Takotsubo cardiomyopathy 2019
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A 68-year-old woman presented to the emergency department with chest pain and shortness of breath. Tests showed elevated troponin and ECG changes suggestive of a heart attack. A ventriculogram revealed ballooning of the left ventricular apex, consistent with Takotsubo cardiomyopathy. Takotsubo is a stress-induced heart condition where the heart enlarges at the apex. It is thought to be caused by high catecholamine levels due to life stress. While initial symptoms mimic a heart attack, prognosis is generally good with typical recovery and low mortality around 1-3%.
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Takotsubo Cardiomyopathy
Takotsubo cardiomyopathy (TC), also known as "broken heart syndrome", is an acute cardiac syndrome that presents similarly to acute coronary syndrome (ACS) but is caused by transient left ventricular dysfunction rather than coronary artery blockages. It often occurs in post-menopausal women in response to severe emotional or physical stress and is characterized by abnormal ventriculograms showing apical ballooning of the left ventricle. While difficult to distinguish from ACS initially, differentiating the two is important to avoid unnecessary thrombolysis in TC patients. The pathophysiology of TC involves excess catecholamine release and microvascular dysfunction resulting in reversible myocardial stunning.
Takotsubo Cardiomyopathy - Rivin
Takotsubo cardiomyopathy (TC), also known as broken heart syndrome, is a temporary heart condition caused by severe emotional or physical stress that causes the left ventricle of the heart to balloon out at the bottom and contract abnormally. It most often affects post-menopausal women and can cause chest pain and symptoms similar to a heart attack. While the exact cause is unknown, it is thought to involve an extreme surge of stress hormones that stuns the heart muscle. The prognosis is generally good with most people making a full recovery within weeks.
Takotsubo cardiomyopathy
Takotsubo cardiomyopathy, also known as broken heart syndrome, is a transient cardiac syndrome characterized by left ventricular dysfunction and apical ballooning that mimics acute coronary syndrome. It is often preceded by stressful physical or emotional triggers and predominantly affects postmenopausal women. Diagnosis involves identifying transient hypokinesis or akinesis of the left ventricle without obstructive coronary artery disease, as well as elevated cardiac troponin levels. While the pathophysiology is not fully understood, it is thought to involve an excessive catecholamine response leading to reversible myocardial stunning. Most patients recover fully within weeks, but complications such as heart failure, cardiogenic shock, or arrhythmias can occasionally occur.
Takotsubo
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is a temporary heart condition where emotional or physical stress causes the heart muscle to become weakened or stunned. It most often affects postmenopausal women and can mimic symptoms of a heart attack. While the exact cause is unknown, it may involve coronary artery spasm or impaired cardiac function triggered by emotional stress. Patients typically experience chest pain and shortness of breath. Diagnosis involves EKG changes, elevated cardiac enzymes, and angiography showing normal coronary arteries with abnormal ventricle function. Most patients fully recover heart function within weeks, though complications in a small percentage can include heart failure, shock, or arrhythmias.
Takatsubo Stress Cardiomyopathy
Takotsubo cardiomyopathy, also known as stress cardiomyopathy or broken heart syndrome, is a temporary heart condition triggered by stressful situations. It causes sudden weakening of the left ventricle and abnormal enlargement of the ventricle's lower chamber. Symptoms include chest pain and shortness of breath. While the exact cause is unknown, it is thought to be related to surges of stress hormones that affect the heart muscle. Treatment focuses on supportive care as left ventricular function usually recovers within weeks. Lifestyle modifications and management of psychological stressors can help prevent recurrences.
Takotsubo cardiomyopathy
Here are the key points from the case:
- A 75-year-old post-menopausal woman presented with pneumonia and chest pain
- In the last 24 hours she experienced dyspnea and sputum production
- This physical stressor of pneumonia could potentially trigger Takotsubo cardiomyopathy in this high-risk demographic
- Her symptoms of chest pain could represent Takotsubo cardiomyopathy mimicking an acute coronary syndrome
- Further workup would be needed to evaluate for potential left ventricular dysfunction and regional wall motion abnormalities consistent with Takotsubo cardiomyopathy versus other causes of her symptoms.
Takasubo cardiomyopathy
- Takatsubo cardiomyopathy (TTC), also known as stress cardiomyopathy or broken heart syndrome, is a reversible form of heart failure caused by transient left ventricular dysfunction.
- It is typically triggered by periods of intense emotional or physical stress and is characterized by EKG changes and chest pain similar to a heart attack despite an absence of coronary artery blockages.
- The leading theories for its pathophysiology include high catecholamine levels from stress overwhelming the heart muscle or coronary microvascular dysfunction impairing blood flow. The heart regains normal function within weeks with supportive care.
The other great masquerader takotsubo cardiomyopathy the indian practittione...
This document describes a case report of a 54-year-old female anatomy professor who experienced takotsubo cardiomyopathy. She collapsed during a lecture and was found to have seizures, low blood pressure, and signs of heart failure. Tests found normal coronary arteries but a ballooned and akinetic left ventricular apex. She was treated with medications and ventilation. Follow-up tests found recovery of left ventricular function, confirming takotsubo cardiomyopathy. The document also reviews the proposed mechanisms and management of this syndrome, which causes transient left ventricular dysfunction that mimics heart attack but has reversible causes.
Recommended
Takotsubo Cardiomyopathy
Takotsubo cardiomyopathy (TC), also known as "broken heart syndrome", is an acute cardiac syndrome that presents similarly to acute coronary syndrome (ACS) but is caused by transient left ventricular dysfunction rather than coronary artery blockages. It often occurs in post-menopausal women in response to severe emotional or physical stress and is characterized by abnormal ventriculograms showing apical ballooning of the left ventricle. While difficult to distinguish from ACS initially, differentiating the two is important to avoid unnecessary thrombolysis in TC patients. The pathophysiology of TC involves excess catecholamine release and microvascular dysfunction resulting in reversible myocardial stunning.
Takotsubo Cardiomyopathy - Rivin
Takotsubo cardiomyopathy (TC), also known as broken heart syndrome, is a temporary heart condition caused by severe emotional or physical stress that causes the left ventricle of the heart to balloon out at the bottom and contract abnormally. It most often affects post-menopausal women and can cause chest pain and symptoms similar to a heart attack. While the exact cause is unknown, it is thought to involve an extreme surge of stress hormones that stuns the heart muscle. The prognosis is generally good with most people making a full recovery within weeks.
Takotsubo cardiomyopathy
Takotsubo cardiomyopathy, also known as broken heart syndrome, is a transient cardiac syndrome characterized by left ventricular dysfunction and apical ballooning that mimics acute coronary syndrome. It is often preceded by stressful physical or emotional triggers and predominantly affects postmenopausal women. Diagnosis involves identifying transient hypokinesis or akinesis of the left ventricle without obstructive coronary artery disease, as well as elevated cardiac troponin levels. While the pathophysiology is not fully understood, it is thought to involve an excessive catecholamine response leading to reversible myocardial stunning. Most patients recover fully within weeks, but complications such as heart failure, cardiogenic shock, or arrhythmias can occasionally occur.
Takotsubo
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is a temporary heart condition where emotional or physical stress causes the heart muscle to become weakened or stunned. It most often affects postmenopausal women and can mimic symptoms of a heart attack. While the exact cause is unknown, it may involve coronary artery spasm or impaired cardiac function triggered by emotional stress. Patients typically experience chest pain and shortness of breath. Diagnosis involves EKG changes, elevated cardiac enzymes, and angiography showing normal coronary arteries with abnormal ventricle function. Most patients fully recover heart function within weeks, though complications in a small percentage can include heart failure, shock, or arrhythmias.
Takatsubo Stress Cardiomyopathy
Takotsubo cardiomyopathy, also known as stress cardiomyopathy or broken heart syndrome, is a temporary heart condition triggered by stressful situations. It causes sudden weakening of the left ventricle and abnormal enlargement of the ventricle's lower chamber. Symptoms include chest pain and shortness of breath. While the exact cause is unknown, it is thought to be related to surges of stress hormones that affect the heart muscle. Treatment focuses on supportive care as left ventricular function usually recovers within weeks. Lifestyle modifications and management of psychological stressors can help prevent recurrences.
Takotsubo cardiomyopathy
Here are the key points from the case:
- A 75-year-old post-menopausal woman presented with pneumonia and chest pain
- In the last 24 hours she experienced dyspnea and sputum production
- This physical stressor of pneumonia could potentially trigger Takotsubo cardiomyopathy in this high-risk demographic
- Her symptoms of chest pain could represent Takotsubo cardiomyopathy mimicking an acute coronary syndrome
- Further workup would be needed to evaluate for potential left ventricular dysfunction and regional wall motion abnormalities consistent with Takotsubo cardiomyopathy versus other causes of her symptoms.
Takasubo cardiomyopathy
- Takatsubo cardiomyopathy (TTC), also known as stress cardiomyopathy or broken heart syndrome, is a reversible form of heart failure caused by transient left ventricular dysfunction.
- It is typically triggered by periods of intense emotional or physical stress and is characterized by EKG changes and chest pain similar to a heart attack despite an absence of coronary artery blockages.
- The leading theories for its pathophysiology include high catecholamine levels from stress overwhelming the heart muscle or coronary microvascular dysfunction impairing blood flow. The heart regains normal function within weeks with supportive care.
The other great masquerader takotsubo cardiomyopathy the indian practittione...
This document describes a case report of a 54-year-old female anatomy professor who experienced takotsubo cardiomyopathy. She collapsed during a lecture and was found to have seizures, low blood pressure, and signs of heart failure. Tests found normal coronary arteries but a ballooned and akinetic left ventricular apex. She was treated with medications and ventilation. Follow-up tests found recovery of left ventricular function, confirming takotsubo cardiomyopathy. The document also reviews the proposed mechanisms and management of this syndrome, which causes transient left ventricular dysfunction that mimics heart attack but has reversible causes.
Brugada syndrome
Brugada syndrome (BrS) is an inherited cardiac disorder,
characterised by a typical ECG pattern and an increased
risk of arrhythmias and sudden cardiac death (SCD).
BrS is a challenging entity, in regard to diagnosis as
well as arrhythmia risk prediction and management.
Nowadays, asymptomatic patients represent the majority
of newly diagnosed patients with BrS, and its incidence
is expected to rise due to (genetic) family screening.
Progress in our understanding of the genetic and
molecular pathophysiology is limited by the absence
of a true gold standard, with consensus on its clinical
definition changing over time. Nevertheless, novel
insights continue to arise from detailed and in-depth
studies, including the complex genetic and molecular
basis. This includes the increasingly recognised
relevance of an underlying structural substrate. Risk
stratification in patients with BrS remains challenging,
particularly in those who are asymptomatic, but recent
studies have demonstrated the potential usefulness
of risk scores to identify patients at high risk of
arrhythmia and SCD. Development and validation of
a model that incorporates clinical and genetic factors,
comorbidities, age and gender, and environmental
aspects may facilitate improved prediction of disease
expressivity and arrhythmia/SCD risk, and potentially
guide patient management and therapy. This review
provides an update of the diagnosis, pathophysiology
and management of BrS, and discusses its future
perspectives.
A DETAILED STUDY ON SHOCK, MYOCARDIAL INFRACTION & STROKE
This is a detailed study about shock , myocardial infraction , & stroke . also contain descriptions about types of shock, further management ,recognition of shock , treatment, first aid options are also mentioned along with cardiac arrest and stroke & emergency management of stroke etc
please comment if you visited this
thank u
Case presentation on myocardial infraction
Mr. Mohammed Ghouse, a 64-year-old male with hypertension, presented with chest pain and was admitted to the hospital. Tests showed extensive heart ischemia. He underwent coronary angiography which revealed triple vessel disease and atherosclerosis. His condition was stabilized with medications and an IABP device, but he later developed ventricular tachycardia and died despite resuscitative efforts. The cause of death was determined to be an acute myocardial infarction due to reduced blood flow from the blocked coronary arteries.
Takotsubo cardiomyopathy Machanism
1) Takotsubo syndrome is a cardiac condition triggered by stressful events where the left ventricle temporarily takes on a distinctive "Takotsubo" shape.
2) It is thought to be caused by very high levels of stress hormones like adrenaline activating negative inotropic pathways in the heart through beta-2 adrenergic receptors, particularly in the left ventricular apex.
3) This leads to left ventricular dysfunction and heart failure symptoms, but the heart typically recovers its normal function within weeks as the stress response subsides. However, the full pathophysiology and long term effects are still being uncovered.
Role of echocardiography in acute myocardial infraction
Echocardiography is useful in the diagnosis and management of acute myocardial infarction (AMI) for several reasons:
1. It can detect regional wall motion abnormalities (RWMAs) that occur prior to ECG changes during a coronary occlusion, aiding early diagnosis.
2. It is recommended to evaluate ventricular function, detect mechanical complications like thrombus, and stratify risk in patients with confirmed AMI.
3. RWMAs seen on echocardiography localize the area of infarction and correspond to the coronary artery territory. Complications like ventricular septal defects and mitral regurgitation can also be identified.
Colchicine drug in cardiovascular clinical trials
1. The COLCOT trial found that in patients who recently suffered a myocardial infarction, low-dose colchicine was effective at preventing major adverse cardiovascular events compared to placebo.
2. The LoDoCo 2 trial found that in patients with chronic coronary disease, low-dose colchicine resulted in a 31% lower risk of cardiovascular death, heart attack, stroke, or revascularization than placebo.
3. Colchicine has anti-inflammatory properties through its inhibition of the NLRP3 inflammasome complex and has a well-established safety profile, making it a promising secondary prevention treatment for cardiovascular disease.
Myocardial infraction
this is a slide on myocardial infraction to figure you out what exactly it is !
though i have not mentioned the diet based causes ............etc.
so enjoy
Myocarditis pediatrics ppt
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An unusual aspect of hypertrophic cardiomyopathy
This document reports on an unusual case of hypertrophic cardiomyopathy (HCM) in a 13-year old girl. Echocardiography revealed an atypical form of HCM with a large spiral recess in the inferoseptal wall and inferior left ventricular wall, along with diastolic dysfunction. While a septal myectomy was considered, the patient unfortunately died a few days after being diagnosed. The discussion notes that HCM in patients with Noonan syndrome, like this case, often shows more severe hypertrophy and diastolic issues compared to other forms of HCM in children.
Myocardial infarction with case
M. Shareef, a 65-year-old male with diabetes and coronary artery disease, presented with chest pain, breathlessness, fever and vomiting for 6 hours. He was admitted to the ICU where an ECG showed signs of a myocardial infarction. His treatment included aspirin, clopidogrel, streptokinase, morphine and metoclopramide. As a known diabetic and heart disease patient, he requires lifestyle modifications and optimized medical management to control his risk factors and prevent further cardiac complications.
S H O C K C A R I O G E N I C O2
- The document discusses cardiogenic shock, which is a clinical condition defined by hypotension and signs of hypoperfusion due to impaired cardiac function, usually caused by acute myocardial infarction.
- Key treatments discussed for cardiogenic shock include early revascularization (within 18 hours) for younger patients, use of an intra-aortic balloon pump, and inotropic support. Fibrinolysis may be considered when intervention is contraindicated.
- Factors such as right ventricular infarction, arrhythmias, and mechanical complications also warrant consideration in management of cardiogenic shock. Early reperfusion and hemodynamic support are emphasized.
Brugada Syndrome - Case Study
Brugada Syndrome - Case Study
Precise data regarding Brugada Syndrome with a Case Study for DGNM, B.Sc Nursing & M.Sc Nursing Students.
Fibrinolysis in stemi a second thought- tip august 2016
This case report describes a 30-year old male who presented with chest discomfort and progressive breathlessness. An ECG showed ST elevation resembling a STEMI. However, cardiac enzymes were normal and there was incoherence between symptoms and ECG. Cardiac sarcoidosis was considered and confirmed through cardiac MRI, endomyocardial biopsy, and elevated serum ACE level. The patient was started on steroids and anti-arrhythmics, resulting in partial symptom remission. This case highlights that cardiac sarcoidosis can present with ST elevation on ECG and should be considered to avoid unnecessary fibrinolysis when there is discrepancy between presentation and test results.
Heart involvement in systemic lupus erythematosus,
Cardiac involvement is common in patients with systemic autoimmune diseases like systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). All parts of the heart can be affected through various mechanisms including autoantibodies, immune complexes, and thrombosis. In SLE, pericarditis and myocarditis are most common while APS is associated with valve abnormalities and coronary artery disease. Treatment involves controlling risk factors, immunosuppression, and in APS, anticoagulation or antiplatelet therapy.
Cardiac amyloidosis
one of the form of restrictive cardiomyopathy usually missed in diagnosis. correct diagnosis can make N different outcome.
ACS 071509
The document provides information on the diagnosis and types of acute myocardial infarction (AMI). It discusses coronary atherosclerosis as a chronic disease that progresses over decades. Acute coronary syndrome (ACS) refers to the spectrum of clinically manifest coronary artery disease from unstable angina to AMI. The criteria for diagnosing AMI include elevated cardiac biomarkers and evidence of myocardial ischemia. The document outlines 5 types of AMI and provides details on interpreting electrocardiograms and cardiac biomarkers in AMI.
Inferior myocardial infarction
The document provides information on inferior wall myocardial infarction (MI), including:
1. Definitions, epidemiology, etiology, clinical features, diagnosis, treatment and complications of inferior wall MI are discussed. Worldwide over 7 million people experience STEMIs or NSTEMIs annually.
2. Diagnosis involves ECG, cardiac imaging, cardiac biomarkers like troponin and CK-MB. Reperfusion therapy within 6 hours includes PCI or thrombolysis. General treatment measures include aspirin, clopidogrel, anticoagulants, analgesics, beta-blockers, nitrates and oxygen.
3. The history of pioneers in cardiology and development of techniques like echocardi
Hypertrophic Cardiomyopathy
This document summarizes a 56-year-old African American man who presented to the hospital after an abnormal stress test. He has a history of hypertension and was previously diagnosed with left ventricular hypertrophy. A recent stress test found ventricular tachycardia and imaging showed an apical aneurysm and small inferior wall ischemia. He is currently taking medications for hypertension and has a family history of coronary artery disease.
Myocarditis
This document discusses myocarditis, including its clinical presentation and findings on cardiac MRI. Regarding clinical presentation, it notes that symptoms can range from subclinical to fulminant heart failure, with the most common symptoms being chest pain, dyspnea, and arrhythmias. Cardiac MRI is useful for identifying myocarditis and can detect tissue edema, hyperemia, and fibrosis. Findings on MRI include increased T2 signal from edema, early contrast enhancement indicating hyperemia, and late gadolinium enhancement of replaced fibrotic tissue. Morphological abnormalities seen include transient increases in wall thickness and LV volumes during active myocarditis.
ST+ Mimics - Session Etat de l'Art - Le Syndrome de Takotsubo Congrès Urgence...
ST+ Mimics - Session Etat de l'Art - Le Syndrome de Takotsubo Congrès Urgence...Nicolas Peschanski, MD, PhD
1. The document discusses Takotsubo syndrome, or stress-induced cardiomyopathy, which causes transient left ventricular dysfunction.
2. It was first reported in Japan in 1990 and predominantly affects post-menopausal women. A stressful trigger, either emotional or physical, often precedes the onset.
3. While the exact pathophysiology is unknown, it is thought to involve microvascular spasm and catecholamine cardiotoxicity leading to calcium overload. This causes transient apical and mid-ventricular akinesia or dyskinesia.Broken heart syndrome. Diagnostics
Broken heart syndrome, also known as Takotsubo cardiomyopathy or stress-induced cardiomyopathy, is a condition where emotional or physical stress causes temporary weakening of the left ventricle. It affects about 1% of those experiencing a myocardial infarction and causes similar symptoms but is not caused by blocked arteries. Diagnosis involves EKG, echocardiogram, cardiac MRI and angiography showing normal arteries and left ventricular dysfunction. Treatment focuses on heart failure medicines and managing symptoms, and most patients fully recover heart function within weeks.
Takotsubo cardiomyopathy presentation.pptx
takotsubo cardiomyopathy interesting disease heartbreak wow interesting very medical doctor doctor
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What's hot
Brugada syndrome
Brugada syndrome (BrS) is an inherited cardiac disorder,
characterised by a typical ECG pattern and an increased
risk of arrhythmias and sudden cardiac death (SCD).
BrS is a challenging entity, in regard to diagnosis as
well as arrhythmia risk prediction and management.
Nowadays, asymptomatic patients represent the majority
of newly diagnosed patients with BrS, and its incidence
is expected to rise due to (genetic) family screening.
Progress in our understanding of the genetic and
molecular pathophysiology is limited by the absence
of a true gold standard, with consensus on its clinical
definition changing over time. Nevertheless, novel
insights continue to arise from detailed and in-depth
studies, including the complex genetic and molecular
basis. This includes the increasingly recognised
relevance of an underlying structural substrate. Risk
stratification in patients with BrS remains challenging,
particularly in those who are asymptomatic, but recent
studies have demonstrated the potential usefulness
of risk scores to identify patients at high risk of
arrhythmia and SCD. Development and validation of
a model that incorporates clinical and genetic factors,
comorbidities, age and gender, and environmental
aspects may facilitate improved prediction of disease
expressivity and arrhythmia/SCD risk, and potentially
guide patient management and therapy. This review
provides an update of the diagnosis, pathophysiology
and management of BrS, and discusses its future
perspectives.
A DETAILED STUDY ON SHOCK, MYOCARDIAL INFRACTION & STROKE
This is a detailed study about shock , myocardial infraction , & stroke . also contain descriptions about types of shock, further management ,recognition of shock , treatment, first aid options are also mentioned along with cardiac arrest and stroke & emergency management of stroke etc
please comment if you visited this
thank u
Case presentation on myocardial infraction
Mr. Mohammed Ghouse, a 64-year-old male with hypertension, presented with chest pain and was admitted to the hospital. Tests showed extensive heart ischemia. He underwent coronary angiography which revealed triple vessel disease and atherosclerosis. His condition was stabilized with medications and an IABP device, but he later developed ventricular tachycardia and died despite resuscitative efforts. The cause of death was determined to be an acute myocardial infarction due to reduced blood flow from the blocked coronary arteries.
Takotsubo cardiomyopathy Machanism
1) Takotsubo syndrome is a cardiac condition triggered by stressful events where the left ventricle temporarily takes on a distinctive "Takotsubo" shape.
2) It is thought to be caused by very high levels of stress hormones like adrenaline activating negative inotropic pathways in the heart through beta-2 adrenergic receptors, particularly in the left ventricular apex.
3) This leads to left ventricular dysfunction and heart failure symptoms, but the heart typically recovers its normal function within weeks as the stress response subsides. However, the full pathophysiology and long term effects are still being uncovered.
Role of echocardiography in acute myocardial infraction
Echocardiography is useful in the diagnosis and management of acute myocardial infarction (AMI) for several reasons:
1. It can detect regional wall motion abnormalities (RWMAs) that occur prior to ECG changes during a coronary occlusion, aiding early diagnosis.
2. It is recommended to evaluate ventricular function, detect mechanical complications like thrombus, and stratify risk in patients with confirmed AMI.
3. RWMAs seen on echocardiography localize the area of infarction and correspond to the coronary artery territory. Complications like ventricular septal defects and mitral regurgitation can also be identified.
Colchicine drug in cardiovascular clinical trials
1. The COLCOT trial found that in patients who recently suffered a myocardial infarction, low-dose colchicine was effective at preventing major adverse cardiovascular events compared to placebo.
2. The LoDoCo 2 trial found that in patients with chronic coronary disease, low-dose colchicine resulted in a 31% lower risk of cardiovascular death, heart attack, stroke, or revascularization than placebo.
3. Colchicine has anti-inflammatory properties through its inhibition of the NLRP3 inflammasome complex and has a well-established safety profile, making it a promising secondary prevention treatment for cardiovascular disease.
Myocardial infraction
this is a slide on myocardial infraction to figure you out what exactly it is !
though i have not mentioned the diet based causes ............etc.
so enjoy
Myocarditis pediatrics ppt
Myocarditis is an inflammation of the heart muscle that is most commonly caused by viral infections in children. Symptoms can range from mild to severe and include fatigue, chest pain, palpitations, and signs of heart failure like shortness of breath. Diagnosis is challenging as symptoms are often subtle, but can involve electrocardiograms, echocardiograms, cardiac MRI, and endomyocardial biopsy. Treatment is supportive with medications for heart failure, though immunoglobulin therapy may help in some cases of proven viral infection. Prognosis depends on age and severity of symptoms, with poorer outcomes more common in newborns and those with more severe heart failure.
An unusual aspect of hypertrophic cardiomyopathy
This document reports on an unusual case of hypertrophic cardiomyopathy (HCM) in a 13-year old girl. Echocardiography revealed an atypical form of HCM with a large spiral recess in the inferoseptal wall and inferior left ventricular wall, along with diastolic dysfunction. While a septal myectomy was considered, the patient unfortunately died a few days after being diagnosed. The discussion notes that HCM in patients with Noonan syndrome, like this case, often shows more severe hypertrophy and diastolic issues compared to other forms of HCM in children.
Myocardial infarction with case
M. Shareef, a 65-year-old male with diabetes and coronary artery disease, presented with chest pain, breathlessness, fever and vomiting for 6 hours. He was admitted to the ICU where an ECG showed signs of a myocardial infarction. His treatment included aspirin, clopidogrel, streptokinase, morphine and metoclopramide. As a known diabetic and heart disease patient, he requires lifestyle modifications and optimized medical management to control his risk factors and prevent further cardiac complications.
S H O C K C A R I O G E N I C O2
- The document discusses cardiogenic shock, which is a clinical condition defined by hypotension and signs of hypoperfusion due to impaired cardiac function, usually caused by acute myocardial infarction.
- Key treatments discussed for cardiogenic shock include early revascularization (within 18 hours) for younger patients, use of an intra-aortic balloon pump, and inotropic support. Fibrinolysis may be considered when intervention is contraindicated.
- Factors such as right ventricular infarction, arrhythmias, and mechanical complications also warrant consideration in management of cardiogenic shock. Early reperfusion and hemodynamic support are emphasized.
Brugada Syndrome - Case Study
Brugada Syndrome - Case Study
Precise data regarding Brugada Syndrome with a Case Study for DGNM, B.Sc Nursing & M.Sc Nursing Students.
Fibrinolysis in stemi a second thought- tip august 2016
This case report describes a 30-year old male who presented with chest discomfort and progressive breathlessness. An ECG showed ST elevation resembling a STEMI. However, cardiac enzymes were normal and there was incoherence between symptoms and ECG. Cardiac sarcoidosis was considered and confirmed through cardiac MRI, endomyocardial biopsy, and elevated serum ACE level. The patient was started on steroids and anti-arrhythmics, resulting in partial symptom remission. This case highlights that cardiac sarcoidosis can present with ST elevation on ECG and should be considered to avoid unnecessary fibrinolysis when there is discrepancy between presentation and test results.
Heart involvement in systemic lupus erythematosus,
Cardiac involvement is common in patients with systemic autoimmune diseases like systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). All parts of the heart can be affected through various mechanisms including autoantibodies, immune complexes, and thrombosis. In SLE, pericarditis and myocarditis are most common while APS is associated with valve abnormalities and coronary artery disease. Treatment involves controlling risk factors, immunosuppression, and in APS, anticoagulation or antiplatelet therapy.
Cardiac amyloidosis
one of the form of restrictive cardiomyopathy usually missed in diagnosis. correct diagnosis can make N different outcome.
ACS 071509
The document provides information on the diagnosis and types of acute myocardial infarction (AMI). It discusses coronary atherosclerosis as a chronic disease that progresses over decades. Acute coronary syndrome (ACS) refers to the spectrum of clinically manifest coronary artery disease from unstable angina to AMI. The criteria for diagnosing AMI include elevated cardiac biomarkers and evidence of myocardial ischemia. The document outlines 5 types of AMI and provides details on interpreting electrocardiograms and cardiac biomarkers in AMI.
Inferior myocardial infarction
The document provides information on inferior wall myocardial infarction (MI), including:
1. Definitions, epidemiology, etiology, clinical features, diagnosis, treatment and complications of inferior wall MI are discussed. Worldwide over 7 million people experience STEMIs or NSTEMIs annually.
2. Diagnosis involves ECG, cardiac imaging, cardiac biomarkers like troponin and CK-MB. Reperfusion therapy within 6 hours includes PCI or thrombolysis. General treatment measures include aspirin, clopidogrel, anticoagulants, analgesics, beta-blockers, nitrates and oxygen.
3. The history of pioneers in cardiology and development of techniques like echocardi
Hypertrophic Cardiomyopathy
This document summarizes a 56-year-old African American man who presented to the hospital after an abnormal stress test. He has a history of hypertension and was previously diagnosed with left ventricular hypertrophy. A recent stress test found ventricular tachycardia and imaging showed an apical aneurysm and small inferior wall ischemia. He is currently taking medications for hypertension and has a family history of coronary artery disease.
Myocarditis
This document discusses myocarditis, including its clinical presentation and findings on cardiac MRI. Regarding clinical presentation, it notes that symptoms can range from subclinical to fulminant heart failure, with the most common symptoms being chest pain, dyspnea, and arrhythmias. Cardiac MRI is useful for identifying myocarditis and can detect tissue edema, hyperemia, and fibrosis. Findings on MRI include increased T2 signal from edema, early contrast enhancement indicating hyperemia, and late gadolinium enhancement of replaced fibrotic tissue. Morphological abnormalities seen include transient increases in wall thickness and LV volumes during active myocarditis.
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A DETAILED STUDY ON SHOCK, MYOCARDIAL INFRACTION & STROKE
A DETAILED STUDY ON SHOCK, MYOCARDIAL INFRACTION & STROKE
Role of echocardiography in acute myocardial infraction
Role of echocardiography in acute myocardial infraction
Fibrinolysis in stemi a second thought- tip august 2016
Fibrinolysis in stemi a second thought- tip august 2016
Heart involvement in systemic lupus erythematosus,
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Similar to Takotsubo cardiomyopathy 2019
ST+ Mimics - Session Etat de l'Art - Le Syndrome de Takotsubo Congrès Urgence...
ST+ Mimics - Session Etat de l'Art - Le Syndrome de Takotsubo Congrès Urgence...Nicolas Peschanski, MD, PhD
1. The document discusses Takotsubo syndrome, or stress-induced cardiomyopathy, which causes transient left ventricular dysfunction.
2. It was first reported in Japan in 1990 and predominantly affects post-menopausal women. A stressful trigger, either emotional or physical, often precedes the onset.
3. While the exact pathophysiology is unknown, it is thought to involve microvascular spasm and catecholamine cardiotoxicity leading to calcium overload. This causes transient apical and mid-ventricular akinesia or dyskinesia.Broken heart syndrome. Diagnostics
Broken heart syndrome, also known as Takotsubo cardiomyopathy or stress-induced cardiomyopathy, is a condition where emotional or physical stress causes temporary weakening of the left ventricle. It affects about 1% of those experiencing a myocardial infarction and causes similar symptoms but is not caused by blocked arteries. Diagnosis involves EKG, echocardiogram, cardiac MRI and angiography showing normal arteries and left ventricular dysfunction. Treatment focuses on heart failure medicines and managing symptoms, and most patients fully recover heart function within weeks.
Takotsubo cardiomyopathy presentation.pptx
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The ECG shows evidence of hyperkalemia including peaked T waves and PR prolongation. Hyperkalemia is commonly seen in patients with chronic renal failure. While the T waves are subtly peaked, they are narrow-based, supporting the diagnosis of hyperkalemia. Chronic renal failure should be suspected as the underlying cause.
Early repolarization: Safety Profile
- Early repolarization is seen in 2-5% of the population and is characterized by J-point elevation and ST-segment slurring or notching, typically in the anterior chest leads.
- While traditionally considered benign, studies have linked early repolarization patterns, especially in the inferior leads, to fatal arrhythmias and sudden cardiac death.
- The prognostic significance may depend on the location and amplitude of the J-point elevation, with inferior locations and elevations over 0.2mV carrying higher risk.
- Early repolarization should not be diagnosed without clinical context and can be difficult to distinguish from conditions like pericarditis based on ECG patterns alone.
Acute MI - NSTEMI
An 81-year-old woman with a history of hypertension, diabetes, heart disease and abdominal pain was admitted to the hospital for worsening abdominal pain. Her ECG showed signs of a previous heart attack. Cardiac enzyme levels were elevated, leading to a diagnosis of a non-ST elevation myocardial infarction (NSTEMI). Angiography revealed blockages in her coronary arteries, which were treated with stent placement. NSTEMIs are less severe than ST elevation MIs and are usually caused by partial blockages that damage part of the heart muscle.
Ihd Presentation V4
The document discusses ischaemic heart disease (IHD). It is a leading cause of death worldwide. IHD occurs when there is an imbalance between the supply of oxygen and demand of the heart muscle, leading to ischemia. The main causes are atherosclerosis, thrombosis, or reduced blood flow. Biomarkers like troponin and CK are important for diagnosing acute coronary syndromes. Endothelial dysfunction and oxidative stress play key roles in the development of atherosclerosis and IHD. Atherothrombosis, characterized by sudden plaque rupture and thrombus formation, is the underlying pathological process.
Diagnostic approach of the adult with chest pain; Cardiology 2020
A "Diagnostic approach of the adult with chest pain" was made in 2020. It is related to Cardiovascular Medicine.
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Cardiology 4.6. Hypertrophic Cardiomyopathy HCM - Dr. Farjad Ikram
Dr. Farjad Ikram provides an overview of hypertrophic cardiomyopathy (HCM) beginning with the case of a 21-year-old male presenting with syncope and a family history notable for early death. Key diagnostic tests revealed left ventricular hypertrophy and outflow tract obstruction consistent with HCM. Treatment involves beta blockers to decrease obstruction and demand as well as implantable cardioverter defibrillators for risk of sudden cardiac death. The document then covers definition, epidemiology, etiology, clinical features, investigations and management of HCM in more detail over several sections.
EMGuideWire's Radiology Reading Room: Stress-Induced Cardiomyopathy
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Stress-Induced Cardiomyopathy and is brought to you by Jenna Pallansch, MD, Claire Lawson, NP, Shelby Hixson, PA, Emily Lipsitz, PA, Ashley Moore-Gibbs, DNP, Laszlo Littmann, MD, and John Symanski, MD.
Cns Stroke 5th Class Medstudents.
This document summarizes cerebrovascular disease and stroke. Stroke is the third leading cause of death and a common cause of disability. Imaging such as CT and MRI are used to distinguish between ischemic and hemorrhagic stroke and identify underlying vascular abnormalities. Risk factors include age, hypertension, cardiac sources of embolism, and other conditions. Treatment aims to reverse pathology, prevent complications, and reduce risk of further strokes.
Cns Stroke 5th Class.
This document summarizes cerebrovascular disease and stroke. Stroke is the third leading cause of death and a common cause of disability. Imaging such as CT and MRI are used to distinguish between ischemic and hemorrhagic stroke and identify underlying vascular abnormalities. Risk factors include age, hypertension, cardiac sources of embolism, and vascular diseases. Acute stroke is characterized by rapid onset neurological deficits localized to the brain region supplied by an occluded artery. Differential diagnosis includes tumors, infections, and seizures.
INTERESTING ECGS -- PART II
This document contains 16 medical cases involving electrocardiogram (ECG) readings and interpretations. Each case provides an ECG image and description of a patient's symptoms or medical history, and asks the reader to identify the diagnosis or next step. The document also includes explanations of various ECG patterns and conditions, such as R on T phenomenon, hyperkalemia, Brugada syndrome, lead reversals, and long QT interval with T-wave alternans. The goal is to teach readers how to properly analyze ECGs and apply that analysis to diagnosing cardiac conditions.
NurseReview.Org - Everything About Stroke Victims
1. The document discusses the differences and similarities between heart attacks and strokes, highlighting that while they both require urgent treatment, strokes can be more difficult to diagnose due to varied symptoms.
2. It provides details on warning signs of stroke and emphasizes the importance of calling 911 immediately if any signs appear in order to receive rapid treatment.
3. Prevention of both heart attacks and strokes is more effective than procedures, and controlling risk factors is key to reducing one's risk.
Cardiology 1.3. Syncope - by Dr. Farjad Ikram
Introduction to one of the more challenging symptoms to investigate. Syncope is transient loss of consciousness with loss of postural tone due to diffuse hypoperfusion of cerebral cortex, followed by rapid, complete and spontaneous recovery.
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Syncope 1 aortic stenosis
This document discusses a case study of an 80-year-old woman presenting with recurrent syncope and chest tightness on exertion. The three key points are:
1) The ECG shows left ventricular hypertrophy which, along with her history of a murmur, suggests she has aortic stenosis likely caused by a calcified bicuspid aortic valve.
2) Aortic stenosis typically presents with symptoms of chest pain, syncope or dyspnea on exertion, and on examination there is a characteristic murmur.
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Uvular edema
A young man presented with a swollen uvula (which he called a "swollen dingle dangle") after smoking marijuana for the first time the night before. Uvular edema, also known as Quinke's edema, can be caused by conditions like hereditary angioedema, allergic reactions, infections, medications/drugs like NSAIDs and ACE inhibitors, trauma, and smoking. While cannabis is a listed cause, it is likely due to thermal injury from the high burning temperature rather than genuine allergy in this case. Treatment would depend on the suspected cause but may include antibiotics for infection or anaphylaxis medication for allergic reaction.
Bartons fracture volar
A 75-year-old woman fell and landed on her outstretched right hand, causing swelling and tenderness in her wrist. An x-ray revealed a Barton's fracture of the distal radius, where the fracture line runs horizontally through the joint on an AP view and vertically on a lateral view. The fracture fragment was displaced proximally on the volar surface, indicating joint instability. Most patients with this intra-articular fracture requiring open reduction and internal fixation to regain stability and reduce arthritis risk, even if conservative treatment is considered for an older patient.
Coining therapy
A 54-year-old woman presents with fever, shortness of breath, and chest pain. On examination, linear bruises are seen on her back consistent with a folk remedy called "coining" used to relieve symptoms. While coining may provide partial relief, the presenting symptoms could indicate serious underlying medical conditions like pneumonia or pulmonary embolism that require diagnosis and treatment. The patient's care should involve pursuing these potential diagnoses through further evaluation rather than focusing on the folk remedy.
Cat scratch abcess picture and ultrasound
A 67-year-old man presented to the emergency department with a swollen right hand after being bitten by his cat three days prior. The clinical photo and ultrasound showed spreading cellulitis and abscess formation in the area of maximal redness and swelling. Cat bites carry a high risk of infection from Pasteurella species, particularly involving nearby tendons and joints. The man should be admitted and started on intravenous antibiotics, and his abscess should be opened, cleaned, and debrided in surgery.
Acetabular fracture
A 65-year old man crashed his bike into a group of cyclists and fell to the ground complaining of right hip pain. An x-ray showed he had a comminuted fracture of the right acetabulum with medial displacement of fragments. A CT scan was recommended to further characterize the injury and inform surgical planning. His treatment options included closed reduction, open reduction, or an acute acetabular prosthesis given the displacement.
Hypothermia ecg 2019
A 79-year-old man was brought to the emergency department after being found collapsed at home. He has a history of diabetes, hypertension, a stroke with residual weakness, and depression. His ECG shows slow atrial fibrillation and Osborne waves, consistent with a body temperature of 29.5°C, indicating moderate to severe hypothermia. Hypothermia is often caused by an underlying condition that leaves the patient unable to rewarm themselves, such as trauma, neurological issues, drugs, endocrine problems, or infection. Treatment focuses on rewarming with a forced air blanket and providing glucose to generate heat.
Battle's sign child 2019
The image shows bruising over the mastoid process, indicating a fracture of the base of the skull from the fall. Important symptoms and signs to identify those at higher risk of brain injury include dangerous mechanisms, decreased consciousness, repeated vomiting, and signs of skull fractures. This child needs a low-dose head CT scan after transfer to a pediatric trauma center given the loss of consciousness and signs of a skull fracture. Ongoing management will involve evaluating for risks of significant brain injury or need for neurosurgery.
Ankle dislocation 2019
A 37-year old man injured his right ankle after stepping in a pothole while jogging. His ankle appears deformed with the foot displaced laterally and posteriorly. The skin over the lower tibia also appears stretched and pale. This clinical presentation is most consistent with a fracture dislocation at the ankle joint. The priorities are to provide analgesia, reduce the injury in the emergency department to preserve skin integrity, and obtain an x-ray for orthopedic guidance before definitive repair. Initial analgesia could include nitrous oxide and narcotics, with additional sedation like propofol or ketamine if needed despite his fasting status.
Posterior shoulder dislocation 2019
The x-ray shows a posterior dislocation of the footballer's right shoulder. Key signs on the x-ray include a symmetrical "light bulb" shaped humeral head and widening of the gleno-humeral joint space. There is also likely a fracture fragment at the inferior rim of the glenoid. The injury should be managed by reducing the dislocation under procedural sedation using traction, abduction, and external rotation, known as the Milch method.
Hyperacute ami ecg 2019
The ECG shows changes suggestive of acute myocardial ischemia, including tall, peaked T waves in leads V2-V4 and possible ST elevation in leads V1 and III. The most important interventions are to give aspirin, heparin, and regular ECGs looking for ST elevation. The man likely needs urgent coronary angiography if ST elevation appears, or angiography soon otherwise, to treat his acute coronary syndrome.
Jefferson fracture xr and ct 2019
A 32-year-old man presented with severe neck pain after being dumped in heavy surf. An x-ray showed a burst fracture of the atlas (C1 vertebra), known as a Jefferson fracture, with fracture lines running vertically through the anterior and posterior arches. Jefferson fractures are caused by an axial load from above, such as falling on the head from height. Although many patients have no neurological deficits, this patient will require immobilization through prolonged use of a cervical collar as treatment, as confirmed by a subsequent CT scan.
Renal trauma ct 2019
A 27-year-old construction worker fell 3 meters and is complaining of abdominal and back pain. A urine test showed blood and his vitals suggest compensated shock. A CT scan revealed a grade 5 injury to the left kidney with shattered architecture, hematoma, and contrast extravasation, indicating active bleeding. The patient has a high chance of requiring a nephrectomy and needs urgent surgical referral. He requires controlled hypotensive resuscitation with sufficient fluids to maintain perfusion but not return to normal blood pressure, as over-resuscitation could worsen bleeding.
Raccoon eyes 2019
A 38-year-old man presents to the emergency department with a headache and nausea after being involved in a bar room brawl while intoxicated the previous night. On examination, he has bilateral bruising around his eyes known as "raccoon eyes" or "panda eyes", which is strongly suggestive of a base of skull fracture given his history of trauma. He will need a head CT scan to further characterize any skull fracture and assess for other significant injuries such as intracranial hemorrhage. He may require neurosurgical consultation and hospitalization for symptom management and monitoring.
Laryngeal injury 2019
A 13-year-old boy was injured after crashing a quad bike into a rope stretched across the track. While he was able to get up and walk away with only a sore neck, the doctor is concerned about potential injuries to his airway, cervical spine, or arteries in his neck. A CT scan and CT angiography are recommended to check for injuries to his larynx or fractures as well as tears or dissections of his carotid or vertebral arteries since his mechanism of injury carries risks of damage to these structures.
Dengue fever 2019
A 22-year old man recently returned from Timor with a fever, headache, body aches and pains, and now a rash. Given his symptoms and travel history, the most likely diagnosis is dengue fever. Blood tests should be performed to check for malaria, as well as a full blood count, electrolytes, liver and kidney function. A diagnosis of dengue can be confirmed by detecting antibodies in follow-up blood samples. With rest and over-the-counter pain medication, most dengue cases can be managed without hospitalization.
Dengue fever 2019
A 22-year old man recently returned from Timor with a fever, headache, body aches and pains, and now a rash. Given his symptoms and travel history, the most likely diagnosis is dengue fever. Blood tests should be performed to check for malaria, as well as a full blood exam, electrolytes, liver and kidney function. While dengue can often be managed as an outpatient, this patient should stay for observation and treatment of symptoms like fever and pain with paracetamol and fluids.
Bifasicular block ecg 2019
A 77-year-old woman presented to the emergency department after losing consciousness at church for about 30 seconds. Her ECG showed signs of a bifascicular block indicating issues with the right and left bundles of the heart's conduction system. Due to her unprovoked loss of consciousness and abnormal ECG, she is at risk of having another episode of complete heart block and should be admitted for monitoring. She may ultimately require a permanent pacemaker given the conduction abnormalities shown on her ECG in the absence of a reversible cause.
Benign bone cyst 7yo xray 2019
A 7-year-old boy complained of thigh pain after jumping from play equipment. An x-ray showed a lucency in his proximal right femur that appears to be a benign bone cyst. As he presented after injury, further investigation with MRI is recommended to check for possible micro-fractures. Treatment options include observation with activity limitation or potential surgery, as cysts sometimes resolve on their own but fracture could require healing.
Pupura fulminans 2019
A 6 month old child presented with fever, poor feeding, and drowsiness. Upon removing the child's sock, their foot appeared severely damaged, which is indicative of severe meningococcal sepsis or purpura fulminans. Treatment in the emergency department should include prompt intravenous access, urgent antibiotics like ceftriaxone, fluid boluses, and expedited transfer to the pediatric ICU. While survival is possible with intensive care, long-term complications such as renal failure and loss of limbs are common with this high-risk condition.
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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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/
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Takotsubo cardiomyopathy 2019
- 1. A 68 year old woman with a past history of hypertension, hypercholesterolaemia, smoking and panic disorder presented to ED in the morning with a 12 hour history of central chest pain and shortness of breath. Her ECG showed T wave inversion in leads V3 to V6 and her Troponin I was elevated at 1.1µg/L. The clinical diagnosis was a nonSTEMI so she went to the cathlab that morning. Her systolic ventriculogram image is shown. •Describe and interpret the image •What is the underlying cause of this disorder ? •What is the likely prognosis ?
- 3. The ventriculogram shows the classic form of so called “Takotsubo” cardiomyopathy with normal basal contraction but ballooning of the apex. (Compare this to a normal ventriculogram which is shown on the picture underneath this page). The same features are visible on echocardiography and indeed this can be used as a diagnostic or confirmatory test. This pattern could also be caused by localised myocardial ischaemia or infarction but in this case the coronary arteries were normal on angiography effectively confirming the diagnosis. Another name for Takotsubo is “broken heart syndrome”. It is thought to be a stress induced cardiomypoathy, probably due to inappropriately high circulating catecholamine levels. It has been reported after a number of life stresses such as bereavement, natural disasters and serious illnesses. The initial clinical presentation including the pain and ECG changes may be indistinguishable from that of typical myocardial ischaemia so it is a difficult diagnosis to make at ED presentation. The mortality for Takotsubo is much better than that for typical STEMI or nonSTEMI presentations. There may be early heart failure and the decreased left ventricular ejection may persist for weeks, but recovery is typical and the mortality is only reported as 1-3%.
- 4. Normal ventriculogram in both diastole (A) & Systole (B)