatment involves multiple staged surgeries culminating in the Fontan procedure to reroute systemic venous return directly to the pulmonary arteries. Complications can include arrhythmias, ventricular dysfunction, protein-losing enteropathy, and thromboembolic events.
Preicardial disease
The pericardium is composed of two layers that surround and lubricate the heart. Acute pericarditis is commonly caused by viruses or acute myocardial infarction and presents with retrosternal chest pain that worsens with breathing or movement. Pericardial effusions can occur and be detected on echocardiogram. Large effusions can cause cardiac tamponade, where increased intrapericardial pressure limits heart function. Tamponade requires drainage by pericardiocentesis for treatment. Tuberculous pericarditis is a rare cause that requires antitubercular drugs and steroids. Chronic constrictive pericarditis involves fibrosis and scarring, with symptoms of right-
Ventricular septal defect
This document discusses ventricular septal defects (VSDs), which are defects in the wall separating the ventricles of the heart. VSDs are the most common type of congenital heart defect, occurring in around 2.5 per 1000 live births. The document describes the different types of VSDs based on their location, size, whether they are isolated or part of other heart defects. Treatment depends on the size of the VSD, with small defects monitored, moderate defects possibly closed between 9-12 months, and large defects closed by 4-5 months to prevent complications like pulmonary arterial hypertension.
A 71 year old man with peripheral edema pleural effusion ascites and breathle...
A 71 year old man with peripheral edema, pleural effusion, ascites and breathlessness. See how one thing led to another, and the final diagnosis and treatment
Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade is caused by fluid accumulating in the pericardial space, putting pressure on the heart and reducing ventricular filling. Common causes include malignant diseases, infections like tuberculosis, and recent cardiovascular procedures. Symptoms include dyspnea, tachycardia, and muffled heart sounds. Diagnosis is made through echocardiogram showing pericardial effusion and ventricular collapse. Treatment involves pericardiocentesis to drain fluid followed by surgery to address the underlying cause and prevent reaccumulation. Complications can include cardiogenic shock if not treated promptly.
Recommended
Tricuspid valve stenosis
information about tricuspid valve stenosis, causes, pathophysiology, clinical manifeastition, investigation, physical examination, complication and treatment
Tricuspid pulmonary valves
This document provides an overview of tricuspid and pulmonary valve diseases. It discusses the anatomy of the right atrium, right ventricle, and tricuspid valve. It then covers tricuspid stenosis, including causes, chest X-ray findings, echocardiography findings, and severity assessment. Tricuspid regurgitation is also discussed, including causes, chest X-ray findings, and echocardiography findings. MRI and CT imaging of tricuspid valve disease is briefly mentioned. The document concludes by stating that Ebstein anomaly is a myopathy.
Penyakit jantung katup'13
1. Tetralogy of Fallot is a cyanotic congenital heart disease that consists of four anatomical features: ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.
2. Clinical manifestations include cyanosis, clubbing of fingers after 6 months of age, and cyanotic spells with breathlessness, fast breathing, weakness, seizures and coma.
3. Diagnosis is made based on clinical examination, chest x-ray, electrocardiogram and echocardiogram findings. Management involves prevention of dehydration and cyanotic spells with medications, and either palliative surgery such as Blalock-Taussig shunt or definitive total correction surgery.
Tricuspid atresia
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent, preventing blood flow from the right atrium to the right ventricle. It occurs in approximately 1-2.4% of congenital heart defects. Survival depends on the presence of an atrial septal defect to allow blood to bypass the right ventricle. Treatment involves multiple staged surgeries culminating in the Fontan procedure to reroute systemic venous return directly to the pulmonary arteries. Complications can include arrhythmias, ventricular dysfunction, protein-losing enteropathy, and thromboembolic events.
Preicardial disease
The pericardium is composed of two layers that surround and lubricate the heart. Acute pericarditis is commonly caused by viruses or acute myocardial infarction and presents with retrosternal chest pain that worsens with breathing or movement. Pericardial effusions can occur and be detected on echocardiogram. Large effusions can cause cardiac tamponade, where increased intrapericardial pressure limits heart function. Tamponade requires drainage by pericardiocentesis for treatment. Tuberculous pericarditis is a rare cause that requires antitubercular drugs and steroids. Chronic constrictive pericarditis involves fibrosis and scarring, with symptoms of right-
Ventricular septal defect
This document discusses ventricular septal defects (VSDs), which are defects in the wall separating the ventricles of the heart. VSDs are the most common type of congenital heart defect, occurring in around 2.5 per 1000 live births. The document describes the different types of VSDs based on their location, size, whether they are isolated or part of other heart defects. Treatment depends on the size of the VSD, with small defects monitored, moderate defects possibly closed between 9-12 months, and large defects closed by 4-5 months to prevent complications like pulmonary arterial hypertension.
A 71 year old man with peripheral edema pleural effusion ascites and breathle...
A 71 year old man with peripheral edema, pleural effusion, ascites and breathlessness. See how one thing led to another, and the final diagnosis and treatment
Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade is caused by fluid accumulating in the pericardial space, putting pressure on the heart and reducing ventricular filling. Common causes include malignant diseases, infections like tuberculosis, and recent cardiovascular procedures. Symptoms include dyspnea, tachycardia, and muffled heart sounds. Diagnosis is made through echocardiogram showing pericardial effusion and ventricular collapse. Treatment involves pericardiocentesis to drain fluid followed by surgery to address the underlying cause and prevent reaccumulation. Complications can include cardiogenic shock if not treated promptly.
Cyanotic Heart Diseases
This document provides information on various cyanotic heart lesions including Tetralogy of Fallot, Transposition of the Great Arteries, Tricuspid Atresia, Ebstein's Anomaly and Total Anomalous Pulmonary Venous Return. It describes the anatomy, clinical features, diagnosis and management of these conditions. Key cyanotic heart lesions are characterized by mixing of oxygenated and deoxygenated blood resulting in central cyanosis.
Peripheral vascular disease,
This document provides information on cardiac rehabilitation considerations for patients with peripheral vascular disease (PVD). It discusses the types and causes of PVD, risk factors, clinical manifestations, diagnosis, complications, and management. For cardiac rehabilitation, it recommends supervised treadmill exercise 3 times per week at a moderate intensity that brings on claudication pain within 3-5 minutes. The goals are to improve walking distance and capacity. Home-based walking with behavioral techniques can also be effective. Upper body ergometry, resistance training, and lifestyle risk factor management are complementary. Regular lifelong maintenance exercise is encouraged to prevent disability from PVD.
Pulmonary artery hypertension
1) The document discusses the updated classification of pulmonary hypertension and outlines the diagnostic and management approach.
2) It reviews the criteria for diagnosing pulmonary hypertension based on mean pulmonary artery pressure and outlines potential causes.
3) The key objectives are to review the updated WHO classification of pulmonary hypertension, diagnostic testing approaches including echocardiography and right heart catheterization, and clinical management based on disease severity including medication options and monitoring response to therapy.
Tricuspid atresia in pediatrics
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent or closed, preventing blood flow from the right atrium to the right ventricle. This causes the right ventricle to be underdeveloped and the pulmonary artery to be narrow. To survive, babies with tricuspid atresia rely on openings between the atria (ASD) or ventricles (VSD) and/or a patent ductus arteriosus to provide pulmonary blood flow. Treatment depends on the amount of pulmonary blood flow, and may involve procedures like shunts, pulmonary artery banding, or ultimately the Fontan procedure. Complications can include arrhythmias, ventricular dysfunction,
Pulmonary hypertension (2014) dr.tinku joseph
This document provides information on pulmonary hypertension (PH), including its definition, classification, pathogenesis, diagnosis, and treatment. It begins with defining PH as a mean pulmonary arterial pressure greater than 25 mmHg at rest based on right heart catheterization. PH is classified into 5 groups. The pathogenesis and pathology of each group is described. Diagnostic workup includes labs, imaging like CXR, echocardiogram and right heart catheterization. Treatment involves general measures, diuretics, anticoagulants, oxygen, and PAH-specific therapies like endothelin receptor antagonists, phosphodiesterase inhibitors, prostanoids, and calcium channel blockers in some cases. Prognostic factors and goals of treatment are also discussed.
Portal hypertension by Dr mohammed Hussien
This document discusses portal hypertension and bleeding varices. It begins by describing the physiology of the portal system and defining portal hypertension. It then discusses the causes of portal hypertension including morphological alterations in the liver from cirrhosis and fibrosis. It also discusses the hyperdynamic circulation seen in portal hypertension which involves increased vasodilators and reduced sensitivity to vasoconstrictors. Risk factors for bleeding varices include portal pressure, variceal size, wall structure, and hepatic function. The document concludes by covering the history, physical exam, classifications, and laboratory evaluation of portal hypertension.
Cyanotic heart disease
Tetralogy of Fallot is the most common cyanotic heart disease characterized by four features: ventricular septal defect, overriding aorta, infundibular pulmonary stenosis, and right ventricular hypertrophy. It presents with cyanosis that is more frequent in the second half of the first year and hypercyanotic spells after exercise or positions like crying and squatting. Treatment involves palliative surgery like Blalock-Taussig shunt initially, followed by complete repair around 6 months of age. Management of hypercyanotic spells includes medications like morphine, oxygen, and positioning changes.
Tricuspid valve disease
This document discusses the anatomy, assessment, and management of tricuspid valve disease. It covers tricuspid stenosis and tricuspid regurgitation. For tricuspid stenosis, the most common causes are rheumatic fever and infective endocarditis. Symptoms include fatigue and swelling. Transthoracic echocardiogram is used to assess the mean gradient and valve morphology. For tricuspid regurgitation, the most common primary causes are rheumatic fever and carcinoid heart disease. Secondary causes are related to right ventricular dilation. Symptoms are similar to stenosis. Echocardiogram can assess the severity of regurgitation and pulmonary pressures. Management involves medical therapy depending on severity of disease.
Cardiac tamponade Toufiqur Rahman
cardiac tamponade, constrictive pericarditis, cardiology, health, medicine, infections, malignancy, SLE, Hypothyroidism
MDCT Evaluation of Varices in Portal Hypertension
MDCT is useful for identifying portosystemic collateral vessels in patients with portal hypertension. It can accurately demonstrate the majority of collateral channels. Dynamic CT with contrast allows visualization of varices in the esophagus, stomach, rectum, and other locations. Precise mapping of collateral vessels is important before surgical or interventional procedures to avoid blood loss. MDCT plays an invaluable role in managing portal hypertension.
Diagnosing pleural effusion
This presentation discusses steps in diagnosis of pleural effusion using a simulated patient scenario. Besides talking about different findings we can possibly see in a pt with pleural effusion on examination, CXR, USG, CT and labs, It also briefly discuss the proper steps in performing thoracocentesis.
Tetrology of fallot
Tetralogy of Fallot is a congenital heart defect with four abnormalities: 1) a ventricular septal defect, 2) pulmonary stenosis, 3) overriding aorta, and 4) right ventricular hypertrophy. This causes deoxygenated blood to bypass the lungs and mix with oxygenated blood, resulting in cyanosis. The severity depends on the degree of pulmonary stenosis and ventricular septal defect. Surgical repair involves relieving the stenosis and closing the VSD.
Cyanotic heart disease tof
This document discusses cyanotic heart disease, specifically tetralogy of Fallot. It describes the characteristics of tetralogy of Fallot as obstruction of the right ventricular outflow, ventricular septal defect, dextroposition of the aorta with septal overriding, and right ventricular hypertrophy. It discusses the pathophysiology, clinical features, diagnosis, complications, treatment including medical management and surgery, and follow up for patients with tetralogy of Fallot.
Single ventricle palliation
The document discusses single ventricle heart conditions and their palliation. It notes there are two hemodynamic goals: (1) pumping blood to the systemic and pulmonary circulations, and (2) separating the circulations to ensure the pulmonary circulation receives the richest oxygenated blood. Common types of single ventricle hearts are then listed. The goals of single ventricle palliation are then stated as pumping blood adequately and separating the circulations. Early surgical corrections for these conditions including shunts from the 1940s-1960s are also briefly discussed.
Echo in pericardial diseases
This document provides an overview of echocardiography in pericardial diseases. It begins with an introduction to pericardial anatomy and pathophysiology. It then discusses various pericardial diseases that can be evaluated by echocardiography, including acute pericarditis, recurrent pericarditis, pericardial effusions, cardiac tamponade, and constrictive pericarditis. For each condition, it describes the echocardiographic findings and techniques used to evaluate the condition. It emphasizes that echocardiography is usually the initial imaging test of choice but that CT or CMR may be needed in some complex cases.
Valvular Heart Disease
The document discusses various types of heart valve disorders including stenosis, regurgitation, and prolapse. It describes the causes, effects, symptoms, and treatments for different valve conditions affecting the mitral, aortic, tricuspid, and pulmonary valves. Surgical interventions for valve disorders include valvuloplasty procedures to repair valves as well as valve replacement using mechanical or biological prosthetics.
Surgical management of tetralogy of fallot
This document discusses the diagnosis and management of Tetralogy of Fallot. It begins with describing the clinical examination findings and various investigations used. Echocardiography, ECG, chest x-ray, cardiac catheterization, CT, and MRI are discussed. Palliative treatments like Blalock-Taussig shunt are explained. Factors deciding definitive repair are covered, along with the surgical techniques and risks of early and late complications. Post-operative care and follow up are briefly mentioned.
Cardiac tamponade
This document discusses cardiac tamponade, a medical emergency caused by fluid accumulation in the pericardium. Symptoms include chest pain and difficulty breathing. A physical exam may reveal Beck's triad of hypotension, jugular vein distension, and muffled heart sounds, as well as pulsus paradoxus. Echocardiography can demonstrate fluid and compression of the heart. Treatment involves pericardiocentesis to drain fluid or a pericardial window procedure.
Cyanotic heart disease
A cyanotic heart defect is a group-type of congenital heart defects (CHDs). The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries.
Cyanotic heart defects, which account for approximately 25% of all CHDs, include:
Tetralogy of Fallot (ToF)
Total anomalous pulmonary venous connection
Hypoplastic left heart syndrome (HLHS)
Transposition of the great arteries (d-TGA)
Truncus arteriosus (Persistent)
Tricuspid atresia
Interrupted aortic arch
Pulmonary atresia (PA)
Pulmonary stenosis (critical)
Eisenmenger syndrome(Reversal of Shunt due to Pulmonary Hypertension) .
Patent ductus arteriosus may cause cyanosis in late stage.
CYANOTIC CONGENITAL HEART DISEASES WITH DECREASED BLOOD FLOW
This document discusses cyanosis and its causes in neonates. It begins by defining cyanosis as a bluish tinge of the skin and mucous membranes, detectable when hemoglobin is reduced by more than 5g% or oxygen saturation is below 85%. It then lists various pulmonary, cardiac, central nervous system, metabolic, hematologic, and infectious conditions that can cause cyanosis in newborns. The majority of the document focuses on describing tetralogy of Fallot, including its characteristic features, pathophysiology, clinical presentation, diagnosis, and management. It provides details on the anatomy, causes, hypoxic spells, and treatment approaches for tetralogy of Fallot.
Cchd
1. Congenital cyanotic heart disease refers to heart defects present at birth that result in low oxygen levels in the blood. They are classified as those with increased or decreased blood flow to the lungs.
2. Common types with increased pulmonary blood flow include persistent truncus arteriosus and transposition of the great arteries (TGA). Common types with decreased pulmonary blood flow include tricuspid atresia and pulmonary atresia with intact ventricular septum.
3. TGA accounts for 5-7% of congenital heart defects. It involves the aorta originating from the right ventricle and the pulmonary artery originating from the left ventricle. It requires mixing of blood between the pulmonary and systemic
Approach to chest pain
This document provides guidance on evaluating and managing patients presenting with chest pain. It outlines the general approach which includes ensuring patient stability, providing oxygen and analgesia. It describes performing a focused history and physical exam, as well as relevant investigations. It discusses life-threatening causes of chest pain including acute coronary syndrome, cardiac tamponade, pulmonary embolism, tension pneumothorax, and aortic dissection. For each condition, it details symptoms, signs, diagnostic tests, and general treatment approaches.
More Related Content
What's hot
Cyanotic Heart Diseases
This document provides information on various cyanotic heart lesions including Tetralogy of Fallot, Transposition of the Great Arteries, Tricuspid Atresia, Ebstein's Anomaly and Total Anomalous Pulmonary Venous Return. It describes the anatomy, clinical features, diagnosis and management of these conditions. Key cyanotic heart lesions are characterized by mixing of oxygenated and deoxygenated blood resulting in central cyanosis.
Peripheral vascular disease,
This document provides information on cardiac rehabilitation considerations for patients with peripheral vascular disease (PVD). It discusses the types and causes of PVD, risk factors, clinical manifestations, diagnosis, complications, and management. For cardiac rehabilitation, it recommends supervised treadmill exercise 3 times per week at a moderate intensity that brings on claudication pain within 3-5 minutes. The goals are to improve walking distance and capacity. Home-based walking with behavioral techniques can also be effective. Upper body ergometry, resistance training, and lifestyle risk factor management are complementary. Regular lifelong maintenance exercise is encouraged to prevent disability from PVD.
Pulmonary artery hypertension
1) The document discusses the updated classification of pulmonary hypertension and outlines the diagnostic and management approach.
2) It reviews the criteria for diagnosing pulmonary hypertension based on mean pulmonary artery pressure and outlines potential causes.
3) The key objectives are to review the updated WHO classification of pulmonary hypertension, diagnostic testing approaches including echocardiography and right heart catheterization, and clinical management based on disease severity including medication options and monitoring response to therapy.
Tricuspid atresia in pediatrics
Tricuspid atresia is a congenital heart defect where the tricuspid valve is absent or closed, preventing blood flow from the right atrium to the right ventricle. This causes the right ventricle to be underdeveloped and the pulmonary artery to be narrow. To survive, babies with tricuspid atresia rely on openings between the atria (ASD) or ventricles (VSD) and/or a patent ductus arteriosus to provide pulmonary blood flow. Treatment depends on the amount of pulmonary blood flow, and may involve procedures like shunts, pulmonary artery banding, or ultimately the Fontan procedure. Complications can include arrhythmias, ventricular dysfunction,
Pulmonary hypertension (2014) dr.tinku joseph
This document provides information on pulmonary hypertension (PH), including its definition, classification, pathogenesis, diagnosis, and treatment. It begins with defining PH as a mean pulmonary arterial pressure greater than 25 mmHg at rest based on right heart catheterization. PH is classified into 5 groups. The pathogenesis and pathology of each group is described. Diagnostic workup includes labs, imaging like CXR, echocardiogram and right heart catheterization. Treatment involves general measures, diuretics, anticoagulants, oxygen, and PAH-specific therapies like endothelin receptor antagonists, phosphodiesterase inhibitors, prostanoids, and calcium channel blockers in some cases. Prognostic factors and goals of treatment are also discussed.
Portal hypertension by Dr mohammed Hussien
This document discusses portal hypertension and bleeding varices. It begins by describing the physiology of the portal system and defining portal hypertension. It then discusses the causes of portal hypertension including morphological alterations in the liver from cirrhosis and fibrosis. It also discusses the hyperdynamic circulation seen in portal hypertension which involves increased vasodilators and reduced sensitivity to vasoconstrictors. Risk factors for bleeding varices include portal pressure, variceal size, wall structure, and hepatic function. The document concludes by covering the history, physical exam, classifications, and laboratory evaluation of portal hypertension.
Cyanotic heart disease
Tetralogy of Fallot is the most common cyanotic heart disease characterized by four features: ventricular septal defect, overriding aorta, infundibular pulmonary stenosis, and right ventricular hypertrophy. It presents with cyanosis that is more frequent in the second half of the first year and hypercyanotic spells after exercise or positions like crying and squatting. Treatment involves palliative surgery like Blalock-Taussig shunt initially, followed by complete repair around 6 months of age. Management of hypercyanotic spells includes medications like morphine, oxygen, and positioning changes.
Tricuspid valve disease
This document discusses the anatomy, assessment, and management of tricuspid valve disease. It covers tricuspid stenosis and tricuspid regurgitation. For tricuspid stenosis, the most common causes are rheumatic fever and infective endocarditis. Symptoms include fatigue and swelling. Transthoracic echocardiogram is used to assess the mean gradient and valve morphology. For tricuspid regurgitation, the most common primary causes are rheumatic fever and carcinoid heart disease. Secondary causes are related to right ventricular dilation. Symptoms are similar to stenosis. Echocardiogram can assess the severity of regurgitation and pulmonary pressures. Management involves medical therapy depending on severity of disease.
Cardiac tamponade Toufiqur Rahman
cardiac tamponade, constrictive pericarditis, cardiology, health, medicine, infections, malignancy, SLE, Hypothyroidism
MDCT Evaluation of Varices in Portal Hypertension
MDCT is useful for identifying portosystemic collateral vessels in patients with portal hypertension. It can accurately demonstrate the majority of collateral channels. Dynamic CT with contrast allows visualization of varices in the esophagus, stomach, rectum, and other locations. Precise mapping of collateral vessels is important before surgical or interventional procedures to avoid blood loss. MDCT plays an invaluable role in managing portal hypertension.
Diagnosing pleural effusion
This presentation discusses steps in diagnosis of pleural effusion using a simulated patient scenario. Besides talking about different findings we can possibly see in a pt with pleural effusion on examination, CXR, USG, CT and labs, It also briefly discuss the proper steps in performing thoracocentesis.
Tetrology of fallot
Tetralogy of Fallot is a congenital heart defect with four abnormalities: 1) a ventricular septal defect, 2) pulmonary stenosis, 3) overriding aorta, and 4) right ventricular hypertrophy. This causes deoxygenated blood to bypass the lungs and mix with oxygenated blood, resulting in cyanosis. The severity depends on the degree of pulmonary stenosis and ventricular septal defect. Surgical repair involves relieving the stenosis and closing the VSD.
Cyanotic heart disease tof
This document discusses cyanotic heart disease, specifically tetralogy of Fallot. It describes the characteristics of tetralogy of Fallot as obstruction of the right ventricular outflow, ventricular septal defect, dextroposition of the aorta with septal overriding, and right ventricular hypertrophy. It discusses the pathophysiology, clinical features, diagnosis, complications, treatment including medical management and surgery, and follow up for patients with tetralogy of Fallot.
Single ventricle palliation
The document discusses single ventricle heart conditions and their palliation. It notes there are two hemodynamic goals: (1) pumping blood to the systemic and pulmonary circulations, and (2) separating the circulations to ensure the pulmonary circulation receives the richest oxygenated blood. Common types of single ventricle hearts are then listed. The goals of single ventricle palliation are then stated as pumping blood adequately and separating the circulations. Early surgical corrections for these conditions including shunts from the 1940s-1960s are also briefly discussed.
Echo in pericardial diseases
This document provides an overview of echocardiography in pericardial diseases. It begins with an introduction to pericardial anatomy and pathophysiology. It then discusses various pericardial diseases that can be evaluated by echocardiography, including acute pericarditis, recurrent pericarditis, pericardial effusions, cardiac tamponade, and constrictive pericarditis. For each condition, it describes the echocardiographic findings and techniques used to evaluate the condition. It emphasizes that echocardiography is usually the initial imaging test of choice but that CT or CMR may be needed in some complex cases.
Valvular Heart Disease
The document discusses various types of heart valve disorders including stenosis, regurgitation, and prolapse. It describes the causes, effects, symptoms, and treatments for different valve conditions affecting the mitral, aortic, tricuspid, and pulmonary valves. Surgical interventions for valve disorders include valvuloplasty procedures to repair valves as well as valve replacement using mechanical or biological prosthetics.
Surgical management of tetralogy of fallot
This document discusses the diagnosis and management of Tetralogy of Fallot. It begins with describing the clinical examination findings and various investigations used. Echocardiography, ECG, chest x-ray, cardiac catheterization, CT, and MRI are discussed. Palliative treatments like Blalock-Taussig shunt are explained. Factors deciding definitive repair are covered, along with the surgical techniques and risks of early and late complications. Post-operative care and follow up are briefly mentioned.
Cardiac tamponade
This document discusses cardiac tamponade, a medical emergency caused by fluid accumulation in the pericardium. Symptoms include chest pain and difficulty breathing. A physical exam may reveal Beck's triad of hypotension, jugular vein distension, and muffled heart sounds, as well as pulsus paradoxus. Echocardiography can demonstrate fluid and compression of the heart. Treatment involves pericardiocentesis to drain fluid or a pericardial window procedure.
Cyanotic heart disease
A cyanotic heart defect is a group-type of congenital heart defects (CHDs). The patient appears blue (cyanotic), due to deoxygenated blood bypassing the lungs and entering the systemic circulation. This can be caused by right-to-left or bidirectional shunting, or malposition of the great arteries.
Cyanotic heart defects, which account for approximately 25% of all CHDs, include:
Tetralogy of Fallot (ToF)
Total anomalous pulmonary venous connection
Hypoplastic left heart syndrome (HLHS)
Transposition of the great arteries (d-TGA)
Truncus arteriosus (Persistent)
Tricuspid atresia
Interrupted aortic arch
Pulmonary atresia (PA)
Pulmonary stenosis (critical)
Eisenmenger syndrome(Reversal of Shunt due to Pulmonary Hypertension) .
Patent ductus arteriosus may cause cyanosis in late stage.
CYANOTIC CONGENITAL HEART DISEASES WITH DECREASED BLOOD FLOW
This document discusses cyanosis and its causes in neonates. It begins by defining cyanosis as a bluish tinge of the skin and mucous membranes, detectable when hemoglobin is reduced by more than 5g% or oxygen saturation is below 85%. It then lists various pulmonary, cardiac, central nervous system, metabolic, hematologic, and infectious conditions that can cause cyanosis in newborns. The majority of the document focuses on describing tetralogy of Fallot, including its characteristic features, pathophysiology, clinical presentation, diagnosis, and management. It provides details on the anatomy, causes, hypoxic spells, and treatment approaches for tetralogy of Fallot.
What's hot (20)
CYANOTIC CONGENITAL HEART DISEASES WITH DECREASED BLOOD FLOW
CYANOTIC CONGENITAL HEART DISEASES WITH DECREASED BLOOD FLOW
Similar to chronic constrictive pericarditis ideal short case presentation
Cchd
1. Congenital cyanotic heart disease refers to heart defects present at birth that result in low oxygen levels in the blood. They are classified as those with increased or decreased blood flow to the lungs.
2. Common types with increased pulmonary blood flow include persistent truncus arteriosus and transposition of the great arteries (TGA). Common types with decreased pulmonary blood flow include tricuspid atresia and pulmonary atresia with intact ventricular septum.
3. TGA accounts for 5-7% of congenital heart defects. It involves the aorta originating from the right ventricle and the pulmonary artery originating from the left ventricle. It requires mixing of blood between the pulmonary and systemic
Approach to chest pain
This document provides guidance on evaluating and managing patients presenting with chest pain. It outlines the general approach which includes ensuring patient stability, providing oxygen and analgesia. It describes performing a focused history and physical exam, as well as relevant investigations. It discusses life-threatening causes of chest pain including acute coronary syndrome, cardiac tamponade, pulmonary embolism, tension pneumothorax, and aortic dissection. For each condition, it details symptoms, signs, diagnostic tests, and general treatment approaches.
Approach to chest pain
This document provides an overview of the approach to evaluating and managing chest pain. It discusses the anatomy and pathophysiology of chest pain, including the differences between somatic and visceral pain. Common causes of chest pain are reviewed, including acute coronary syndrome (ACS), pulmonary embolism, thoracic aortic dissection, and others. Risk stratification tools for ACS are described. The document then outlines the stepwise approach to a patient with chest pain, including history, physical exam, ECG, imaging, labs, and potential treatments.
APPROACH TO CHEST PAIN.pptx
The document provides guidance on evaluating and diagnosing the causes of chest pain, including cardiac conditions like acute coronary syndrome (ACS) and pulmonary embolism. It describes approaches to obtaining a history, performing a physical exam, and ordering diagnostic tests like electrocardiograms (ECGs) and cardiac biomarkers. The goal is to identify high-risk conditions and accurately diagnose the underlying cause of the patient's chest discomfort.
DISEASES OF PERICARDIUM BY DRV AILU SHASHANK
The document discusses diseases of the pericardium, including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade. It describes the anatomy and functions of the pericardium, symptoms and signs of different pericardial diseases, diagnostic tests including ECG, echo, CT and treatment approaches.
Cardiac disease
This patient has signs of mild congestive heart failure on chest x-ray including cardiomegaly and mild pulmonary edema. Further imaging with echocardiogram showed mild aortic regurgitation, likely due to root disease such as hypertension. The patient presents with limited exercise tolerance and mild shortness of breath on exertion consistent with mild heart failure from aortic regurgitation.
Constrictive pericarditis
Constrictive pericarditis is caused by scarring and thickening of the pericardium, restricting cardiac filling. It is diagnosed using echocardiography which shows septal bounce, exaggerated mitral inflow, and hepatic vein reversal. While similar to restrictive cardiomyopathy, constrictive pericarditis shows increased ventricular interaction and respiratory effects on cardiac physiology. Surgical pericardiectomy is usually required for treatment but is high risk, with post-op complications common. Long-term survival depends on the underlying cause of constriction.
Pericardial compressive syndromes
This document provides information on cardiac tamponade, including its pathophysiology, clinical features, diagnostic testing, and treatment. Cardiac tamponade is characterized by fluid accumulation in the pericardial space, which increases intracardiac pressures and reduces ventricular filling. Key signs include pulsus paradoxus, elevated jugular venous pressure, and echocardiographic findings of right heart chamber collapse. Treatment involves urgent pericardiocentesis or surgery to drain fluid and relieve pressure on the heart.
Pericardial diseases 2
Constrictive pericarditis is usually caused by fibrosis and scarring of the pericardium due to prior infection, surgery, radiation, or other inflammatory processes. Tuberculosis is a common cause in developing countries. The scarring restricts cardiac filling, leading to elevated pressures in all chambers. Patients experience symptoms of right and left heart failure like edema and dyspnea. Diagnosis involves echocardiography, cardiac catheterization and MRI/CT. Treatment is surgical removal of the pericardium (pericardiectomy), which carries risks but is usually definitive. Diuretics and other medications can help symptoms but do not treat the underlying condition.
Ccpa catheter basics07medicine
The Swan-Ganz catheter, also known as a pulmonary artery catheter, is a specialized catheter used to monitor a patient's hemodynamics. It is inserted into the internal jugular or subclavian vein and threaded through the heart into the pulmonary artery. This allows direct measurement of pressures in the right atrium, right ventricle, pulmonary artery, and indirect measurement of left-sided pressures. The catheter is useful for diagnosis and management of conditions affecting heart function or pulmonary circulation. However, randomized controlled trials found no improvement in outcomes with its use and increased risks, so the catheter's benefits must be weighed against risks for each individual patient.
Its all about ECG..from A to Z.its so easy to understand
we will see so many ecgs in our daily lifrle..thid is a guide to decode any ecg to make easy diagnosis
Approach to cyanotic congenital heart disease in new born
This document provides an overview of the approach to cyanotic congenital heart disease in newborns. It discusses the importance of early recognition and stabilization of these patients before transporting them to a cardiac care center. Physical exam findings, tests like chest x-ray and echocardiogram can help make the clinical diagnosis which is then confirmed by echocardiography. Specific cyanotic lesions discussed in detail include transposition of the great arteries, total anomalous pulmonary venous connection, truncus arteriosus, tetralogy of Fallot, hypoplastic left heart syndrome, and tricuspid atresia.
Imaging of portal hypertension
This document discusses non-invasive imaging techniques for evaluating portal hypertension. Ultrasound is the most widely used initial imaging modality to assess for portal vein patency, presence of collaterals, portal blood flow, and changes of cirrhosis. CT and MRI can further evaluate the portal venous system and collateral vessels. Ultrasound Doppler is used to measure portal blood flow direction, velocity, and assess for portosystemic collaterals and changes in hepatic veins. Imaging findings of various etiologies of portal hypertension are described, including cirrhosis, non-cirrhotic portal fibrosis, portal vein thrombosis, Budd-Chiari syndrome, and extrahepatic causes.
Pulmonary embolism
1. Pulmonary embolism (PE) has an annual incidence of about 1 case per 1000 people in the US. Risk factors include immobilization, recent surgery or trauma, cancer, and certain genetic conditions.
2. PE occurs when a blood clot forms, most often in the legs, and travels to the lungs where it can partially or completely block pulmonary arteries. This can strain the right ventricle of the heart and impair oxygen exchange in the lungs.
3. Diagnosis is made through clinical assessment, blood tests like D-dimer and BNP, imaging like CT scans, and evaluation of risk factors. Treatment involves blood thinners, thrombolysis in some cases, and occasionally surgery to
HYPERCALCEMIA-V-HYPOCALCEMIA.pptx
This document discusses several types of congenital heart diseases including their etiology, pathophysiology, clinical manifestations, diagnostic evaluation, and management. It covers tetralogy of fallot, persistent ductus arteriosus, atrial septal defect, and ventricular septal defect. For each condition, it provides details on the anatomical defects involved, characteristic signs and symptoms, relevant test findings, and treatment options including surgical repair when indicated.
Pericardial diseases - Etiopathogenesis, Clinical features, Advances in Manag...
Pericardial diseases - Etiopathogenesis, Clinical features, Advances in Manag...Chetan Ganteppanavar
1. The document discusses pericardial anatomy and functions, including its arterial supply, venous drainage, and innervation. It then covers various causes of pericardial disease like acute pericarditis, pericardial effusions, cardiac tamponade, and constrictive pericarditis.
2. For acute pericarditis, it lists infectious and non-infectious etiologies and describes the pathogenesis, clinical presentation, diagnostic workup, and treatment options. It highlights the ECG findings in pericarditis.
3. For pericardial effusions, it discusses the pathophysiology, clinical features, diagnostic studies including echocardiography findings,39.7.Rajiah.pptx
MRI can evaluate pericardial abnormalities with high accuracy. It can identify pericardial effusions such as simple, complex, or loculated collections. It can also detect other abnormalities like hematomas, cardiac tamponade with findings like flattened heart and chamber inversion, and different types of pericarditis showing thickened enhancing pericardium or chronic fibrosis. MRI is useful for comprehensive assessment of pericardial diseases.
Aortic valve disease
This document discusses aortic valve disease, including aortic stenosis and aortic regurgitation. It provides definitions and descriptions of aortic valve stenosis in terms of etiology, pathophysiology, clinical presentation, investigations, and treatment options including surgical aortic valve replacement and percutaneous approaches. For aortic regurgitation, it covers etiology, pathophysiology, symptoms, physical exam findings for assessing severity, investigations, and indications for surgical valve replacement. Key points are made about compensatory changes in the left ventricle and how these relate to severity and timing of intervention.
Tetralogy of fallot
This document discusses the classification, symptoms, diagnosis, and treatment of tetralogy of Fallot (TOF), a congenital heart defect. TOF is characterized by four components: pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. Symptoms in infants include cyanosis that worsens with activity due to reduced pulmonary blood flow. Diagnosis involves examination findings like a murmur, ECG showing right ventricular hypertrophy, and CXR/ECHO images. Treatment ranges from medical management to palliative surgeries like Blalock-Taussig shunts or corrective repair via surgery to close defects.
Peri op management of mitral stenosis patient coming for non cardiac surgery
Mitral stenosis is a chronic mechanical obstruction of the left ventricular inflow caused by narrowing of the mitral valve orifice. This document discusses the anesthetic considerations for a patient with mitral stenosis undergoing non-cardiac surgery. It covers the pathophysiology of mitral stenosis, preoperative evaluation and optimization of the patient, and intraoperative anesthetic goals of maintaining normal hemodynamics while avoiding tachycardia, changes in preload or afterload, and worsening of pulmonary hypertension.
Similar to chronic constrictive pericarditis ideal short case presentation (20)
Its all about ECG..from A to Z.its so easy to understand
Its all about ECG..from A to Z.its so easy to understand
Approach to cyanotic congenital heart disease in new born
Approach to cyanotic congenital heart disease in new born
Pericardial diseases - Etiopathogenesis, Clinical features, Advances in Manag...
Pericardial diseases - Etiopathogenesis, Clinical features, Advances in Manag...
Peri op management of mitral stenosis patient coming for non cardiac surgery
Peri op management of mitral stenosis patient coming for non cardiac surgery
More from Kunwar Saurabh
ASD case presentation Ideal Case
This document presents the case of a 4-year-old boy who presented with complaints of breathlessness on exertion for the past 6 months. On examination, he was found to have a grade 3 ejection systolic murmur in the pulmonary area and a grade 2 mid-diastolic murmur at the left lower parasternal border. Echocardiography revealed an atrial septal defect, most likely of the secundum type. The boy's symptoms, murmurs on examination, and echocardiography findings are consistent with an atrial septal defect allowing left-to-right shunting.
ideal case presentation for aortic stenosis
Manoj, a 47-year-old male teacher, presented with 1 year of chest pain on exertion, 9 months of breathlessness with exercise, and 2 months of occasional blackouts. Examination found a grade IV midsystolic murmur and systolic thrill. Imaging showed severe calcific aortic stenosis, concentric left ventricular hypertrophy, and a peak aortic valve gradient of 74 mmHg. The patient was diagnosed with severe aortic stenosis.
tetralogy of fallot ideal case 2
The echocardiogram showed septal hypertrophy, a large non-restrictive ventricular septal defect, severe infundibular pulmonic stenosis, aortic override, and right ventricular hypertrophy. No other structural defects were seen. Cardiac catheterization measurements confirmed these findings and additionally showed normal coronary arteries. Surgical repair would need to consider approaches, pulmonary arteriotomy, transannular patching, preserving coronary arteries, and managing other septal defects while dividing obstructive muscles in the right ventricular outflow tract.
tetralogy of fallot ideal case 1
This document presents a case study of a 4-year-old boy named Rahim who has been experiencing bluish discoloration of his lips since infancy and breathlessness with exertion for the past 1.5 years. On examination, he was found to have cyanosis of his lips, tongue, and fingers as well as clubbing in his extremities. Tests revealed hemoglobin of 18.9 gm/dl and oxygen saturation of 83% on room air. Based on the history and examination, the provisional diagnosis is tetralogy of Fallot.
Comparision of management protocols for aortic disease
This document compares guidelines from American, European, and Asian societies for managing aortic diseases. It summarizes differences in recommendations for imaging modalities like CT and MRI. The guidelines broadly agree on classifications for acute aortic syndromes like aortic dissection but have some differences. Recommendations also vary for conditions like thoracic and abdominal aortic aneurysms and Marfan syndrome regarding follow-up schedules and treatment thresholds. The European guidelines provide details on aortic root measurements and surgical approaches for aortic regurgitation and aneurysms.
Asd
This document provides an overview of atrial septal defects (ASD), including definitions, types, development, associated conditions, clinical presentation, investigations, and treatment. The main types of ASD are fossa ovalis/ostium secundum, sinus venosus, and ostium primum defects. Clinical features may include fatigue, breathlessness, and arrhythmias. Investigations include chest X-ray, echocardiogram, and cardiac catheterization. Large defects or those causing heart failure or pulmonary hypertension typically warrant surgical closure to repair the septal defect. The surgery aims to close the defect without causing heart block or valve problems.
Pulmonary hypertension part 1
This document discusses pulmonary hypertension (PH), defined as a mean pulmonary arterial pressure over 25 mmHg. PH is classified into 5 groups based on etiology. Common causes include left heart disease (group 2) and idiopathic pulmonary arterial hypertension (group 1). Symptoms are nonspecific but relate to right ventricular dysfunction. Diagnosis requires right heart catheterization to confirm PH and assess severity. Evaluation includes echocardiogram, CT, V/Q scan, PFTs, and labs. Prognosis correlates with functional class and exercise capacity.
Thoracic outlet syndrome
a brief review of thoracic outlet syndrome, including surgical management. Dorsal sympathectomy has been left out
Right superior vena cava draining to left atrium
This document discusses a rare case of an anomalous right superior vena cava (RSVC) draining directly into the left atrium. The key points are:
1. Embryological development explains how the RSVC could anomalously connect to the left atrium.
2. A 34-year-old woman presented with hypoxemia and was found to have this rare condition.
3. Surgical correction was performed to reroute the RSVC into the right atrium, resolving the hypoxemia.
Atrial fibrillation
This document discusses atrial fibrillation (AF), including its definition, classification, clinical features, pathophysiology, triggers, treatment strategies, and more. Some key points:
- AF is the most common cardiac arrhythmia characterized by uncoordinated atrial activation. Risk factors include increasing age, male sex, and white race.
- It can be classified as paroxysmal, persistent, or permanent. Triggers often originate from the pulmonary veins or other areas.
- Consequences include reduced cardiac output and increased filling pressures. Treatment involves preventing thromboembolism with anticoagulants, controlling heart rate, and restoring normal rhythm.
- Rate control is usually first-line and
Seizures post cardiac surgery
This study aimed to identify preoperative predictors of seizures after cardiac surgery and their impact on postoperative outcomes. The study analyzed 2578 patients who underwent cardiac procedures between 2007-2009. Seizures occurred in 1.2% of patients, usually within 2 days of surgery. Independent risk factors for seizures included critical preoperative states like ventricular fibrillation and the need for ionotropes or IABP. Patients who experienced seizures had higher rates of mortality, complications, and lower 1-year survival compared to those without seizures. The study found embolic infarcts on CT scans in 34% of seizure patients, suggesting cerebral embolism plays a role in postoperative seizures.
Pa catheter
This document discusses the use of pulmonary artery catheters and pressure tracings. It provides basic principles on cardiac output and how pulmonary artery diastolic pressure generally correlates with pulmonary capillary wedge pressure. It notes that a PAD higher than a PCWP can indicate pulmonary arterial hypertension or intrinsic pulmonary disease. The document also discusses thermodilution technique, ratios used in congestive heart failure and hypoxemia, and ideally maintaining a cardiac index greater than 2.2 L/min/m2 with normal mixed venous oxygen saturation. It concludes by asking for the reader's opinion on using pulmonary artery catheters and thanks them.
Mitral regurgitation
Mitral regurgitation is the abnormal reversal of blood from the left ventricle to the left atrium, caused by disruption of the mitral valve apparatus. It can be divided into acute, chronic compensated, and chronic decompensated stages. The etiology includes primary causes where the valve itself is abnormal, and secondary causes where the heart problem leads to valve dysfunction. Diagnosis is typically made using a 2D echocardiogram to visualize the valve and assess the severity and cause of regurgitation. Treatment options involve medical management or surgical repair or replacement of the valve.
Invisible threat of antibiotic resistance
The document discusses the invisible threat of antibiotic resistance and how ignorance exacerbates the problem. It references studies on infections and risk factors in cardiac surgery. To prevent further antibiotic resistance, it suggests starting to practice guidelines discussed in a previous class, while ensuring patient safety and antibiotic quality. Key questions are raised on whether guidelines fit practical logic and how to improve the situation.
Hydatid cyst pulmonary
Cystic pulmonary hydatidosis is caused by the larval stage of the Echinococcus parasite. It is endemic in many parts of the world. Imaging such as chest x-rays and CT scans are used to diagnose the disease and show features such as cysts, detachment of the endocyst, and air-fluid levels. Surgical techniques like enucleation, pericystectomy, and lobectomy may be used for treatment along with albendazole therapy to prevent recurrence. Post-operative monitoring with imaging and liver function tests is important to check for complications or reoccurrence of the disease.
Guidelines for management of peripheral arterial disease
1) Medical therapy including antiplatelets, statins, and structured exercise therapy is the primary treatment for peripheral arterial disease (PAD). Revascularization may be considered for lifestyle-limiting claudication that does not improve with medical therapy and exercise.
2) The goal of revascularization in critical limb ischemia (CLI) is to restore blood flow to the foot through at least one patent artery in order to reduce the risk of amputation and cardiovascular events. Endovascular and surgical revascularization have shown similar outcomes for amputation-free survival in CLI.
3) Acute limb ischemia is a medical emergency requiring prompt evaluation and revascularization within 6-24 hours to prevent limb loss.
Aortic regurgitation pathophysiology
This document discusses the pathophysiology, etiology, clinical presentation, investigations, and management of aortic regurgitation. Key points include:
- Aortic regurgitation results in both volume and pressure overload on the left ventricle, leading to eccentric and concentric hypertrophy.
- Patients may remain asymptomatic for decades due to compensatory mechanisms, but some eventually develop left ventricular systolic dysfunction and heart failure symptoms.
- Examination may reveal a low diastolic blood pressure, wide pulse pressure, displaced apical impulse, and holodiastolic murmur.
- Echocardiography can quantify the degree of regurgitation and assess ventricular size and function.
Sequential segmental analysis of heart
This document discusses sequential segmental analysis of the heart. It begins by introducing the concept and origins in the 1960s. It then explains that sequential segmental analysis involves evaluating the heart in segments using a pattern recognition approach. This allows for comprehensive examination and minimizes error in detecting defects. The remainder of the document details the specific segments analyzed - atrial, ventricular, ventriculoarterial, and arterial - and describes the Van Praagh classification system for analyzing each segment.
Pa catheter
This document discusses the use of pulmonary artery catheters and pressure tracings. It provides basic principles on cardiac output and how pulmonary artery diastolic pressure generally correlates with pulmonary capillary wedge pressure. It notes that a PAD higher than a PCWP can indicate pulmonary arterial hypertension or intrinsic pulmonary disease. The document also discusses thermodilution technique, ratios used in congestive heart failure and hypoxemia, and ideally maintaining a cardiac index greater than 2.2 L/min/m2 with normal mixed venous oxygen saturation. It concludes by asking for the reader's opinion on using pulmonary artery catheters and thanks them.
Cardiac catheterisation
Cardiac catheterization is a procedure used to diagnose and treat cardiovascular conditions either diagnostically or therapeutically. It remains the gold standard for comprehensively evaluating complex heart disease through invasive physiologic assessment. It can also be used to provide minimally invasive definitive therapy for some selective cardiac defects. The procedure allows for measurement of blood flows and pressures throughout the heart and vessels, as well as calculation of systemic and pulmonary vascular resistances, to fully understand a patient's heart condition.
More from Kunwar Saurabh (20)
Comparision of management protocols for aortic disease
Comparision of management protocols for aortic disease
Guidelines for management of peripheral arterial disease
Guidelines for management of peripheral arterial disease
Recently uploaded
Cell Therapy Expansion and Challenges in Autoimmune Disease
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.
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Learn about body grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd Edition by DeMarco, Walsh, Verified Chapters 1 - 25, Complete Newest Version Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Study Guide Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Stuvia Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Test Bank For Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Pdf Download Course Hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Answers Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Ebook Download Course hero Community and Public Health Nursing: Evidence for Practice 3rd Edition Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Chapters Download Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Pdf Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Study Guide Questions and Answers Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Ebook Download Stuvia Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Questions Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Studocu Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Quizlet Community and Public Health Nursing: Evidence for Practice 3rd Edition Test Bank Stuvia
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Role of Mukta Pishti in the Management of Hyperthyroidism
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.
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
vertical loop
horizontal loop
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
The Electrocardiogram - Physiologic Principles
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
All info about Diabetes and how to control it.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Recently uploaded (20)
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
TEST BANK For Community and Public Health Nursing: Evidence for Practice, 3rd...
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
chronic constrictive pericarditis ideal short case presentation
- 2. Clinical Diagnosis • Chronic Constrictive Pericarditis, Ascites, Hepatomegaly, Pedal Edema, CCF, Probably tubercular etiology, NSR, NYHA Grade III, on ATT,
- 3. Chest X Ray
- 4. ECG
- 9. Echocardiography report • Chronic Constrictive Pericarditis • Pericardial thickening present – 5mm • No pericardial effusion • Diastolic Dysfunction grade (Biventricular) III • Increased respiratory variation of early diastolic velocity across mitral valve (>25%), Annulus paradoxus • Increased respiratory variation of early diastolic velocity across tricuspid valve (>40%) • IVC Dilated and non collapsible • Increased hepatic doppler flow reversal during expiration • PA pressure across valve -30 mm HG • Severe TR, Other Valves Normal • Intact IAS/IVS • Septal Bounce +nt • Diastolic Collapse of RV present • Normal LV function