Surgical management of valvular heart disease update
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This medical document discusses two heart conditions: aortic stenosis and tricuspid regurgitation. Aortic stenosis is a narrowing of the aortic valve that can be caused by lung disease or other left-sided heart problems. The document also mentions operative mortality rates after surgery for valvular heart disease.
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1. Hypoplasia of the ascending aorta is a rare condition occurring in 0.2 per 1000 live births and can be lethal if left untreated.
2. Patent ductus arteriosus normally closes within 2 days of birth but may remain open and be associated with conditions like coarctation of the aorta, transposition of the great arteries, and ventricular septal defects.
3. Variations can occur in the branching patterns of arteries originating from the aortic arch including the right subclavian artery, bronchial arteries, celiac artery, and renal arteries. Accessory arteries or anomalous branching patterns are possible.
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This document discusses acute coronary syndromes and provides information in the following areas:
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2) Diagnosis - The initial diagnostic test is a 12-lead ECG within 10 minutes, and may be repeated at 15-30 minute intervals if the first is nondiagnostic.
3) Treatment - For a STEMI, the goals are reperfusion via percutaneous coronary intervention (PCI) within 90 minutes or fibrinolytic therapy within 30 minutes of arriving at the emergency department.
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2) Aortic and pulmonary stenosis that are asymptomatic until duct closure causes heart failure or cyanosis respectively.
3) Right to left shunts like tetralogy of Fallot and transposition of the great vessels that present with cyanosis when the duct closes.
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2. Patent ductus arteriosus normally closes within 2 days of birth but may remain open and be associated with conditions like coarctation of the aorta, transposition of the great arteries, and ventricular septal defects.
3. Variations can occur in the branching patterns of arteries originating from the aortic arch including the right subclavian artery, bronchial arteries, celiac artery, and renal arteries. Accessory arteries or anomalous branching patterns are possible.
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This document discusses acute coronary syndromes and provides information in the following areas:
1) Anatomy - It describes the blood supply areas of the three main coronary arteries: LAD, LCx, and RCA.
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Post cardiac surgery resuscitation is complex. Nikki describes them as “brown trouser moments”. She highlights this with three cases. A15-year-old girl who exsanguinated on Day 12 after dissection repair in the community. A 40-year-old female arrested within an hour of a re-do aortic root procedure. A 72-year-old lady who arrested after a bradycardic arrest following an aortic valve replacement. Only one survived – this is serious business.
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This document discusses various congenital heart diseases that are duct-dependent and require a patent ductus arteriosus to survive, including:
1) Obstructions to the left ventricle like aortic atresia that present with heart failure and absent pulses when the duct closes.
2) Aortic and pulmonary stenosis that are asymptomatic until duct closure causes heart failure or cyanosis respectively.
3) Right to left shunts like tetralogy of Fallot and transposition of the great vessels that present with cyanosis when the duct closes.
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1. Define an electrocardiogram (ECG) and electrocardiography
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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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
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