Stroke volume and cardiac output
•Download as PPTX, PDF•
5 likes•2,699 views
This document discusses using echocardiography to measure stroke volume and cardiac output in ICU patients. It explains that stroke volume and cardiac output can provide early warning of circulation failure beyond what mean arterial pressure indicates. The document outlines how to obtain echocardiography images of the heart and left ventricle outflow tract to measure stroke volume using pulsed-wave Doppler. Stroke volume combined with heart rate can then be used to calculate cardiac output. Measuring stroke volume allows assessment of the effectiveness of fluid challenges, inotropes, or other therapeutic maneuvers.
Report
Share
Report
Share
Recommended
Cath hemodynamics vir
The document summarizes key aspects of cardiac catheterization and hemodynamic data collection. It describes the normal cardiac cycle, pressure measurement systems, normal pressure waveforms, methods to measure cardiac output like thermodilution and Fick, how to evaluate valvular stenosis and regurgitation, determine vascular resistance and shunts. Specific details are provided on assessing aortic stenosis, mitral stenosis, right-sided valves and quantifying regurgitant fractions. Oxygen saturation analysis and Fick principles are outlined for shunt determinations.
CONTRAST ECHOCARDIOGRAPHY
Contrast echocardiography uses microbubble ultrasound contrast agents to improve image quality. These microbubbles remain in the intravascular space and allow for assessment of cardiac structure, function, and perfusion. Second generation contrast agents use an inert gas encapsulated by albumin or phospholipid shells. They interact with ultrasound by reflecting at fundamental frequencies and resonating to produce harmonic frequencies. Continuous infusion provides steady contrast levels needed for perfusion assessment. Contrast echocardiography is a non-invasive technique that improves evaluation of the heart.
Non infarction Q waves
Non infarction Q waves
Precise guide for Allied Health Science Students especially cardiac specialty students, DGNM, B.Sc Nursing & M.Sc Nursing Students regarding Non Infarction Q waves
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
Echo assessment of mitral regurgitation
This document provides an overview of echocardiographic assessment of mitral regurgitation. It describes the anatomy of the mitral valve including the leaflets, annulus, chordae, and papillary muscles. It discusses Carpentier's functional classification system for describing the mechanism of mitral valve dysfunction. Methods for assessing severity are covered, including color flow imaging, continuous wave Doppler, vena contracta width, proximal isovelocity surface area, and volumetric assessment. Key points are made about evaluating jet direction, duration, and velocity in context of blood pressure. The importance of assessing left ventricular and left atrial size and function is also highlighted.
Coronary anatomy and angiographic views
The document discusses the history, anatomy, angiographic views, variations, and clinical relevance of coronary arteries. It provides a detailed overview of the typical anatomy and branches of the left main, left anterior descending, left circumflex, and right coronary arteries. It also describes common anatomical variations and anomalies seen in coronary arteries and their clinical implications. Angiographic classification methods for different coronary artery segments are presented.
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.
Echo assessment of aortic stenosis
The document provides an overview of echocardiographic assessment of aortic valve stenosis. It describes the normal aortic valve anatomy and imaging windows used to visualize the valve. Common causes of aortic stenosis including bicuspid aortic valve and calcific stenosis are discussed. Methods for Doppler assessment of aortic stenosis including peak velocity, mean gradient, and valve area via the continuity equation are summarized. Limitations of these assessment techniques are also noted.
Recommended
Cath hemodynamics vir
The document summarizes key aspects of cardiac catheterization and hemodynamic data collection. It describes the normal cardiac cycle, pressure measurement systems, normal pressure waveforms, methods to measure cardiac output like thermodilution and Fick, how to evaluate valvular stenosis and regurgitation, determine vascular resistance and shunts. Specific details are provided on assessing aortic stenosis, mitral stenosis, right-sided valves and quantifying regurgitant fractions. Oxygen saturation analysis and Fick principles are outlined for shunt determinations.
CONTRAST ECHOCARDIOGRAPHY
Contrast echocardiography uses microbubble ultrasound contrast agents to improve image quality. These microbubbles remain in the intravascular space and allow for assessment of cardiac structure, function, and perfusion. Second generation contrast agents use an inert gas encapsulated by albumin or phospholipid shells. They interact with ultrasound by reflecting at fundamental frequencies and resonating to produce harmonic frequencies. Continuous infusion provides steady contrast levels needed for perfusion assessment. Contrast echocardiography is a non-invasive technique that improves evaluation of the heart.
Non infarction Q waves
Non infarction Q waves
Precise guide for Allied Health Science Students especially cardiac specialty students, DGNM, B.Sc Nursing & M.Sc Nursing Students regarding Non Infarction Q waves
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
Echo assessment of mitral regurgitation
This document provides an overview of echocardiographic assessment of mitral regurgitation. It describes the anatomy of the mitral valve including the leaflets, annulus, chordae, and papillary muscles. It discusses Carpentier's functional classification system for describing the mechanism of mitral valve dysfunction. Methods for assessing severity are covered, including color flow imaging, continuous wave Doppler, vena contracta width, proximal isovelocity surface area, and volumetric assessment. Key points are made about evaluating jet direction, duration, and velocity in context of blood pressure. The importance of assessing left ventricular and left atrial size and function is also highlighted.
Coronary anatomy and angiographic views
The document discusses the history, anatomy, angiographic views, variations, and clinical relevance of coronary arteries. It provides a detailed overview of the typical anatomy and branches of the left main, left anterior descending, left circumflex, and right coronary arteries. It also describes common anatomical variations and anomalies seen in coronary arteries and their clinical implications. Angiographic classification methods for different coronary artery segments are presented.
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.
Echo assessment of aortic stenosis
The document provides an overview of echocardiographic assessment of aortic valve stenosis. It describes the normal aortic valve anatomy and imaging windows used to visualize the valve. Common causes of aortic stenosis including bicuspid aortic valve and calcific stenosis are discussed. Methods for Doppler assessment of aortic stenosis including peak velocity, mean gradient, and valve area via the continuity equation are summarized. Limitations of these assessment techniques are also noted.
Doppler echocardiography
Doppler echocardiography uses the Doppler effect to analyze the velocity and direction of blood flow. There are several Doppler modalities used in cardiac evaluation including continuous wave Doppler, pulsed wave Doppler, and color flow Doppler. Continuous wave Doppler measures very high velocities, pulsed wave Doppler samples local low velocities, and color flow Doppler visually displays velocities using color scales. The Nyquist limit defines the maximum detectable velocity and avoiding aliasing. Tissue Doppler also evaluates myocardial velocities. The Bernoulli equation relates velocity and pressure gradients which allows Doppler to estimate valve pressures.
Tissue doppler Echocardiography (TDE)
Tissue Doppler echocardiography allows assessment of myocardial motion using Doppler ultrasound. It uses frequency shifts of ultrasound waves to calculate myocardial velocity, focusing on lower velocities than blood flow Doppler. There are two techniques: pulsed TDE uses a sample volume gate while color-coded TDE uses autocorrelation to display multigated velocity data superimposed on images. TDE is useful for evaluating systolic and diastolic left ventricular function by measuring velocities of the mitral annulus, and can help distinguish conditions like constrictive pericarditis from restrictive cardiomyopathy.
Diastolic dysfunction
This document discusses the echocardiographic assessment of diastolic dysfunction. It outlines key parameters used to evaluate diastolic function including mitral inflow patterns, tissue Doppler imaging of mitral annular velocities, and pulmonary venous flow. Normal values for these parameters are provided. Guidelines for grading diastolic dysfunction according to the 2016 ASE/EACVI guidelines are presented. Special considerations for evaluating diastolic function in conditions like HCM, mitral stenosis, mitral regurgitation, and atrial fibrillation are also reviewed. Novel indices using speckle tracking echocardiography to assess diastolic function are mentioned.
LEFT HEART CATHETERIZATION
This document provides an overview of cardiac catheterization procedures. It discusses indications, contraindications, techniques, views obtained, and interpretation of pressure waveforms. Key points include that cardiac catheterization guides treatment decisions by measuring pressures, outputs, and obtaining images. It is now often used therapeutically for procedures like angioplasty and device closures. The document outlines patient preparation, access methods, catheters used, views obtained, and complications that can occur.
Tissue doppler imaging
Tissue Doppler Imaging (TDI) provides low velocity, high amplitude signals from the myocardium that can be used to assess systolic and diastolic function. TDI utilizes pulsed wave and color Doppler techniques to measure peak myocardial velocities. The E/E' ratio, where E is transmitral early diastolic velocity and E' is early diastolic mitral annular velocity, correlates well with left ventricular filling pressures and can help distinguish normal from elevated pressures. TDI parameters are useful for evaluating global and regional systolic function, diastolic function, ischemia, and viability as well as distinguishing between restrictive cardiomyopathy and constrictive pericarditis.
Treadmill test (TMT)
Exercise testing is a noninvasive tool to evaluate the cardiovascular system's response to stress from exercise. During exercise, the body's metabolic rate and cardiac output increase substantially, placing high demands on the cardiopulmonary system. This makes exercise an effective way to assess cardiac function and perfusion. Various protocols exist for exercise testing using treadmills, bicycles, or other devices, with different protocols suited for evaluating patients with different cardiovascular conditions or exercise capacities. Careful analysis of electrocardiogram changes during and after exercise can provide information about myocardial ischemia.
ECG ARTIFACTS AND PITFALLS
This document discusses ECG artifacts and pitfalls in interpretation. It outlines 10 commandments for proper ECG acquisition to avoid artifacts. Artifacts are classified as internal (physiological) or external (non-physiological). Common artifacts include limb and precordial lead reversals, tremor artifact, computer averaging errors, and electromagnetic interference. Differentiating artifacts from true arrhythmias like ventricular tachycardia is important. Characteristics that can help differentiate include absence of hemodynamic effects, normal complexes within the artifact, and association with movement. Proper electrode placement and equipment grounding can help reduce artifact occurrence.
Echo assessment of Aortic Regurgitation
Identification, etiology, qualitative and quantitative assessment of severity of AR by Echocardiography
Dobutamine stress echocardiography
This document summarizes dobutamine stress echocardiography (DSE). Key points include:
- DSE uses the drug dobutamine to simulate exercise and increase heart rate, contractility, and myocardial oxygen demand to detect ischemia.
- It is useful for evaluating ischemia, viability, and valvular dysfunction in patients unable to exercise.
- The document reviews the DSE protocol, interpretation of wall motion abnormalities, indications, side effects, and applications for assessing ischemic heart disease, viability, valvular stenosis like mitral and aortic stenosis, and pulmonary hypertension.
Left ventricular pressure tracings
1) Pressure tracing of the left ventricle involves using fluid-filled catheters connected to pressure transducers to record intracardiac pressures. Factors such as catheter size, damping, and natural frequency determine recording quality.
2) Sources of error in pressure measurements include catheter whip, end-pressure artifacts, and deterioration of frequency response. Invasive monitoring is useful for evaluating conditions like aortic stenosis and mitral stenosis when noninvasive data is discrepant or unclear.
3) Distinguishing constrictive pericarditis from restrictive cardiomyopathy involves assessing ventricular interdependence, pulmonary pressures, and left ventricular pressure tracings. Hemodynamic data aids in diagnosis and management of many conditions.
Contrast echocardiography
Contrast echocardiography uses microbubble contrast agents to improve echocardiographic image quality and assess cardiac structures and function. Second-generation agents can pass through the lungs to opacify the left ventricle. Clinical applications include detecting shunts, assessing ventricular function and volumes, guiding procedures like alcohol ablation, and evaluating perfusion and viability. Optimal settings enhance microbubble signals, like harmonic imaging and intermittent pulses. Contrast is useful when images are suboptimal and helps evaluate many conditions.
Lv systolic function
Left ventricular systolic function can be assessed through several echocardiographic parameters such as ejection fraction, fractional shortening, mitral annular plane systolic excursion, tissue Doppler imaging, and more recently, deformation imaging including global longitudinal strain. Ejection fraction is considered the gold standard measurement but requires obtaining left ventricular volumes, while fractional shortening and mitral annular plane systolic excursion provide simpler alternatives. Deformation imaging such as global longitudinal strain provides a sensitive measure of subclinical changes in systolic function.
Left ventricular diastolic dysfunction in echocardiography
Left ventricular diastolic dysfunction refers to the heart's inability to properly relax and fill during diastole. It can be caused by primary myocardial diseases like cardiomyopathy, hypertension, or secondary issues like aortic stenosis. Diagnosis involves evaluating left ventricular mass, dimensions, and function using 2D echocardiography, Doppler ultrasound to assess mitral inflow and pulmonary vein patterns, and tissue Doppler imaging of mitral annular motion. Diastolic dysfunction is graded from mild to severe based on these evaluation findings.
Artifacts in echocardiography
1. Artifacts in echocardiography can result in structures appearing that are not present, failing to visualize structures that are, or images that differ in size or shape from reality.
2. Common artifacts include acoustic shadowing from strong reflectors, reverberations between reflectors, beam width issues, range ambiguity, and Doppler artifacts like velocity underestimation and aliasing.
3. Optimizing the ultrasound system settings, changing the acoustic window or transducer position, and in some cases using transesophageal echocardiography can help reduce many artifact types. Proper recognition of artifacts is important to avoid misdiagnosis.
Aortic stenosis - Echocardiography
This document summarizes the evaluation of aortic valve stenosis using echocardiography. It describes the normal aortic valve anatomy and various types of aortic valve stenosis including calcific, bicuspid, rheumatic, and supravalvular or subvalvular stenosis. Doppler echocardiography is used to evaluate aortic valve stenosis severity based on valve area, mean gradient, and peak jet velocity. Stress echocardiography with dobutamine can help distinguish true severe from pseudo-severe low-flow, low-gradient aortic stenosis.
Stress echocardiography
Stress echocardiography uses ultrasound imaging during exercise or pharmacologic stress testing to detect ischemia-induced changes in heart wall motion. It has several advantages over nuclear stress testing including better visualization of cardiac structures and no radiation exposure. Various stress agents can be used including exercise, dobutamine, dipyridamole, and adenosine. Detection of new or worsening wall motion abnormalities or improvement after revascularization indicates viable myocardium. Factors like image quality, timing of acquisition, and operator experience can impact test sensitivity. Stress echo is an established technique for diagnosing coronary artery disease and assessing myocardial viability.
M mode echo
This document discusses M-mode echocardiography, including its physics, applications, and findings. M-mode provides high temporal resolution to evaluate cardiac structure movement and timing. It can be used to assess valves, walls, intervals, and morphology. Examples are given of M-mode findings in various cardiac pathologies at the mitral, aortic, pulmonary, and tricuspid valves as well as the left ventricle. Measurements like fractional shortening and ejection fraction are also reviewed.
cath Lab Hemoduhynamic
This document discusses hemodynamic principles and various cardiac pressures measured in the circulatory system. It begins by explaining how electrical activity leads to mechanical functions that generate pressure waves. It then discusses how to measure and interpret pressures in different parts of the heart including the aorta, pulmonary artery, right and left ventricles, and right atrium. Factors that influence pressures and common abnormalities are provided. Diagrams of normal pressure waveforms are displayed. The document concludes by defining pulmonary and systemic vascular resistances.
Contrast Echocardiography
This document discusses contrast echocardiography, including the mechanism by which microbubble contrast agents improve echocardiographic imaging. Ideal contrast agents are described as being safe, metabolically inert, long-lasting, strong sound reflectors that are small enough to pass through capillaries. Several FDA-approved second generation contrast agents are mentioned along with their shell materials and gases. Optimal echocardiographic settings for contrast imaging are outlined. Clinical applications of contrast echocardiography include assessing shunts, venous anomalies, and leaks. Examples of its use in specific cases are provided.
Stress echocardiography/Dobutamine stress echocardiography
Stress echocardiography combines echocardiography with physical, pharmacological, or electrical stress to effectively evaluate for myocardial ischemia. It is used to screen for coronary artery disease and identify affected coronary territories. Stress echocardiography can also differentiate viable myocardium from scarred tissue and provides important prognostic information after myocardial infarction and before noncardiac surgery. Dobutamine stress echocardiography is widely used to assess viable myocardium while exercise stress echocardiography is preferred when possible due to its safety. Stress echocardiography techniques are safe and relatively inexpensive options for evaluating myocardial ischemia and viability.
hemodynamic in cath lab: aortic stenosis and hocm
1) Cardiac catheterization can provide key information about aortic stenosis including transvalvular pressure gradients, the level of stenosis, and estimation of valve area.
2) Low-flow, low-gradient aortic stenosis can be further classified as either having a decreased ejection fraction or a paradoxically normal ejection fraction.
3) In hypertrophic cardiomyopathy, cardiac catheterization can identify dynamic intraventricular pressure gradients that may only be provoked with maneuvers like the Valsalva maneuver.
Aortic regurgitation pathophysiology
This document discusses the pathophysiology, etiology, clinical presentation, investigations, and management of aortic regurgitation. Key points include:
- Aortic regurgitation results in both volume and pressure overload on the left ventricle, leading to eccentric and concentric hypertrophy.
- Patients may remain asymptomatic for decades due to compensatory mechanisms, but some eventually develop left ventricular systolic dysfunction and heart failure symptoms.
- Examination may reveal a low diastolic blood pressure, wide pulse pressure, displaced apical impulse, and holodiastolic murmur.
- Echocardiography can quantify the degree of regurgitation and assess ventricular size and function.
More Related Content
What's hot
Doppler echocardiography
Doppler echocardiography uses the Doppler effect to analyze the velocity and direction of blood flow. There are several Doppler modalities used in cardiac evaluation including continuous wave Doppler, pulsed wave Doppler, and color flow Doppler. Continuous wave Doppler measures very high velocities, pulsed wave Doppler samples local low velocities, and color flow Doppler visually displays velocities using color scales. The Nyquist limit defines the maximum detectable velocity and avoiding aliasing. Tissue Doppler also evaluates myocardial velocities. The Bernoulli equation relates velocity and pressure gradients which allows Doppler to estimate valve pressures.
Tissue doppler Echocardiography (TDE)
Tissue Doppler echocardiography allows assessment of myocardial motion using Doppler ultrasound. It uses frequency shifts of ultrasound waves to calculate myocardial velocity, focusing on lower velocities than blood flow Doppler. There are two techniques: pulsed TDE uses a sample volume gate while color-coded TDE uses autocorrelation to display multigated velocity data superimposed on images. TDE is useful for evaluating systolic and diastolic left ventricular function by measuring velocities of the mitral annulus, and can help distinguish conditions like constrictive pericarditis from restrictive cardiomyopathy.
Diastolic dysfunction
This document discusses the echocardiographic assessment of diastolic dysfunction. It outlines key parameters used to evaluate diastolic function including mitral inflow patterns, tissue Doppler imaging of mitral annular velocities, and pulmonary venous flow. Normal values for these parameters are provided. Guidelines for grading diastolic dysfunction according to the 2016 ASE/EACVI guidelines are presented. Special considerations for evaluating diastolic function in conditions like HCM, mitral stenosis, mitral regurgitation, and atrial fibrillation are also reviewed. Novel indices using speckle tracking echocardiography to assess diastolic function are mentioned.
LEFT HEART CATHETERIZATION
This document provides an overview of cardiac catheterization procedures. It discusses indications, contraindications, techniques, views obtained, and interpretation of pressure waveforms. Key points include that cardiac catheterization guides treatment decisions by measuring pressures, outputs, and obtaining images. It is now often used therapeutically for procedures like angioplasty and device closures. The document outlines patient preparation, access methods, catheters used, views obtained, and complications that can occur.
Tissue doppler imaging
Tissue Doppler Imaging (TDI) provides low velocity, high amplitude signals from the myocardium that can be used to assess systolic and diastolic function. TDI utilizes pulsed wave and color Doppler techniques to measure peak myocardial velocities. The E/E' ratio, where E is transmitral early diastolic velocity and E' is early diastolic mitral annular velocity, correlates well with left ventricular filling pressures and can help distinguish normal from elevated pressures. TDI parameters are useful for evaluating global and regional systolic function, diastolic function, ischemia, and viability as well as distinguishing between restrictive cardiomyopathy and constrictive pericarditis.
Treadmill test (TMT)
Exercise testing is a noninvasive tool to evaluate the cardiovascular system's response to stress from exercise. During exercise, the body's metabolic rate and cardiac output increase substantially, placing high demands on the cardiopulmonary system. This makes exercise an effective way to assess cardiac function and perfusion. Various protocols exist for exercise testing using treadmills, bicycles, or other devices, with different protocols suited for evaluating patients with different cardiovascular conditions or exercise capacities. Careful analysis of electrocardiogram changes during and after exercise can provide information about myocardial ischemia.
ECG ARTIFACTS AND PITFALLS
This document discusses ECG artifacts and pitfalls in interpretation. It outlines 10 commandments for proper ECG acquisition to avoid artifacts. Artifacts are classified as internal (physiological) or external (non-physiological). Common artifacts include limb and precordial lead reversals, tremor artifact, computer averaging errors, and electromagnetic interference. Differentiating artifacts from true arrhythmias like ventricular tachycardia is important. Characteristics that can help differentiate include absence of hemodynamic effects, normal complexes within the artifact, and association with movement. Proper electrode placement and equipment grounding can help reduce artifact occurrence.
Echo assessment of Aortic Regurgitation
Identification, etiology, qualitative and quantitative assessment of severity of AR by Echocardiography
Dobutamine stress echocardiography
This document summarizes dobutamine stress echocardiography (DSE). Key points include:
- DSE uses the drug dobutamine to simulate exercise and increase heart rate, contractility, and myocardial oxygen demand to detect ischemia.
- It is useful for evaluating ischemia, viability, and valvular dysfunction in patients unable to exercise.
- The document reviews the DSE protocol, interpretation of wall motion abnormalities, indications, side effects, and applications for assessing ischemic heart disease, viability, valvular stenosis like mitral and aortic stenosis, and pulmonary hypertension.
Left ventricular pressure tracings
1) Pressure tracing of the left ventricle involves using fluid-filled catheters connected to pressure transducers to record intracardiac pressures. Factors such as catheter size, damping, and natural frequency determine recording quality.
2) Sources of error in pressure measurements include catheter whip, end-pressure artifacts, and deterioration of frequency response. Invasive monitoring is useful for evaluating conditions like aortic stenosis and mitral stenosis when noninvasive data is discrepant or unclear.
3) Distinguishing constrictive pericarditis from restrictive cardiomyopathy involves assessing ventricular interdependence, pulmonary pressures, and left ventricular pressure tracings. Hemodynamic data aids in diagnosis and management of many conditions.
Contrast echocardiography
Contrast echocardiography uses microbubble contrast agents to improve echocardiographic image quality and assess cardiac structures and function. Second-generation agents can pass through the lungs to opacify the left ventricle. Clinical applications include detecting shunts, assessing ventricular function and volumes, guiding procedures like alcohol ablation, and evaluating perfusion and viability. Optimal settings enhance microbubble signals, like harmonic imaging and intermittent pulses. Contrast is useful when images are suboptimal and helps evaluate many conditions.
Lv systolic function
Left ventricular systolic function can be assessed through several echocardiographic parameters such as ejection fraction, fractional shortening, mitral annular plane systolic excursion, tissue Doppler imaging, and more recently, deformation imaging including global longitudinal strain. Ejection fraction is considered the gold standard measurement but requires obtaining left ventricular volumes, while fractional shortening and mitral annular plane systolic excursion provide simpler alternatives. Deformation imaging such as global longitudinal strain provides a sensitive measure of subclinical changes in systolic function.
Left ventricular diastolic dysfunction in echocardiography
Left ventricular diastolic dysfunction refers to the heart's inability to properly relax and fill during diastole. It can be caused by primary myocardial diseases like cardiomyopathy, hypertension, or secondary issues like aortic stenosis. Diagnosis involves evaluating left ventricular mass, dimensions, and function using 2D echocardiography, Doppler ultrasound to assess mitral inflow and pulmonary vein patterns, and tissue Doppler imaging of mitral annular motion. Diastolic dysfunction is graded from mild to severe based on these evaluation findings.
Artifacts in echocardiography
1. Artifacts in echocardiography can result in structures appearing that are not present, failing to visualize structures that are, or images that differ in size or shape from reality.
2. Common artifacts include acoustic shadowing from strong reflectors, reverberations between reflectors, beam width issues, range ambiguity, and Doppler artifacts like velocity underestimation and aliasing.
3. Optimizing the ultrasound system settings, changing the acoustic window or transducer position, and in some cases using transesophageal echocardiography can help reduce many artifact types. Proper recognition of artifacts is important to avoid misdiagnosis.
Aortic stenosis - Echocardiography
This document summarizes the evaluation of aortic valve stenosis using echocardiography. It describes the normal aortic valve anatomy and various types of aortic valve stenosis including calcific, bicuspid, rheumatic, and supravalvular or subvalvular stenosis. Doppler echocardiography is used to evaluate aortic valve stenosis severity based on valve area, mean gradient, and peak jet velocity. Stress echocardiography with dobutamine can help distinguish true severe from pseudo-severe low-flow, low-gradient aortic stenosis.
Stress echocardiography
Stress echocardiography uses ultrasound imaging during exercise or pharmacologic stress testing to detect ischemia-induced changes in heart wall motion. It has several advantages over nuclear stress testing including better visualization of cardiac structures and no radiation exposure. Various stress agents can be used including exercise, dobutamine, dipyridamole, and adenosine. Detection of new or worsening wall motion abnormalities or improvement after revascularization indicates viable myocardium. Factors like image quality, timing of acquisition, and operator experience can impact test sensitivity. Stress echo is an established technique for diagnosing coronary artery disease and assessing myocardial viability.
M mode echo
This document discusses M-mode echocardiography, including its physics, applications, and findings. M-mode provides high temporal resolution to evaluate cardiac structure movement and timing. It can be used to assess valves, walls, intervals, and morphology. Examples are given of M-mode findings in various cardiac pathologies at the mitral, aortic, pulmonary, and tricuspid valves as well as the left ventricle. Measurements like fractional shortening and ejection fraction are also reviewed.
cath Lab Hemoduhynamic
This document discusses hemodynamic principles and various cardiac pressures measured in the circulatory system. It begins by explaining how electrical activity leads to mechanical functions that generate pressure waves. It then discusses how to measure and interpret pressures in different parts of the heart including the aorta, pulmonary artery, right and left ventricles, and right atrium. Factors that influence pressures and common abnormalities are provided. Diagrams of normal pressure waveforms are displayed. The document concludes by defining pulmonary and systemic vascular resistances.
Contrast Echocardiography
This document discusses contrast echocardiography, including the mechanism by which microbubble contrast agents improve echocardiographic imaging. Ideal contrast agents are described as being safe, metabolically inert, long-lasting, strong sound reflectors that are small enough to pass through capillaries. Several FDA-approved second generation contrast agents are mentioned along with their shell materials and gases. Optimal echocardiographic settings for contrast imaging are outlined. Clinical applications of contrast echocardiography include assessing shunts, venous anomalies, and leaks. Examples of its use in specific cases are provided.
Stress echocardiography/Dobutamine stress echocardiography
Stress echocardiography combines echocardiography with physical, pharmacological, or electrical stress to effectively evaluate for myocardial ischemia. It is used to screen for coronary artery disease and identify affected coronary territories. Stress echocardiography can also differentiate viable myocardium from scarred tissue and provides important prognostic information after myocardial infarction and before noncardiac surgery. Dobutamine stress echocardiography is widely used to assess viable myocardium while exercise stress echocardiography is preferred when possible due to its safety. Stress echocardiography techniques are safe and relatively inexpensive options for evaluating myocardial ischemia and viability.
What's hot (20)
Left ventricular diastolic dysfunction in echocardiography
Left ventricular diastolic dysfunction in echocardiography
Stress echocardiography/Dobutamine stress echocardiography
Stress echocardiography/Dobutamine stress echocardiography
Similar to Stroke volume and cardiac output
hemodynamic in cath lab: aortic stenosis and hocm
1) Cardiac catheterization can provide key information about aortic stenosis including transvalvular pressure gradients, the level of stenosis, and estimation of valve area.
2) Low-flow, low-gradient aortic stenosis can be further classified as either having a decreased ejection fraction or a paradoxically normal ejection fraction.
3) In hypertrophic cardiomyopathy, cardiac catheterization can identify dynamic intraventricular pressure gradients that may only be provoked with maneuvers like the Valsalva maneuver.
Aortic regurgitation pathophysiology
This document discusses the pathophysiology, etiology, clinical presentation, investigations, and management of aortic regurgitation. Key points include:
- Aortic regurgitation results in both volume and pressure overload on the left ventricle, leading to eccentric and concentric hypertrophy.
- Patients may remain asymptomatic for decades due to compensatory mechanisms, but some eventually develop left ventricular systolic dysfunction and heart failure symptoms.
- Examination may reveal a low diastolic blood pressure, wide pulse pressure, displaced apical impulse, and holodiastolic murmur.
- Echocardiography can quantify the degree of regurgitation and assess ventricular size and function.
VSD ECHO.pptx
This document discusses the echocardiographic evaluation of ventricular septal defects (VSDs). It describes the use of 2D, color Doppler, and Doppler echocardiography to identify and characterize VSDs based on location, size, and hemodynamics. Key aspects that can be assessed include the presence, number and size of defects, ventricular sizes and function, shunt direction and quantity, and pulmonary hypertension. Post-repair, echocardiography can check for residual shunts, patches, and evaluate ventricular function.
Physiology
This document discusses coronary circulation and the factors that influence coronary blood flow. It provides details on the physiologic anatomy of the coronary arteries, including their origin, branches, and distribution. It also discusses the normal coronary blood flow and various physical, metabolic, neural, and neurohormonal factors that can impact coronary flow, such as cardiac cycle, aortic pressure, coronary resistance, heart rate, and myocardial metabolism. The document emphasizes the critical role of metabolic factors and how the heart regulates its own blood flow in response to oxygen demand.
Bedside Ultrasound in Neurosurgery Part 3/3
Ultrasound can be used to assess intracranial dural arteriovenous fistulas (DAVF) and carotid cavernous fistulas (CCF). For DAVF, ultrasound shows increased velocities in feeding arteries and decreased resistance indices, allowing assessment before and after treatment. For CCF, ultrasound reveals abnormal mosaic flow in the cavernous sinus and engorged veins with reversed flow. It can monitor hemodynamic changes and treatment response in a noninvasive manner. Ultrasound is also useful for assessing cerebral veins and sinuses, and can diagnose temporal arteritis by identifying hypoechoic wall thickening and stenoses in temporal arteries.
Invasive Hemodynamics: Assessment and interpretation
This document provides an overview of invasive hemodynamics techniques and measurements. It discusses when invasive hemodynamics are used, important measurements for the right and left heart, cardiac output determination methods, valvular lesions, and tips for provoked measurements. Key measurements include pressures, flows, gradients, valve areas, oxygen saturations for shunt calculations, and how values change in response to interventions.
Aortic_Stenosis
This document provides information about aortic stenosis, including its definition, location, morphology, etiology, types, stages, symptoms, complications, risk factors, diagnostic testing, and management. Aortic stenosis is a narrowing of the aortic valve that reduces or blocks blood flow from the heart to the rest of the body. It is most commonly caused by calcification of the aortic valve and affects older adults. Diagnosis involves echocardiography to evaluate valve anatomy and hemodynamics. Treatment depends on symptom severity and may include medications, lifestyle changes, surgical valve replacement, or transcatheter aortic valve replacement.
Doppler applications copy.pptx
This document provides an overview of Doppler ultrasound applications for evaluating various vascular structures and conditions. It discusses Doppler evaluation of the carotid arteries, renal arteries, portal vein, hepatic veins, and arteriovenous fistulas. Key points include diagnostic criteria for stenosis of the carotid, renal and hepatic arteries as well as portal hypertension. Imaging findings and waveforms related to conditions such as subclavian steal, Budd-Chiari syndrome, and arteriovenous fistula maturation/complications are also reviewed. The document emphasizes a thorough ultrasound technique and understanding of normal versus abnormal vascular Doppler evaluations.
Carotid doppler ultrasound
This document discusses carotid Doppler ultrasound. It begins by outlining the anatomy of the carotid arteries and normal Doppler findings. It then discusses causes of carotid artery disease including atherosclerosis. Extra-carotid diseases that can affect the carotid arteries are also mentioned. The document provides detailed guidance on performing and interpreting carotid Doppler ultrasound scans including evaluating the intima-media thickness, flow patterns, spectral analysis, and grading stenosis. Imaging features of normal and diseased arteries are presented along with tips for accurate evaluation.
Low cardiac output syndrome- minati
This document discusses low cardiac output syndrome (LCOS), including its causes, assessment, and management. It defines LCOS as a cardiac index less than 2 L/min/m2 and left sided filling pressures greater than 20mmHg. The key determinants of cardiac output are reviewed as heart rate, stroke volume, preload, afterload, and contractility. Etiologies of LCOS are discussed including preoperative, intraoperative, and postoperative factors. Assessment involves bedside examination, hemodynamic measurements, labs, and imaging like echocardiogram. Management focuses on optimizing preload, contractility, afterload, oxygen delivery, and treating underlying causes.
New carotid doppler ultrasound
1) Carotid Doppler ultrasound is used to evaluate the carotid arteries for stenosis or occlusion. It involves using grayscale, color Doppler, and spectral Doppler to examine the anatomy and flow of the carotid arteries.
2) A normal carotid Doppler ultrasound will show triphasic waveforms within the carotid arteries with velocities under 125 cm/sec. The intima-media thickness should be less than 0.8-0.9mm.
3) Carotid artery disease is most commonly caused by atherosclerosis which can be evaluated using Doppler ultrasound parameters like peak systolic velocity, end diastolic velocity, and ICA/CCA velocity ratios to grade the severity of stenosis.
CVS PSL and Monitoring
This document provides an overview of cardiovascular physiology and ECG monitoring. It discusses the coronary circulation and conduction system of the heart. It describes the different cardiac cell types and their functions. Topics covered include the action potential, automaticity, conduction speed, the phases of the cardiac cycle, and pressure-volume loops. The document also discusses regulation of the cardiovascular system through neural mechanisms, hormones, and the renin-angiotensin-aldosterone system. Finally, it provides guidance on interpreting ECGs, including identifying rates, durations, abnormalities, and determining the location of myocardial infarction.
Hemodynamic monitoring
Hemodynamic monitoring involves measuring the motion of blood through the body and interpreting how the cardiovascular system is performing. The goal is optimizing oxygen delivery. Key metrics include cardiac output, arterial and venous oxygen levels, and oxygen delivery and consumption. Common monitoring methods are non-invasive blood pressure, arterial catheters, central venous pressure, pulmonary artery catheters, and pulse oximetry. Each method has advantages and limitations for assessing hemodynamics and tissue oxygenation. Careful interpretation of the data is important for clinical decision making.
Advances in haemodynamic monitoring
Hemodynamic monitoring has advanced with new equipment allowing continuous, non-invasive monitoring of key parameters. Pulse contour analysis uses an arterial catheter to provide beat-to-beat measurements used to calculate stroke volume, cardiac output, and contractility. Thermodilution techniques inject cold saline to measure parameters like intrathoracic blood volume, extravascular lung water, and ejection fraction. Echocardiography non-invasively assesses cardiac structure and function. These advances allow early detection and guided therapy for shock.
Echo assesment of Aortic Stenosis and Regurgitation
A simple ppt presentation on echo assesment of AS and AR. Don forget to leave a comment if u find this ppt useful. - Dr. Praveen Babu, Vijaya HOspital, Chennai
hemodynamic support in STEMI.pptx
This document discusses hemodynamic support for ST-elevation myocardial infarction (STEMI) patients with cardiogenic shock. It recommends prompt management of hypotension and hypoperfusion with intravenous fluids and inotropes like norepinephrine. While intra-aortic balloon pumps (IABPs) can be used for hemodynamic instability, trials show no mortality benefit. The Impella device shows some benefit when initiated early before percutaneous coronary intervention. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can reduce ventricular volumes but risks include bleeding and insufficient oxygenation. Right ventricular myocardial infarction carries a worse prognosis, and support devices like the Impella RP show immediate hemodynamic benefit.
Shock
This document defines and discusses the pathophysiology of different types of shock: cardiogenic, obstructive, hypovolemic, and distributive. It notes that shock occurs when there is inadequate perfusion and oxygenation of cells, leading to cellular and organ dysfunction. The key signs of shock include tachycardia, hypotension, altered mental status, and decreased urine output. Early goal-directed resuscitation is important to prevent end organ damage and death, and should focus on airway management, oxygenation, fluid resuscitation, and treating the underlying cause.
cvs physiology part 2.pptx
This document discusses the anatomy and physiology of the cardiovascular system. It begins by describing the conduction system of the heart, including the sinoatrial node, atrioventricular node, bundle of His, and Purkinje fibers. It then discusses the membrane potential of ventricular cardiac muscle cells and its relationship to electrocardiograms. Several major cardiovascular reflexes are also outlined, including the arterial baroreceptor reflex. The document provides detailed descriptions of coronary artery anatomy and blood flow regulation to the myocardium. Pathophysiology of ventricular septal defects and their management are summarized.
Echo assessment of aortic valve disease
This document discusses the echocardiographic assessment of aortic valve diseases. It describes how aortic stenosis is classified based on its location as valvular, subvalvular, or supravalvular. It outlines the etiology of valvular aortic stenosis and discusses echocardiographic methods for assessing the severity of aortic stenosis including peak transvalvular velocity, mean transvalvular gradient, and aortic valve area using the continuity equation. The document also discusses the assessment of aortic regurgitation severity using measurements such as vena contracta width, regurgitant jet width and area, pressure half time, diastolic flow reversal, and regurgitant volume and fraction. Methods for
Jugular Venous pressure
The document discusses the jugular venous pulse and what it can indicate about heart function. The jugular veins provide information about right atrial and right ventricular pressures during the cardiac cycle. Examining the jugular venous pulse can provide insights into heart rhythms, valve function, and heart pressures. Abnormalities in the jugular venous pulse waves or pressures could indicate issues like atrial fibrillation, heart failure, constrictive pericarditis, or valve problems.
Similar to Stroke volume and cardiac output (20)
Invasive Hemodynamics: Assessment and interpretation
Invasive Hemodynamics: Assessment and interpretation
Echo assesment of Aortic Stenosis and Regurgitation
Echo assesment of Aortic Stenosis and Regurgitation
More from Nguyen Phong Trung
Echocardiographic anatomy in the fetus 2009 pg
This document provides an introduction and overview of a textbook on fetal echocardiography. It discusses the importance of understanding normal fetal cardiac anatomy and improving detection of congenital heart defects. The textbook aims to educate medical professionals by providing high-quality echocardiographic images alongside pathological specimens. It describes the fetal heart within the body and relationships to surrounding structures, rather than in isolation. The goal is to serve as a basic tool for understanding normal and abnormal fetal echocardiographic anatomy.
Hemodynamic
This document discusses hemodynamic principles and waveform analysis from cardiac catheterization. It provides an overview of normal and abnormal pressure waveforms from the right atrium, pulmonary artery, left ventricle, and aorta. Key points include how respiration and different disease states can impact pressure tracings. The document also outlines the components and uses of the Swan-Ganz catheter for measuring pressures in the right heart and pulmonary circulation.
Echocardiography in shock
This document discusses using echocardiography to diagnose and manage shock in pediatric patients. It outlines steps for evaluating fluid requirements, including using measurements of the inferior vena cava and passive leg raises to guide fluid administration. Methods for assessing left ventricular systolic function, such as ejection fraction, Simpson's rule, and Doppler tissue imaging are presented. The document concludes with recommendations for a step-by-step practical echocardiographic evaluation of septic shock patients, including evaluating stroke volume and cardiac output in response to fluids and checking for other issues like pericardial effusions.
Echocardiography in res failure
This document discusses using echocardiography to diagnose and manage acute respiratory failure. It outlines how echocardiography can differentiate between cardiogenic pulmonary edema caused by left ventricular failure and non-cardiogenic pulmonary edema caused by conditions like acute respiratory distress syndrome. It provides guidance on using echocardiography to estimate left ventricular filling pressures and diagnose diastolic heart failure. It also explores how echocardiography can evaluate right ventricular function in patients with acute respiratory failure and pulmonary edema.
Echocardiography in res failure [autosaved]
This document discusses using echocardiography to diagnose and manage acute respiratory failure. It outlines how echocardiography can differentiate between cardiogenic pulmonary edema caused by left heart failure and non-cardiogenic pulmonary edema caused by conditions like acute respiratory distress syndrome. It provides guidance on using echocardiography to estimate left ventricular filling pressures and diagnose diastolic heart failure. It also explores how echocardiography can evaluate right ventricular function in patients with acute respiratory failure and pulmonary edema.
Echocardiographic evaluation of lv function
Doppler echocardiography is the main method used to evaluate ventricular function in children. It provides important information not available from adult assessments due to differences in myocardial maturation and the effects of congenital heart disease. Echocardiography allows assessment of ventricular dimensions, ejection fraction, wall motion, and Doppler indices of systolic and diastolic function. Newer techniques like Doppler tissue imaging and strain rate imaging provide enhanced evaluation of regional myocardial function. Comprehensive echocardiography is crucial for understanding the complex effects of pediatric heart conditions on ventricular performance.
More from Nguyen Phong Trung (20)
8. p. 289 to 302 quality improvement module vietnamese
8. p. 289 to 302 quality improvement module vietnamese
7. p. 279 to 288 emotional support module vietnamese
7. p. 279 to 288 emotional support module vietnamese
Recently uploaded
The Electrocardiogram - Physiologic Principles
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
Histololgy of Female Reproductive System.pptx
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Recently uploaded (20)
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
CHEMOTHERAPY_RDP_CHAPTER 6_Anti Malarial Drugs.pdf
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotes
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Stroke volume and cardiac output
- 1. ECHOCARDIOGRAPHY IN ICU MEASUREMENT OF STROKE VOLUME AND CARDIAC OUTPUT BÙI GIO AN, MD
- 2. WHY MONITORED? • MEAN ARTERIAL PRESSURE- MAP: END POINT FOR RESUSCITATION. • BIOLOGICAL MARKERS: MIXED VENOUS OXYGEN SATURATION (SVO2) AND SERUM LACTATE. • SYSTEMIC STROKE VOLUME AND CRDIAC OUTPUT? • TECHNICAL DIFFICULTIES? • MORE SUITABLE THAN MAP? • EARLY WARNING OF CIRCULATION FAILURE?
- 4. EVALUATE SV OR CO? • ↓ STROKE VOLUME MAY BE COMPENSATED BY ↑ HEART RATE “PSEUDO NORMAL” CARDIAC OUTPUT. • FLUID CHALLENGE ↑ STROKE VOLUME ↓ HR CARDIAC OUTPUT NOT CHANGE. • PREFER DIRECT MEASUREMENT OF STROKE VOLUME
- 6. OBTAIN A PARASTERNAL LONG-AXIS VIEW
- 7. MEASURE LEFT VENTRICULAR OUTFLOW TRACT (LVOT) DIAMETER
- 8. APICAL FIVE-CHAMBER VIEW OF THE HEART. RV: RIGHT VENTRICLE. LV: LEFT VENTRICLE AO: AORTA. LA: LEFT ATRIUM RA: RIGHT ATRIUM
- 9. PULSED-WAVE DOPPLER IN THE LVOT, Width 2–4 mm in the LVOT Just below the aortic valve
- 10. RECORD BLOOD FLOW VELOCITY VTI OF LVOT AORTIC VELOCITY TIME INTERVAL (VTI)
- 11. CALCULATE SV: SUMMARY CO = SV * HR
- 12. STROKE VOLUME MEASUREMENT AND THERAPEUTIC MANEUVER • FLUID TEST. • INOTROPES/VASODILATORS • NITRIC OXIDE INHALATION.
- 13. CONCLUSIONS • OFFER AN EASY WAY TO ASSESS STROKE VOLUME AND CARDIAC OUTPUT. • ASSESS THE BLOOD FLOW: SV • HELPFUL IN ICU PRACTICE WHEN COMBINE WITH OTHER DATA