The document discusses Triple Rule Out CT (TRO-CT), which is a CT exam that evaluates the coronary arteries, pulmonary arteries, and aorta to diagnose causes of acute chest pain. TRO-CT is appropriate when there is suspicion of acute coronary syndrome along with pulmonary embolism or acute aortic syndrome. It describes the anatomy of the aorta, pulmonary arteries, and coronary arteries. It also discusses common causes of chest pain related to the heart, lungs, chest wall, and digestion. The criteria and exclusion criteria for TRO-CT are provided.
The document discusses the anatomy and physiology of the heart. It describes the heart's location and coverings including the pericardium. It details the heart chambers including the atria which receive blood and the ventricles which pump blood out. It explains the pathway of blood flow through the two circuits, pulmonary and systemic. It outlines the heart valves and electrical conduction system. Finally, it discusses the cardiac cycle and factors regulating cardiac output such as preload, contractility, and afterload.
The document discusses ruptured aneurysms of the aorta, specifically focusing on ruptured abdominal aortic aneurysms (RAAAs). It describes the typical presentation of RAAAs, which includes abdominal or back pain, hypotension, and the potential presence of a pulsatile abdominal mass. It notes that RAAAs have a high mortality rate if not treated emergently through open repair or potentially endovascular aneurysm repair (EVAR). Unusual presentations of RAAAs are also discussed, which can include symptoms like leg paralysis or groin/testicular pain that mimic other conditions and delay diagnosis.
USMLE CVS 004 Coronary circulation and venous drainage heart.pdfAHMED ASHOUR
The blood supply to the heart is crucial for its function as a muscular organ that pumps blood to the rest of the body.
The coronary circulation provides oxygen and nutrients to the heart muscle (myocardium).
Understanding the blood supply to the heart is crucial for diagnosing and treating cardiovascular conditions, and interventions such as coronary artery bypass grafting (CABG) may be performed to restore blood flow to the heart muscle in certain cases.
The document discusses the anatomy and imaging of the ascending aorta, aortic arch, and descending thoracic aorta. It describes the branches arising from each section of the aorta and the structures they supply. Imaging options for assessing the thoracic aorta are mentioned, including plain radiography, echocardiography, CT, MRI, and catheter angiography. Variations in aortic arch position and anomalies like right-sided aortic arch are also noted.
The document provides information about myocardial infarction (MI), also known as a heart attack. It discusses the structure and function of the heart, signs and symptoms of an MI, risk factors, diagnosis, and treatment options. Some key points:
- An MI occurs when blood flow to part of the heart is blocked, depriving heart muscle cells of oxygen and causing them to die. This is usually due to a blockage in one of the coronary arteries.
- Symptoms of an MI can include chest pain, sweating, shortness of breath, and pain radiating to the arms or jaw. Diagnosis involves ECG, blood tests, and imaging tests.
- Treatment may include oxygen, medications to
This document discusses coronary artery disease (CAD) and atherosclerosis. It defines CAD as a buildup of plaque in the coronary arteries that supply the heart with blood. Risk factors include age, family history, smoking, high blood lipids, and diabetes. Symptoms can include chest pain and shortness of breath. Diagnosis involves electrocardiograms, blood tests, and assessing cholesterol levels. Treatment includes lifestyle changes like a low-fat diet and medications to lower cholesterol and blood pressure.
The document discusses the anatomy and physiology of the heart. It describes the heart's location and coverings including the pericardium. It details the heart chambers including the atria which receive blood and the ventricles which pump blood out. It explains the pathway of blood flow through the two circuits, pulmonary and systemic. It outlines the heart valves and electrical conduction system. Finally, it discusses the cardiac cycle and factors regulating cardiac output such as preload, contractility, and afterload.
The document discusses ruptured aneurysms of the aorta, specifically focusing on ruptured abdominal aortic aneurysms (RAAAs). It describes the typical presentation of RAAAs, which includes abdominal or back pain, hypotension, and the potential presence of a pulsatile abdominal mass. It notes that RAAAs have a high mortality rate if not treated emergently through open repair or potentially endovascular aneurysm repair (EVAR). Unusual presentations of RAAAs are also discussed, which can include symptoms like leg paralysis or groin/testicular pain that mimic other conditions and delay diagnosis.
USMLE CVS 004 Coronary circulation and venous drainage heart.pdfAHMED ASHOUR
The blood supply to the heart is crucial for its function as a muscular organ that pumps blood to the rest of the body.
The coronary circulation provides oxygen and nutrients to the heart muscle (myocardium).
Understanding the blood supply to the heart is crucial for diagnosing and treating cardiovascular conditions, and interventions such as coronary artery bypass grafting (CABG) may be performed to restore blood flow to the heart muscle in certain cases.
The document discusses the anatomy and imaging of the ascending aorta, aortic arch, and descending thoracic aorta. It describes the branches arising from each section of the aorta and the structures they supply. Imaging options for assessing the thoracic aorta are mentioned, including plain radiography, echocardiography, CT, MRI, and catheter angiography. Variations in aortic arch position and anomalies like right-sided aortic arch are also noted.
The document provides information about myocardial infarction (MI), also known as a heart attack. It discusses the structure and function of the heart, signs and symptoms of an MI, risk factors, diagnosis, and treatment options. Some key points:
- An MI occurs when blood flow to part of the heart is blocked, depriving heart muscle cells of oxygen and causing them to die. This is usually due to a blockage in one of the coronary arteries.
- Symptoms of an MI can include chest pain, sweating, shortness of breath, and pain radiating to the arms or jaw. Diagnosis involves ECG, blood tests, and imaging tests.
- Treatment may include oxygen, medications to
This document discusses coronary artery disease (CAD) and atherosclerosis. It defines CAD as a buildup of plaque in the coronary arteries that supply the heart with blood. Risk factors include age, family history, smoking, high blood lipids, and diabetes. Symptoms can include chest pain and shortness of breath. Diagnosis involves electrocardiograms, blood tests, and assessing cholesterol levels. Treatment includes lifestyle changes like a low-fat diet and medications to lower cholesterol and blood pressure.
overview of heart and its disease
The heart is a powerful muscle that pumps
blood throughout the body by means of a
coordinated contraction.
The contraction is generated by an
electrical activation, which is spread by a
wave of bioelectricity that propagates in a
coordinated manner throughout the
heart.
It is located in thoracic cavity,
posterior to the sternum ,superior
to the diaphragm between the
lungs.
A human heart beats an average of
100,000 times per day. During that
time, it pumps more than 4,300
gallons of blood throughout
the entire body.
EPICARDIUM:
It is the outer layer of the wall of the heart which is composed of
connective tissue covered by epithelium. It is also known as
visceral pericardium.
2) MYOCARDIUM:
It is the muscular middle layer of the wall of the heart. It is
composed of spontaneously contracting cardiac muscle fibers
which allow the heart to contract. It stimulates heart contraction
to pump blood from the ventricles and relaxes the heart to allow
the arteries to receive blood.
ENDOCARDIUM:
It is the inner layer of the heart which consist of epithelial
tissue and connective tissue.
1. The document describes the anatomy and features of the superior vena cava, arch of aorta, and pulmonary trunk. It discusses the formation, course, branches, and relations of each structure.
2. The superior vena cava collects blood from the upper body and drains into the right atrium. The arch of aorta begins at the level of the right second costal cartilage and gives off three branches before continuing as the descending thoracic aorta.
3. The pulmonary trunk conveys deoxygenated blood from the right ventricle to the lungs, arising from the upper part of the right ventricle at the level of the left third costal cartilage.
USMLE CVS 001 Mediastinum anatomy medical chest .pdfAHMED ASHOUR
The mediastinum is the central compartment of the thoracic cavity, located between the lungs.
It is a three-dimensional space that houses various structures within the chest.
The mediastinum extends from the sternum (front of the chest) to the vertebral column (back of the chest) and from the superior thoracic aperture (top of the chest) to the diaphragm (bottom of the chest).
Understanding the anatomy of the mediastinum is crucial for healthcare professionals to interpret diagnostic findings and manage conditions affecting this central compartment of the thoracic cavity.
The document summarizes the anatomy and physiology of the heart. It describes the heart's location in the mediastinum and its coverings of pericardium. It details the heart's chambers, including the thin-walled atria that receive blood and the thicker-walled ventricles that pump blood to the lungs and body. The pathways of blood flow are explained, along with the heart's valves that enforce one-way flow. The coronary arteries that supply blood to the heart muscle are also outlined. Finally, the electrical conduction system is summarized, from the sinoatrial node setting the pacemaker rhythm through the Purkinje fibers activating contraction.
The document provides an overview of coronary CT angiography (CCTA). It discusses recent advances in CCTA technology including perfusion imaging, spectral imaging, and fractional flow reserve CT (FFR-CT). The anatomy and physiology of the coronary arteries is described. The document outlines the equipment, indications, procedures, and post-processing techniques used in CCTA. It also discusses calcium scoring, artifacts, case studies, radiation dose, and limitations of CCTA.
Tricuspid valve disease involves the valve on the right side of the heart. It can be caused by structural abnormalities present from birth (congenital) or acquired later in life. The two main types are tricuspid stenosis, where the valve does not open fully, and tricuspid regurgitation, where the valve does not close properly and allows blood to flow backward. Symptoms include fatigue, swelling, and pain. Diagnosis involves echocardiography and Doppler ultrasound of the heart. Treatment options include medical management or surgical repair or replacement of the tricuspid valve.
Valvular heart disease affects the mitral, aortic, tricuspid, and pulmonary valves. Imaging plays an important role in assessing valve stenosis and regurgitation, effects on ventricular function, and associated pulmonary pathologies. Echocardiography is the main imaging modality and can evaluate valve structure and function, ventricular size, and pressures. Chest x-ray is also useful and can show valve calcification and chamber enlargement. Imaging is used to assess disease severity and guide management.
This document discusses the development of the heart and fetal circulation. It then provides guidance on evaluating plain radiographs of congenital heart disease. Key findings include:
- Increased pulmonary vascularity can indicate increased venous or arterial flow, such as from left-to-right shunts in atrial septal defect (ASD) or ventricular septal defect (VSD).
- Decreased pulmonary vascularity suggests outflow tract issues as in Tetralogy of Fallot.
- Conditions like hypoplastic left heart present with pulmonary edema due to the left ventricle's inability to handle venous return.
- Fetal circulation has three shunts (ductus venosus, foramen
The aorta is the main artery that carries oxygenated blood from the heart to the rest of the body. It originates from the left ventricle and splits into the common iliac arteries in the abdomen. The aorta is divided into four sections - the ascending aorta, aortic arch, descending aorta, and abdominal aorta. It supplies blood to the entire body except the lungs. The aorta is composed of three layers - the tunica intima, tunica media, and tunica adventitia. Common conditions of the aorta include aneurysms, which involve abnormal dilations, and coarctation, which is a narrowing of the aorta.
The structure and Function of the Heart TessMiller519
The document provides an overview of heart anatomy and physiology. It describes the four chambers of the heart, including the atria and ventricles, separated by septa. Blood flows through the heart in two circuits - pulmonary circulation from the heart to the lungs and systemic circulation from the heart to the body. The heart's conduction system controls heart rate and rhythm through the sinoatrial node, atrioventricular node, and Purkinje fibers. An electrocardiogram traces the electrical activity of the heart as P, QRS, and T waves. High or low blood pressure can impact heart health.
Hey, these are the slides me n my friends made... Use them if u want to... for viewing the videos used click on the links given ahead.
http://www.youtube.com/watch?v=jzOti_MtmBk
http://www.youtube.com/watch?v=N9MARqmqSf4
http://www.youtube.com/watch?v=yokcKhqq48c
http://www.youtube.com/watch?v=rJZVFRJmc9M
A presentation on structural and functional properties of heartMahade Hashan
The document discusses the anatomy and function of the heart. It describes that William Harvey discovered the heart in the 17th century. The heart is located in the chest cavity and pumps blood through two circuits - the pulmonary and systemic circulations. The heart has four chambers and valves that ensure one-way blood flow. Common heart conditions include coronary heart disease, cardiomyopathy, and arrhythmias. Lifestyle changes, medications, procedures, and surgery are used to treat various heart diseases.
The heart is a hollow muscular organ located in the mediastinum. It has four chambers - right atrium, left atrium, right ventricle, and left ventricle. The heart is supplied by coronary arteries which arise from the aorta. It has dual innervation - sympathetic increases heart rate while parasympathetic decreases it. Deoxygenated blood enters the right atrium from the superior and inferior vena cava and is pumped to the lungs by the right ventricle. Oxygenated blood returns to the left atrium from the lungs and is pumped by the left ventricle throughout the body via the aorta. Heart valves ensure one-way blood flow through the chambers.
The document summarizes the cardiovascular system, including the circulatory and lymphatic systems. It describes the heart, blood vessels, blood flow through pulmonary and systemic circulation. It also discusses common diseases like atherosclerosis, heart attack, angina, and their diagnosis and treatment. The circulatory system functions to transport blood throughout the body, while the lymphatic system transports lymph and maintains fluid balance.
Atherosclerosis is a disease where fatty deposits build up in the arteries and restrict blood flow. It is the leading cause of heart attacks and occurs when cholesterol builds up on the inner walls of the arteries that supply the heart. Over time, this buildup narrows the arteries and reduces blood flow. If a blocked artery completely closes off, it can cause a heart attack. Risk factors include high blood pressure, smoking, obesity, lack of exercise, diabetes, and high cholesterol. Treatment options depend on the severity and can include lifestyle changes, medications, angioplasty, stents, or bypass surgery to reroute blood flow around blocked arteries.
USMLE CVS 005 Blood vessels – Arteries and veins.pdfAHMED ASHOUR
The major blood vessels in the human body form an extensive network that facilitates the transportation of blood, oxygen, and nutrients to various tissues and organs.
Understanding the anatomy and function of major blood vessels is essential for comprehending the circulatory system and diagnosing and treating cardiovascular conditions.
The document discusses the anatomy and physiology of the cardiovascular system. It covers topics such as heart anatomy, heart valves and circulation, cardiac muscle tissue, the cardiac conduction system, the cardiac cycle, cardiac output, regulation of stroke volume, exercise and the heart, and blood supply to the myocardium. The key points are:
1. The heart is located in the mediastinum and has four chambers - two upper atria and two lower ventricles.
2. Blood flows through the heart in two circuits - systemic circulation through the left side of the heart and pulmonary circulation through the right side.
3. Cardiac output is calculated as stroke volume multiplied by heart rate and is regulated by factors like pre
1. The document discusses a demo class on myocardial infarction (MI) or heart attack. It defines MI as the death of heart muscle from interrupted blood supply.
2. Risk factors for MI include smoking, high blood pressure, high cholesterol, lack of physical activity, and more. Causes are typically coronary artery disease, blood clots, or coronary artery spasms.
3. Diagnostic tests discussed are electrocardiogram, stress test, echocardiogram, coronary angiography and more to evaluate symptoms, location, and extent of MI.
Coronary artery disease is one of the most common and serious effects of aging where fatty deposits build up in the walls of blood vessels and narrow the passageway for blood flow. Over time, this condition called atherosclerosis can lead to a blockage of the coronary arteries and a heart attack. The heart is a muscle that pumps blood through the lungs and body to provide oxygen and nutrients. The coronary arteries supply blood to the heart muscle itself. Risk factors for coronary artery disease include high blood pressure, high cholesterol, smoking, obesity, and lack of physical activity. Treatment options depend on the severity of blockages and may include lifestyle changes, medications, angioplasty, stenting, or bypass surgery.
This document discusses imaging techniques for evaluating obstructive jaundice. It begins by describing jaundice and its causes, including prehepatic, hepatic, and post-hepatic (obstructive) etiologies. For obstructive jaundice, imaging plays a key role in identifying the level and cause of obstruction. Ultrasound is often the initial study, while CT, MRCP, ERCP, and intraoperative ultrasound may provide additional information. The document outlines various imaging techniques and their abilities to characterize common causes of obstruction like stones, strictures, and malignancies. It emphasizes the importance of determining the presence, level, and cause of obstruction to guide management.
The document discusses cardiomyopathy, which refers to diseases of the heart muscle. There are three main types - dilated, hypertrophic, and restrictive. Dilated cardiomyopathy involves an enlarged and weakened left ventricle. Causes include viral infections, toxins, and genetic factors. Symptoms range from fatigue to breathing difficulties. Diagnosis involves echocardiography, ECG, and cardiac catheterization. Treatment focuses on medications and lifestyle changes to manage symptoms.
overview of heart and its disease
The heart is a powerful muscle that pumps
blood throughout the body by means of a
coordinated contraction.
The contraction is generated by an
electrical activation, which is spread by a
wave of bioelectricity that propagates in a
coordinated manner throughout the
heart.
It is located in thoracic cavity,
posterior to the sternum ,superior
to the diaphragm between the
lungs.
A human heart beats an average of
100,000 times per day. During that
time, it pumps more than 4,300
gallons of blood throughout
the entire body.
EPICARDIUM:
It is the outer layer of the wall of the heart which is composed of
connective tissue covered by epithelium. It is also known as
visceral pericardium.
2) MYOCARDIUM:
It is the muscular middle layer of the wall of the heart. It is
composed of spontaneously contracting cardiac muscle fibers
which allow the heart to contract. It stimulates heart contraction
to pump blood from the ventricles and relaxes the heart to allow
the arteries to receive blood.
ENDOCARDIUM:
It is the inner layer of the heart which consist of epithelial
tissue and connective tissue.
1. The document describes the anatomy and features of the superior vena cava, arch of aorta, and pulmonary trunk. It discusses the formation, course, branches, and relations of each structure.
2. The superior vena cava collects blood from the upper body and drains into the right atrium. The arch of aorta begins at the level of the right second costal cartilage and gives off three branches before continuing as the descending thoracic aorta.
3. The pulmonary trunk conveys deoxygenated blood from the right ventricle to the lungs, arising from the upper part of the right ventricle at the level of the left third costal cartilage.
USMLE CVS 001 Mediastinum anatomy medical chest .pdfAHMED ASHOUR
The mediastinum is the central compartment of the thoracic cavity, located between the lungs.
It is a three-dimensional space that houses various structures within the chest.
The mediastinum extends from the sternum (front of the chest) to the vertebral column (back of the chest) and from the superior thoracic aperture (top of the chest) to the diaphragm (bottom of the chest).
Understanding the anatomy of the mediastinum is crucial for healthcare professionals to interpret diagnostic findings and manage conditions affecting this central compartment of the thoracic cavity.
The document summarizes the anatomy and physiology of the heart. It describes the heart's location in the mediastinum and its coverings of pericardium. It details the heart's chambers, including the thin-walled atria that receive blood and the thicker-walled ventricles that pump blood to the lungs and body. The pathways of blood flow are explained, along with the heart's valves that enforce one-way flow. The coronary arteries that supply blood to the heart muscle are also outlined. Finally, the electrical conduction system is summarized, from the sinoatrial node setting the pacemaker rhythm through the Purkinje fibers activating contraction.
The document provides an overview of coronary CT angiography (CCTA). It discusses recent advances in CCTA technology including perfusion imaging, spectral imaging, and fractional flow reserve CT (FFR-CT). The anatomy and physiology of the coronary arteries is described. The document outlines the equipment, indications, procedures, and post-processing techniques used in CCTA. It also discusses calcium scoring, artifacts, case studies, radiation dose, and limitations of CCTA.
Tricuspid valve disease involves the valve on the right side of the heart. It can be caused by structural abnormalities present from birth (congenital) or acquired later in life. The two main types are tricuspid stenosis, where the valve does not open fully, and tricuspid regurgitation, where the valve does not close properly and allows blood to flow backward. Symptoms include fatigue, swelling, and pain. Diagnosis involves echocardiography and Doppler ultrasound of the heart. Treatment options include medical management or surgical repair or replacement of the tricuspid valve.
Valvular heart disease affects the mitral, aortic, tricuspid, and pulmonary valves. Imaging plays an important role in assessing valve stenosis and regurgitation, effects on ventricular function, and associated pulmonary pathologies. Echocardiography is the main imaging modality and can evaluate valve structure and function, ventricular size, and pressures. Chest x-ray is also useful and can show valve calcification and chamber enlargement. Imaging is used to assess disease severity and guide management.
This document discusses the development of the heart and fetal circulation. It then provides guidance on evaluating plain radiographs of congenital heart disease. Key findings include:
- Increased pulmonary vascularity can indicate increased venous or arterial flow, such as from left-to-right shunts in atrial septal defect (ASD) or ventricular septal defect (VSD).
- Decreased pulmonary vascularity suggests outflow tract issues as in Tetralogy of Fallot.
- Conditions like hypoplastic left heart present with pulmonary edema due to the left ventricle's inability to handle venous return.
- Fetal circulation has three shunts (ductus venosus, foramen
The aorta is the main artery that carries oxygenated blood from the heart to the rest of the body. It originates from the left ventricle and splits into the common iliac arteries in the abdomen. The aorta is divided into four sections - the ascending aorta, aortic arch, descending aorta, and abdominal aorta. It supplies blood to the entire body except the lungs. The aorta is composed of three layers - the tunica intima, tunica media, and tunica adventitia. Common conditions of the aorta include aneurysms, which involve abnormal dilations, and coarctation, which is a narrowing of the aorta.
The structure and Function of the Heart TessMiller519
The document provides an overview of heart anatomy and physiology. It describes the four chambers of the heart, including the atria and ventricles, separated by septa. Blood flows through the heart in two circuits - pulmonary circulation from the heart to the lungs and systemic circulation from the heart to the body. The heart's conduction system controls heart rate and rhythm through the sinoatrial node, atrioventricular node, and Purkinje fibers. An electrocardiogram traces the electrical activity of the heart as P, QRS, and T waves. High or low blood pressure can impact heart health.
Hey, these are the slides me n my friends made... Use them if u want to... for viewing the videos used click on the links given ahead.
http://www.youtube.com/watch?v=jzOti_MtmBk
http://www.youtube.com/watch?v=N9MARqmqSf4
http://www.youtube.com/watch?v=yokcKhqq48c
http://www.youtube.com/watch?v=rJZVFRJmc9M
A presentation on structural and functional properties of heartMahade Hashan
The document discusses the anatomy and function of the heart. It describes that William Harvey discovered the heart in the 17th century. The heart is located in the chest cavity and pumps blood through two circuits - the pulmonary and systemic circulations. The heart has four chambers and valves that ensure one-way blood flow. Common heart conditions include coronary heart disease, cardiomyopathy, and arrhythmias. Lifestyle changes, medications, procedures, and surgery are used to treat various heart diseases.
The heart is a hollow muscular organ located in the mediastinum. It has four chambers - right atrium, left atrium, right ventricle, and left ventricle. The heart is supplied by coronary arteries which arise from the aorta. It has dual innervation - sympathetic increases heart rate while parasympathetic decreases it. Deoxygenated blood enters the right atrium from the superior and inferior vena cava and is pumped to the lungs by the right ventricle. Oxygenated blood returns to the left atrium from the lungs and is pumped by the left ventricle throughout the body via the aorta. Heart valves ensure one-way blood flow through the chambers.
The document summarizes the cardiovascular system, including the circulatory and lymphatic systems. It describes the heart, blood vessels, blood flow through pulmonary and systemic circulation. It also discusses common diseases like atherosclerosis, heart attack, angina, and their diagnosis and treatment. The circulatory system functions to transport blood throughout the body, while the lymphatic system transports lymph and maintains fluid balance.
Atherosclerosis is a disease where fatty deposits build up in the arteries and restrict blood flow. It is the leading cause of heart attacks and occurs when cholesterol builds up on the inner walls of the arteries that supply the heart. Over time, this buildup narrows the arteries and reduces blood flow. If a blocked artery completely closes off, it can cause a heart attack. Risk factors include high blood pressure, smoking, obesity, lack of exercise, diabetes, and high cholesterol. Treatment options depend on the severity and can include lifestyle changes, medications, angioplasty, stents, or bypass surgery to reroute blood flow around blocked arteries.
USMLE CVS 005 Blood vessels – Arteries and veins.pdfAHMED ASHOUR
The major blood vessels in the human body form an extensive network that facilitates the transportation of blood, oxygen, and nutrients to various tissues and organs.
Understanding the anatomy and function of major blood vessels is essential for comprehending the circulatory system and diagnosing and treating cardiovascular conditions.
The document discusses the anatomy and physiology of the cardiovascular system. It covers topics such as heart anatomy, heart valves and circulation, cardiac muscle tissue, the cardiac conduction system, the cardiac cycle, cardiac output, regulation of stroke volume, exercise and the heart, and blood supply to the myocardium. The key points are:
1. The heart is located in the mediastinum and has four chambers - two upper atria and two lower ventricles.
2. Blood flows through the heart in two circuits - systemic circulation through the left side of the heart and pulmonary circulation through the right side.
3. Cardiac output is calculated as stroke volume multiplied by heart rate and is regulated by factors like pre
1. The document discusses a demo class on myocardial infarction (MI) or heart attack. It defines MI as the death of heart muscle from interrupted blood supply.
2. Risk factors for MI include smoking, high blood pressure, high cholesterol, lack of physical activity, and more. Causes are typically coronary artery disease, blood clots, or coronary artery spasms.
3. Diagnostic tests discussed are electrocardiogram, stress test, echocardiogram, coronary angiography and more to evaluate symptoms, location, and extent of MI.
Coronary artery disease is one of the most common and serious effects of aging where fatty deposits build up in the walls of blood vessels and narrow the passageway for blood flow. Over time, this condition called atherosclerosis can lead to a blockage of the coronary arteries and a heart attack. The heart is a muscle that pumps blood through the lungs and body to provide oxygen and nutrients. The coronary arteries supply blood to the heart muscle itself. Risk factors for coronary artery disease include high blood pressure, high cholesterol, smoking, obesity, and lack of physical activity. Treatment options depend on the severity of blockages and may include lifestyle changes, medications, angioplasty, stenting, or bypass surgery.
This document discusses imaging techniques for evaluating obstructive jaundice. It begins by describing jaundice and its causes, including prehepatic, hepatic, and post-hepatic (obstructive) etiologies. For obstructive jaundice, imaging plays a key role in identifying the level and cause of obstruction. Ultrasound is often the initial study, while CT, MRCP, ERCP, and intraoperative ultrasound may provide additional information. The document outlines various imaging techniques and their abilities to characterize common causes of obstruction like stones, strictures, and malignancies. It emphasizes the importance of determining the presence, level, and cause of obstruction to guide management.
The document discusses cardiomyopathy, which refers to diseases of the heart muscle. There are three main types - dilated, hypertrophic, and restrictive. Dilated cardiomyopathy involves an enlarged and weakened left ventricle. Causes include viral infections, toxins, and genetic factors. Symptoms range from fatigue to breathing difficulties. Diagnosis involves echocardiography, ECG, and cardiac catheterization. Treatment focuses on medications and lifestyle changes to manage symptoms.
Interventional radiology is a subspecialty of radiology that performs minimally invasive medical procedures using image guidance. Common procedures include angioplasty, stent placement, biopsy, drainage, and embolization. The Seldinger technique is commonly used to access blood vessels through a small skin puncture using guidewires and catheters. Embolization procedures use various agents like particles, coils, liquid embolics, and glues to occlude blood flow. Applications of interventional radiology procedures include treatment of liver tumors, portal hypertension, varicose veins, and bone tumors.
Bronchial artery embolization (BAE) is a minimally invasive procedure used to control massive or recurrent hemoptysis by occluding the blood supply from abnormal bronchial vessels. It involves catheterizing the bronchial arteries under imaging guidance and injecting embolic agents like particles or coils to cut off the blood flow. BAE has success rates of 64-100% for immediate bleeding control and is preferred over surgery due to lower risks, especially in high-risk patients. Potential complications include recurrence of bleeding from collateral vessels or reopening of embolized arteries, and rarely, spinal cord damage from unintended embolization of critical radiculomedullary branches.
EUS has revolutionized both the diagnostic and therapeutic aspects of gastroenterology. It combines an endoscope with an ultrasound probe to examine the GI tract walls and nearby structures. EUS is very useful for staging cancers of the esophagus, pancreas, and biliary tract, and is the most sensitive method for distinguishing between benign and malignant pancreatic tumors. EUS also has several important therapeutic roles, including draining pancreatic fluid collections, accessing the biliary tree non-surgically, celiac plexus neurolysis for pancreatic cancer pain relief, and delivering targeted cancer treatments. Recent advances have further increased the diagnostic and therapeutic capabilities of EUS.
Digital subtraction angiography (DSA) is a type of angiography that involves injecting a contrast agent and digitally subtracting images before and after injection to visualize blood vessels. It was developed in the 1970s and allows for real-time visualization of vessels. DSA is used both diagnostically to identify issues like aneurysms, and therapeutically for procedures like aneurysm coiling. The procedure involves accessing an artery, usually in the groin, inserting a catheter and injecting contrast to acquire images of the vasculature.
A catheter is a hollow, flexible tube that can be inserted into the body. It allows for drainage, injection of fluids, or access by surgical instruments. Catheters are made of various polymers like silicone, PVC, or polyethylene. They have parts like a hub, body, and tip. Catheter size is measured using the French scale by dividing the French number by 3. There are various types of catheters classified by shape, size, or use. The Seldinger technique is commonly used for catheter insertion using a needle and guidewire. Radiologists play a key role in procedures like angiography, chemoembolization, stent placement, and drainage of obstructions using catheters.
PACS (Picture Archiving and Communications System) is a medical imaging technology that provides economical storage and access to images from multiple modalities. It began development in the 1950s and was further advanced by the military in the 1980s. PACS replaces film storage with electronic images that can be accessed from various workstations, integrated with patient data, and viewed remotely. It consists of imaging modalities, a network, workstations, and archives. PACS provides benefits like hard copy replacement and remote access, but also has disadvantages like high costs and potential for lost images.
This document discusses radiotherapy planning for pituitary adenoma. It begins with an introduction to pituitary adenomas and the role of radiotherapy in management. Key steps in the radiotherapy planning process are then outlined, including patient evaluation, immobilization, imaging, image fusion, target delineation, dose prescription, and consideration of organs at risk. Target volumes are defined based on MRI images and dose-volume constraints are established for critical structures like the optic pathways and pituitary gland. The document provides guidance on optimizing the radiotherapy plan for effective treatment of pituitary adenomas while minimizing risks of toxicity.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2. Objective
To assess the validity and efficacy of Triple-rule-out (TRO) computed
tomographic (CT) angiography in diagnosis of different vascular
causes of chest pain.
3. Triple Rule Out CT
TRO-CTA is a specialized computed tomography (CT) imaging exam
tailored to evaluate for pathology within the coronary arteries,
pulmonary arteries, and the aorta in a single CT study, hence the
name ‘triple-rule out’.
4. Why we take TRO-CT?
Acute chest pain is the second most common presentation after abdominal pain
in the emergency department.
represents a major diagnostic challenge in emergency care as it has a broad
differential diagnosis varying from benign causes to life-threatening conditions.
TRO studies are most appropriate and cost-effective when there is a suspicion
for acute coronary syndrome along with other diagnoses such as pulmonary
embolism, acute aortic syndrome, or nonvascular disease in the thorax.
5. Most common causes of Chest Pain
Acute Coronary Syndrome
Pulmonary Embolism
Acute Aortic Syndrome
6. Causes of Chest pain
Heart related causes
Heart-attack
Angina
Aortic Dissection
Digestive Causes
Chest pain can be caused by disorders of the digestive system,
including:
Heartburn
Swallowing disorders
Gallbladder or pancreas problems
7. Muscle and bone causes
Some types of chest pain are associated with injuries and other
problems affecting the structures that make up the chest wall,
including:
Costochondritis
Injured rib
Lung-related causes
lung disorders can cause chest pain, including:
Pulmonary embolism
Pleurisy
Pulmonary hypertension
8. In many clinical situations, a definite diagnosis of ED chest pain is not
possible solely based on clinical symptoms and laboratory findings.
In addition, most diagnostic modalities (i.e., ECG, cardiac enzymes,
exercise treadmill testing, radionuclide perfusion imaging and stress
echocardiography) other than MDCT are focused on the diagnosis or
exclusion of ACS and do not exclude other life-threatening causes of
acute chest pain.
9. For this reason, Triple Role Out (TRO) protocol with ECG-gating
technology has been proposed to encompass the entire thorax,
allowing simultaneous evaluation of coronary arteries, thoracic aorta
and pulmonary arteries for improving diagnosis of acute chest pain in
a single study.
10. Criteria for TRO_CT study
Clinical presentation – low to moderate risk of ACS
Clinical presentation – non ACS diagnosed considered
Normal ECG or non-specific changes
Patient able to tolerate CT and hold breath
Cardiac rhythm acceptable ECG gated scan
Adequate renal function
11. Exclusion criteria
Contra-indications to iodinated contrast material including known
allergy and renal insufficiency (serum creatinine more than 1.4
mg/dl).
Marked heart failure.
Clinically unfit patients (unable to stop breathing during the
examination).
Extensive calcium score above 1000.
12. Why don’t we take coronary angiography above 1000 calcium score?
Because of blooming artifacts, which can cause erroneous
enlargement of calcification, make less accuracy to determine the
coronary arteries lumen that results in false positive diagnosis.
Fig: (A) shows enlargement in the lumen of RCA because of the blooming artifacts
(B) shows normal in state of RCA
13. Anatomy of Aorta, Pulmonary and Coronary
Aorta
the largest blood vessel in the body.
responsible for transporting oxygen rich blood from your heart to the
rest of the body.
begins at the left ventricle of the heart, extending upward into the
chest to form an arch.
downward into the abdomen, where it branches into the iliac arteries
just above the pelvis.
14. Aortic Root
the portion of the aorta that is attached to the heart.
major part of the aortic root is the aortic valve
allows blood to flow from the heart
to the rest of the body
when it is open and prevents blood
from flowing backwards into the heart when it is closed.
15. Ascending Aorta
begins at the sinotubular junction of the aortic root and extends up
and out from the heart until it connects with the aortic arch.
16. Aortic Arch
the portion of the aorta that is in the shape of an arch and connects the
ascending aorta with the descending aorta.
The major arteries : the brachiocephalic artery,
the left carotid artery and the left subclavian artery.
17. Descending Thoracic Aorta
begins at the end of the aortic arch and continues down into the
abdomen. Two parts:
1. T. aorta(provides blood to the muscles of the chest wall and the
spinal cord.)
2. Ab.Aorta (five arteries that branch from the abdominal aorta: the
celiac artery, the superior mesenteric artery, the inferior
mesenteric artery, the renal arteries and the iliac arteries)
18. celiac artery superior mesenteric artery
inferior mesenteric artery renal arteries iliac arteries
Stomach
Liver
Pancreas
supplies blood to the small
intestine
supplies blood to the large
intestine
blood to the kidneys as well
as the muscles of the
abdominal wall and the lower
spinal cord
blood to the legs and the
organs in the pelvis.
Figure: shows five arteries from the abdominal aorta and their blood
supply
19. Thoracic aorta disease
1. aortic aneurysms and dissections,
2. atherosclerotic disease,
3. infections and
4. traumatic injuries.
Note: Ruptured thoracic aortic aneurysms and aortic dissections represent
life-threatening emergencies that require immediate medical attention.
Thoracic aortic aneurysms affect approximately 15,000 people in the United
States each year
21. The most common types of aortic aneurysms are thoracic and
abdominal. In addition, the following can signal a more serious
condition:
1. Sudden and severe chest pain
2. Fainting
3. Leg pain or numbness
4. Shortness of breath
5. Weakness
22. Coronary Artery
heart is mostly supplied by the two coronary arteries which arise
from the ascending aorta immediately above the aortic valve.
coronary arteries and their branches run on the surface of the heart.
RCA
arise from the anterior aortic sinus of the ascending aorta
immediately above the aortic valve.
first runs forwards between the pulmonary trunk and the right
auricle.
23. Then, it descends almost vertically enter the rt. Atrioventricular
groove, the rt. anterior coronary sulcus. At the inferior border of the
heart, it turns posteriorly and runs into the atrioventricular groove,
after the posterior interventricular groove finally anastomosing with
the LCA.
24. LCA
arise from the left posterior aortic sinus of the ascending aorta, immediately
above the aortic valve and enters the left between the pulmonary trunk and the
left auricle. then divides into the anterior interventricular artery also know as left
anterior descending artery which runs downwards in the anterior interventricular
groove to the apex of the heart.
25.
26. Clinical Correlation
Angina Pectoris – since coronary arteries are narrowed, the blood
supply to the cardiac muscles is reduced.
As a result, on exertion, the patient feels moderately severe pain in
region of the left pericardium last as long as 20 mins.
Pain is often referred to the left shoulder and medial side of the arm
and forearm.
Angina pectoris pain occurs on exertion and relieved by rest.
27. Myocardial Infarction
sudden block of the larger branches of either coronary artery usually
leads to myocardial ischaemia followed by the myocardial necrosis
(myocardial infarction).
Part of the heart suffering from MI, stops functioning and often
causes death.
This condition is termed as the heart attack or coronary attack.
28. Clinical features of MI
Sensation of pressure, sinking and pain in the chest that lasts longer
than 30 minutes.
Nausea (or) vomiting, sweating, shortness of breath, and tachycardia.
Pain radiates to the medial side of the arm, forearm, and hand.
Sometimes, it may be referred to jaw or neck.
29. Sites of coronary artery occlusion
The three most common site of CAO are
1. Anterior interventricular artery or LAD (40-50%),
2. RCA (30-40%)
3. Circumflex branch of LCA (15-20%)
NOTE: MI mostly occurs at rest whereas angina occurs on exertion.
30. Blood supply of the major coronary arteries
The 2 main coronary arteries are the left main and right coronary arteries.
Left main coronary artery (LMCA).
The left main coronary artery supplies blood to the left side of the heart
muscle (the left ventricle and left atrium). The left main coronary divides into
branches:
1. The left anterior descending artery branches off the left coronary artery and
supplies blood to the front of the left side of the heart.
2. The circumflex artery branches off the left coronary artery and encircles the
heart muscle. This artery supplies blood to the outer side and back of the heart.
31. Right coronary artery (RCA)
The right coronary artery supplies blood to the right ventricle, the right
atrium, and the SA (sinoatrial) and AV (atrioventricular) nodes, which
regulate the heart rhythm.
The right coronary artery divides into smaller branches, including the right
posterior descending artery and the acute marginal artery.
Together with the left anterior descending artery, the right coronary
artery helps supply blood to the middle or septum of the heart.
34. Types of Circulation
Pulmonary Circulation
the portion of the cardiovascular system that carries oxygen-poor
(deoxygenated) blood from the heart to the lungs and returns
oxygenated blood back to the heart.
deoxygenated blood from the body leaves the right ventricle through
the pulmonary arteries, which carry the blood to each lung.
34
35. Cont.;
pulmonary arteries are the only arteries that carry deoxygenated
blood.
In the lungs, red blood cells release carbon dioxide and pick up
oxygen during respiration.
The oxygenated blood then leaves the lungs through the pulmonary
veins, which return it to the left side of the heart and complete the
pulmonary cycle.
36. Cont.;
The oxygenated blood is then distributed to the body through the
systemic circulation before returning again to the pulmonary
circulation.
37. Fig: The pulmonary circulation carries blood between the heart and lungs.
38. Systemic Circulation
the portion of the cardiovascular system that carries oxygenated
blood from the heart to the body and returns deoxygenated blood
back to the heart.
Oxygenated blood from the lungs leaves the left ventricle through the
aorta.
From here it is distributed to the body's organs and tissues, which
absorb the oxygen through a complex network of arteries, arterioles,
and capillaries.
39. Cont.;
The deoxygenated blood is then collected by venules and flows into
veins before reaching the inferior and superior venae cavae, which
return it to the right heart, completing the systemic cycle.
The blood is then re-oxygenated through the pulmonary circulation
before returning again to the systemic circulation.
40. Fig: The systemic circulation. The systemic circulation brings oxygenated blood to the body cells and tissues and
transports cellular wastes away from the cells and tissues. It is also responsible for temperature regulation and
transport of hormones and other substances around the body.
41. Coronary Circulation
the heart needs its own blood supply, which it gets through the
coronary circulation.
the heart muscle tissue is so thick that it needs blood vessels to
deliver oxygen and nutrients deep within it.
The vessels that deliver oxygen-rich blood to the heart muscle are
called coronary arteries.
42. Cont.;
branch directly from the aorta, just above the heart.
The vessels that remove the deoxygenated blood from the heart
muscle are known as cardiac veins.
44. Patient preparation for TRO
An 18–20-gauge intravenous catheter is placed into a large vein in the
antecubital fossa.
The patient is lying in a supine position with arm in front of him.
ECG leads are positioned above and below the level of the scan to prevent
streak artifact.
The ideal heart rate for ECG-gated studies is a slow regular rhythm, usually
a sinus bradycardia at 50–60 beats per minute.
Oral-blockers may be given at least 1 h before the scan for control of heart
rate.
45. Contrast material and scanning protocol
In order to image both the coronary and pulmonary arteries, a biphasic
injection technique was used: 70 mL of undiluted (ultravist 370) was
injected at 5 mL/s, followed by 25 mL of the same contrast material diluted
with 25 mL of saline, also injected at 5 mL/s.
For injection Protocol we used a bolus tracking technique where we
started contrast medium injection when the HU in the left atrium reached
100 HU then in the second phase we depended on the observation, for
assessment of the opacification of the pulmonary artery.
46. The first phase of the injection opacifies the coronary arteries during
image acquisition, while the second phase of the injection, provides
simultaneous homogeneous enhancement of the pulmonary arteries.
Data acquisition starts from the level of the medial end of the
clavicles to the lower border of the heart in cranio–caudal direction.
47. Fig: Typical Z axis coverage in dedicated coronary CT angiography versus triple rule-out study. A: the field of view in a
dedicated coronary CT angiography is demonstrated. B: note the increased Z axis length in the triple rule-out study
compared with dedicated coronary CT angiography.
48. Data evaluation
For coronary assessment every case was evaluated in the axial plane
and with slab maximum intensity projection images that were rotated
to visualize each vessel in multiple planes.
Vessels with complex plaque were also evaluated with curved
multiplanar reconstruction by using vessel tracking software with
automatic centerline determination.
49. Different parts of the thoracic aorta regarding their diameter,
contrast filling, presence of filling defects, dissections, wall
irregularities, calcification, mural thrombus.
The main pulmonary artery, right and left pulmonary arteries, their
segmental and subsegmental branches, regarding their diameter,
contrast filling, presence of filling defects, wall irregularities,
calcification, mural thrombus.
51. Female patient 37 year old presenting with acute chest pain, dyspnea and hemoptysis. CT axial (A and B),
sagittal (C) and (D) images of pulmonary angiography showing left main and segmental pulmonary embolism
and left sided pleural effusion.
52. Triple rule-out CT angiography images (sagittal and axial views) of two patients with aortic dissection,
with standard (a, b) and low dose (c, d). The diagnostic and image quality were excellent in both patients
in the left descending artery (white arrow), the aorta(white star) and the pulmonary artery (arrowhead).
The first patient had an history of surgical replacement of the ascending aorta.
53. Pros
TRO CT can reduce
(a) time for patient triage,
(b) number of required diagnostic tests,
(c) costs, and
(d) radiation exposure to the patient.
54. Limitations
Beta-blockers that are required for coronary CTA may not be safe in
patients with pulmonary embolism.
Obesity and calcifications limit interpretation, rapid heart rate,
arrhythmias, renal dysfunction and contrast allergies.
55. Conclusion
Since there are a lot of chest pain cases in emergency department , it is difficult
to know the real cause of chest pain.
triple rule out is a relatively new technique, examination the coronary arteries,
pulmonary arteries and aorta in just a single study, which gives us the advantage
of screening emergency patients presenting with chest pain in a rapid and safe
way for detection of their vascular diseases.
In addition, it can reduce the radiation dose to the patient because it investigates
the coronary arteries, pulmonary arteries and aorta in just a single study and we
don’t need to separated studies to check those of them.
That’s why, it is most effective investigation to know the origin of abnormalities
even though it has still challenges.
56. References
Pitts SR, Niska RW, Xu J, Burt CW. National hospital ambulatory
medical care survey: 2006 emergency department summary. Natl
Health Stat Rep 2008;7:1–8.
Stillman AE, Oudkerk M, Ackerman M. Use of multidetector
computed tomography for the assessment of acute chest pain:
aconsensus statement of the North American Society of Cardiac
Imaging and the European Society of Cardiac Radiology. Int J
Cardiovascular Imaging 2007;23:415–27.
Thomas J, Rideau AM, Paulson EK, Bisset 3rd GS. Emergency
department imaging: current practice. J Am Coll Radiol
2008;5(7):811–816e2.
57. Kevin M, Ethan J. Evaluation of a ‘‘Triple Rule-Out’’ coronary CT
angiography protocol: use of 64-section CT in low-tomoderate risk
emergency department patients suspected of having acute coronary
syndrome. Radiology 2008;248(2).
Rubinshtein R, Halon D, Gaspar T, et al. Usefulness of 64-slice cardiac
computed tomographic angiography for diagnosing acute coronary
syndromes and predicting clinical outcome in emergency department
patients with chest pain of uncertain origin. Circulation
2007;115:1762–8.
Kevin M, Ethan J. Evaluation of a ‘‘Triple Rule-Out’’ coronary CT
angiography protocol: use of 64-section CT in low-tomoderate risk
emergency department patients suspected of having acute coronary
syndrome. Radiology 2008;248(2)