chronic constrictive pericarditis ideal short case presentation
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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.
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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) .
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Cchd
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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.
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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...
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Peri op management of mitral stenosis patient coming for non cardiac surgery
Peri op management of mitral stenosis patient coming for non cardiac surgery
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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.
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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