Dyspnea (cardio) pathology
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Atelectasis
This document discusses atelectasis, which is the collapse or closure of alveoli in the lungs. It defines atelectasis and reviews its causes, types, symptoms, diagnosis, and treatment. Atelectasis can be obstructive or non-obstructive, acute or chronic. Risk factors include smoking and general anesthesia. Diagnosis involves chest x-ray, pulse oximetry, and arterial blood gas analysis. Treatment focuses on treating the underlying cause, chest physiotherapy, bronchodilators, surgery if needed, and preventing complications like pneumonia. Nursing care involves airway clearance techniques and strategies to improve ventilation and gas exchange.
Approach to a patient of dyspnea
This document provides an overview of the approach to a patient presenting with dyspnea. It begins with definitions of dyspnea and classifications including the modified Medical Research Council dyspnea scale and NYHA classification. It then discusses the receptors involved in the mechanism of dyspnea, common causes of acute, subacute and chronic dyspnea, important parts of the physical examination, red flags, and recommended initial testing.
Valvular heart disease
This document discusses various types of valvular heart disease including stenosis, regurgitation, and specific valve diseases like mitral stenosis. It covers the etiology, pathophysiology, clinical manifestations and diagnostic studies for each type. Treatment options discussed include medications, percutaneous balloon valvuloplasty, various surgical repair procedures like valvuloplasty, annuloplasty and chordoplasty, and valve replacements using mechanical or biologic prosthetic valves. Nursing management focuses on assessment, monitoring, education, and addressing diagnoses like activity intolerance and fluid overload.
L 7.approach to dyspnea
Dyspnea, also known as breathlessness or shortness of breath, is defined as a subjective experience of breathing discomfort that can vary in intensity. It is caused by stimulation of pulmonary and extra-pulmonary receptors in response to conditions like asthma, COPD, pneumonia, pulmonary embolism, cardiac failure, and more. The document outlines the pathophysiology, stages, differential diagnosis, physical exam findings, and key investigations for evaluating the underlying cause of a patient's dyspnea.
Pericardial diseases
The document discusses various pericardial diseases including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade. It provides details on the anatomy and functions of the pericardium, pathophysiology, clinical features, diagnostic tests, and management of these conditions. Key points include that pericardial diseases can present with non-specific symptoms, clinical suspicion is important for diagnosis, and treatment depends on underlying etiology and presence of hemodynamic compromise. Differentiating constrictive pericarditis from restrictive cardiomyopathy is important as treatment approaches differ significantly.
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Definition of shock
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Types of Shock
Stages of Shock
Physiologic Determinants of Shock
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Congestive cardiac Failure
1) Congestive heart failure results from structural or functional abnormalities that impair the heart's ability to pump or fill with blood adequately.
2) As a result, the heart cannot pump enough blood to meet the body's needs, leading to a buildup of fluid in the lungs or tissues.
3) Treatment focuses on lifestyle modifications, medications such as diuretics, ACE inhibitors, beta blockers, and device-based therapies as needed to manage symptoms and improve outcomes.
Recommended
Atelectasis
This document discusses atelectasis, which is the collapse or closure of alveoli in the lungs. It defines atelectasis and reviews its causes, types, symptoms, diagnosis, and treatment. Atelectasis can be obstructive or non-obstructive, acute or chronic. Risk factors include smoking and general anesthesia. Diagnosis involves chest x-ray, pulse oximetry, and arterial blood gas analysis. Treatment focuses on treating the underlying cause, chest physiotherapy, bronchodilators, surgery if needed, and preventing complications like pneumonia. Nursing care involves airway clearance techniques and strategies to improve ventilation and gas exchange.
Approach to a patient of dyspnea
This document provides an overview of the approach to a patient presenting with dyspnea. It begins with definitions of dyspnea and classifications including the modified Medical Research Council dyspnea scale and NYHA classification. It then discusses the receptors involved in the mechanism of dyspnea, common causes of acute, subacute and chronic dyspnea, important parts of the physical examination, red flags, and recommended initial testing.
Valvular heart disease
This document discusses various types of valvular heart disease including stenosis, regurgitation, and specific valve diseases like mitral stenosis. It covers the etiology, pathophysiology, clinical manifestations and diagnostic studies for each type. Treatment options discussed include medications, percutaneous balloon valvuloplasty, various surgical repair procedures like valvuloplasty, annuloplasty and chordoplasty, and valve replacements using mechanical or biologic prosthetic valves. Nursing management focuses on assessment, monitoring, education, and addressing diagnoses like activity intolerance and fluid overload.
L 7.approach to dyspnea
Dyspnea, also known as breathlessness or shortness of breath, is defined as a subjective experience of breathing discomfort that can vary in intensity. It is caused by stimulation of pulmonary and extra-pulmonary receptors in response to conditions like asthma, COPD, pneumonia, pulmonary embolism, cardiac failure, and more. The document outlines the pathophysiology, stages, differential diagnosis, physical exam findings, and key investigations for evaluating the underlying cause of a patient's dyspnea.
Pericardial diseases
The document discusses various pericardial diseases including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade. It provides details on the anatomy and functions of the pericardium, pathophysiology, clinical features, diagnostic tests, and management of these conditions. Key points include that pericardial diseases can present with non-specific symptoms, clinical suspicion is important for diagnosis, and treatment depends on underlying etiology and presence of hemodynamic compromise. Differentiating constrictive pericarditis from restrictive cardiomyopathy is important as treatment approaches differ significantly.
Approach to Shock (for Undergraduates)
Definition of shock
Initial Assessment of shock – ABC
Types of Shock
Stages of Shock
Physiologic Determinants of Shock
Common Features of Shock
Work-up of shock
General Approach to management of shock
Congestive cardiac Failure
1) Congestive heart failure results from structural or functional abnormalities that impair the heart's ability to pump or fill with blood adequately.
2) As a result, the heart cannot pump enough blood to meet the body's needs, leading to a buildup of fluid in the lungs or tissues.
3) Treatment focuses on lifestyle modifications, medications such as diuretics, ACE inhibitors, beta blockers, and device-based therapies as needed to manage symptoms and improve outcomes.
Respiratory failure
Respiratory failure occurs when the lungs fail to effectively oxygenate the blood or remove carbon dioxide. It is classified as type 1 (hypoxic but normal CO2 levels) or type 2 (hypoxic and elevated CO2 levels). Type 1 is more common and caused by conditions like pneumonia that affect only part of the lungs. Type 2 involves more generalized lung damage. Acute respiratory failure develops rapidly while chronic failure progresses over days or longer. Treatment depends on the underlying cause but may include supplemental oxygen, mechanical ventilation, treating infection, or lung transplantation in severe cases.
Respiratory failure
This document summarizes respiratory failure, including its types, causes, clinical manifestations, diagnosis, treatment, and considerations for older patients. Respiratory failure occurs when the lungs cannot effectively exchange oxygen and carbon dioxide and can be acute or chronic. The two main types are hypoxemic respiratory failure, characterized by low blood oxygen, and hypercapnic respiratory failure, characterized by high blood carbon dioxide. Causes range from lung diseases like COPD to neurological conditions. Treatment involves oxygen therapy, medications, and nutrition management.
heart failure
This document provides information on heart failure, including:
1. It defines heart failure as the inability of the heart to pump an adequate amount of blood to meet the body's needs.
2. It describes compensatory mechanisms the body uses in response to heart failure like increasing sympathetic activity and activating the renin-angiotensin system.
3. It discusses treatments for heart failure like diuretics, ACE inhibitors, beta-blockers, and cardiac glycosides which aim to reduce workload on the heart and improve contractility.
Respiratory failure
This document provides an overview of respiratory failure, including its causes, types, symptoms, diagnosis, and management. It begins by defining respiratory failure as the failure of the respiratory system in gas exchange functions of oxygenation and carbon dioxide elimination. Respiratory failure is then classified based on PaO2 and PaCO2 levels into hypoxemic (Type I) and hypercapnic (Type II) types. Common causes, clinical features, investigations, and general management principles are discussed for respiratory failure. Key aspects of managing hypoxemia and hypercapnia are also summarized.
Pulmonary edema
This document provides an overview of pulmonary edema, including its definition, epidemiology, pathophysiology, classifications, causes, clinical manifestations, diagnosis, and treatment. Pulmonary edema is fluid accumulation in the lungs caused by increased fluid filtration from pulmonary capillaries into lung tissue. It can be cardiogenic, caused by left ventricular failure which increases hydrostatic pressure, or non-cardiogenic, caused by altered capillary permeability independent of cardiac issues. Symptoms include shortness of breath, cough, and hypoxemia. Treatment focuses on supporting oxygenation, reducing preload and afterload on the heart, and addressing any underlying conditions.
Dyspnea
Dyspnea, or shortness of breath, is a common symptom that can be caused by many cardiac and pulmonary conditions. A thorough diagnostic evaluation of dyspnea involves taking a detailed patient history, conducting a physical exam, and obtaining initial tests like an electrocardiogram, chest x-ray, and blood tests to evaluate for conditions involving the heart, lungs, blood, and other potential causes and to guide further testing if needed. Grading scales are used to characterize the severity of a patient's dyspnea. The pathophysiology of dyspnea involves an imbalance between the perceived need to breathe and the ability to breathe.
Approach To Dyspnea
Dyspnea, also known as shortness of breath, is difficult or labored breathing that can have many causes. The document outlines an approach to evaluating and treating dyspnea in patients. It describes taking a history, performing an examination, ordering relevant tests, and treating any underlying conditions found to be contributing to the dyspnea. Specific causes discussed include asthma, pulmonary edema, pneumonia, congestive heart failure, and acute coronary syndrome. For each, the document provides details on treatments aimed at opening airways, reducing fluid buildup, fighting infections, and improving blood flow.
Dyspnea
This document defines and discusses dyspnea (shortness of breath) and cyanosis (blue discoloration of the skin). It outlines the mechanisms, causes, and characteristics of dyspnea associated with respiratory, cardiac, and other medical conditions. Key signs and symptoms that may suggest pulmonary or cardiac origins of dyspnea are provided. The document also defines and describes peripheral and central cyanosis, listing various conditions that can cause each type.
MITRAL STENOSIS (Case based & Evidence based)
This document contains 8 case studies presented by Dr. Md. Toufiqur Rahman regarding patients with symptoms of dyspnea and cardiac abnormalities. For each case, the document describes the patient's history, examination findings, and in some cases diagnostic test results. It also provides background information on mitral stenosis including causes, pathophysiology, clinical features, investigations, and stages of severity.
Aortic Regurgitation
Aortic regurgitation is a condition where the aortic valve does not close properly, allowing blood to flow back into the left ventricle. This forces the heart to work harder. Symptoms may include shortness of breath, chest pain, and palpitations. Causes can include aging, hypertension, infective endocarditis, or genetic factors. Long term complications include heart failure or valve infection if not treated. Diagnosis involves echocardiography, chest X-ray, and ECG. Treatment options depend on severity but may include medications, antibiotics, or surgery to repair or replace the valve.
Bronchectasis
Bronchiectasis is a chronic lung disease defined by irreversible dilation of the bronchi. It develops from an initial event that impairs mucociliary clearance, allowing bacteria to colonize and further damage the lungs. The hallmark symptoms are a chronic cough and sputum production lasting months to years. Risk factors include cystic fibrosis, infections, immunodeficiencies, and exposures to toxic substances. Management involves antibiotics, airway clearance techniques, and supplemental oxygen. Severe cases may require surgery.
L 5.approach to dyspnea
This document provides an overview of dyspnea, or shortness of breath. It defines dyspnea and outlines its physiological and clinical definitions. Common causes of dyspnea are then discussed, including pulmonary issues like COPD, pneumonia, and pulmonary embolism, as well as cardiac issues like heart failure, coronary syndromes, and dysrhythmias. The pathophysiology of how these conditions can stimulate breathing and cause the sensation of dyspnea is explained. Finally, the document discusses assessing and diagnosing patients presenting with dyspnea through clinical exams, investigations like chest x-rays, and determining if the cause is chronic or acute.
Chronic Bronchitis
Shahd Alali has chronic bronchitis, characterized by a chronic cough lasting over 2 years. Chronic bronchitis is common among smokers and is caused by smoking as well as air pollutants. It involves hypertrophy of the bronchial mucus glands leading to hypersecretion of mucus and inflammation in the large airways. On morphology, the large airways appear hyperemic, swollen, and covered in mucus secretions with increased goblet cells and inflammatory cells in the trachea and bronchi. Clinical features include a prominent cough producing sputum, cyanosis, increased risk of infection, and dyspnea.
Sinus tachycardia
Sinus tachycardia is characterized by a heart rate over 100 beats per minute originating from the sinus node. It can be a normal response to exercise or stress or indicate underlying conditions like heart failure. Symptoms may occur if the heart rate is very fast or the patient has heart disease. Treatment involves addressing the underlying cause and reducing stress or anxiety.
Cardiomyopathies
This document discusses various types of cardiomyopathies:
- Dilated cardiomyopathy is caused by an unknown etiology and results in left ventricular dilatation and systolic dysfunction. It is a common cause of heart failure.
- Hypertrophic cardiomyopathy involves abnormal thickening of the heart muscle and can lead to outflow obstruction. It is a common cause of sudden death in young athletes.
- Restrictive cardiomyopathy causes stiff ventricles and impaired ventricular filling due to disorders like amyloidosis. It presents with symptoms of right and left heart failure.
- Other rare types discussed include arrhythmogenic right ventricular dysplasia and obliterative cardiomyopathy. Diagnosis involves imaging and endomyocardial biopsy
Heart Failure
This document defines heart failure and discusses its key characteristics. It describes how heart failure occurs when the heart is unable to pump enough blood to meet the body's needs due to problems like abnormal heart muscle function or excessive loads on the heart. The document outlines the pathophysiology and progression of heart failure, including ventricular dilation and hypertrophy as compensatory mechanisms that ultimately fail. It also covers the clinical features, diagnostic tests, medical management, and nursing care considerations for patients with heart failure.
Acute pericarditis
The document discusses acute pericarditis, which is the most common disorder of the pericardium. The pericardium is a sac surrounding the heart. Acute pericarditis can be caused by infections, cardiac issues, autoimmune diseases, metabolic problems, neoplasms, drugs, or trauma. Common symptoms include chest pain, a pericardial friction rub sound, and ECG changes showing widespread concave ST elevation. Treatment typically involves NSAIDs and colchicine, though some cases require invasive therapies like drainage. Prognosis is generally good, but risks include cardiac tamponade or constrictive pericarditis.
Symptoms of CARDIOVASCULAR DISEASES
This document summarizes common symptoms of cardiovascular disease (CVD). It describes symptoms such as dyspnea (shortness of breath), orthopnea (difficulty breathing when lying flat), paroxysmal nocturnal dyspnea (sudden breathing issues at night), edema (swelling) in the lower limbs, abdominal distension, palpitations, chest pain, low cardiac output causing syncope (fainting), embolic manifestations like stroke, and symptoms of infective endocarditis (heart valve infection) like fever and weight loss. The document provides details on the causes and characteristics of each symptom to aid in differential diagnosis of potential cardiac or pulmonary conditions.
Heart Failure
This document provides an overview of heart failure, including its pathophysiology, types, clinical presentation, investigations, and management. Heart failure occurs when the heart cannot pump enough blood to meet the body's needs and can develop due to conditions that weaken the heart such as heart attacks or high blood pressure. Symptoms depend on whether the left side, right side, or both sides of the heart are affected. Management involves treating the underlying cause, reducing symptoms through medications, lifestyle changes, and addressing complications.
dyspnea approach
This document outlines an approach to evaluating and diagnosing dyspnea. It begins by defining dyspnea and noting its high prevalence. Types of dyspnea like orthopnea and paroxysmal nocturnal dyspnea are described. The diagnostic approach involves obtaining a detailed history regarding onset, duration, patterns and associated symptoms. A physical exam assesses respiratory effort, oxygenation, and signs of heart failure. Initial tests may include EKG, chest x-ray, and bloodwork. Further tests are guided by initial findings and may include echocardiogram, pulmonary function tests, CT, or arterial blood gas. Treatment focuses on the underlying cause identified through diagnosis.
Shortness Of Breath
This document provides information on evaluating and diagnosing shortness of breath. It lists various potential causes of shortness of breath including cardiac, lung, anatomical, trauma, and other issues. Specific conditions that could cause wheezing, stridor, crepitations, or a clear chest are identified. The speed of onset can help determine if the underlying cause is acute, subacute, or chronic. Guidelines for triaging patients with shortness of breath into green, yellow, or red zones based on dyspnea and oxygen saturation are also provided. The evaluation involves assessing severity, examining the chest, providing oxygen support if needed, and getting a chest x-ray.
Dyspnea
The patient is a 67-year-old male former smoker presenting with shortness of breath on exertion. Physical examination finds reduced breath sounds and wheezing. Tests show reduced lung function and oxygen levels. The differential diagnosis includes cardiac and pulmonary causes like COPD. Dyspnea is the medical term for shortness of breath and can result from various lung and heart conditions. Treatment focuses on the underlying cause, like using bronchodilators for COPD.
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Respiratory failure
Respiratory failure occurs when the lungs fail to effectively oxygenate the blood or remove carbon dioxide. It is classified as type 1 (hypoxic but normal CO2 levels) or type 2 (hypoxic and elevated CO2 levels). Type 1 is more common and caused by conditions like pneumonia that affect only part of the lungs. Type 2 involves more generalized lung damage. Acute respiratory failure develops rapidly while chronic failure progresses over days or longer. Treatment depends on the underlying cause but may include supplemental oxygen, mechanical ventilation, treating infection, or lung transplantation in severe cases.
Respiratory failure
This document summarizes respiratory failure, including its types, causes, clinical manifestations, diagnosis, treatment, and considerations for older patients. Respiratory failure occurs when the lungs cannot effectively exchange oxygen and carbon dioxide and can be acute or chronic. The two main types are hypoxemic respiratory failure, characterized by low blood oxygen, and hypercapnic respiratory failure, characterized by high blood carbon dioxide. Causes range from lung diseases like COPD to neurological conditions. Treatment involves oxygen therapy, medications, and nutrition management.
heart failure
This document provides information on heart failure, including:
1. It defines heart failure as the inability of the heart to pump an adequate amount of blood to meet the body's needs.
2. It describes compensatory mechanisms the body uses in response to heart failure like increasing sympathetic activity and activating the renin-angiotensin system.
3. It discusses treatments for heart failure like diuretics, ACE inhibitors, beta-blockers, and cardiac glycosides which aim to reduce workload on the heart and improve contractility.
Respiratory failure
This document provides an overview of respiratory failure, including its causes, types, symptoms, diagnosis, and management. It begins by defining respiratory failure as the failure of the respiratory system in gas exchange functions of oxygenation and carbon dioxide elimination. Respiratory failure is then classified based on PaO2 and PaCO2 levels into hypoxemic (Type I) and hypercapnic (Type II) types. Common causes, clinical features, investigations, and general management principles are discussed for respiratory failure. Key aspects of managing hypoxemia and hypercapnia are also summarized.
Pulmonary edema
This document provides an overview of pulmonary edema, including its definition, epidemiology, pathophysiology, classifications, causes, clinical manifestations, diagnosis, and treatment. Pulmonary edema is fluid accumulation in the lungs caused by increased fluid filtration from pulmonary capillaries into lung tissue. It can be cardiogenic, caused by left ventricular failure which increases hydrostatic pressure, or non-cardiogenic, caused by altered capillary permeability independent of cardiac issues. Symptoms include shortness of breath, cough, and hypoxemia. Treatment focuses on supporting oxygenation, reducing preload and afterload on the heart, and addressing any underlying conditions.
Dyspnea
Dyspnea, or shortness of breath, is a common symptom that can be caused by many cardiac and pulmonary conditions. A thorough diagnostic evaluation of dyspnea involves taking a detailed patient history, conducting a physical exam, and obtaining initial tests like an electrocardiogram, chest x-ray, and blood tests to evaluate for conditions involving the heart, lungs, blood, and other potential causes and to guide further testing if needed. Grading scales are used to characterize the severity of a patient's dyspnea. The pathophysiology of dyspnea involves an imbalance between the perceived need to breathe and the ability to breathe.
Approach To Dyspnea
Dyspnea, also known as shortness of breath, is difficult or labored breathing that can have many causes. The document outlines an approach to evaluating and treating dyspnea in patients. It describes taking a history, performing an examination, ordering relevant tests, and treating any underlying conditions found to be contributing to the dyspnea. Specific causes discussed include asthma, pulmonary edema, pneumonia, congestive heart failure, and acute coronary syndrome. For each, the document provides details on treatments aimed at opening airways, reducing fluid buildup, fighting infections, and improving blood flow.
Dyspnea
This document defines and discusses dyspnea (shortness of breath) and cyanosis (blue discoloration of the skin). It outlines the mechanisms, causes, and characteristics of dyspnea associated with respiratory, cardiac, and other medical conditions. Key signs and symptoms that may suggest pulmonary or cardiac origins of dyspnea are provided. The document also defines and describes peripheral and central cyanosis, listing various conditions that can cause each type.
MITRAL STENOSIS (Case based & Evidence based)
This document contains 8 case studies presented by Dr. Md. Toufiqur Rahman regarding patients with symptoms of dyspnea and cardiac abnormalities. For each case, the document describes the patient's history, examination findings, and in some cases diagnostic test results. It also provides background information on mitral stenosis including causes, pathophysiology, clinical features, investigations, and stages of severity.
Aortic Regurgitation
Aortic regurgitation is a condition where the aortic valve does not close properly, allowing blood to flow back into the left ventricle. This forces the heart to work harder. Symptoms may include shortness of breath, chest pain, and palpitations. Causes can include aging, hypertension, infective endocarditis, or genetic factors. Long term complications include heart failure or valve infection if not treated. Diagnosis involves echocardiography, chest X-ray, and ECG. Treatment options depend on severity but may include medications, antibiotics, or surgery to repair or replace the valve.
Bronchectasis
Bronchiectasis is a chronic lung disease defined by irreversible dilation of the bronchi. It develops from an initial event that impairs mucociliary clearance, allowing bacteria to colonize and further damage the lungs. The hallmark symptoms are a chronic cough and sputum production lasting months to years. Risk factors include cystic fibrosis, infections, immunodeficiencies, and exposures to toxic substances. Management involves antibiotics, airway clearance techniques, and supplemental oxygen. Severe cases may require surgery.
L 5.approach to dyspnea
This document provides an overview of dyspnea, or shortness of breath. It defines dyspnea and outlines its physiological and clinical definitions. Common causes of dyspnea are then discussed, including pulmonary issues like COPD, pneumonia, and pulmonary embolism, as well as cardiac issues like heart failure, coronary syndromes, and dysrhythmias. The pathophysiology of how these conditions can stimulate breathing and cause the sensation of dyspnea is explained. Finally, the document discusses assessing and diagnosing patients presenting with dyspnea through clinical exams, investigations like chest x-rays, and determining if the cause is chronic or acute.
Chronic Bronchitis
Shahd Alali has chronic bronchitis, characterized by a chronic cough lasting over 2 years. Chronic bronchitis is common among smokers and is caused by smoking as well as air pollutants. It involves hypertrophy of the bronchial mucus glands leading to hypersecretion of mucus and inflammation in the large airways. On morphology, the large airways appear hyperemic, swollen, and covered in mucus secretions with increased goblet cells and inflammatory cells in the trachea and bronchi. Clinical features include a prominent cough producing sputum, cyanosis, increased risk of infection, and dyspnea.
Sinus tachycardia
Sinus tachycardia is characterized by a heart rate over 100 beats per minute originating from the sinus node. It can be a normal response to exercise or stress or indicate underlying conditions like heart failure. Symptoms may occur if the heart rate is very fast or the patient has heart disease. Treatment involves addressing the underlying cause and reducing stress or anxiety.
Cardiomyopathies
This document discusses various types of cardiomyopathies:
- Dilated cardiomyopathy is caused by an unknown etiology and results in left ventricular dilatation and systolic dysfunction. It is a common cause of heart failure.
- Hypertrophic cardiomyopathy involves abnormal thickening of the heart muscle and can lead to outflow obstruction. It is a common cause of sudden death in young athletes.
- Restrictive cardiomyopathy causes stiff ventricles and impaired ventricular filling due to disorders like amyloidosis. It presents with symptoms of right and left heart failure.
- Other rare types discussed include arrhythmogenic right ventricular dysplasia and obliterative cardiomyopathy. Diagnosis involves imaging and endomyocardial biopsy
Heart Failure
This document defines heart failure and discusses its key characteristics. It describes how heart failure occurs when the heart is unable to pump enough blood to meet the body's needs due to problems like abnormal heart muscle function or excessive loads on the heart. The document outlines the pathophysiology and progression of heart failure, including ventricular dilation and hypertrophy as compensatory mechanisms that ultimately fail. It also covers the clinical features, diagnostic tests, medical management, and nursing care considerations for patients with heart failure.
Acute pericarditis
The document discusses acute pericarditis, which is the most common disorder of the pericardium. The pericardium is a sac surrounding the heart. Acute pericarditis can be caused by infections, cardiac issues, autoimmune diseases, metabolic problems, neoplasms, drugs, or trauma. Common symptoms include chest pain, a pericardial friction rub sound, and ECG changes showing widespread concave ST elevation. Treatment typically involves NSAIDs and colchicine, though some cases require invasive therapies like drainage. Prognosis is generally good, but risks include cardiac tamponade or constrictive pericarditis.
Symptoms of CARDIOVASCULAR DISEASES
This document summarizes common symptoms of cardiovascular disease (CVD). It describes symptoms such as dyspnea (shortness of breath), orthopnea (difficulty breathing when lying flat), paroxysmal nocturnal dyspnea (sudden breathing issues at night), edema (swelling) in the lower limbs, abdominal distension, palpitations, chest pain, low cardiac output causing syncope (fainting), embolic manifestations like stroke, and symptoms of infective endocarditis (heart valve infection) like fever and weight loss. The document provides details on the causes and characteristics of each symptom to aid in differential diagnosis of potential cardiac or pulmonary conditions.
Heart Failure
This document provides an overview of heart failure, including its pathophysiology, types, clinical presentation, investigations, and management. Heart failure occurs when the heart cannot pump enough blood to meet the body's needs and can develop due to conditions that weaken the heart such as heart attacks or high blood pressure. Symptoms depend on whether the left side, right side, or both sides of the heart are affected. Management involves treating the underlying cause, reducing symptoms through medications, lifestyle changes, and addressing complications.
dyspnea approach
This document outlines an approach to evaluating and diagnosing dyspnea. It begins by defining dyspnea and noting its high prevalence. Types of dyspnea like orthopnea and paroxysmal nocturnal dyspnea are described. The diagnostic approach involves obtaining a detailed history regarding onset, duration, patterns and associated symptoms. A physical exam assesses respiratory effort, oxygenation, and signs of heart failure. Initial tests may include EKG, chest x-ray, and bloodwork. Further tests are guided by initial findings and may include echocardiogram, pulmonary function tests, CT, or arterial blood gas. Treatment focuses on the underlying cause identified through diagnosis.
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Shortness Of Breath
This document provides information on evaluating and diagnosing shortness of breath. It lists various potential causes of shortness of breath including cardiac, lung, anatomical, trauma, and other issues. Specific conditions that could cause wheezing, stridor, crepitations, or a clear chest are identified. The speed of onset can help determine if the underlying cause is acute, subacute, or chronic. Guidelines for triaging patients with shortness of breath into green, yellow, or red zones based on dyspnea and oxygen saturation are also provided. The evaluation involves assessing severity, examining the chest, providing oxygen support if needed, and getting a chest x-ray.
Dyspnea
The patient is a 67-year-old male former smoker presenting with shortness of breath on exertion. Physical examination finds reduced breath sounds and wheezing. Tests show reduced lung function and oxygen levels. The differential diagnosis includes cardiac and pulmonary causes like COPD. Dyspnea is the medical term for shortness of breath and can result from various lung and heart conditions. Treatment focuses on the underlying cause, like using bronchodilators for COPD.
Dyspnoea (2)
This document provides guidance on evaluating patients presenting with dyspnea (shortness of breath). It defines dyspnea and lists some specific types based on position. Common causes are outlined for pulmonary, cardiac, mixed, and non-cardiopulmonary origins. A clinical approach is described beginning with vital signs and history, followed by physical exam focusing on respiratory, cardiac, and fluid status findings. Initial investigations include chest X-ray, blood gases, ECG, and blood tests. Further tests may include lung function, exercise testing, and biomarkers to differentiate cardiac from pulmonary causes when the chest X-ray is normal. Careful history taking and physical exam remain important to identify underlying conditions.
How to get over Shortness of Breath
Most periods of breathlessness are not severe. However, you need to have some hand tips to deal with the breathlessness.
Oxygen toxicity
Oxygen toxicity is a condition caused by exposure to high levels of oxygen under pressure. It can cause symptoms like dizziness, nausea, and visual disturbances. The problem arises when too much oxygen is present in the body and some oxygen molecules cannot be used by electrons, instead binding with other molecules and causing issues. To prevent oxygen toxicity, the level of oxygen exposure needs to be controlled based on the situation. Photosynthesis can also help because it produces oxygen as a byproduct that humans can breathe without risk of toxicity.
Assessment of Dyspnea by Chest Ultrasound
1) The document discusses using ultrasound to assess dyspnea by examining both shallow and deep chest structures using high-frequency or low-frequency probes.
2) Key signs of a normal lung include the presence of the pleural line and A lines, while the presence of B lines or confluent B lines indicate interstitial syndrome or thick fluid in the alveoli.
3) Pathologies like pneumonia, pneumothorax, pulmonary embolism and congestive heart failure can be identified using ultrasound by examining lung sliding, comet tail artifacts, and the appearance of the pleural line and lung parenchyma.
Palpitation
This document discusses palpitations, which are an uncomfortable awareness of heartbeat caused by alterations in heart rate, rhythm, or contractions. It describes approaches to evaluating palpitations by determining if they are cardiac or non-cardiac in origin, if they are paroxysmal or persistent, and associated symptoms. Potential causes of palpitations include arrhythmias, valvular lesions, structural heart disease, drugs, electrolyte imbalances, and extracardiac factors like anxiety. The examination should include vitals and cardiac auscultation, with ECG, Holter monitoring, or event monitoring used to document any arrhythmias.
Hyperventilation
The patient presents with shortness of breath, inability to fill their lungs, palpitations, chest or abdominal pain, and tingling or numbness. Their respiratory rate is increased with a larger tidal volume or frequent sighing. The physical exam is otherwise normal. The patient's history may reveal an emotional trigger for the hyperventilation.
The doctor should perform a brief physical exam, check pulse oximetry, explain the hyperventilation cycle and have the patient slow their breathing, use a paper bag or tubing for the patient to rebreathe exhaled air if needed to increase carbon dioxide levels and calm breathing, and consider administering hydroxyzine. If symptoms are not reversed within 15-20 minutes
Acute dyspnea
This document discusses acute dyspnea, defined as an uncomfortable need to breathe. It results from an imbalance between the perceived need and ability to breathe, often due to carbon dioxide buildup or oxygen deprivation. Common causes include pulmonary issues like pneumonia, cardiac issues like pulmonary edema, and metabolic acidosis. Diagnosis involves history, exam, and tests to identify the underlying cause. Treatment focuses on relieving symptoms like with opioids and addressing the specific condition through methods such as antibiotics for pneumonia or oxygen therapy for pulmonary edema.
Dyspnoea
Dyspnoea refers to undue awareness of one's own breathing and increased drive to breathe. It can be normal with strenuous exercise but is pathological if it occurs at lower thresholds. Dyspnoea has many potential causes including cardiac, respiratory, neuromuscular, metabolic issues or toxins. It is classified based on the cardiovascular and respiratory systems with grades ranging from no limitations to total confinement based on the level of physical activity one can perform without symptoms.
oxygen therapy and toxicity
Oxygen therapy involves administering oxygen at concentrations greater than room air (21%) to treat or prevent hypoxia. There are various devices that deliver oxygen at different concentrations, including low flow devices like nasal cannulas (25-45% oxygen), reservoir systems like simple face masks (35-60% oxygen), and high flow devices like venturi masks that use air entrainment to deliver higher concentrations (35-40% oxygen). Proper nursing care is required to monitor patients receiving oxygen therapy and address any potential complications like oxygen toxicity from overexposure.
Chest pain history
This document discusses signs and symptoms of chest pain and how to differentiate between cardiac and non-cardiac causes. It covers topics like site of pain, onset, character, aggravating and relieving factors, associated symptoms, and past medical history. Cardiac causes like angina and myocardial infarction present with central, diffuse pain that radiates, is exacerbated by exertion and relieved by rest. Non-cardiac causes result in peripheral, localized stabbing pain unaffected by rest and influenced by posture and movement.
Case of dyspnea
1) A 45-year-old female presented with progressive breathlessness, swelling of the lower limbs, and hard nodules on her palms and soles.
2) Testing revealed features of multiple autoimmune diseases including a strongly positive ANA, interstitial lung disease, pulmonary hypertension, and calcinosis cutis.
3) She was diagnosed with mixed connective tissue disease based on Sharp's criteria, characterized by overlapping features of systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and polymyositis as well as high titers of anti-U1 RNP antibodies.
Syncope
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Dyspnea (cardio) pathology
- 1. Dyspnea
- 2. Dyspnea • Dyspnea or shortness of breath is an abnormal awareness of respiration • Dyspnea in heart disease is precipitated or exacerbated by exertion but may occur at rest • It results from elevated left atrial and pulmonary venous pressure • Hypoxia • Result of left ventricular systolic or diastolic dysfunction • Valvular obstruction
- 3. Grading of dyspnea by (NYH) Grade 1 No breathlessness Grade 2 Breathlessness on severe exertion Grade 3 Breathlessness on mild exertion Grade 4 Breathlessness at rest
- 4. Types of cardiac dyspnea • There are three type of cardiac dyspnea • Acute pulmonary edema • Angina equivalent • Chronic heart failular
- 5. Acute pulmonary edema • Develops from • Acute myocardial infarction (in previously healthy heart) • Atrial fibrillation (in previously heart disease) • Symptoms Suddenly develop shortness of breath Distress Agitation Cyanosis with coughing Wheezing Sputum may profuse Frothy of blood-streaked or pink Heart auscultation reveals crepitation and rhonchi
- 6. Angina equivalent • When shortness of breath is the dominant or sole feature of myocardial ischemia instead of chest pain this is called angina equivalent • In old people present ischemia with shortness of breath without feature of pulmonary edema • ECG show st change • Treatment of angina relieves shortness of breath even without diuretics
- 7. Shortness of breath (dyspnea) System Acute dyspnea at rest Chronic exertional dyspnea Cardiovascular Acute pulmonary edema Myocardia ischemia (angina may present just with dyspnea and this presentation is called angina equivalent) Chronic heart failure Myocardial ischemia (angina may present jut dystaca and this presentation is called angina equivalent)
- 8. Chronic heart failure • Orthopnea is dyspnea that occur during supine position (recumbency) as a result from increase venous return Paroxysmal Nocturnal dyspnea (PND) is the shortness of breath that occurs abruptly 30 min to 2 hours after going to bed and is relieved by sitting up or standing up