The document discusses diagnostic procedures for congestive heart failure, including clinical exams, echocardiography, blood tests, cardiac imaging like angiography and MRI, and hemodynamic monitoring. Key diagnostic tests are clinical exams, echocardiography to assess heart structure and function, blood tests like BNP to support diagnosis, and additional cardiac imaging tests like angiography to evaluate underlying heart conditions. Hemodynamic monitoring provides cardiac functional parameters but has limited clinical use due to its invasiveness.
This document summarizes a lecture on the treatment of congestive heart failure. It defines heart failure classifications according to the New York Heart Association. For acute heart failure, the main treatment goals are treating life-threatening conditions and improving quality of life through vasodilation, organ protection, and volume control. Chronic heart failure treatment aims to improve quality of life, reduce disability, and increase longevity. Evidence-based drug therapies recommended for chronic heart failure include ACE inhibitors, beta-blockers, and aldosterone antagonists. Other options discussed include surgical treatments like heart transplantation and resynchronization therapy, as well as developing treatments like stem cell therapy. The document emphasizes the importance of home care programs for long-term heart failure
This document discusses congestive heart failure (CHF). It provides epidemiological data on CHF, showing it affects millions of people worldwide and costs billions of dollars annually. It defines CHF as the heart's inability to meet circulatory demands and classifies it based on location (left vs right heart) and time course (acute vs chronic). Causes of acute and chronic CHF include myocardial infarction, hypertension, valvular diseases, and cardiomyopathies. The pathophysiology of CHF involves systolic and diastolic dysfunction that can lead to ventricular hypertrophy, dilation, and neurohormonal activation causing further organ damage.
This document provides information on the management of angina pectoris. It discusses the different types of angina including stable angina, unstable angina, and variant angina. For stable angina, management includes general measures, drug treatment, and coronary artery revascularization if needed. Common antianginal drugs discussed are organic nitrates, calcium channel blockers, and beta-blockers. Unstable angina is treated with nitrates, beta-blockers, aspirin, and sometimes thrombolytics. Variant angina is managed with nitrates and calcium channel blockers.
The document discusses congestive cardiac failure (heart failure) and its management. It provides details on:
- The high prevalence and mortality of heart failure.
- Current medical therapies including ACE inhibitors, beta-blockers, and aldosterone antagonists that have been shown to improve survival.
- Device therapies like cardiac resynchronization therapy and implantable cardioverter defibrillators that treat symptoms and reduce mortality.
- The benefits of multidisciplinary and integrated care approaches including telehealth monitoring in improving outcomes for heart failure patients.
This document provides information about cardiac emergencies presented by Mrs. Shalini, an Assistant Professor of Nursing. It defines cardiac emergencies and lists the learning objectives. The major cardiac emergencies discussed include acute myocardial infarction, heart failure, sudden cardiac death, cardiac tamponade, hypertensive emergencies, and dysrhythmias. For each emergency, the document provides definitions, causes, signs and symptoms, diagnostic tests, management, and nursing care considerations.
Dr. Alberto Foschi of Saint Francis Hospital in Evanston, Illinois presents the risk factors for heart attack, presentation of an attack, diagnosis, treatment options and recovery.
IHD also known as coronary artery diseases is a condition in which there is inadequate supply of blood and oxygen to a portion of myocardium. Imbalance between myocardial oxygen supply and demand causes Angina, MI, Hear failure, and Arrhythmia
This document summarizes a lecture on the treatment of congestive heart failure. It defines heart failure classifications according to the New York Heart Association. For acute heart failure, the main treatment goals are treating life-threatening conditions and improving quality of life through vasodilation, organ protection, and volume control. Chronic heart failure treatment aims to improve quality of life, reduce disability, and increase longevity. Evidence-based drug therapies recommended for chronic heart failure include ACE inhibitors, beta-blockers, and aldosterone antagonists. Other options discussed include surgical treatments like heart transplantation and resynchronization therapy, as well as developing treatments like stem cell therapy. The document emphasizes the importance of home care programs for long-term heart failure
This document discusses congestive heart failure (CHF). It provides epidemiological data on CHF, showing it affects millions of people worldwide and costs billions of dollars annually. It defines CHF as the heart's inability to meet circulatory demands and classifies it based on location (left vs right heart) and time course (acute vs chronic). Causes of acute and chronic CHF include myocardial infarction, hypertension, valvular diseases, and cardiomyopathies. The pathophysiology of CHF involves systolic and diastolic dysfunction that can lead to ventricular hypertrophy, dilation, and neurohormonal activation causing further organ damage.
This document provides information on the management of angina pectoris. It discusses the different types of angina including stable angina, unstable angina, and variant angina. For stable angina, management includes general measures, drug treatment, and coronary artery revascularization if needed. Common antianginal drugs discussed are organic nitrates, calcium channel blockers, and beta-blockers. Unstable angina is treated with nitrates, beta-blockers, aspirin, and sometimes thrombolytics. Variant angina is managed with nitrates and calcium channel blockers.
The document discusses congestive cardiac failure (heart failure) and its management. It provides details on:
- The high prevalence and mortality of heart failure.
- Current medical therapies including ACE inhibitors, beta-blockers, and aldosterone antagonists that have been shown to improve survival.
- Device therapies like cardiac resynchronization therapy and implantable cardioverter defibrillators that treat symptoms and reduce mortality.
- The benefits of multidisciplinary and integrated care approaches including telehealth monitoring in improving outcomes for heart failure patients.
This document provides information about cardiac emergencies presented by Mrs. Shalini, an Assistant Professor of Nursing. It defines cardiac emergencies and lists the learning objectives. The major cardiac emergencies discussed include acute myocardial infarction, heart failure, sudden cardiac death, cardiac tamponade, hypertensive emergencies, and dysrhythmias. For each emergency, the document provides definitions, causes, signs and symptoms, diagnostic tests, management, and nursing care considerations.
Dr. Alberto Foschi of Saint Francis Hospital in Evanston, Illinois presents the risk factors for heart attack, presentation of an attack, diagnosis, treatment options and recovery.
IHD also known as coronary artery diseases is a condition in which there is inadequate supply of blood and oxygen to a portion of myocardium. Imbalance between myocardial oxygen supply and demand causes Angina, MI, Hear failure, and Arrhythmia
This document provides information on chronic congestive heart failure (CHF), including its definition, stages of evolution, pathophysiology, treatment objectives and options. It discusses the effects and uses of various drug classes for CHF treatment, including diuretics, digoxin, inotropic agents, vasodilators and neurohormonal antagonists. It describes the mechanisms of action, effects, benefits, risks and guidelines for use of these drug classes in managing CHF.
This document discusses the assessment, investigation, and treatment of chronic stable angina. It defines chronic stable angina as chest pain or discomfort that is reproducibly associated with exertion or stress and relieved by rest. The document outlines how to evaluate patients presenting with chest pain through history, physical exam, risk factor assessment, and probability estimation models. It recommends initial tests like ECG, cardiac biomarkers, and stress testing. Treatment focuses on lifestyle changes, medications like aspirin, beta-blockers, calcium channel blockers, and revascularization if needed. Regular patient follow up and education are also emphasized.
Non invasive cardiac testing for acute coronary syndromeSCGH ED CME
This document discusses non-invasive tests for diagnosing acute coronary syndrome (ACS). It begins with some background on the history of cardiovascular disease and current statistics. It then provides an overview and algorithm for the chest pain pathway and risk stratification process for evaluating patients presenting with possible ACS. This involves an initial ECG, troponin tests, and evaluating symptoms and risk factors to determine whether the patient is at high, intermediate or low risk. For low risk patients a non-invasive strategy may be appropriate, while higher risk patients warrant further cardiac investigation and management.
This document discusses heart failure, including its increasing prevalence globally, definitions, classifications, management, and new strategies. Some key points:
- Heart failure prevalence is increasing worldwide and mortality remains high, around 50% within 5 years of diagnosis.
- The universal definition characterizes heart failure as a clinical syndrome caused by structural or functional cardiac abnormalities, accompanied by typical symptoms and signs.
- Management focuses on guideline-directed medical therapies (GDMT) including ACE inhibitors, ARBs, beta-blockers, and MRAs, though utilization remains suboptimal.
- The PARADIGM-HF trial showed the ARNI drug sacubitril/valsartan reduced cardiovascular death and heart failure
The document summarizes the past, present, and future of heart failure treatment. In the past (1950s-1970s), treatment focused on rest, sodium restriction, and drugs like digitalis and diuretics. Currently (2000s), guidelines recommend optimal medical therapy including ACE inhibitors, ARBs, beta-blockers, diuretics, and devices like ICDs, CRT, and LVADs which have improved outcomes. The future holds promise for gene and cell-based therapies, left ventricular assist devices, and prevention through understanding of genetic factors influencing heart failure.
The document discusses congestive heart failure (CHF), including its definition, epidemiology, pathophysiology, diagnosis, classification, and treatment approaches. It notes that CHF affects over 5 million Americans and costs over $10 billion annually. The main causes are coronary artery disease and hypertension. Treatment focuses on reducing preload and afterload through ACE inhibitors, beta-blockers, and aldosterone antagonists. Other therapies include diuretics, digoxin, resynchronization devices, and ventricular assist devices.
This document summarizes a clinical case report of a 79-year-old female patient admitted for heart failure with acute exacerbation likely due to infection. Key details include:
- The patient has a history of hypertension, atrial fibrillation, hyperuricemia, and impaired glucose tolerance.
- Exams and tests show signs of congestive heart failure including jugular vein distension and crackles in the lungs. Echocardiogram finds diastolic dysfunction.
- She is treated with antibiotics, diuretics, and other heart failure medications. Her symptoms improve with treatment and she is discharged with medications including valsartan and furosemide.
This document provides information on heart failure, including:
1) It defines heart failure and discusses its epidemiology, types, prognosis, and basic mechanisms including systolic and diastolic dysfunction.
2) It covers left ventricular remodeling, diagnosis including biomarkers and imaging, and management of acute heart failure syndromes.
3) It discusses pharmacological treatments for chronic heart failure including vasodilators, inotropic agents, vasopressin antagonists, and diuretics.
Update in HF Definition and Classification: Universal Definition and Stages o...Duke Heart
1. The document presents an overview of Biykem Bozkurt, an expert in heart failure, and their work updating the definition and classification of heart failure.
2. The Universal Definition of Heart Failure (UDHF) defines heart failure as a clinical syndrome with current or prior symptoms and/or signs caused by structural and/or functional cardiac abnormalities, as corroborated by elevated natriuretic peptide levels or objective evidence of congestion.
3. The UDHF also establishes a classification system with Stages A through D based on risk, presence of structural heart disease, and severity of symptoms, to help guide treatment strategies according to the stage of heart failure.
Heart failure results from left ventricular dysfunction and is a common outcome of many cardiovascular diseases. It is characterized by symptoms like dyspnea and fatigue. The main causes are coronary artery disease, hypertension, valvular heart disease and cardiomyopathy. Treatment involves drugs like ACE inhibitors, beta-blockers, diuretics and digoxin to improve symptoms, reduce disease progression and mortality risk. These drugs act via different mechanisms such as neurohormonal inhibition and reducing preload and afterload.
This document provides a summary of angina pectoris (chest pain). It begins with an example case history and treatment. It then defines angina and describes the main types (stable and unstable). It discusses the pathophysiology and clinical presentation. It outlines the diagnostic tests and procedures used to diagnose angina. The goals and approaches to treatment are summarized, including drug therapies like nitrates, beta blockers, and calcium channel blockers. Other measures for managing coronary artery disease are mentioned like treating risk factors and lifestyle changes.
Cardiogenicshock by Dr.Afroza Prioty -140123092109-phpapp02Afroza Prioty
1) Cardiogenic shock is a clinical condition caused by the heart's inability to pump an adequate amount of blood to vital organs, resulting in inadequate tissue perfusion.
2) The document discusses the causes, pathophysiology, clinical manifestations, diagnosis, and management of cardiogenic shock, with a focus on cardiogenic shock caused by acute myocardial infarction.
3) Early revascularization through percutaneous coronary intervention or coronary artery bypass grafting is recommended for suitable patients with cardiogenic shock due to acute myocardial infarction, along with supportive therapies like intra-aortic balloon pump counterpulsation or ventricular assist devices.
Diastolic heart failure is defined as heart failure with preserved left ventricular ejection fraction. It accounts for 30-50% of heart failure cases. The main causes are cardiac ischemia, hypertension, aging, obesity, and aortic stenosis. Diagnosis requires clinical signs of heart failure, normal left ventricular ejection fraction, and evidence of left ventricular diastolic dysfunction. Treatment focuses on reducing congestion with diuretics, controlling hypertension and ischemia, and improving left ventricular relaxation.
This document summarizes guidelines for the treatment of stable coronary artery disease. It discusses recommendations for both the prevention of cardiovascular events and the relief of angina symptoms. For event prevention, it recommends low-dose aspirin daily for all patients, as well as statin therapy. For angina relief, it recommends short-acting nitrates and calcium channel blockers or beta-blockers as first-line treatment. It also discusses the evidence and recommendations for various second-line treatment options. The guidelines provide classifications for each recommendation based on the level of evidence.
This document provides guidelines for treating heart failure cases using the 2016 ESC Guidelines. It defines heart failure and discusses diagnostic algorithms. It presents 4 clinical case scenarios to illustrate how to apply guideline recommendations in primary care patients presenting with heart failure symptoms. For each case, it analyzes diagnostic tests, identifies treatments, and describes how to initiate and titrate medications like ACE inhibitors and beta-blockers. The document also covers topics like imaging tests, classifications of heart failure, treatment objectives, and algorithms for managing reduced ejection fraction.
This document provides an overview of congestive heart failure, including definitions, types, classification, time course, and treatment strategies. It defines CHF as a syndrome most commonly caused by cardiomyopathy. It describes types as right or left heart failure, and with reduced or preserved ejection fraction. Treatment objectives for acute CHF are to decrease congestion and increase perfusion, while chronic CHF aims to slow functional decline. Key medications that improve mortality in chronic CHF include ACE inhibitors, beta blockers, aldosterone antagonists, and ARNI.
ECG- Atrial Fibrillation, CXR-P/A view-Cardiomegaly,
Echocardiogram-severe mitral stenosis with severe MR with
moderate pulmonary hypertension. Patient underwent MVR and
she is doing well.
This document discusses heart failure, including causes, symptoms, classifications, treatment options and guidelines. It covers systolic and diastolic heart failure, risk factors, physical findings, NYHA functional classes, medications like ACE inhibitors, beta blockers, ARBs and more. It also discusses device options, special populations like African Americans, and the cardio-renal syndrome.
Mr. I, a 64-year-old male, presented to the hospital with chest pain. He reported feeling pressure and tightness in his chest for the past 5 months that had worsened. Examinations found elevated blood pressure, tachycardia, and signs of cardiomegaly on chest x-ray. ECG showed sinus rhythm with poor R wave progression. Echocardiogram indicated left ventricular dysfunction. The working diagnosis was unstable angina pectoris and hypertension. Management included medications to reduce blood pressure and prevent clots, with monitoring through daily ECGs.
This document discusses the current management of cardiogenic shock. It defines cardiogenic shock and describes its causes, predictors of mortality, and pathophysiology. Treatment involves hemodynamic support, volume management, inotropic drugs, and early revascularization, which significantly reduces mortality. Mechanical circulatory support devices like IABP, Tandem Heart, Impella, and ECMO can further improve hemodynamics and outcomes when used as adjuncts to optimal medical therapy. Timing of revascularization is critical, with survival benefits seen for up to 48 hours after myocardial infarction onset. Special considerations are discussed for managing shock in the elderly, from mechanical causes, and with specific device therapies.
Management of anticoagulation in lvad recipientsdrucsamal
This document discusses management of anticoagulation for patients receiving left ventricular assist devices (LVADs). It notes that thrombosis is a major problem for LVADs. Under-anticoagulation is thought to be a key cause of pump thrombosis. The relationship between activated partial thromboplastin time (aPTT) and anti-Xa levels is poor in LVAD patients on warfarin compared to heart failure patients, indicating aPTT may not accurately reflect anticoagulation levels in LVAD patients. Future directions include further evaluating the role of anti-platelet agents and factors like blood type and hyperco
This document provides information on cardiac heart failure, including its definition, epidemiology, etiology, pathophysiology, types, signs and symptoms, diagnostic tests, treatment goals, and management approaches. Some key points:
- Heart failure is a clinical syndrome where the heart cannot pump enough blood to meet the body's needs due to problems with ventricular filling or contractility.
- Common causes include ischemic heart disease, cardiomyopathy, hypertension, and valvular disease.
- Treatment aims to improve oxygenation, reduce cardiac workload, and enhance contractility through diuretics, vasodilators, beta-blockers, and other drugs, as well as lifestyle modifications.
- Management requires a multif
This document provides information on chronic congestive heart failure (CHF), including its definition, stages of evolution, pathophysiology, treatment objectives and options. It discusses the effects and uses of various drug classes for CHF treatment, including diuretics, digoxin, inotropic agents, vasodilators and neurohormonal antagonists. It describes the mechanisms of action, effects, benefits, risks and guidelines for use of these drug classes in managing CHF.
This document discusses the assessment, investigation, and treatment of chronic stable angina. It defines chronic stable angina as chest pain or discomfort that is reproducibly associated with exertion or stress and relieved by rest. The document outlines how to evaluate patients presenting with chest pain through history, physical exam, risk factor assessment, and probability estimation models. It recommends initial tests like ECG, cardiac biomarkers, and stress testing. Treatment focuses on lifestyle changes, medications like aspirin, beta-blockers, calcium channel blockers, and revascularization if needed. Regular patient follow up and education are also emphasized.
Non invasive cardiac testing for acute coronary syndromeSCGH ED CME
This document discusses non-invasive tests for diagnosing acute coronary syndrome (ACS). It begins with some background on the history of cardiovascular disease and current statistics. It then provides an overview and algorithm for the chest pain pathway and risk stratification process for evaluating patients presenting with possible ACS. This involves an initial ECG, troponin tests, and evaluating symptoms and risk factors to determine whether the patient is at high, intermediate or low risk. For low risk patients a non-invasive strategy may be appropriate, while higher risk patients warrant further cardiac investigation and management.
This document discusses heart failure, including its increasing prevalence globally, definitions, classifications, management, and new strategies. Some key points:
- Heart failure prevalence is increasing worldwide and mortality remains high, around 50% within 5 years of diagnosis.
- The universal definition characterizes heart failure as a clinical syndrome caused by structural or functional cardiac abnormalities, accompanied by typical symptoms and signs.
- Management focuses on guideline-directed medical therapies (GDMT) including ACE inhibitors, ARBs, beta-blockers, and MRAs, though utilization remains suboptimal.
- The PARADIGM-HF trial showed the ARNI drug sacubitril/valsartan reduced cardiovascular death and heart failure
The document summarizes the past, present, and future of heart failure treatment. In the past (1950s-1970s), treatment focused on rest, sodium restriction, and drugs like digitalis and diuretics. Currently (2000s), guidelines recommend optimal medical therapy including ACE inhibitors, ARBs, beta-blockers, diuretics, and devices like ICDs, CRT, and LVADs which have improved outcomes. The future holds promise for gene and cell-based therapies, left ventricular assist devices, and prevention through understanding of genetic factors influencing heart failure.
The document discusses congestive heart failure (CHF), including its definition, epidemiology, pathophysiology, diagnosis, classification, and treatment approaches. It notes that CHF affects over 5 million Americans and costs over $10 billion annually. The main causes are coronary artery disease and hypertension. Treatment focuses on reducing preload and afterload through ACE inhibitors, beta-blockers, and aldosterone antagonists. Other therapies include diuretics, digoxin, resynchronization devices, and ventricular assist devices.
This document summarizes a clinical case report of a 79-year-old female patient admitted for heart failure with acute exacerbation likely due to infection. Key details include:
- The patient has a history of hypertension, atrial fibrillation, hyperuricemia, and impaired glucose tolerance.
- Exams and tests show signs of congestive heart failure including jugular vein distension and crackles in the lungs. Echocardiogram finds diastolic dysfunction.
- She is treated with antibiotics, diuretics, and other heart failure medications. Her symptoms improve with treatment and she is discharged with medications including valsartan and furosemide.
This document provides information on heart failure, including:
1) It defines heart failure and discusses its epidemiology, types, prognosis, and basic mechanisms including systolic and diastolic dysfunction.
2) It covers left ventricular remodeling, diagnosis including biomarkers and imaging, and management of acute heart failure syndromes.
3) It discusses pharmacological treatments for chronic heart failure including vasodilators, inotropic agents, vasopressin antagonists, and diuretics.
Update in HF Definition and Classification: Universal Definition and Stages o...Duke Heart
1. The document presents an overview of Biykem Bozkurt, an expert in heart failure, and their work updating the definition and classification of heart failure.
2. The Universal Definition of Heart Failure (UDHF) defines heart failure as a clinical syndrome with current or prior symptoms and/or signs caused by structural and/or functional cardiac abnormalities, as corroborated by elevated natriuretic peptide levels or objective evidence of congestion.
3. The UDHF also establishes a classification system with Stages A through D based on risk, presence of structural heart disease, and severity of symptoms, to help guide treatment strategies according to the stage of heart failure.
Heart failure results from left ventricular dysfunction and is a common outcome of many cardiovascular diseases. It is characterized by symptoms like dyspnea and fatigue. The main causes are coronary artery disease, hypertension, valvular heart disease and cardiomyopathy. Treatment involves drugs like ACE inhibitors, beta-blockers, diuretics and digoxin to improve symptoms, reduce disease progression and mortality risk. These drugs act via different mechanisms such as neurohormonal inhibition and reducing preload and afterload.
This document provides a summary of angina pectoris (chest pain). It begins with an example case history and treatment. It then defines angina and describes the main types (stable and unstable). It discusses the pathophysiology and clinical presentation. It outlines the diagnostic tests and procedures used to diagnose angina. The goals and approaches to treatment are summarized, including drug therapies like nitrates, beta blockers, and calcium channel blockers. Other measures for managing coronary artery disease are mentioned like treating risk factors and lifestyle changes.
Cardiogenicshock by Dr.Afroza Prioty -140123092109-phpapp02Afroza Prioty
1) Cardiogenic shock is a clinical condition caused by the heart's inability to pump an adequate amount of blood to vital organs, resulting in inadequate tissue perfusion.
2) The document discusses the causes, pathophysiology, clinical manifestations, diagnosis, and management of cardiogenic shock, with a focus on cardiogenic shock caused by acute myocardial infarction.
3) Early revascularization through percutaneous coronary intervention or coronary artery bypass grafting is recommended for suitable patients with cardiogenic shock due to acute myocardial infarction, along with supportive therapies like intra-aortic balloon pump counterpulsation or ventricular assist devices.
Diastolic heart failure is defined as heart failure with preserved left ventricular ejection fraction. It accounts for 30-50% of heart failure cases. The main causes are cardiac ischemia, hypertension, aging, obesity, and aortic stenosis. Diagnosis requires clinical signs of heart failure, normal left ventricular ejection fraction, and evidence of left ventricular diastolic dysfunction. Treatment focuses on reducing congestion with diuretics, controlling hypertension and ischemia, and improving left ventricular relaxation.
This document summarizes guidelines for the treatment of stable coronary artery disease. It discusses recommendations for both the prevention of cardiovascular events and the relief of angina symptoms. For event prevention, it recommends low-dose aspirin daily for all patients, as well as statin therapy. For angina relief, it recommends short-acting nitrates and calcium channel blockers or beta-blockers as first-line treatment. It also discusses the evidence and recommendations for various second-line treatment options. The guidelines provide classifications for each recommendation based on the level of evidence.
This document provides guidelines for treating heart failure cases using the 2016 ESC Guidelines. It defines heart failure and discusses diagnostic algorithms. It presents 4 clinical case scenarios to illustrate how to apply guideline recommendations in primary care patients presenting with heart failure symptoms. For each case, it analyzes diagnostic tests, identifies treatments, and describes how to initiate and titrate medications like ACE inhibitors and beta-blockers. The document also covers topics like imaging tests, classifications of heart failure, treatment objectives, and algorithms for managing reduced ejection fraction.
This document provides an overview of congestive heart failure, including definitions, types, classification, time course, and treatment strategies. It defines CHF as a syndrome most commonly caused by cardiomyopathy. It describes types as right or left heart failure, and with reduced or preserved ejection fraction. Treatment objectives for acute CHF are to decrease congestion and increase perfusion, while chronic CHF aims to slow functional decline. Key medications that improve mortality in chronic CHF include ACE inhibitors, beta blockers, aldosterone antagonists, and ARNI.
ECG- Atrial Fibrillation, CXR-P/A view-Cardiomegaly,
Echocardiogram-severe mitral stenosis with severe MR with
moderate pulmonary hypertension. Patient underwent MVR and
she is doing well.
This document discusses heart failure, including causes, symptoms, classifications, treatment options and guidelines. It covers systolic and diastolic heart failure, risk factors, physical findings, NYHA functional classes, medications like ACE inhibitors, beta blockers, ARBs and more. It also discusses device options, special populations like African Americans, and the cardio-renal syndrome.
Mr. I, a 64-year-old male, presented to the hospital with chest pain. He reported feeling pressure and tightness in his chest for the past 5 months that had worsened. Examinations found elevated blood pressure, tachycardia, and signs of cardiomegaly on chest x-ray. ECG showed sinus rhythm with poor R wave progression. Echocardiogram indicated left ventricular dysfunction. The working diagnosis was unstable angina pectoris and hypertension. Management included medications to reduce blood pressure and prevent clots, with monitoring through daily ECGs.
This document discusses the current management of cardiogenic shock. It defines cardiogenic shock and describes its causes, predictors of mortality, and pathophysiology. Treatment involves hemodynamic support, volume management, inotropic drugs, and early revascularization, which significantly reduces mortality. Mechanical circulatory support devices like IABP, Tandem Heart, Impella, and ECMO can further improve hemodynamics and outcomes when used as adjuncts to optimal medical therapy. Timing of revascularization is critical, with survival benefits seen for up to 48 hours after myocardial infarction onset. Special considerations are discussed for managing shock in the elderly, from mechanical causes, and with specific device therapies.
Management of anticoagulation in lvad recipientsdrucsamal
This document discusses management of anticoagulation for patients receiving left ventricular assist devices (LVADs). It notes that thrombosis is a major problem for LVADs. Under-anticoagulation is thought to be a key cause of pump thrombosis. The relationship between activated partial thromboplastin time (aPTT) and anti-Xa levels is poor in LVAD patients on warfarin compared to heart failure patients, indicating aPTT may not accurately reflect anticoagulation levels in LVAD patients. Future directions include further evaluating the role of anti-platelet agents and factors like blood type and hyperco
This document provides information on cardiac heart failure, including its definition, epidemiology, etiology, pathophysiology, types, signs and symptoms, diagnostic tests, treatment goals, and management approaches. Some key points:
- Heart failure is a clinical syndrome where the heart cannot pump enough blood to meet the body's needs due to problems with ventricular filling or contractility.
- Common causes include ischemic heart disease, cardiomyopathy, hypertension, and valvular disease.
- Treatment aims to improve oxygenation, reduce cardiac workload, and enhance contractility through diuretics, vasodilators, beta-blockers, and other drugs, as well as lifestyle modifications.
- Management requires a multif
This presentation provides an overview of cardiac failure, also known as heart failure. It defines cardiac failure as when the heart is unable to pump enough blood to meet the body's needs. The objectives covered include the definition of cardiac failure, its signs and symptoms, types (right and left heart failure), causes, diagnosis, and treatment. The main causes discussed are coronary artery disease, heart attack, high blood pressure, and heart muscle diseases. Diagnosis involves blood tests, imaging like echocardiograms, and exams like electrocardiograms. Treatment consists primarily of medications to help the heart function better along with lifestyle changes and in some cases procedures like surgery.
El documento describe los sonidos anormales S3 y S4. El S3 o galope ventricular es un sonido diastólico producido por la disminución de la distensibilidad ventricular. Se ausculta en la punta y es causado por sobrecargas diastólicas. El S4 o galope auricular es un sonido telediastólico producido por el aumento de la contracción auricular y se ausculta en la punta, siendo causado por sobrecargas sistólicas. Se enumeran las causas comunes de sobrecargas diastólicas
Este documento resume los principales tipos de ruidos cardíacos, incluyendo su causa y significado clínico. Explica las características del primer y segundo ruido, así como variaciones como el desdoblamiento, acentuación y atenuación. Detalla las causas fisiológicas y patológicas de estas variaciones y su relación con diferentes condiciones cardiacas como defectos del tabique auricular, hipertensión pulmonar y otras.
The document discusses left ventricular assist devices (LVADs), which are mechanical pumps that help the failing left ventricle pump blood to the body. It provides background on the history and development of LVAD technology, describing early models and milestones as well as current FDA-approved devices like the HeartMate II. The document also outlines how LVADs work, their uses as either a bridge to transplant or for destination therapy, and outcomes data from clinical trials.
Este documento resume los principales tipos de soplos cardiacos. Define un soplo cardiaco como un ruido anormal producido por vibraciones dentro del corazón o las grandes arterias. Explica que los soplos pueden ser sistólicos, diastólicos o continuo y describe las características de los soplos más comunes como la insuficiencia mitral, la estenosis aórtica y la insuficiencia aórtica. También cubre cómo evaluar los soplos mediante la auscultación y clasificarlos según factores como la intensidad, el ton
Heart failure, also known as cardiac decompensation or cardiac insufficiency, occurs when the heart is unable to pump enough blood to meet the body's needs. It can be caused by conditions that impair the heart muscle's ability to contract effectively or limit ventricular filling. Symptoms vary depending on whether the left or right ventricle is primarily affected and include dyspnea, fatigue, edema and others. Diagnostic tests may include echocardiography, ECG, chest x-ray and BNP level. Treatment focuses on managing symptoms, slowing disease progression, and preventing hospitalizations through lifestyle changes and medication.
Heart failure is a common condition where the heart is unable to pump enough blood to meet the body's needs. It can result from structural or functional disorders of the heart. The document provides details on the definition, causes, risk factors, pathophysiology, symptoms, diagnostic evaluation, classification systems, and treatment of heart failure. It emphasizes the importance of controlling risk factors, using medications such as ACE inhibitors and diuretics to manage symptoms, and making lifestyle changes like following a low-sodium diet and exercising regularly.
Primary hypertension accounts for 90% of hypertension cases. It is defined as high blood pressure without an identifiable secondary cause. The main pathophysiological drivers of primary hypertension are an overactive renin-angiotensin-aldosterone system and endothelial dysfunction. This leads to increased peripheral resistance and higher blood pressure. Over time, uncontrolled high blood pressure can damage target organs like the heart, brain, kidneys, and blood vessels, potentially causing complications like heart failure, stroke, and kidney disease. Managing risk factors and treating hypertension can help prevent its progression and reduce complications.
The document discusses the diagnosis and management of primary hypertension, including defining diagnostic criteria, describing diagnostic procedures such as clinical exams, blood pressure measurements, laboratory tests, and imaging studies to identify target organ damage, and outlining treatment pathways including lifestyle modifications and medication management. Target organ damage of the heart, brain, kidneys, eyes, and peripheral arteries from long-term high blood pressure is also reviewed.
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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Heart failure 2013 Diagnostic Procedures
1. Medical Science Tanzania Cardiology Lectures
Congestive Heart Failure
2. Diagnostic procedures
Prof. Hennersdorf SES
March 2013 ghennersdorf DGK ESC SES 1
5. Definition of Heart Failure CHF
New York Heart Association (NYHA)
I no visible signs and symptoms
II signs and symptoms at high level exercise
III signs and symptoms at low level exercise
IV no physical exercise possible, bed rest
necessary
Mostly used functional definition of CHF throughout the world!
March 2013 ghennersdorf DGK ESC SES 5
6. NYHA
NYHA II NYHA III NYHA IV
NYHA I without clinical signs and symptoms
March 2013 ghennersdorf DGK ESC SES 6
7. Physical examination: general
• Dyspnea (rest, exercise), Orthopnea
• Weight gain, swelling of the legs
• Nocturia
• Tachycardia (Palpitation)
• Fatigue
• Sweating
• Nausea, vomiting, cough
• Anorexia
• Cachexia (cardiac)
March 2013 ghennersdorf DGK ESC SES 7
11. Physical examination: acute vs. chronic
• acute
– Severe symptoms
– No weight gain due to rapid onset
– Tachycardia
• Chronic
– Less severe symptoms (NYHA classes)
– Weight gain
– Nausea, vomiting, cough
– Anorexia
– Cachexia
March 2013 ghennersdorf DGK ESC SES 11
14. Physical examination: heart sounds
S1 S2 S3
midsystolic murmur Sound
ECG
March 2013 ghennersdorf DGK ESC SES 14
15. Physical examination:
functional tests
6-min walk: Pt. is forced to walk as he likes walking,
standing, running etc. The achieved distance is
documented
and should reach
>350 (female) - 400 (male) m
weak but reproducible relation to peak O2-
consumption
Ergometry: objective measurement of workload, but
also used for rehabilitation in special cases or
postoperatively (HTX): sitting or supine, treadmill
preferred
March 2013 ghennersdorf DGK ESC SES 15
16. Physical examination:
Exercise device ergometry equipment
ECG Cart
Emergency Kit
(necessary)
March 2013 ghennersdorf DGK ESC SES 16
19. Left heart failure: US LVDD*
*left ventricle diast.
Diameter, norm
<50<mm
March 2013 ghennersdorf DGK ESC SES 19
20. Left heart failure: US TMF*
A B
C A normal transmitral filling
B early diastolic dysfunction
C progredient diastolic
Dysfunction
*Transmitral flow
DT deceleration time
March 2013 ghennersdorf DGK ESC SES 20
24. Chest XRay CXR
normal finding
March 2013 ghennersdorf DGK ESC SES 24
25. Chest XR CXR
Pulmonary edema
March 2013 ghennersdorf DGK ESC SES 25
26. Chest XR CXR
Pulmonary edema Pulmonary edema
before therapy after successful therapy
March 2013 ghennersdorf DGK ESC SES 26
27. Angiography indications
Underlying disease (CHD) with therapeutic
consequences (PCI, CABG)
Intervention (cardiogenic shock)
March 2013 ghennersdorf DGK ESC SES 27
28. Left heart failure, hemo + angio
Angio
+
hemodynamics
Left ventricle shape, size and function Pumping, blood delivery, work
March 2013 ghennersdorf DGK ESC SES 28
29. Left heart failure:
right heart hemodynamics
SWAN GANZ Catheter PA Pressure monitoring
March 2013 ghennersdorf DGK ESC SES 29
30. Left heart failure, hemodynamics
Measurements:
Cardiac output
Ventricular filling pressures,
Vascular resistances
Work load
Work capacity
Limited clinical value, limited use to invasive cases (Cathlab,OP),
potentially harmful!
March 2013 ghennersdorf DGK ESC SES 30
31. HF parameter by heart catheterization
Some hemodynamic values
Cardiac output/index norm 2-2.5 l(min/m 2)
Stroke work norm 21 mjoule
enddiastolic pressure norm 12 mm Hg
Vascular bed resistances (norm)
TPR 1200 dyn*sec*cm-5
PVR 70 dyn*sec*cm-5
Clinical use limited to ICU control
during vasoactive therapy
e.g. of cardogenic shock
March 2013 ghennersdorf DGK ESC SES 31
32. CHF parameter by angiography*
Ejection fraction EF
EDV**
EF = --------------- x 100 (%)
EDV**-ESV***
Norm = 70%
Strongest predictors
Reduced = <40%
Low= <20% of survival and prognosis
*today fairly achieved by echocardiography
**Enddiastolic volume/area
*** endsystolic volume/area
March 2013 ghennersdorf DGK ESC SES 32
33. Angiography diagnose: LV shape
Systole
Regional scar Diastole
EF < 20%
red lines
Diastole show normal
contraction
Regional scar
Systole
Anterior wall infarction
Dilated cardiomyopathy
March 2013 ghennersdorf DGK ESC SES 33
34. Angiography diagnose: LV shape
Regional scar
Diastole
Regional scar
Systole
EF 70%
normal infarction
March 2013 ghennersdorf DGK ESC SES 34
35. CHF and MRI
• Dimensions
• Contractility, Viability
• Valve function
MRI crossectional
sequence of dilated LV
March 2013 ghennersdorf DGK ESC SES 35
37. Biochemistry
Red, white BC
Blood sedimentation rate
Electrolytes
Urinalysis, Kreatinine
Enzymes (GOT, GPT, LDH, CK, CKMB, Troponine)
CRP (Inflammation)
Epinephrine/Norepinephrine levels scientific
Peptide (BNP/ANP) levels mostly scientific, but probably
prognostic
Value: diagnostic, prognostic, therapy control
March 2013 ghennersdorf DGK ESC SES 37
38. Biochemistry: BNP/NT-proBNP
BNP= brain natriuretic peptide
(delivered in myocardial atrial tissue
during atrial stress)
regulating hormone in order to reduce atrial stress
Inactive precursor of BNP = NT-proBNP
Blood test after 10 min valid
Mostly valid to exclude CHF under clinical conditions
March 2013 ghennersdorf DGK ESC SES 38