Shock
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This document discusses the four main types of shock: distributive, hypovolemic, cardiogenic, and obstructive. It provides details on the primary problem, compensatory mechanisms, and features of each type of shock. The key points are: 1) Distributive shock is caused by widespread vasodilation leading to low blood pressure and involves mechanisms like sepsis and anaphylaxis. 2) Hypovolemic shock results from massive bleeding and low blood volume, triggering compensations like vasoconstriction and increased heart rate. 3) Cardiogenic shock stems from left heart failure due to issues like myocardial infarction impairing contractility and cardiac output. 4) Ob
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Rheumatoid heart disease
Rheumatic heart disease is a chronic condition resulting from rheumatic fever, which is caused by a streptococcus infection. This infection leads to inflammation in connective tissues like the heart, joints, blood vessels and skin. Over time, this inflammation can cause scarring and deformity of the heart valves through swelling, erosion and fibrous thickening of the valve leaflets. Major symptoms include heart murmurs, joint pain and skin rashes. Treatment focuses on antibiotics to destroy the bacteria, anti-inflammatories to reduce symptoms, and management of any heart valve complications.
Cardiology notes . medical pearls
This document contains notes from a cardiologist on various topics:
1. The most common causes of congestive heart failure and signs on a chest x-ray.
2. Major risk factors for dilated cardiomyopathy and the triad seen in acute pericarditis.
3. The classic presentation of cardiac tamponade and differential diagnosis of an abnormal early diastolic sound.
4. How murmur intensity is affected by position changes in hypertrophic cardiomyopathy and the mechanism of pulsus paradoxus.
5. Causes of an increased QT interval and features of Wolff-Parkinson-White syndrome on an electrocardiogram.
Cardiac tamponade
This document discusses cardiac tamponade and pericardial effusion. Pericardial effusion is an abnormal collection of fluid in the pericardial cavity. Cardiac tamponade is a clinical syndrome caused by excess accumulation of fluid in the pericardial space, reducing ventricular filling and causing hemodynamic compromise. Causes include rapidly developing issues like trauma or surgery, or long term issues like infections, tumors, or hypothyroidism. Symptoms include breathlessness, chest pain, and fatigue. Treatment for severe cases involves pericardiocentesis, while milder cases may be treated conservatively with oxygen, fluids, rest, and drugs.
IHD , CARDIAC FAILURE & CARDIAC RESERVE
Ischemic heart disease is characterized by ischemia of the heart muscle usually due to coronary artery disease. Risk factors include smoking, high cholesterol, diabetes, hypertension, and increasing age. Symptoms may include angina, heart failure, heart burn, and myocardial infarction. Cardiac failure is the failure of the heart to pump enough blood to satisfy the body's needs and can be acute or chronic. Chronic cardiac failure results in reduced arterial pressure and fluid retention by the kidneys. Factors that decrease cardiac reserve and lead to symptoms like dyspnea and fatigue include ischemic heart disease, primary myocardial disease, and vitamin deficiencies.
cardiac tamponade
Cardiac tamponade is a condition where fluid, blood, pus or clots accumulate in the pericardial space surrounding the heart, compressing the heart and reducing cardiac output. It can occur when the pericardial sac contains over 100ml of fluid rapidly or over 1 liter slowly. Causes include aortic aneurysm, heart attack, cancer, infections, trauma and other conditions. Symptoms include anxiety, shortness of breath, fast heart rate and pulse pressure changes. Diagnosis is made through echocardiogram, chest x-ray and ECG. Treatment involves draining fluid via pericardiocentesis or surgery as well as medications and fluids to support blood pressure.
Aortic stenosis
Aortic stenosis is a progressive disease where the aortic valve narrows over time. It affects the semi-lunar valve located in the aorta. As the valve thickens and becomes stiffer, the aorta narrows creating a smaller opening and increased resistance to blood flow. Common causes are rheumatic fever, congenital valve deformities, and calcification of the valve. Symptoms include shortness of breath, chest pain, dizziness, and syncope. Treatments may include valve replacement, valvuloplasty, or medications to manage blood pressure.
Ischemic heart dz2
This document summarizes ischemic heart disease, which is characterized by reduced blood supply to the heart muscle, usually due to coronary artery disease. Key causes include high cholesterol, high blood pressure, smoking, obesity, and diabetes. Clinical manifestations include angina pectoris (chest pain), myocardial infarction (heart attack), sudden cardiac death, and chronic congestive heart failure. The document further details the pathogenesis and complications of myocardial infarction, classification of hypertension, effects of long-term high blood pressure on heart structure and function, and complications of both benign and malignant hypertension.
Pericardial effusion
Pericardial effusion occurs when fluid accumulates in the pericardial cavity surrounding the heart. Normally up to 50 mL of fluid is present but the cavity can hold up to 2 L if the fluid builds up slowly. Fluid accumulation can negatively impact heart function. There are four main types of pericardial effusion: transudative, exudative, hemorrhagic, and malignant. The two main causes are an imbalance of fluid pressures that allows fluid to leave blood vessels, or inflammation/injury of the pericardium. Symptoms include chest pain, fever, fatigue, and shortness of breath. Fluid is collected via pericardiocentesis and tested based on
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Rheumatic heart disease is a chronic condition resulting from rheumatic fever, which is caused by a streptococcus infection. This infection leads to inflammation in connective tissues like the heart, joints, blood vessels and skin. Over time, this inflammation can cause scarring and deformity of the heart valves through swelling, erosion and fibrous thickening of the valve leaflets. Major symptoms include heart murmurs, joint pain and skin rashes. Treatment focuses on antibiotics to destroy the bacteria, anti-inflammatories to reduce symptoms, and management of any heart valve complications.
Cardiology notes . medical pearls
This document contains notes from a cardiologist on various topics:
1. The most common causes of congestive heart failure and signs on a chest x-ray.
2. Major risk factors for dilated cardiomyopathy and the triad seen in acute pericarditis.
3. The classic presentation of cardiac tamponade and differential diagnosis of an abnormal early diastolic sound.
4. How murmur intensity is affected by position changes in hypertrophic cardiomyopathy and the mechanism of pulsus paradoxus.
5. Causes of an increased QT interval and features of Wolff-Parkinson-White syndrome on an electrocardiogram.
Cardiac tamponade
This document discusses cardiac tamponade and pericardial effusion. Pericardial effusion is an abnormal collection of fluid in the pericardial cavity. Cardiac tamponade is a clinical syndrome caused by excess accumulation of fluid in the pericardial space, reducing ventricular filling and causing hemodynamic compromise. Causes include rapidly developing issues like trauma or surgery, or long term issues like infections, tumors, or hypothyroidism. Symptoms include breathlessness, chest pain, and fatigue. Treatment for severe cases involves pericardiocentesis, while milder cases may be treated conservatively with oxygen, fluids, rest, and drugs.
IHD , CARDIAC FAILURE & CARDIAC RESERVE
Ischemic heart disease is characterized by ischemia of the heart muscle usually due to coronary artery disease. Risk factors include smoking, high cholesterol, diabetes, hypertension, and increasing age. Symptoms may include angina, heart failure, heart burn, and myocardial infarction. Cardiac failure is the failure of the heart to pump enough blood to satisfy the body's needs and can be acute or chronic. Chronic cardiac failure results in reduced arterial pressure and fluid retention by the kidneys. Factors that decrease cardiac reserve and lead to symptoms like dyspnea and fatigue include ischemic heart disease, primary myocardial disease, and vitamin deficiencies.
cardiac tamponade
Cardiac tamponade is a condition where fluid, blood, pus or clots accumulate in the pericardial space surrounding the heart, compressing the heart and reducing cardiac output. It can occur when the pericardial sac contains over 100ml of fluid rapidly or over 1 liter slowly. Causes include aortic aneurysm, heart attack, cancer, infections, trauma and other conditions. Symptoms include anxiety, shortness of breath, fast heart rate and pulse pressure changes. Diagnosis is made through echocardiogram, chest x-ray and ECG. Treatment involves draining fluid via pericardiocentesis or surgery as well as medications and fluids to support blood pressure.
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Aortic stenosis is a progressive disease where the aortic valve narrows over time. It affects the semi-lunar valve located in the aorta. As the valve thickens and becomes stiffer, the aorta narrows creating a smaller opening and increased resistance to blood flow. Common causes are rheumatic fever, congenital valve deformities, and calcification of the valve. Symptoms include shortness of breath, chest pain, dizziness, and syncope. Treatments may include valve replacement, valvuloplasty, or medications to manage blood pressure.
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This document summarizes ischemic heart disease, which is characterized by reduced blood supply to the heart muscle, usually due to coronary artery disease. Key causes include high cholesterol, high blood pressure, smoking, obesity, and diabetes. Clinical manifestations include angina pectoris (chest pain), myocardial infarction (heart attack), sudden cardiac death, and chronic congestive heart failure. The document further details the pathogenesis and complications of myocardial infarction, classification of hypertension, effects of long-term high blood pressure on heart structure and function, and complications of both benign and malignant hypertension.
Pericardial effusion
Pericardial effusion occurs when fluid accumulates in the pericardial cavity surrounding the heart. Normally up to 50 mL of fluid is present but the cavity can hold up to 2 L if the fluid builds up slowly. Fluid accumulation can negatively impact heart function. There are four main types of pericardial effusion: transudative, exudative, hemorrhagic, and malignant. The two main causes are an imbalance of fluid pressures that allows fluid to leave blood vessels, or inflammation/injury of the pericardium. Symptoms include chest pain, fever, fatigue, and shortness of breath. Fluid is collected via pericardiocentesis and tested based on
pericardial effusion, cardiac tamponade and myocardial rupture
consists of P.E,cardiac tamponade and myocardial rupture and describes their definitions, pathophysiologies, clinical manifestations, dx, medical-surgical mgt and nursing mgt
for more inquiries/feedback; gufuabdikadir96@gmail.com
Signs of aortic regurgitation
Signs of aortic regurgitation include light house sign, Landolfi's sign, Becker's sign, de Musset's sign, Muller's sign, Quincke's sign, Corrigan's sign, Locomotor brachii, collapsing pulse, Pulsus bisferiens, Traube's sign, Duroziez s sign, Hill's sign, Rosenbach’s-sign, Gerhardt’s sign. The severity of aortic regurgitation is indicated by the duration of the diastolic murmur, presence of bisferiens pulse, positive Hill's sign greater than 60 mm Hg, displaced apical impulse, Austin-Flint murmur
The document discusses the use of an intra-aortic balloon pump (IABP), including appropriate timing of inflation in the cardiac cycle, risks of premature or late deflation, and guidelines for weaning a patient from the device. It notes that the IABP has applications in cardiac failure, refractory angina, cardiogenic shock, and as a bridge to transplantation. Risks include limb ischemia, thrombosis, emboli, bleeding, and aortic complications. Weaning should occur over 24-48 hours with decreasing inotropic support and pump ratios monitored closely.
Aortic stenosis
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Aortic stenosis- Dr Shaz Pamangadan
1) Aortic stenosis occurs when the aortic valve narrows, obstructing blood flow from the heart into the aorta.
2) It has several causes, including congenital bicuspid valve issues, calcification of normal or rheumatic valves, and rarely atherosclerosis.
3) Symptomatic patients have a poor survival without valve obstruction relief, with average survival of 1-3 years after symptom onset. Asymptomatic patients have an excellent long-term prognosis but severity increases gradually over 10-15 years.
Tricuspid stenosis
This presentation contains details of clinical features, diagnosis and management of tricuspid stenosis
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Aortic stenosis is a narrowing of the aorta caused by several factors such as rheumatic fever, atherosclerosis, or congenital malformations. It results in increased pressure and workload on the left ventricle, causing the ventricle to thicken and enlarge over time. If untreated, aortic stenosis can reduce blood flow to the heart and lead to angina, fainting, heart failure or sudden cardiac death. Diagnosis involves echocardiography, ECG and chest x-ray to detect the thickened aortic valve, enlarged heart chambers and diminished blood flow. Treatment options include medications to manage symptoms as well as surgical procedures to dilate or replace the stenotic aortic valve.
Congestive cardiac failure
This document provides information on congestive cardiac failure (CCF), including its definition, pathophysiology, clinical features, investigations, and management. CCF occurs when the heart muscle is weakened and cannot maintain adequate cardiac output. The pathophysiology involves changes in preload, afterload, and contractility that decrease cardiac output. Compensatory mechanisms initially help but later worsen symptoms. Clinically, CCF presents with dyspnea, edema, elevated JVP, hepatomegaly, and other signs. Investigations include BNP, ECG, echocardiogram. Management focuses on treating the underlying cause, reducing preload/afterload, and improving contractility. Diuretics, ACE inhibitors, beta
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
Venous circulation
This document discusses the physiology of the cardiovascular system with a focus on venous circulation. It describes the functions of veins including drainage of blood from the body to the heart, acting as blood reservoirs, and aiding in blood propulsion via the venous pump. Venous pressure is discussed including peripheral, central, and jugular venous pressure. Determinants of venous pressure like venous tone, skeletal muscle pump, and respiratory pump are explained. Factors affecting central venous pressure like gravity, blood volume, exercise, and respiration are also summarized. The document concludes with sections on venous pulsations, elevated jugular venous pressure, Kussmaul's sign, and venous hum.
Hypertensive heart disease (hhd)
Hypertensive heart disease (HHD) is a hypertrophic adaptive response of the heart to hypertension that can progress to myocardial dysfunction, cardiac dilatation, congestive heart failure, and sudden death if not controlled. The degree of hypertrophy varies depending on the underlying cause, ranging from 350-1000 grams. The pattern of hypertrophy also reflects the stimulus, with pressure overload causing a concentric thickening pattern and volume overload a dilation with increased ventricular diameter. Chronic cor pulmonale is characterized by a markedly dilated and hypertrophied right ventricle secondary to prolonged pulmonary hypertension from obstruction or compression of the lungs.
Cardiac tamponade
Cardiac tamponade is a condition caused by the accumulation of fluid in the pericardial sac, which surrounds the heart. Normally there is a small amount of fluid present, but too much fluid builds pressure and prevents the heart from filling properly. Symptoms include chest pain, difficulty breathing, and low blood pressure. The excess fluid must be drained through procedures like pericardiocentesis in order to relieve pressure on the heart and stabilize the patient. Left untreated, cardiac tamponade can cause loss of consciousness and sudden death due to insufficient blood flow.
Cardiology2472010
A 49-year-old male presented with syncope and was found to have cardiomyopathy with severely reduced ejection fraction less than 25% based on echocardiogram findings. Cardiac catheterization showed severe blockages of the left anterior descending and circumflex arteries. Despite a non-ischemic etiology, the patient was evaluated for an implantable cardioverter-defibrillator due to the reduced ejection fraction. A separate 33-year-old male presented with chest pain and was diagnosed with an anterior STEMI based on ECG findings.
Pericardial diseases
The document discusses various pericardial diseases including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade. It provides details on the anatomy and functions of the pericardium, pathophysiology, clinical features, diagnostic tests, and management of these conditions. Key points include that pericardial diseases can present with non-specific symptoms, clinical suspicion is important for diagnosis, and treatment depends on underlying etiology and presence of hemodynamic compromise. Differentiating constrictive pericarditis from restrictive cardiomyopathy is important as treatment approaches differ significantly.
Quiz 17 Diastolic Murmur
This document presents 17 clinical cases describing patients with various diastolic murmurs. For each case, it provides brief details about the patient's symptoms, examination findings including heart sounds and location of any murmurs. The murmurs vary in timing within diastole and location on the chest. Clinical clues are given that help identify the underlying cardiac abnormalities.
Circulation
Blood flow, pressure, and resistance are key components of circulation. Resistance depends on vessel length and diameter, with smaller diameters resulting in greater resistance. Blood pressure includes systolic, diastolic, and mean arterial pressures. The circulatory system is regulated through neural, chemical, and renal mechanisms to maintain homeostasis. Issues like hypotension, hypertension, and shock can occur if regulation is compromised.
Mitral stenosis (propeduetics)
Mitral stenosis is a narrowing of the mitral valve opening that blocks (obstructs) blood flow from the left atrium to the left ventricle. Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition. Mitral stenosis does not cause symptoms unless it is severe
acute Aortic regurge
1. Acute aortic regurgitation is a medical emergency that can result from conditions like infective endocarditis, aortic dissection, or trauma.
2. It leads to a sudden rise in left ventricular diastolic pressure and fall in cardiac output, often causing profound hypotension and cardiogenic shock.
3. Emergency aortic valve replacement or repair is usually required for severe acute aortic regurgitation, while temporary stabilization measures may be used if surgery faces delay.
Cardiac tamponade
Cardiac tamponade is a medical emergency caused by an accumulation of fluid in the pericardial space, which surrounds the heart. This increased fluid pressure restricts the heart's filling and reduces cardiac output. If untreated, cardiac tamponade is rapidly fatal. Diagnosis is made through physical exam findings, electrocardiogram, chest x-ray and echocardiogram. Pericardiocentesis, a procedure to drain the fluid via needle insertion, provides immediate relief and is lifesaving for cardiac tamponade. After the procedure, close monitoring is needed to watch for potential complications and recurrence of fluid buildup.
Constrictive pericarditis pathophysiology
This document discusses the pathophysiology of constrictive pericarditis (CCP). CCP is caused by a thickened and fibrotic pericardium that restricts heart filling. This leads to 4 key hemodynamic changes: 1) impaired diastolic filling, 2) dissociation of intrathoracic and intracardiac pressures with respiration, 3) excessive ventricular coupling, and 4) heart rate dependent filling. The thick pericardium equalizes pressures in all chambers and abruptly halts early diastolic filling. Inspiration decreases left ventricular filling while increasing right ventricular filling via septal shift. Expiration causes the opposite effect.
HF clinical presentation slides
Heart failure is a chronic condition where the heart cannot pump enough blood to meet the body's needs. It can be caused by conditions that overload the heart or damage heart muscles. Symptoms include dyspnea, edema, fatigue, and weakness. On physical exam, providers listen for S3 gallops and check for jugular vein distention and edema. Treatment focuses on lifestyle changes like diet and exercise as well as medications to lower blood pressure and edema like diuretics, ACE inhibitors, and beta-blockers. Regular exercise is important to increase cardiac efficiency and decrease energy wasted on heart contractions.
Conshock
Shock is defined as multi system organ hypoperfusion due to tissue hypoperfusion and can be caused by cardiogenic, hypovolemic, neurogenic, septic, or traumatic factors. The initial management of shock involves a rapid evaluation followed by resuscitation including oxygen supplementation, intravenous fluids, and monitoring of vital signs to determine the etiology and guide further treatment such as volume expansion, vasoactive drugs, antibiotics, or surgery. The overall goals of therapy are to restore adequate tissue perfusion and oxygen delivery through optimization of preload, cardiac contractility, and afterload.
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pericardial effusion, cardiac tamponade and myocardial rupture
consists of P.E,cardiac tamponade and myocardial rupture and describes their definitions, pathophysiologies, clinical manifestations, dx, medical-surgical mgt and nursing mgt
for more inquiries/feedback; gufuabdikadir96@gmail.com
Signs of aortic regurgitation
Signs of aortic regurgitation include light house sign, Landolfi's sign, Becker's sign, de Musset's sign, Muller's sign, Quincke's sign, Corrigan's sign, Locomotor brachii, collapsing pulse, Pulsus bisferiens, Traube's sign, Duroziez s sign, Hill's sign, Rosenbach’s-sign, Gerhardt’s sign. The severity of aortic regurgitation is indicated by the duration of the diastolic murmur, presence of bisferiens pulse, positive Hill's sign greater than 60 mm Hg, displaced apical impulse, Austin-Flint murmur
The document discusses the use of an intra-aortic balloon pump (IABP), including appropriate timing of inflation in the cardiac cycle, risks of premature or late deflation, and guidelines for weaning a patient from the device. It notes that the IABP has applications in cardiac failure, refractory angina, cardiogenic shock, and as a bridge to transplantation. Risks include limb ischemia, thrombosis, emboli, bleeding, and aortic complications. Weaning should occur over 24-48 hours with decreasing inotropic support and pump ratios monitored closely.
Aortic stenosis
Aortic stenosis is a narrowing of the aortic valve that obstructs blood flow from the left ventricle to the aorta. It can be caused by rheumatic heart disease or congenital issues. As the stenosis progresses, it increases left ventricular pressure and causes compensatory hypertrophy. Symptoms include dyspnea, dizziness, angina, and syncope. On examination, one may hear a crescendo-decrescendo murmur and feel a weak pulse. Echocardiography can measure valve area and gradients to diagnose and classify severity. Treatment options include medical management for symptoms or valve replacement surgery or TAVR for severe cases.
Aortic stenosis- Dr Shaz Pamangadan
1) Aortic stenosis occurs when the aortic valve narrows, obstructing blood flow from the heart into the aorta.
2) It has several causes, including congenital bicuspid valve issues, calcification of normal or rheumatic valves, and rarely atherosclerosis.
3) Symptomatic patients have a poor survival without valve obstruction relief, with average survival of 1-3 years after symptom onset. Asymptomatic patients have an excellent long-term prognosis but severity increases gradually over 10-15 years.
Tricuspid stenosis
This presentation contains details of clinical features, diagnosis and management of tricuspid stenosis
Aortic Stenosis
Aortic stenosis is a narrowing of the aorta caused by several factors such as rheumatic fever, atherosclerosis, or congenital malformations. It results in increased pressure and workload on the left ventricle, causing the ventricle to thicken and enlarge over time. If untreated, aortic stenosis can reduce blood flow to the heart and lead to angina, fainting, heart failure or sudden cardiac death. Diagnosis involves echocardiography, ECG and chest x-ray to detect the thickened aortic valve, enlarged heart chambers and diminished blood flow. Treatment options include medications to manage symptoms as well as surgical procedures to dilate or replace the stenotic aortic valve.
Congestive cardiac failure
This document provides information on congestive cardiac failure (CCF), including its definition, pathophysiology, clinical features, investigations, and management. CCF occurs when the heart muscle is weakened and cannot maintain adequate cardiac output. The pathophysiology involves changes in preload, afterload, and contractility that decrease cardiac output. Compensatory mechanisms initially help but later worsen symptoms. Clinically, CCF presents with dyspnea, edema, elevated JVP, hepatomegaly, and other signs. Investigations include BNP, ECG, echocardiogram. Management focuses on treating the underlying cause, reducing preload/afterload, and improving contractility. Diuretics, ACE inhibitors, beta
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
Venous circulation
This document discusses the physiology of the cardiovascular system with a focus on venous circulation. It describes the functions of veins including drainage of blood from the body to the heart, acting as blood reservoirs, and aiding in blood propulsion via the venous pump. Venous pressure is discussed including peripheral, central, and jugular venous pressure. Determinants of venous pressure like venous tone, skeletal muscle pump, and respiratory pump are explained. Factors affecting central venous pressure like gravity, blood volume, exercise, and respiration are also summarized. The document concludes with sections on venous pulsations, elevated jugular venous pressure, Kussmaul's sign, and venous hum.
Hypertensive heart disease (hhd)
Hypertensive heart disease (HHD) is a hypertrophic adaptive response of the heart to hypertension that can progress to myocardial dysfunction, cardiac dilatation, congestive heart failure, and sudden death if not controlled. The degree of hypertrophy varies depending on the underlying cause, ranging from 350-1000 grams. The pattern of hypertrophy also reflects the stimulus, with pressure overload causing a concentric thickening pattern and volume overload a dilation with increased ventricular diameter. Chronic cor pulmonale is characterized by a markedly dilated and hypertrophied right ventricle secondary to prolonged pulmonary hypertension from obstruction or compression of the lungs.
Cardiac tamponade
Cardiac tamponade is a condition caused by the accumulation of fluid in the pericardial sac, which surrounds the heart. Normally there is a small amount of fluid present, but too much fluid builds pressure and prevents the heart from filling properly. Symptoms include chest pain, difficulty breathing, and low blood pressure. The excess fluid must be drained through procedures like pericardiocentesis in order to relieve pressure on the heart and stabilize the patient. Left untreated, cardiac tamponade can cause loss of consciousness and sudden death due to insufficient blood flow.
Cardiology2472010
A 49-year-old male presented with syncope and was found to have cardiomyopathy with severely reduced ejection fraction less than 25% based on echocardiogram findings. Cardiac catheterization showed severe blockages of the left anterior descending and circumflex arteries. Despite a non-ischemic etiology, the patient was evaluated for an implantable cardioverter-defibrillator due to the reduced ejection fraction. A separate 33-year-old male presented with chest pain and was diagnosed with an anterior STEMI based on ECG findings.
Pericardial diseases
The document discusses various pericardial diseases including acute pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade. It provides details on the anatomy and functions of the pericardium, pathophysiology, clinical features, diagnostic tests, and management of these conditions. Key points include that pericardial diseases can present with non-specific symptoms, clinical suspicion is important for diagnosis, and treatment depends on underlying etiology and presence of hemodynamic compromise. Differentiating constrictive pericarditis from restrictive cardiomyopathy is important as treatment approaches differ significantly.
Quiz 17 Diastolic Murmur
This document presents 17 clinical cases describing patients with various diastolic murmurs. For each case, it provides brief details about the patient's symptoms, examination findings including heart sounds and location of any murmurs. The murmurs vary in timing within diastole and location on the chest. Clinical clues are given that help identify the underlying cardiac abnormalities.
Circulation
Blood flow, pressure, and resistance are key components of circulation. Resistance depends on vessel length and diameter, with smaller diameters resulting in greater resistance. Blood pressure includes systolic, diastolic, and mean arterial pressures. The circulatory system is regulated through neural, chemical, and renal mechanisms to maintain homeostasis. Issues like hypotension, hypertension, and shock can occur if regulation is compromised.
Mitral stenosis (propeduetics)
Mitral stenosis is a narrowing of the mitral valve opening that blocks (obstructs) blood flow from the left atrium to the left ventricle. Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition. Mitral stenosis does not cause symptoms unless it is severe
acute Aortic regurge
1. Acute aortic regurgitation is a medical emergency that can result from conditions like infective endocarditis, aortic dissection, or trauma.
2. It leads to a sudden rise in left ventricular diastolic pressure and fall in cardiac output, often causing profound hypotension and cardiogenic shock.
3. Emergency aortic valve replacement or repair is usually required for severe acute aortic regurgitation, while temporary stabilization measures may be used if surgery faces delay.
Cardiac tamponade
Cardiac tamponade is a medical emergency caused by an accumulation of fluid in the pericardial space, which surrounds the heart. This increased fluid pressure restricts the heart's filling and reduces cardiac output. If untreated, cardiac tamponade is rapidly fatal. Diagnosis is made through physical exam findings, electrocardiogram, chest x-ray and echocardiogram. Pericardiocentesis, a procedure to drain the fluid via needle insertion, provides immediate relief and is lifesaving for cardiac tamponade. After the procedure, close monitoring is needed to watch for potential complications and recurrence of fluid buildup.
Constrictive pericarditis pathophysiology
This document discusses the pathophysiology of constrictive pericarditis (CCP). CCP is caused by a thickened and fibrotic pericardium that restricts heart filling. This leads to 4 key hemodynamic changes: 1) impaired diastolic filling, 2) dissociation of intrathoracic and intracardiac pressures with respiration, 3) excessive ventricular coupling, and 4) heart rate dependent filling. The thick pericardium equalizes pressures in all chambers and abruptly halts early diastolic filling. Inspiration decreases left ventricular filling while increasing right ventricular filling via septal shift. Expiration causes the opposite effect.
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pericardial effusion, cardiac tamponade and myocardial rupture
pericardial effusion, cardiac tamponade and myocardial rupture
Similar to Shock
HF clinical presentation slides
Heart failure is a chronic condition where the heart cannot pump enough blood to meet the body's needs. It can be caused by conditions that overload the heart or damage heart muscles. Symptoms include dyspnea, edema, fatigue, and weakness. On physical exam, providers listen for S3 gallops and check for jugular vein distention and edema. Treatment focuses on lifestyle changes like diet and exercise as well as medications to lower blood pressure and edema like diuretics, ACE inhibitors, and beta-blockers. Regular exercise is important to increase cardiac efficiency and decrease energy wasted on heart contractions.
Conshock
Shock is defined as multi system organ hypoperfusion due to tissue hypoperfusion and can be caused by cardiogenic, hypovolemic, neurogenic, septic, or traumatic factors. The initial management of shock involves a rapid evaluation followed by resuscitation including oxygen supplementation, intravenous fluids, and monitoring of vital signs to determine the etiology and guide further treatment such as volume expansion, vasoactive drugs, antibiotics, or surgery. The overall goals of therapy are to restore adequate tissue perfusion and oxygen delivery through optimization of preload, cardiac contractility, and afterload.
SHOCK_2.ppt
This document discusses different types of shock, including their causes, pathophysiology, clinical features, diagnosis, and treatment. It defines shock as a life-threatening condition where inadequate perfusion leads to tissue hypoxia and organ damage. The main types of shock covered are hypovolemic, cardiogenic, obstructive, distributive (septic, anaphylactic, neurogenic), and their compensatory mechanisms. Effective treatment depends on identifying the specific cause of shock in each case.
Approach to paediatric shock dr jason
1. Shock is defined as inadequate tissue perfusion to meet metabolic demand and can be caused by hypovolemia, cardiac dysfunction, obstruction of blood flow, or inappropriate blood vessel dilation.
2. Clinical signs of shock include tachycardia, abnormal capillary refill time, weak pulses, hypotension, and altered mental status.
3. Management of shock involves optimizing oxygen delivery through fluid resuscitation, antibiotics, vasopressors, ventilation, and treating the underlying cause to increase blood pressure and tissue perfusion.
Shock
This document defines and describes the different types of shock:
1) Hypovolemic shock occurs when there is severe bleeding, fluid loss, or reduced circulating blood volume leading to decreased cardiac output and blood flow.
2) Cardiogenic shock results from heart failure or damage that prevents the heart from pumping effectively.
3) Septic shock is caused by an overwhelming systemic infection where toxic substances impair blood flow.
4) Anaphylactic shock involves an allergic reaction that causes blood vessel dilation and low blood pressure through histamine release.
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Cardiac examination
This document provides guidance on performing a cardiac examination, including examination of:
1. The general patient (e.g. build, position)
2. Specific areas (hands, head, neck, legs, abdomen, lungs) to examine signs like clubbing, edema, jugular vein distension
3. The local heart (palpation for enlarged chambers or thrills, auscultation to identify affected valves or sounds like murmurs, clicks)
It describes what to listen for at different auscultation sites and how heart sounds and splits may indicate different cardiac issues. Additional signs like S3 and S4 gallops or pericardial rubs are also covered.
shock
Shock is a life-threatening condition characterized by inadequate tissue perfusion and hypotension. The body responds to shock through sympathetic nervous system activation to increase heart rate, contractility and circulating volume. There are four main types of shock: hypovolemic from blood/fluid loss, cardiogenic from heart failure, distributive from vascular problems, and obstructive. Treatment focuses on treating the underlying cause, improving cardiac function, and restoring tissue perfusion through fluid resuscitation and inotropic support. Without treatment, shock can progress to multi-organ failure and death.
Cardiovascular cardiovascular cardiovascular cardiovascular
1. Infective endocarditis is an infection of the inner tissues of the heart, usually affecting the heart valves. It can be subacute or acute depending on the causative bacteria. Common causes include streptococci and staphylococci.
2. Risk factors include prosthetic heart valves, previous infective endocarditis, congenital heart disease, cardiac surgery or procedures on the heart, and intravenous drug use.
3. Treatment involves targeted antibiotic therapy for 4-6 weeks as well as prophylactic antibiotics for high-risk individuals before certain medical procedures to prevent infective endocarditis. Surgery may be needed for complications like heart failure, abscesses or an unstable prosthetic valve
Shock & Haemorrhage, Blood Transfusion, Blood Products
A very narrative discussion over Shock & Haemorrhage, Blood Transfusion, Blood Products which is presented in seminers. A concise guideline of a vast chapter.
Approach to a patient in shock
Shock is characterized by reduced systemic tissue perfusion and oxygen delivery, creating an imbalance between oxygen delivery and consumption. Prolonged oxygen deprivation can lead to cellular hypoxia and biochemical derangements. There are several types of shock including hypovolemic, cardiogenic, septic, neurogenic, and hypoadrenal shock. Mean arterial pressure depends on cardiac output and systemic vascular resistance. Parameters like lactate, blood pressure, heart rate, respiratory rate, urine output are used to classify shock into compensated, decompensated, and irreversible stages. Treatment involves identifying and treating the underlying cause while aggressively resuscitating with fluids and vasopressors.
Shock
This document discusses shock, including definitions, types, stages, assessment, and management. It defines shock as inadequate perfusion and oxygenation of cells. The main types of shock discussed are cardiogenic, obstructive, hypovolemic, and distributive. Assessment involves the ABCs with consideration of exposure for trauma. Management aims to optimize oxygen content, cardiac output, blood pressure, and regional blood flow. Case examples demonstrate application to patients with hemorrhagic, cardiogenic, septic, neurogenic, and pancreatitis-associated shock.
SHOCK.ppt
This document discusses shock and its pathophysiology. It begins by defining shock as inadequate perfusion leading to inadequate oxygen delivery to tissues. It then covers the stages of shock from the initial insult through compensatory mechanisms failing, leading to end organ damage and potential death. It discusses the different types of shock including cardiogenic, hypovolemic, neurogenic, and septic shock. The document provides details on cardiovascular physiology and the body's compensatory responses to maintain perfusion. It also discusses signs and symptoms of shock along with criteria for diagnosis and treatment approaches.
SHOCK.ppt
This document discusses shock and its pathophysiology. It begins by defining shock as inadequate perfusion leading to inadequate oxygen delivery to tissues. It then covers the stages of shock from the initial insult through compensatory mechanisms failing, leading to end organ damage and potential death. It discusses the different types of shock including cardiogenic, hypovolemic, neurogenic, and septic shock. The document provides details on cardiovascular physiology and the body's compensatory responses to maintain perfusion. It also discusses signs and symptoms of shock along with criteria for diagnosis and treatment approaches.
Exam Cvs 09.
This document provides an overview of a general exam related to the cardiovascular system. It describes aspects of the exam including inspection of the face, eyes, skin, bones and hands. It also covers assessment of breathing patterns, cyanosis, pulses, jugular venous pressure, precordial exam, auscultation of heart sounds and murmurs. The document contains detailed information on abnormal findings and their potential cardiovascular causes.
Cardiology
This document provides an overview of cardiology topics including the basic clinical cardiac exam, cardiac diagnostic tests, arrhythmias, ischemic heart disease, heart failure, cardiomyopathies, valvular heart disease, pericardial disease, syncope, commonly used cardiac therapeutics, and sample ECGs. It describes the functional classification scales used to assess cardiovascular disability, the components of the cardiac exam such as inspection, palpation, auscultation of heart sounds and murmurs, and evaluation of jugular venous pulsations. Various cardiac diagnostic tests are also summarized such as ECG, echocardiography, exercise testing, and nuclear imaging. Common cardiac conditions are reviewed including arrhythmias, ischemic heart disease
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shock.pptx
Shock is defined as a life-threatening condition where blood flow to organs is low, decreasing oxygen and nutrient delivery and waste removal. There are four main types of shock: hypovolemic from low blood volume, cardiogenic from low cardiac output despite adequate volume, distributive from low vascular resistance usually due to sepsis, and obstructive from outflow obstruction. Hypovolemic shock is caused by blood loss, fluid loss, or decreased intake and presents with tachycardia, hypotension, and decreased urine output. Initial management focuses on restoring circulating volume through fluid resuscitation and controlling any bleeding. Cardiogenic shock presents with cool skin, tachypnea, hypotension, and altered mental status and
Heart failure
Heart failure is a condition where the ventricles cannot maintain adequate cardiac output to meet metabolic demands. It results from structural or functional impairments of ventricular filling or ejection. Compensatory mechanisms initially help but later become counterproductive, causing manifestations like pulmonary congestion and increased oxygen demand. Heart failure is classified based on location (left, right, bi-ventricular), acute vs chronic time course, low vs high cardiac output, systolic vs diastolic dysfunction, and forward vs backward heart failure. Management involves treating underlying causes and using medications like ACE inhibitors, beta-blockers, diuretics, and aldosterone antagonists based on functional class and symptoms.
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- 1. High JVP (high RH preload; normal systemic bloo d volume) Extremeties Warm (pathological vasodilation ↓ afterload, ↓ BP) 1. Distributive shock Low JVP (low RH preload; low systemic blood volume) Shock Inadequate tissue perfusion to meet O2, nutrient requirements anaerobic resp’n, ↑ lactate end-organ damage Causes: Anaphylaxis, Sepsis , Neurogenic, Adrenal Insufficiency Main problem: generalized pathologic (often inflammatory) vasodilation ↓ afterload, ↓ BP (reduces tissue perfusion) 3. Cardiogenic Shock Primary problem: LV failure (MI, dissection, or dysrhythmia ↓ contractility, ↓ heart rate/ rhythm ↓ CO, ↓ BP . Also, Blood accumulate in L-heart, ↑ L preload; backs up into lungs/veins, ↑ JVP) Compensation: 1) Peripheral vasoconstriction (divert blood to vital organs & ↑ afterload cool extremeties) 2) ↑ HR (to ↑ CO) Features: -history -lung crackles (Left H. issue) -S3, murmurs -dysrhythmia (palpitations) 4. Obstructive Shock Primary problem: PE , Tension PTX or tamponade obstructs blood flow from R to L heart ↓ L heart pre-load ↓ SV ↓ BP. Also, ↑ RH afterload RH failure ↑ RH preload/JVP Compensation: 1) Sytemic Vasoconstriction (↑ LH afterload) to ↑BP 2) ↑ HR (to ↑ CO) Features: -history, Plethoric facies (red face) -no lung crackles -Muffled HS Acute Tx: Tx underlying cause! 2. Hypovolemic Shock Primary problem: massive bleeding ↓ preload Compensation: 1) Peripheral vasoconstriction (to divert blood back to vital organs & ↑ afterload cool extremeties) 2) ↑ contractility (to ↑ CO) 3) ↑ HR (to ↑ CO) Features: -History (NSAID ingestion, H. pylori, alcohol/wretching, bleeding) -livedo reticularis, dry skin/mucus membranes, flat JVP Extremeties Cool (compensatory vasoconstriction to ↑ systemic afterload) Compensation: 1) ↑ contractility (to ↑ CO) 2) ↑ HR (to ↑ CO) Features: Appropriate history (i.e. infection), Bounding pulses (large pulse pressure), warm extremeties, tachycardic; sources of infection Tension Pneumothorax Unequal unilateral breath sounds Pulmonary Embolism Cardiac Tamponade ↓ Heart sounds High JVP Hypotension Pts in shock are often hypotensive, but not always! (i.e. in young people, & in chronic hypertensive pts) 2+ types of shock can occur simultaneously! Echo, or Pulmonary Artery Catheters (PACs) BP = (HR x SV) x SVR = (rate, rhythm) x (contractility, preload) x afterload (Disturbance of any factor inadequate perfusion) Ways of analysing each factor: JVP (filling status) Pulse, apex, ECG PAC, Warmth of extremeties ABG, O2 sat If 1 component of BP goes array, body compensates by altering other components! Shock and end-organ damage is self-perpetuating! “Golden interval” for intervention in shock (like in trauma, stroke, or MIs): Early intervention is most effective. Decompensated Distributive Shock can look like Hypovolemic Shock: in Sepsis, inflammation causes loss of serum from blood into tissues, also ↓ heart function, esp in kids. Compensatory mechanisms in all causes of shock: 1) ↑ HR (to ↑ CO), 2) ↑ RR (to counterac anaerobic respiration, 3) blood diverted from non- essential places (skin) to brain, heart, lungs, kidneys. Yan Yu, 2012 (www.yanyu.ca)