Mitral regurgitation
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Mitral regurgitation is a heart valve condition where the mitral valve does not close properly, allowing blood to flow backward in the heart. It has various etiologies and risk factors. Diagnosis involves listening for murmurs downstream of the defect via auscultation. Treatment aims to reduce preload on the heart through diuretics and vasodilators like nitroprusside. Surgery to repair or replace the mitral valve may be needed.
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Mitral Regurgitation
Mitral regurgitation is caused by abnormalities of the mitral valve leaflets, chordae tendineae, or annulus that prevent complete coaptation of the leaflets during systole. The main causes include degenerative diseases like mitral valve prolapse or rheumatic heart disease. Severe mitral regurgitation can lead to left atrial and ventricular dilation and dysfunction over time if left untreated. Echocardiography is the main imaging modality used to assess severity based on regurgitant jet area and velocity. Surgery is recommended for symptomatic patients or asymptomatic patients with severe regurgitation and abnormal ventricular size or function. Mitral valve repair is preferred over replacement when possible due to better long-
Mitral valve regurgitation
The document outlines mitral regurgitation (MR), including its definition, causes, progression, signs and symptoms, and diagnostic tests. MR occurs when the mitral valve does not close properly, allowing blood to flow back into the left atrium. It begins as an acute condition but can progress to chronic compensated and decompensated phases. In acute and decompensated phases, symptoms include heart failure signs. Chronic compensated MR often presents without symptoms. Diagnosis involves physical exam, echocardiogram, and other cardiac tests.
Mitral regurgitation
This presentation contains details of clinical features, diagnosis and management of mitral regurgitation.
Role of echocardiography in acute myocardial infraction
Echocardiography is useful in the diagnosis and management of acute myocardial infarction (AMI) for several reasons:
1. It can detect regional wall motion abnormalities (RWMAs) that occur prior to ECG changes during a coronary occlusion, aiding early diagnosis.
2. It is recommended to evaluate ventricular function, detect mechanical complications like thrombus, and stratify risk in patients with confirmed AMI.
3. RWMAs seen on echocardiography localize the area of infarction and correspond to the coronary artery territory. Complications like ventricular septal defects and mitral regurgitation can also be identified.
Mitral valve
The mitral valve lies between the left atrium and left ventricle. Mitral stenosis is usually caused by rheumatic fever which causes scarring of the mitral valve leaflets and commissures. In early mitral stenosis, the leaflets can open but have restricted motion. Over time, the leaflets become thickened and rigid, reducing valve opening. This causes symptoms like dyspnea and pulmonary hypertension. On examination, findings may include an irregular pulse from atrial fibrillation, elevated jugular venous pressure, accentuated S1, and a diastolic murmur. Severe mitral stenosis can lead to right heart failure and complications like hemoptysis.
Mitral regurgitation by dr kalpana chetia
Mitral regurgitation - rheumatic heart disease is the commonest cause of MR. It coexists with MS and AR, particularly Ar
Mitral stenosis
Mitral stenosis is usually caused by rheumatic fever, which causes fusion and thickening of the mitral valve, restricting its opening. This restricts blood flow from the left atrium to the left ventricle, causing left atrial pressure to rise and lead to pulmonary congestion and breathlessness. The elevated left atrial pressure also raises pulmonary pressures over time, causing pulmonary hypertension, right heart strain, and eventual right heart failure if left untreated. Diagnosis is made through echocardiogram and symptoms include dyspnea, fatigue, chest pain, cough, and palpitations from potential atrial fibrillation. Treatment involves antibiotics to prevent future rheumatic fever, diuretics, and potentially mitral
Mitral regurgitation
determining the suitability of the mitral valve for repair most likely in patients with mitral regurgitation due to myxomatous degeneration and is least likely in patients with regurgitation due to endocarditis most likely with posterior prolapse or flail, whereas ileaflet involvement and isolated anterior leaflet prolapse reduce the likelihood of successful repair substantially.
Recommended
Mitral Regurgitation
Mitral regurgitation is caused by abnormalities of the mitral valve leaflets, chordae tendineae, or annulus that prevent complete coaptation of the leaflets during systole. The main causes include degenerative diseases like mitral valve prolapse or rheumatic heart disease. Severe mitral regurgitation can lead to left atrial and ventricular dilation and dysfunction over time if left untreated. Echocardiography is the main imaging modality used to assess severity based on regurgitant jet area and velocity. Surgery is recommended for symptomatic patients or asymptomatic patients with severe regurgitation and abnormal ventricular size or function. Mitral valve repair is preferred over replacement when possible due to better long-
Mitral valve regurgitation
The document outlines mitral regurgitation (MR), including its definition, causes, progression, signs and symptoms, and diagnostic tests. MR occurs when the mitral valve does not close properly, allowing blood to flow back into the left atrium. It begins as an acute condition but can progress to chronic compensated and decompensated phases. In acute and decompensated phases, symptoms include heart failure signs. Chronic compensated MR often presents without symptoms. Diagnosis involves physical exam, echocardiogram, and other cardiac tests.
Mitral regurgitation
This presentation contains details of clinical features, diagnosis and management of mitral regurgitation.
Role of echocardiography in acute myocardial infraction
Echocardiography is useful in the diagnosis and management of acute myocardial infarction (AMI) for several reasons:
1. It can detect regional wall motion abnormalities (RWMAs) that occur prior to ECG changes during a coronary occlusion, aiding early diagnosis.
2. It is recommended to evaluate ventricular function, detect mechanical complications like thrombus, and stratify risk in patients with confirmed AMI.
3. RWMAs seen on echocardiography localize the area of infarction and correspond to the coronary artery territory. Complications like ventricular septal defects and mitral regurgitation can also be identified.
Mitral valve
The mitral valve lies between the left atrium and left ventricle. Mitral stenosis is usually caused by rheumatic fever which causes scarring of the mitral valve leaflets and commissures. In early mitral stenosis, the leaflets can open but have restricted motion. Over time, the leaflets become thickened and rigid, reducing valve opening. This causes symptoms like dyspnea and pulmonary hypertension. On examination, findings may include an irregular pulse from atrial fibrillation, elevated jugular venous pressure, accentuated S1, and a diastolic murmur. Severe mitral stenosis can lead to right heart failure and complications like hemoptysis.
Mitral regurgitation by dr kalpana chetia
Mitral regurgitation - rheumatic heart disease is the commonest cause of MR. It coexists with MS and AR, particularly Ar
Mitral stenosis
Mitral stenosis is usually caused by rheumatic fever, which causes fusion and thickening of the mitral valve, restricting its opening. This restricts blood flow from the left atrium to the left ventricle, causing left atrial pressure to rise and lead to pulmonary congestion and breathlessness. The elevated left atrial pressure also raises pulmonary pressures over time, causing pulmonary hypertension, right heart strain, and eventual right heart failure if left untreated. Diagnosis is made through echocardiogram and symptoms include dyspnea, fatigue, chest pain, cough, and palpitations from potential atrial fibrillation. Treatment involves antibiotics to prevent future rheumatic fever, diuretics, and potentially mitral
Mitral regurgitation
determining the suitability of the mitral valve for repair most likely in patients with mitral regurgitation due to myxomatous degeneration and is least likely in patients with regurgitation due to endocarditis most likely with posterior prolapse or flail, whereas ileaflet involvement and isolated anterior leaflet prolapse reduce the likelihood of successful repair substantially.
Constrictive pericarditis
The document discusses constrictive pericarditis, providing details on:
1) The pathology of constrictive pericarditis which involves thickening and scarring of the pericardium leading to loss of elasticity.
2) The pathophysiology of constrictive pericarditis where the inelastic pericardium constrains cardiac filling and prevents adaptation to volume changes.
3) Key diagnostic features of constrictive pericarditis seen on echocardiogram include septal bounce, rapid early diastolic mitral inflow, and increased mitral annular velocities that rise with inspiration.
Bundle branch blocks
Bundle branch blocks occur when the left or right bundle branch is blocked, preventing normal conduction of electrical impulses through the ventricles. Right bundle branch block is usually benign but can worsen prognosis in acute myocardial infarction by indicating occlusion of the proximal left anterior descending artery. Left bundle branch block is more serious as it can mask signs of myocardial infarction and worsen prognosis in acute infarction. The Sgarbossa criteria can help diagnose myocardial infarction in the presence of left bundle branch block. Left anterior and posterior hemiblocks involve conduction abnormalities localized to one side of the ventricles.
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Hocm
Hypertrophic cardiomyopathy is a genetic heart condition characterized by thickened heart muscle and potential outflow tract obstruction. It affects 0.2-0.5% of the population and is caused by mutations in genes encoding sarcomere proteins. Symptoms include chest pain, dizziness, and palpitations. Diagnosis is made via echocardiogram and genetic testing. Treatment focuses on symptom relief through medications or procedures to reduce outflow tract obstruction, as well as preventing sudden cardiac death through ICD implantation in high-risk patients.
Mitral valve prolapse
Mitral valve prolapse (MVP) is a common condition where the mitral valve leaflets bulge into the left atrium during systole. While often asymptomatic, it can increase the risk of arrhythmias, endocarditis, stroke, and mitral regurgitation. The classic findings are a mid-to-late systolic click and murmur. Treatment involves monitoring for complications and addressing symptoms like with beta-blockers. For severe mitral regurgitation, early surgical repair is recommended to prevent left ventricular dysfunction.
HOCM Hypertrophic cardiomyopathy
This document discusses hypertrophic cardiomyopathy (HCM), including its definition, causes, variants, pathophysiology, clinical presentation, diagnostic workup, and management. Key points include:
- HCM is defined by left and/or right ventricular hypertrophy, usually involving the septum with a thickness over 15mm. It is commonly caused by genetic mutations affecting cardiac proteins.
- Presentation can range from being asymptomatic to symptoms of heart failure, angina, or syncope. Exams may reveal murmurs and EKGs often show abnormal patterns. Echocardiograms and cardiac catheterization are used for diagnosis and assessment.
- Management involves medications like beta-blockers to reduce
Echo assessment of lv systolic function and swma
This document discusses various techniques for assessing left ventricular systolic function using echocardiography, including:
- Visual assessment of endocardial motion and wall thickening to evaluate global and regional function
- Quantitative measures like fractional shortening, ejection fraction, and volumes
- Tissue Doppler imaging of mitral annular velocities
- Tissue tracking and strain imaging to evaluate timing and extent of myocardial contraction
- Wall motion scoring to characterize regional abnormalities
Restrictive cardiomyopathy
Restrictive cardiomyopathy is characterized by impaired ventricular filling during diastole due to a primary decrease in ventricular compliance. The myocardium is partially infiltrated by noncontractile tissue or extracellular material, impairing the heart's ability to dilate. Causes include amyloidosis, sarcoidosis, and idiopathic restrictive cardiomyopathy. On morphology, the ventricles are normally or slightly enlarged while the cavities are not dilated. The myocardium is firm and noncompliant, and the atria show biatrial dilation. Patients experience signs and symptoms of congestive heart failure with prominent right-sided features.
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM)
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by excessive thickening of the heart muscle. It was initially described in the 1950s and causes significant morbidity and mortality due to heart failure, arrhythmias, and sudden cardiac death. The pathophysiology involves left ventricular outflow tract obstruction, diastolic dysfunction, myocardial ischemia, and mitral regurgitation. Treatment involves medications, septal reduction procedures like myectomy or alcohol ablation, and implantable cardioverter-defibrillators in high-risk patients. Prognosis depends on symptom severity and risk factors for sudden cardiac death.
Restrictive cardiomyopathy
This document provides information on restrictive cardiomyopathy (RCM), including its definition, classification, etiology, symptoms, diagnosis, and treatment. Some key points:
- RCM is characterized by diastolic dysfunction with a stiffened myocardium that impairs ventricular filling. It is usually not associated with ventricular dilation or hypertrophy.
- Causes include infiltrative diseases of the myocardium (e.g. amyloidosis, sarcoidosis), endomyocardial fibrosis, and genetic/familial factors.
- Symptoms are related to reduced cardiac output and include dyspnea, fatigue, arrhythmias. Diagnosis involves echocardiogram, cardiac catheterization and MRI to evaluate
Echo assessment of cardiomyopathy pdf
This document discusses the use of echocardiography in evaluating various types of cardiomyopathies. It provides echocardiographic features of dilated cardiomyopathy including dilated chambers, normal wall thickness, and complications like mitral regurgitation. Hypertrophic cardiomyopathy features include unexplained hypertrophy, diastolic dysfunction, and left ventricular outflow tract obstruction. Restrictive cardiomyopathies show hypertrophy, enlarged atria, restricted filling, and elevated pressures. Left ventricular non-compaction and arrhythmogenic right ventricular cardiomyopathy also have distinct echocardiographic characteristics described.
Constrictive pericarditis
- Constrictive pericarditis results from scarring and loss of elasticity of the pericardial sac, typically due to chronic inflammation and sometimes calcification. This causes the pericardium to thicken and lose its ability to expand and contract normally.
- The inelastic pericardium prevents normal filling of the heart chambers, especially in mid to late diastole. Inspiration does not decrease pressure in the left ventricle as it normally would due to the thickened pericardium isolating the heart.
- Diagnosis involves physical exam findings like elevated JVP, hepatomegaly, and Kussmaul's sign combined with echocardiography findings like sept
Echocardiography in mitral stenosis
Mitral stenosis can be evaluated using echocardiography. Key findings include measuring the mitral valve area using planimetry, pressure half-time, and continuity equation methods. Pressure gradients and pulmonary artery systolic pressure can also assess severity. Mild mitral stenosis is defined as a mitral valve area greater than 1.5 cm2, moderate as 1-1.5 cm2, and severe as less than 1 cm2. Stress echocardiography may reveal symptoms in borderline cases by monitoring pressures with exercise.
Mitral valve diseases
The document discusses pathophysiology of mitral valve diseases. It begins with an overview of rheumatic fever and rheumatic heart disease as the leading cause of mitral stenosis worldwide. It then covers the anatomy of the mitral valve and describes the pathogenesis and hemodynamic consequences of mitral stenosis, including left atrial pressure overload, pulmonary hypertension, and symptoms like dyspnea. Late stages can involve left ventricular dysfunction. The document also briefly discusses etiology, classification and mechanisms of mitral regurgitation.
Valvular heart disease
Valvular heart disease refers to abnormalities of the heart valves that result in obstruction of blood flow or backflow of blood. Echocardiography plays a key role in evaluating valve function and structure non-invasively. Common valvular abnormalities include aortic stenosis, aortic regurgitation, mitral stenosis, and mitral regurgitation. Treatment depends on severity and symptoms, ranging from medical management to surgical repair or replacement of the affected valve.
Echo Mitral Stenosis
This document summarizes the echocardiographic assessment of mitral stenosis (MS). It describes the anatomy of the mitral valve and causes of MS. Methods for assessing MS severity include measuring the pressure gradient, mitral valve area using planimetry and pressure half-time, and pulmonary artery pressure. Suitability for percutaneous transvenous mitral commissurotomy is evaluated. Concomitant valve lesions are also identified. Stress echocardiography may be used when symptoms are equivocal. Transesophageal echocardiography is recommended in some cases.
Hypertrophic cardiomyopathy
A 17-year-old male basketball player collapsed during practice and suffered cardiac arrest. An autopsy later revealed he had hypertrophic cardiomyopathy (HCM), a genetic heart condition where the heart muscle becomes abnormally thick. HCM is a leading cause of sudden cardiac death in young athletes. The patient had previously noticed some shortness of breath with exertion but it did not limit his activity. He was found to have a heart murmur as a child but it was never investigated. HCM causes the left ventricle to become thickened and stiff, which can obstruct blood flow out of the heart and cause heart failure, chest pain, arrhythmias, and sudden cardiac death.
Lvh & rvh
This document discusses left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). It defines LVH as an increase in left ventricle mass due to increased wall thickness or cavity size. There are two types of LVH - systolic overload from conditions like hypertension which compromise the left ventricle during systole, and diastolic overload from things like valvular diseases which compromise it during diastole. The document outlines ECG criteria for diagnosing LVH including Sokolov-Lyon and Cornell voltage criteria. It also discusses RVH manifestations on ECG like right axis deviation, tall R waves in right precordial leads, and an S1S2S3 pattern.
Chronic constrictive pericarditis
Chronic constrictive pericarditis is a condition where the pericardium thickens and scar tissue forms, restricting the heart's ability to fill with blood. It results from various causes like infections, radiation, surgery, or idiopathic. On examination, elevated jugular venous pressure and hepatomegaly are seen. Imaging shows thickened pericardium. Catheterization demonstrates equal pressures in the heart chambers. Definitive treatment is surgical removal of the pericardium (pericardiectomy), which improves symptoms in most patients.
Mitral regurgitation
Mitral valve anatomy
Mitral Regurgitation
Etiology
Pathology
Primary mitral regurgitation
Secondary mitral regurgitation
Functional Classification
Pathophysiology
Acute phase
Chronic compensated phase
Clinical Manifestations
Physical examination
Investigations
classification of severity
Indication for surgery
MV operations for correction of MR
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ardspptslideshare. distress syndrome health
ARDS is characterized by severe pulmonary edema and hypoxemia due to diffuse alveolar damage. It occurs in 10-15% of ICU patients and has a mortality rate of 26-58%. Risk factors include aspiration, infection, trauma, and sepsis. Symptoms include dyspnea, cough, and hypoxemia. Diagnosis is based on history, physical exam, chest x-ray, and low oxygen levels. Treatment involves mechanical ventilation, antibiotics, diuretics, and positioning the patient prone to improve oxygenation. Complications can include pneumonia, barotrauma, and multiple organ dysfunction.
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Constrictive pericarditis
The document discusses constrictive pericarditis, providing details on:
1) The pathology of constrictive pericarditis which involves thickening and scarring of the pericardium leading to loss of elasticity.
2) The pathophysiology of constrictive pericarditis where the inelastic pericardium constrains cardiac filling and prevents adaptation to volume changes.
3) Key diagnostic features of constrictive pericarditis seen on echocardiogram include septal bounce, rapid early diastolic mitral inflow, and increased mitral annular velocities that rise with inspiration.
Bundle branch blocks
Bundle branch blocks occur when the left or right bundle branch is blocked, preventing normal conduction of electrical impulses through the ventricles. Right bundle branch block is usually benign but can worsen prognosis in acute myocardial infarction by indicating occlusion of the proximal left anterior descending artery. Left bundle branch block is more serious as it can mask signs of myocardial infarction and worsen prognosis in acute infarction. The Sgarbossa criteria can help diagnose myocardial infarction in the presence of left bundle branch block. Left anterior and posterior hemiblocks involve conduction abnormalities localized to one side of the ventricles.
Atrioventricular canal defect, Firas Aljanadi,MD
a cardiac surgery presentation about Atrioventricular septal defect,Definition, Prevalence,Anatomy,Classification,presentation ,diagnosis and management
Hocm
Hypertrophic cardiomyopathy is a genetic heart condition characterized by thickened heart muscle and potential outflow tract obstruction. It affects 0.2-0.5% of the population and is caused by mutations in genes encoding sarcomere proteins. Symptoms include chest pain, dizziness, and palpitations. Diagnosis is made via echocardiogram and genetic testing. Treatment focuses on symptom relief through medications or procedures to reduce outflow tract obstruction, as well as preventing sudden cardiac death through ICD implantation in high-risk patients.
Mitral valve prolapse
Mitral valve prolapse (MVP) is a common condition where the mitral valve leaflets bulge into the left atrium during systole. While often asymptomatic, it can increase the risk of arrhythmias, endocarditis, stroke, and mitral regurgitation. The classic findings are a mid-to-late systolic click and murmur. Treatment involves monitoring for complications and addressing symptoms like with beta-blockers. For severe mitral regurgitation, early surgical repair is recommended to prevent left ventricular dysfunction.
HOCM Hypertrophic cardiomyopathy
This document discusses hypertrophic cardiomyopathy (HCM), including its definition, causes, variants, pathophysiology, clinical presentation, diagnostic workup, and management. Key points include:
- HCM is defined by left and/or right ventricular hypertrophy, usually involving the septum with a thickness over 15mm. It is commonly caused by genetic mutations affecting cardiac proteins.
- Presentation can range from being asymptomatic to symptoms of heart failure, angina, or syncope. Exams may reveal murmurs and EKGs often show abnormal patterns. Echocardiograms and cardiac catheterization are used for diagnosis and assessment.
- Management involves medications like beta-blockers to reduce
Echo assessment of lv systolic function and swma
This document discusses various techniques for assessing left ventricular systolic function using echocardiography, including:
- Visual assessment of endocardial motion and wall thickening to evaluate global and regional function
- Quantitative measures like fractional shortening, ejection fraction, and volumes
- Tissue Doppler imaging of mitral annular velocities
- Tissue tracking and strain imaging to evaluate timing and extent of myocardial contraction
- Wall motion scoring to characterize regional abnormalities
Restrictive cardiomyopathy
Restrictive cardiomyopathy is characterized by impaired ventricular filling during diastole due to a primary decrease in ventricular compliance. The myocardium is partially infiltrated by noncontractile tissue or extracellular material, impairing the heart's ability to dilate. Causes include amyloidosis, sarcoidosis, and idiopathic restrictive cardiomyopathy. On morphology, the ventricles are normally or slightly enlarged while the cavities are not dilated. The myocardium is firm and noncompliant, and the atria show biatrial dilation. Patients experience signs and symptoms of congestive heart failure with prominent right-sided features.
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM)
Hypertrophic cardiomyopathy (HCM) is a genetic heart condition characterized by excessive thickening of the heart muscle. It was initially described in the 1950s and causes significant morbidity and mortality due to heart failure, arrhythmias, and sudden cardiac death. The pathophysiology involves left ventricular outflow tract obstruction, diastolic dysfunction, myocardial ischemia, and mitral regurgitation. Treatment involves medications, septal reduction procedures like myectomy or alcohol ablation, and implantable cardioverter-defibrillators in high-risk patients. Prognosis depends on symptom severity and risk factors for sudden cardiac death.
Restrictive cardiomyopathy
This document provides information on restrictive cardiomyopathy (RCM), including its definition, classification, etiology, symptoms, diagnosis, and treatment. Some key points:
- RCM is characterized by diastolic dysfunction with a stiffened myocardium that impairs ventricular filling. It is usually not associated with ventricular dilation or hypertrophy.
- Causes include infiltrative diseases of the myocardium (e.g. amyloidosis, sarcoidosis), endomyocardial fibrosis, and genetic/familial factors.
- Symptoms are related to reduced cardiac output and include dyspnea, fatigue, arrhythmias. Diagnosis involves echocardiogram, cardiac catheterization and MRI to evaluate
Echo assessment of cardiomyopathy pdf
This document discusses the use of echocardiography in evaluating various types of cardiomyopathies. It provides echocardiographic features of dilated cardiomyopathy including dilated chambers, normal wall thickness, and complications like mitral regurgitation. Hypertrophic cardiomyopathy features include unexplained hypertrophy, diastolic dysfunction, and left ventricular outflow tract obstruction. Restrictive cardiomyopathies show hypertrophy, enlarged atria, restricted filling, and elevated pressures. Left ventricular non-compaction and arrhythmogenic right ventricular cardiomyopathy also have distinct echocardiographic characteristics described.
Constrictive pericarditis
- Constrictive pericarditis results from scarring and loss of elasticity of the pericardial sac, typically due to chronic inflammation and sometimes calcification. This causes the pericardium to thicken and lose its ability to expand and contract normally.
- The inelastic pericardium prevents normal filling of the heart chambers, especially in mid to late diastole. Inspiration does not decrease pressure in the left ventricle as it normally would due to the thickened pericardium isolating the heart.
- Diagnosis involves physical exam findings like elevated JVP, hepatomegaly, and Kussmaul's sign combined with echocardiography findings like sept
Echocardiography in mitral stenosis
Mitral stenosis can be evaluated using echocardiography. Key findings include measuring the mitral valve area using planimetry, pressure half-time, and continuity equation methods. Pressure gradients and pulmonary artery systolic pressure can also assess severity. Mild mitral stenosis is defined as a mitral valve area greater than 1.5 cm2, moderate as 1-1.5 cm2, and severe as less than 1 cm2. Stress echocardiography may reveal symptoms in borderline cases by monitoring pressures with exercise.
Mitral valve diseases
The document discusses pathophysiology of mitral valve diseases. It begins with an overview of rheumatic fever and rheumatic heart disease as the leading cause of mitral stenosis worldwide. It then covers the anatomy of the mitral valve and describes the pathogenesis and hemodynamic consequences of mitral stenosis, including left atrial pressure overload, pulmonary hypertension, and symptoms like dyspnea. Late stages can involve left ventricular dysfunction. The document also briefly discusses etiology, classification and mechanisms of mitral regurgitation.
Valvular heart disease
Valvular heart disease refers to abnormalities of the heart valves that result in obstruction of blood flow or backflow of blood. Echocardiography plays a key role in evaluating valve function and structure non-invasively. Common valvular abnormalities include aortic stenosis, aortic regurgitation, mitral stenosis, and mitral regurgitation. Treatment depends on severity and symptoms, ranging from medical management to surgical repair or replacement of the affected valve.
Echo Mitral Stenosis
This document summarizes the echocardiographic assessment of mitral stenosis (MS). It describes the anatomy of the mitral valve and causes of MS. Methods for assessing MS severity include measuring the pressure gradient, mitral valve area using planimetry and pressure half-time, and pulmonary artery pressure. Suitability for percutaneous transvenous mitral commissurotomy is evaluated. Concomitant valve lesions are also identified. Stress echocardiography may be used when symptoms are equivocal. Transesophageal echocardiography is recommended in some cases.
Hypertrophic cardiomyopathy
A 17-year-old male basketball player collapsed during practice and suffered cardiac arrest. An autopsy later revealed he had hypertrophic cardiomyopathy (HCM), a genetic heart condition where the heart muscle becomes abnormally thick. HCM is a leading cause of sudden cardiac death in young athletes. The patient had previously noticed some shortness of breath with exertion but it did not limit his activity. He was found to have a heart murmur as a child but it was never investigated. HCM causes the left ventricle to become thickened and stiff, which can obstruct blood flow out of the heart and cause heart failure, chest pain, arrhythmias, and sudden cardiac death.
Lvh & rvh
This document discusses left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). It defines LVH as an increase in left ventricle mass due to increased wall thickness or cavity size. There are two types of LVH - systolic overload from conditions like hypertension which compromise the left ventricle during systole, and diastolic overload from things like valvular diseases which compromise it during diastole. The document outlines ECG criteria for diagnosing LVH including Sokolov-Lyon and Cornell voltage criteria. It also discusses RVH manifestations on ECG like right axis deviation, tall R waves in right precordial leads, and an S1S2S3 pattern.
Chronic constrictive pericarditis
Chronic constrictive pericarditis is a condition where the pericardium thickens and scar tissue forms, restricting the heart's ability to fill with blood. It results from various causes like infections, radiation, surgery, or idiopathic. On examination, elevated jugular venous pressure and hepatomegaly are seen. Imaging shows thickened pericardium. Catheterization demonstrates equal pressures in the heart chambers. Definitive treatment is surgical removal of the pericardium (pericardiectomy), which improves symptoms in most patients.
Mitral regurgitation
Mitral valve anatomy
Mitral Regurgitation
Etiology
Pathology
Primary mitral regurgitation
Secondary mitral regurgitation
Functional Classification
Pathophysiology
Acute phase
Chronic compensated phase
Clinical Manifestations
Physical examination
Investigations
classification of severity
Indication for surgery
MV operations for correction of MR
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1) A review of respiratory anatomy and physiology, pathophysiology, assessment of the respiratory system, and management of respiratory disorders.
2) Descriptions of specific respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and lung cancer.
3) Details on respiratory assessment techniques, diagnostic testing, and treatment approaches for various respiratory conditions.
Cor pulmonale.pptx
Cor pulmonale, also known as pulmonary heart disease, is a type of right heart failure caused by lung disease. It is characterized by enlargement and failure of the right ventricle due to increased pulmonary blood pressure and resistance. Common causes include chronic obstructive pulmonary disease (COPD) and pulmonary embolism. Symptoms may include dyspnea, edema, and cyanosis. Diagnosis involves echocardiogram, chest x-ray, and right heart catheterization. Treatment focuses on managing the underlying lung condition with oxygen therapy and medications to dilate blood vessels in the lungs such as vasodilators. Nursing care aims to improve oxygenation and manage symptoms like anxiety from dyspnea. Complications can
Dyspnea and Pulmonary Edema
1) Dyspnea, or shortness of breath, is a subjective experience that results from interactions between physiological, psychological, and environmental factors. It can be caused by disorders of the ventilatory pump or sensory receptors in the lungs and muscles.
2) Pulmonary edema occurs when fluid accumulates in the lungs, which can be cardiogenic due to increased hydrostatic pressures from heart problems, or noncardiogenic from direct lung injury or diseases affecting the lung barrier.
3) Differentiating cardiogenic and noncardiogenic pulmonary edema involves examining physical exam findings, chest x-rays, and response to supplemental oxygen, as they have distinct mechanisms and presentations.
Cardiogenic vs noncardiogenic pulmonary edema (ARDs)
The document discusses the differential diagnosis and treatment of cardiogenic and non-cardiogenic pulmonary edema. Cardiogenic pulmonary edema is caused by left heart failure leading to increased pulmonary venous pressure and fluid accumulation in the lungs. Non-cardiogenic pulmonary edema includes conditions like ARDS which has an acute inflammatory process in the lungs. Treatment for both involves supportive care like oxygen supplementation and ventilation, while cardiogenic pulmonary edema additionally responds to diuretics and vasodilators to reduce preload and afterload on the heart.
acute respiratory failure ppt.ppt
The document outlines the assessment and management of pediatric patients presenting with respiratory distress. It discusses performing a rapid initial assessment to determine severity and stabilize the patient. Specific causes of respiratory distress include upper airway obstruction, lower airway obstruction, lung tissue disease, and disordered control of breathing. The document provides details on evaluating and treating each of these categories.
Cor pulmonale
Cor pulmonale, or right heart failure, is caused by high blood pressure in the pulmonary artery and right ventricle due to conditions that restrict pulmonary blood flow such as chronic lung diseases. It develops when pulmonary hypertension leads to enlargement and failure of the right ventricle. Symptoms include shortness of breath, leg swelling, and fatigue. Diagnosis involves physical exam, imaging like echocardiogram and chest x-ray, and assessing pulmonary pressures. Treatment focuses on managing the underlying lung condition, giving diuretics and vasodilators, and may involve oxygen therapy or lung transplantation in severe cases.
Rehabilitation of patient with pleural effusion
1) Pulmonary embolism occurs when a blood clot blocks an artery in the lungs, and can cause pleural effusions in about 30% of cases. Physiotherapy is an important part of managing patients with pleural effusions secondary to pulmonary embolism.
2) Physiotherapy includes techniques like incentive spirometry, chest physiotherapy, and exercises to improve cardiopulmonary function and endurance. Drainage of fluid from chest tubes is also facilitated.
3) As the patient's condition improves with physiotherapy, their ability to exercise intensifies and shortness of breath decreases, with the goal of restoring independence and fitness.
EM Board Review Pulmonary & Critical Care...Carrie Clark
Sweat chloride >60mmol/L on quantitative sweat test confirms
diagnosis
Genetic testing
Identifies mutations in CFTR gene
This document provides a summary of respiratory physiology, hypoxemia, critical care topics including ARDS, and disorders of the pleura, mediastinum, and chest wall. It also reviews obstructive lung diseases such as asthma, COPD, and cystic fibrosis including their etiology, symptoms, diagnosis, and management. Key points covered include the alveolar gas equation, causes of hypoxemia, management of ARDS with low tidal volume ventilation and PEEP, diagnosis and treatment of pneumothorax and ple
pulm edema.pptx
1. Pulmonary edema occurs when fluid builds up in the tiny air sacs (alveoli) in the lungs, causing shortness of breath.
2. It can be caused by conditions that increase hydrostatic pressure in the pulmonary capillaries like heart failure (cardiogenic pulmonary edema) or disrupt the alveolar-capillary membrane like pneumonia or inhaled toxins (non-cardiogenic pulmonary edema).
3. The document provides definitions, classifications, signs and symptoms, differential diagnosis, and management approaches for dyspnea and pulmonary edema.
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Pulmonary vascular disease / Pulmoary hypertension
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Symptoms Signs & Investigations in Cardiovascular Diseases
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Cardiogenic vs noncardiogenic pulmonary edema (ARDs)
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This document summarizes and analyzes key elements of Edgar Allan Poe's short story "The Fall of the House of Usher". It discusses chronological deviations in the story, characters such as Roderick and Madeline Usher, the relationship between spaces and characters, narrative techniques used by Poe such as descriptions and foreshadowing, instances of mise en abyme, and invites any questions about the analysis.
Tropical diseases, malaria
The document discusses malaria diagnosis and treatment in Gambia. It notes that in 2005, the entire population of Gambia was at risk for malaria infection, and 40% of hospital deaths among children and pregnant women were due to malaria, making it the country's number one health problem. Differential diagnoses for malaria include typhoid fever, meningitis, dengue fever, influenza, and viral hepatitis. Laboratory tests for malaria diagnosis include examining Giemsa-stained thick and thin blood films to identify parasites, as well as rapid antigen detection tests and serological tests. Features of severe falciparum malaria can include renal problems, anemia, bleeding, low white blood cell counts, and thrombocytopenia. Liver dysfunction is also
The death of mr lazarescu
Mr. Lazarescu suffers from neglect and poor medical care as he is bounced between multiple hospitals in one night. The doctors show a lack of compassion and focus more on passing responsibility than properly treating the patient. By the end of the night, Mr. Lazarescu's condition worsens due to the failure of the medical professionals to listen, communicate, and prioritize his care.
Team creativity
Team B is currently underperforming and needs transformation. A new leadership approach is required to motivate employees and improve processes. By implementing strategic changes to culture, communication, and accountability, Team B can become high performing.
Suicide
According to Dutch statistics, males who are older and alone have an increased risk of successful suicide. A clinical diagnostic interview is the most important part of risk assessment, and should involve discussing specific suicide plans, methods, and statistics. The document also discusses euthanasia, noting that while only 14 requests were granted out of 500, 49 people who requested euthanasia ultimately died by suicide.
Sexual transmittable disease
This document discusses a case involving a girl from the Antilles and the potential dimensions this adds. It provides statistics showing higher rates of sexually transmitted diseases among people from the Antilles compared to those in the Netherlands. Questions are presented that could have been asked of the girl if she were there to get more information about her sexual experiences and symptoms. Common reasons cited for unprotected sex are discussed, such as trusting a partner or intercourse feeling more pleasurable without a condom.
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This poster summarizes the potential benefits and drawbacks of widespread use of cognitive and motivational pharmaceutical enhancers, known as "smart pills". The poster finds that while smart pills may improve attention, alertness, energy and motivation in the short term, there are concerns about potential long-term side effects since long-term studies have not been conducted. Alternative approaches like exercise, sleep, nutrition and transcranial direct current stimulation may provide equal or greater benefits without the same safety and ethical concerns as widespread smart pill use. The poster concludes that while smart pills show some cognitive benefits, their long-term impacts are unknown, and natural alternatives exist and should also be considered.
Quotes
Ban Ki-Moon outlines his "Zero Hunger Challenge" which aims to end world hunger within his lifetime through five objectives: 1) ensuring everyone has access to nutritious food year-round, 2) ending malnutrition in pregnancy and early childhood, 3) making all food systems sustainable, 4) empowering smallholder farmers, especially women, to double productivity and income, and 5) cutting post-production food losses and wasting less food. He invites governments, businesses, farmers, scientists, and consumers to work together to honor commitments to this vision of resilient, equitable food systems where everyone enjoys their right to food, boosting economic growth, reducing poverty, and safeguarding the environment.
Mental health in west africa
Mental health services and resources are lacking across many West African countries. Traditional and spiritual healers play a large role where professional psychiatric care is inaccessible to most. Studies of mental health epidemiology are rare due to a lack of data collection. Without treatment, individuals can experience severe consequences like being chained to trees, but programs that provide antidepressants or psychosocial therapy have led to lower depression scores and unemployment rates in participants. Significant barriers to treatment include shortages of psychiatrists and facilities, as well as limited access to affordable psychotropic medications.
Loss of libido
This document discusses the case of a Moroccan Muslim couple who are unable to have children. The male partner has experienced same-sex attraction in the past which concerned him for religious reasons. Current issues are the male partner's fatigue from work stress and the female partner's inability to become pregnant. The male partner asks what he should do. The document then discusses cultural and religious factors around homosexuality in Islam and Moroccan culture, noting that homosexuality is strictly prohibited in Islam.
Leukemia
Chronic leukemia results in a neoplastic proliferation of B-cells that causes few complications initially, allowing for a normal hemoglobin and platelet count. Acute leukemia originates in the bone marrow's hematopoietic stem cells, affecting all cell lineages and commonly presenting with anemia and low platelet count due to its more rapid progression overwhelming normal blood cell production. Unlike chronic leukemia, acute leukemia typically impacts red and platelet cell development in the bone marrow from the onset.
Investigations and prescription
This document provides guidelines for managing a patient with diabetes, hypertension, and obesity through a 6 step process:
Step 1 involves diagnosing the patient's problems of hypertension, diabetes type 2, and obesity.
Step 2 aims to prevent cardiovascular events through lifestyle changes like exercise and weight loss, and starting metformin and hydrochlorothiazide medication.
Step 3 outlines discussing lifestyle modifications with the motivated patient and potentially referring them to dietitians or other professionals.
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Step 6 is to assess renal function and compliance after starting the diuretic and check effectiveness at follow-
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Infection
A 66-year-old male presented with fever, dyspnea, and angina. On physical exam, he had a respiratory rate of 33 breaths per minute, use of accessory muscles, clouded consciousness, temperature of 39.3 degrees Celsius, blood pressure of 110/55 mm Hg, pulse of 115 beats per minute, and crackles on lung auscultation. The differential diagnosis included community-acquired pneumonia, hospital-acquired pneumonia, and tuberculosis. Chest radiography and initiation of broad-spectrum antibiotics were recommended pending microbiological results.
Indigenous religions
Animism is a religious belief found around the world that views all things as having a soul. Followers of animism believe that rivers, mountains, and other natural phenomena possess spirits or souls. Burial rituals differ between tribes and often involve ceremonies to honor the deceased soul as well as rituals performed by elders. Nelson Mandela's Xhosa clan burial involved ceremonies, the slaughtering of oxen, washing of hands and tools, and the removal of mourning garb after a year.
mind and body
This document discusses bilirubin metabolism and transport, normal and high bilirubin levels, causes of jaundice, and treatment for pancreatic cancer. It notes that bilirubin is a yellow breakdown product of heme metabolism. There are two forms: unconjugated bilirubin, which is insoluble and bound to albumin; and conjugated bilirubin, which is soluble and loosely bound to albumin. High bilirubin levels can cause jaundice. Causes of jaundice include increased red blood cell destruction and obstruction of the bile ducts. The document presents a case of a patient with very high total and conjugated bilirubin levels who is diagnosed with pancreatic
Hypertension and edema
An 85-year-old woman presented with dyspnea, hypertension, and edema. On examination, she had an S1 murmur and weak S2. Additional investigations including cardiac ultrasound, oxygen saturation measurement, ECG, blood tests, and angiography were recommended to evaluate her cardiac function and check for issues like ischemic damage or coronary artery occlusion. Her treatment considerations included a diuretic to reduce edema and hypertension, compression stockings, and elective cardiac surgery depending on her condition and test results. Medications such as ACE inhibitors, ARBs, nitrates, aspirin, and statins were also suggested.
Hypersensitivity types
The document discusses different types of hypersensitivity reactions (HSRs) and shock. It covers HSR types 1-4, anaphylactic shock, and shock. It provides examples of asthma to illustrate HSR types 1 and 4. The treatment of anaphylaxis and angioedema are differentiated.
Hypersensitivities
The document discusses different types of hypersensitivity reactions (HSRs). It defines HSR type 4 as a T-cell mediated delayed reaction, examples include contact with poison ivy or gluten. HSR type 3 involves immune complexes causing conditions like the Arthus reaction. HSR type 2 reactions can be cytotoxic or non-cyotoxic, with examples of erythroblastosis fetalis and myasthenia gravis. HSR type 1 is an immediate hypersensitivity mediated by IgE, which can cause anaphylaxis with its immediate and late phase responses. Finally, it briefly touches on the different types of shock including anaphylactic shock.
Erysipelas and cushings
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Mitral regurgitation
- 4. murmurs: heard best downstream of the defect
- 8. auscultation: crackles at the base of the lungs
- 9. auscultation: narrowed airways lead to wheezing
- 10. hypoxemia -> increased respiratory rate: 36 per minute
- 13. Healthy PV loop
- 14. Reduce preload AND edema: short acting diuretic: Nitroprusside Notice: no isovolumic contraction
- 15. Prevent exacerbation: Decreased blood flow to kidney Activation of renin-angiotensin Angiotensin stimulates aldosterone Water reabsorption and vasoconstriction Even larger volume overload Even higher blood pressure Use ACE-inhibitor
- 16. Surgery to repair/replace the mitral valve
- 17. Left sided heart failure Damage to pulmonary capillaries due to infection or breathing noxious substances Medications Cardiomyopathy High altitude Heart disease Renal failure Risks