Cardiac Arrhythmias 1/3 - Heart Physiology - USMLE Step 1
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Orignal From: Cardiac Arrhythmias 1/3 - Heart Physiology - USMLE Step 1
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Article by Michael A. Morales
Ventricular Fibrillation (also called v-fib or vf) is a lethal arrhythmia that originates in the ventricles. It commonly occurs in cardiac arrest patients and is the primary rhythm that AED's (automated external defibrillators) are looking for to initiate a shock to the victim of cardiac arrest
In v-fib there is no organized depolarization of the ventricles. The heart muscle simply quivers with no contraction to pump the blood. As a result, there is no pulse. There are a number of reasons that ventricular fibrillation can occur:
Electrolyte ImbalanceAcute Coronary SyndromesHeart failure DysrhythmiasHypertrophyIncreased sympathetic Nervous System Activity
The list really only provides a snap shot and is not all inclusive. The only known effective treatment for ventricular fibrillation is defibrillation. When defibrillation occurs, the heart is stopped for an instant and aloud to reset. You can think of it as kind of like rebooting your computer. Once reset, the heart may go back to an organized rhythm and blood flow can resume to the heart and vital organs.
Generally, CPR is performed while and AED is being accessed. CPR does not change ventricular fibrillation to a normal heart rhythm. CPR pumps the heart so that oxygen rich blood can continue to flow to the heart and vital organs until defibrillation is available. CPR buys the victims some time and may keep brain damage from occurring. Together early CPR and defibrillation saves lives if provided immediately and is currently the best defense against ventricular fibrillation for the victim of cardiac arrest.
Although the heart can go into a number of different rhythms in a cardiac arrest, ventricular fibrillation is one of the most common, and is treatable if address quickly. Without early defibrillation the hearts electrical system will cease to function. No electrical activity in the heart is a condition known as asystole or flat line. Defibrillation will correct asystole.
The 2005 American Heart Association guidelines recommend defibrillation within the first 3-5 minutes of a cardiac arrest. It is during this time period that the victim is more likely to be in v-fib and benefit from defibrillation.
Michael Morales
Michael Morales is an EMT paramedic and director of education for Vital Ethics Inc., providing basic and advanced life support training and certification programs.
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Article by jekky
(721, 'Sites for measuring PPG br While pulse oximeters are a commonly used medical device the PPG derived from them is rarely displayed and is nominally only processed to determine heart rate PPGs can be obtained from transmissive absorption as at the finger tip or reflective as on the forehead br In outpatient setting pulse oximeters are commonly worn on the finger and ear However in cases of shock hypothermia etc blood flow to the periphery can be reduced resulting in a PPG without a discernible cardiac pulse In this case a PPG can be obtained from a pulse oximeter on the head with the most common sites being the ear nasal septum and forehead br PPGs can also be obtained from the vagina and esophagus br Uses br Premature Ventricular Contraction PVC can be seen in the PPG just as in the EKG and the Blood Pressure BP br Venous pulsations can be clearly seen in this PPG br Monitoring Heart Rate and Cardiac Cycle br Because the skin is so richly perfused it is relatively easy to detect the pulsatile component of the cardiac cycle The DC component of the signal is attributable to the bulk absorption of the skin tissue while the AC component is directly attributable to variation in blood volume in the skin caused by the pressure pulse of the cardiac cycle br The height of AC component of the photoplethysmogram is proportional to the pulse pressure the difference between the systolic and diastolic pressure in the arteries As seen in the figure showing Premature Ventricular Contractions PVCs the PPG pulse for the cardiac cycle with the PVC results in lower amplitude blood pressure and a PPG Ventricular Tachycardia and Ventricular Fibrillation can also be detected br Monitoring Respiration br The effects of Sodium Nitroprusside Nipride a peripheral vasodilator on the finger PPG of a sedated subject As expected the PPG amplitude increases after infusion and additionally the Respiratory Induced Variation RIV becomes enhanced br Respiration affects the cardiac cycle by varying the intrapleural pressure the pressure between the thoracic wall and the lungs Since the heart resides in the thoracic cavity between the lungs the partial pressure of inhaling and exhaling greatly influence the pressure on the vena cava and the filling of the right atrium This effect is often referred to as normal sinus arrhythmia br During inspiration intrapleural pressure decreases by up to 4 mm Hg which distends the right atrium allowing for faster filling from the vena cava increasing ventricular preload and increasing the stroke volume Conversely during expiration the heart is compressed decreasing cardiac efficiency and reducing stroke volume However the overall net effect of respiration is to act as pump for the cardiovascular system When the frequency and depth of respiration increases the venous return increases leading to increased cardiac output Shelley et al 2006 br Monitoring Depth of Anesthesia br Effects of an incision on a subject under general anesthesia on the photoplethysmograph PPG and blood pressure BP br Anesthesiologist must often judge subjectively whether a patient is sufficiently anesthetized for surgery As seen in the figure if a patient is not sufficiently anesthetized the sympathetic nervous system response to an incision can generate an immediate response in the amplitude of the PPG br Monitoring Hypo and Hyper volemia br Shamir Eidelman et al studied the interaction between inspiration and removal of 10 of a patient blood volume for blood banking before surgery Shamir Eidelman et al 1999 They found that blood loss could be detected both from the photoplethysmogram from a pulse oximeter and an arterial catheter Patients showed a decrease in the cardiac pulse amplitude caused by reduced cardiac preload during exhalation when the heart is being compressed br References br M Shamir L A Eidelman Y Floman L Kaplan and R Pi zov Pulse Oximetry Plethysmographic Waveform During Changes in Blood Volume Br J Anaesth vol 82 pp 178 181 1999 br K Shelley and S Shelley Pulse Oximeter Waveform Photoelectric Plethysmography in Clinical Monitoring Carol Lake R Hines and C Blitt Eds W B Saunders Company 2001 pp 420 428 br K H Shelley D H Jablonka A A Awad R G Stout H Rezkanna and D G Silverman What Is the Best Site for Measuring the Effect of Ventilation on the Pulse Oximeter Waveform Anesth Analg vol 103 pp 372 377 2006 br A T Reisner P A Shaltis D McCombie and H H Asada Utility of the Photoplethysmogram in Circulatory Monitoring Anesthesiology vol 108 pp 950 958 2008 br External links br A student project building a device for collecting PPGs br See also br Hemodynamics br Categories Cardiology Medical tests')
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Article by Marcus Pierre
An automated external defibrillator (AED) is a device the size of a laptop that is used for medical emergencies, specifically cardiac arrest or when the heart stops beating. Sometimes, when a victim is in cardiac arrest, their heart start experiencing an irregular quivering caused by chaotic electrical activity in the heart cells.
This quivering is called ventricular fibrillation or V Fib for short. V Fib is treated by shocking the heart with controlled electric shock. This works because the heart muscle contains electrical cells. The AED is used to shock the heart that is in V Fib to a normal heart rhythm.
Studies show that if an AED is used within 3-5 minutes of cardiac arrest, the victim's chance of survival increases by approximately 70%. So you want to use the AED as soon as it becomes available.
Using the AED:
Once you get the AED at the vicitm's side -
1: Turn on the AED. Do this by wither pressing the on/off button or lifting the lid of the unit.
2: Follow the prompts exactly as directed. The device will instruct you to place the electrode pads on the bare skin of the victim. One of the pads are to be placed on the right upper chest of the victim, while the second pad is to be placed just under the left chest.
3: Once the pads are placed on the bare chese of the victim, you may be required to insert the pad connector to the AED. Some AEDs already have the pads preconnected to them.
4: Next you must make sure that no one (including yourself) is touching the victim. The machine will prompt that it is "analyzing." During the analysis, all CPR efforts must be paused in order for the AED to evaluate if the victim's heart is experiencing V Fib and can therefore be treated with a shock. This is one of the 2 time you must "clear" the victim of all bystander contact.
5: If the AED prompts that a shock is indicated, then you must "clear" the victim a second time ensuring that you or no bystanders are not in contact with the victim. If someone is touching the victim while the AED is delivering the shock, the bystander can experience a shock as well which can even render them unconscious. Once you see that victim is "clear," you must then press the "shock" button to deliver a shock. Fully automated AEDs will deliver the shock automatically.
6: Immediately after administering the shock, the defibrillator will instruct you to resume CPR. You must not remove the pads or turn off the unit at this time. Simply leave the pads on the victim's chest, leave the AED on and resume CPR beginning with chest compressions.Some of the new AED models have the CPR coaching feature which guides the rescuer in the CPR process.
AEDs are very simple to use as long as the instructions are followed completely. The information in this article does not substitute a CPR/AED course in which training is performed in its entirety. This information is provided solely as a reference to supplement CPR/AED training.
For more information or questions on AEDs please visit http://www.lifesaversny.com
Marcus Pierre is a respiratory therapist, CPR instructor and AED consultant. He has worked at several hospitals in the New York area and has also trained many participants in CPR/AED & First Aid. He has serviced Regal Cinemas, the Governor's office, the Attorney General's office, DMV offices and many more NY state and personal clients. He is also the president of Lifesavers, Inc - a CPR & First Aid training company and an AED distributor. He can be contacted at http://www.lifesaversny.com
Ventricular bigeminy Anterior St elevation MI
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Problem Patients, who have survived cardiac arrest, ventricular tachycardia or cardiac syncope, have an increased risk of sudden cardiac death. Many of those patients are normally living at home without any kind of arrhythmia monitoring system or cardiac alarm solutions. In the United States alone, over 1.1 million individuals experience a heart attack each year. Approximately 540000 are fatal, and about half of these deaths occur within acute care settings. Even in the acute care environment up to half of fatal cardiac events are unwitnessed. Solution 'Non-Stop' is an integrated real-time monitoring system with an emphasis on early detection and treatment of life threatening events. It is a measurement and evaluation system of vital parameters focusing on the ongoing measurement of direct and indirect parameters of the cardiovascular system. The system is intended for high risk patients. With a wireless and wearable ECG (Electrocardiograph), the system continually logging heart rate data and providing detection of life threatening events and pass along these data to a respondent who is capable of treatment of such events. On the detection of arrhythmia situations, the system is possible to provide quick alarms to a central safety alarm system and thereby take necessary action for an emergency rescue.
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Article by jekky
Precursor, and types of angiotensin AngiotensinogenAngiotensinogen is an -2-globulin that is produced constitutively and released into the circulation mainly by the liver. It is a member of the serpin family, although it is not known to inhibit other enzymes, unlike most serpins. Plasma angiotensinogen levels are increased by plasma corticosteroid, estrogen, thyroid hormone, and angiotensin II levels.Angiotensinogen is also known as renin substrate.Human angiotensinogen is 452 amino acids long, but other species have angiotensinogen of varying sizes. The first 12 amino acids are the most important for activity.Asp-Arg-Val-Tyr-Ile-His-Pro-Phe-His-Leu-Val-Ile Angiotensin IAsp-Arg-Val-Tyr-Ile-His-Pro-Phe-His-LeuRenin-angiotensin-aldosterone systemAngiotensin I (CAS# 11128-99-7) is formed by the action of renin on angiotensinogen. Renin is produced in the kidneys in response to both decreased intra-renal blood pressure at the juxtaglomerular cells, or decreased delivery of Na+ and Cl- to the macula densa. If more Na+ is sensed, renin release is decreased.Renin cleaves the peptide bond between the leucine (Leu) and valine (Val) residues on angiotensinogen, creating the ten amino acid peptide (des-Asp) angiotensin I (CAS# 9041-90-1).Angiotensin I appears to have no biological activity and exists solely as a precursor to angiotensin 2. Angiotensin IIAsp-Arg-Val-Tyr-Ile-His-Pro-PheAngiotensin I is converted to angiotensin II through removal of two C-terminal residues by the enzyme angiotensin-converting enzyme (ACE, or kinase), which is found predominantly in the capillaries of the lung. ACE is actually found all over the body, but has its highest density in the lung due to the high density of capillary beds there. Angiotensin II acts as an endocrine, autocrine/paracrine, and intracrine hormone.ACE is a target for inactivation by ACE inhibitor drugs, which decrease the rate of angiotensin II production. Angiotensin II increases blood pressure by stimulating the Gq protein in vascular smooth muscle cells (which in turn activates contraction by an IP3-dependent mechanism). ACE inhibitor drugs are major drugs against hypertension.Other cleavage products of ACE, 7 or 9 amino acids long, are also known; they have differential affinity for angiotensin receptors, although their exact role is still unclear. The action of angiotensin II itself is targeted by angiotensin II receptor antagonists, which directly block angiotensin II AT1 receptors.Angiotensin II is degraded to angiotensin III by angiotensinases that are located in red blood cells and the vascular beds of most tissues. It has a half-life in circulation of around 30 seconds, whereas, in tissue, it may be as long as 1530 minutes. Angiotensin IIIAsp | Arg-Val-Tyr-Ile-His-Pro-PheAngiotensin III has 40% of the pressor activity of Angiotensin II, but 100% of the aldosterone-producing activity. Angiotensin IVArg | Val-Tyr-Ile-His-Pro-PheAngiotensin IV is a hexapeptide that, like angiotensin III, has some lesser activity. EffectsSee also Renin-angiotensin_system#EffectsAngiotensins II, III & IV have a number of effects throughout the body: Cardiovascular effectsThey are potent direct vasoconstrictors, constricting arteries and veins and increasing blood pressure.Angiotensin II has prothrombotic potential through adhesion and aggregation of platelets and production of PAI-1 and PAI-2.When cardiac cell growth is stimulated, a local (autocrine-paracrine) renin-angiotensin system is activated in the cardiac myocyte, which stimulates cardiac cell growth through Protein Kinase C. The same system can be activated in smooth muscle cells in conditions of hypertension, atherosclerosis, or endothelial damage. Angiotensin II is the most important Gq stimulator of the heart during hypertrophy, compared to endothelin-1 and A1 adrenoreceptors. Neural effectsAngiotensin III increases thirst sensation (dipsogen) through the subfornical organ (SFO) of the brain, decreases the response of the baroreceptor reflex, and increases the desire for salt. It increases secretion of ADH in the posterior pituitary and secretion of ACTH in the anterior pituitary. It also potentiates the release of norepinephrine by direct action on postganglionic sympathetic fibers. Adrenal effectsAngiotensin II acts on the adrenal cortex, causing it to release aldosterone, a hormone that causes the kidneys to retain sodium and lose potassium. Elevated plasma angiotensin II levels are responsible for the elevated aldosterone levels present during the luteal phase of the menstrual cycle. Renal effectsAngiotensin II has a direct effect on the proximal tubules to increase Na+ reabsorption. It has a complex and variable effect on glomerular filtration and renal blood flow depending on the setting. Increases in systemic blood pressure will maintain renal perfusion pressure, however constriction of the afferent and efferent glomerular arterioles will tend to restrict renal blood flow. The effect on the efferent arteriolar resistance is, however, markedly greater, in part due to its smaller basal diameter; this tends to increase glomerular capillary hydrostatic pressure and maintain glomerular filtration rate. A number of other mechanisms can affect renal blood flow and GFR. High concentrations of Angiotensin II can constrict the glomerular mesangium reducing the area for glomerular filtration. Angiotensin II as a sensitizer to tubuloglomerular feedback preventing an excessive rise in GFR. Angiotensin II causes the local release of prostaglandins, which, in turn, antagonize renal vasoconstriction. The net effect of these competing mechanisms on glomerular filtration will vary with the physiological and pharmacological environment.Renal effects of Angiotensin IITargetActionMechanismRenal artery &afferent arteriolesvasoconstrictionVDCCs Ca2+ influxefferent arteriolevasoconstriction(probably) activate Angiotensin receptor 1 Activation of Gq LC activity P3 and DAG activation of IP3 receptor in SR ntracellular Ca2+mesangial cellscontraction iltration areaactivation of Gq LC activity P3 and DAG activation of IP3 receptor in SR ntracellular Ca2+VDCCs Ca2+ influxTubuloglomerular feedbackIncreased sensitivityIncrease in afferent arteriole responsiveness to signals from macula densamedullary blood flowReduction See alsoACE inhibitorAngiotensin receptorAngiotensin II receptor antagonist References^ Basso N, Terragno NA (December 2001). "History about the discovery of the renin-angiotensin system". Hypertension 38 (6): 12469. doi:10.1161/hy1201.101214. PMID 11751697. http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=11751697. ^ NCBI HomePage^ Physiology at MCG 7/7ch09/7ch09p16^ Skurk T, Lee YM, Hauner H (May 2001). "Angiotensin II and its metabolites stimulate PAI-1 protein release from human adipocytes in primary culture". Hypertension 37 (5): 133640. PMID 11358950. http://hyper.ahajournals.org/cgi/pmidlookup?view=long&pmid=11358950. ^ Gesualdo L, Ranieri E, Monno R, et al. (August 1999). "Angiotensin IV stimulates plasminogen activator inhibitor-1 expression in proximal tubular epithelial cells". Kidney Int. 56 (2): 46170. doi:10.1046/j.1523-1755.1999.00578.x. PMID 10432384. ^ Unless else specified in table, then ref is: Walter F., PhD. Boron (2005). Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. ISBN 1-4160-2328-3. Page 771 Further readingde Gasparo M, Catt KJ, Inagami T, "et al." (2000). "International union of pharmacology. XXIII. The angiotensin II receptors". Parmacol Rev. 52: 415472. PMID 10977869. Brenner & Rector's The Kidney, 7th ed., Saunders, 2004.Mosby's Medical Dictionary, 3rd Ed., CV Mosby Company, 1990.Review of Medical Physiology, 20th Ed., William F. Ganong, McGraw-Hill, 2001.Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th ed., Burton David Rose & Theodore W. Post McGraw-Hill, 2001Lees KR, MacFadyen RJ, Doig JK, Reid JL (1993). "Role of angiotensin in the extravascular system". Journal of human hypertension 7 Suppl 2: S712. PMID 8230088. Weir MR, Dzau VJ (2000). "The renin-angiotensin-aldosterone system: a specific target for hypertension management". Am. J. Hypertens. 12 (12 Pt 3): 205S213S. doi:10.1016/S0895-7061(99)00103-X. PMID 10619573. Berry C, Touyz R, Dominiczak AF, et al. (2002). "Angiotensin receptors: signaling, vascular pathophysiology, and interactions with ceramide". Am. J. Physiol. Heart Circ. Physiol. 281 (6): H233765. PMID 11709400. Sernia C (2002). "A critical appraisal of the intrinsic pancreatic angiotensin-generating system". JOP 2 (1): 505. PMID 11862023. Varagic J, Frohlich ED (2003). "Local cardiac renin-angiotensin system: hypertension and cardiac failure". J. Mol. Cell. Cardiol. 34 (11): 143542. doi:10.1006/jmcc.2002.2075. PMID 12431442. Wolf G (2006). "Role of reactive oxygen species in angiotensin II-mediated renal growth, differentiation, and apoptosis". Antioxid. Redox Signal. 7 (9-10): 133745. doi:10.1089/ars.2005.7.1337. PMID 16115039. Cazaubon S, Deshayes F, Couraud PO, Nahmias C (2006). "[Endothelin-1, angiotensin II and cancer]". Med Sci (Paris) 22 (4): 41622. PMID 16597412. Ariza AC, Bobadilla NA, Halhali A (2007). "[Endothelin 1 and angiotensin II in preeeclampsia]". Rev. Invest. Clin. 59 (1): 4856. PMID 17569300. ... External linksMeSH Angiotensinsv d eCardiovascular system, physiology: cardiovascular physiologyHeartVolumesStroke volume = End-diastolic volume End-systolic volumeCardiac output = Heart rate Stroke volumeAfterload PreloadFrank-Starling law of the heart Cardiac function curve Venous return curveAortic valve area calculation Ejection fraction Cardiac indexInteraction diagramsCardiac cycle Wiggers diagram Pressure volume diagramTropismChronotropic (Heart rate) Dromotropic (Conduction velocity) Inotropic (Contractility) Batmotropic (Excitability) Lusitropic (Relaxation)Conduction system /Cardiac electrophysiologyCardiac action potential (Atrial action potential, Ventricular action potential) Effective refractory period Pacemaker potential EKG (P wave, PR interval, QRS complex, QT interval, ST segment, T wave, U wave) Hexaxial reference systemChamber pressureCentral venous pressure/right atrial pressure Right ventricular pressure Pulmonary artery pressure Pulmonary wedge pressure/left atrial pressure Left ventricular pressure Aortic pressureOtherVentricular remodelingVascular system/HemodynamicsBlood flowCompliance Vascular resistance (Total peripheral resistance) Pulse PerfusionBlood pressurePulse pressure (Systolic - Diastolic) Mean arterial pressureJugular venous pressurePortal venous pressureRegulation of BPBaroreflex Kinin-kallikrein system Renin-angiotensin system Vasoconstrictors/Vasodilators Autoregulation (Myogenic mechanism, Tubuloglomerular feedback) Paraganglia (Aortic body, Carotid body, Glomus cell)heart navs: anat/physio/dev, noncongen/congen/neoplasia, symptoms+signs/eponymous, procvascular navs: anat/physio/dev, noncongen/systemic vasculitis/congen/neoplasia, symptoms+signs/eponymous, procv d ePeptides: neuropeptidesHypothalamicSomatostatin CRH GnRH GHRH Orexins TRH POMC (ACTH MSH Lipotropin)Gastrointestinal hormonesCholecystokinin Gastric inhibitory polypeptide Gastrin Motilin Secretin Vasoactive intestinal peptideOther hormonesCalcitonin Oxytocin VasopressinOther neuropeptidesAngiotensin Bombesin Calcitonin gene-related peptide Carnosine Cocaine and amphetamine regulated transcript Delta sleep-inducing peptide FMRFamide Galanin Galanin-like peptide Gastrin releasing peptide Kinins (Bradykinin Tachykinins) Neuropeptide S Neuropeptide Y Neurophysins Neurotensin Pancreatic polypeptide Pituitary adenylate cyclase activating peptide VGFNeuromedinsB N S UOpioid peptidesDynorphin Endomorphin Endorphin Enkephalin Nociceptin Opiorphinv d eAutacoidsKininsKininogen (HMWK, LMWK) Bradykinin Kallidin Tachykinins Urotensin-IIOthersAngiotensin Eicosanoid Histamine Platelet-activating factor Serotonin Categories: Human proteins | Peptide hormones | Cardiovascular system | Endocrinology | Physiology
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Article by Clive Harman
I have cardiac arrhythmia, this is a recording of my heartbeat when I am well-controlled on medication. I forgot to add in the slide, it is best heard with headphones. The rate in this one is 70-80 which is my normal resting rate. I think there may be one or two PVC's, but I am not sure, it could be my microphone.
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Article by Armughan Riaz
An Echocardiography is actually the Ultrasound of Heart, this ultrasound produces sound waves and one can have moving picture of heart. This procedure does not involve any radiations and it gives more detail than X-ray. It is a good diagnostic tool for Valvular heart diseases, evaluating pumping function of heart, i.e ejection fraction, in heart attack patients. It is also a good screening test for certain heart disease. However, there are some situations or diseases that one should have an echocardiography test.
Following diseased patients must have an echocardiography. These are the situations in which an echo may influence the clinical management of a patient.
Assessment of valve function, e.g systolic or diastolic murmursAssessment of left ventricular function, systolic diastolic and regional wall motions, e.g suspected heart failure in a patient with breathlessness, or preoperative assessment.Suspected EndocarditisSuspected MyocarditisCardiac TemponadePericardial Disease (e.g Pericarditis) or pericardial effusion, especially if clinical evidence of temponadeComplications of myocardial Infarction, eg MR VSD or pericardial effusion.Suspicion of intracardiac masses- tumour or thrombusCardiac chamber size e.g Left atrial size in atrial fibrillation (AF), Cardiomegaly in chest X-ray.Assessment of artificial valve function.Arrhythmias, e.g Atrial fibrillation, ventricular techycardia (VT)Assessment of right ventricle and right heart Estimation of intracardiac and vascular pressures, e.g pulmonary artery systolic pressures in lung disease and suspected pulmonary hypertensionTo find out cardiac source of embolism in stroke and transient ischaemic attack patients.Exclusion of left ventricular hypertrophy in hypertentionAssessment of congenital heart diseases.These abnormalities are just few and most common that an echo can reveal. For details you may contact your doctor.
What can I expect during an echocardiogram?Often when you visit a Cardiologist, your doctor suggests you for echocardiography of your heart. It is basically the ultrasound of Heart to diagnose various diseases of heart. With the help of sound waves moving picture of heart can be taken.
Echo is a painless and simple procedure without involvement of any radiations. There are no known hazards or risks associated with echocardiography. When you are going to echo room, you will be asked to lie down on a bed and disrobe from the waist up. Doctor or echocardiographer will place electrode on your chest to record ECG during echocardiography. Small amount of gel is applied on your chest and then a small transducer will be placed near the sternum on your chest. Transducer produces sound waves towards the heart.
Echocardiographer may apply some pressure during echo on your chest with transducer. You may be asked to turn your side to left or right depending upon your technician position. You may be asked to hold your breath to take high quality pictures. Then technician will move transducer to different parts of chest to take picture of heart from different angles. Sometimes a dye may be injected before taking echo, as occasionally lungs ribs body tissue prevents sound waves to reach heart muscles. If your heart beat is too fast, then echo may give false result, so echo is avoided in fast tachycardia. A typical echo is performed in about 30-45 minutes. If you have a lung disease, obesity, restlessness or breathlessness, may result in longer test duration. During test, printed pictures are taken by technician from echo machine and later examined by a cardiologist.
Who should have an Echocardiography? Article written by Dr. Armughan Riaz M.B.B.S Dip Card. To Know more about High Blood Pressureand cardiovascular diseases please visit our site.
Dr.Armughan maintaining site High Blood Pressure Symptoms Treatment
You will notice that the darker clouds are moving and the other ventricular clouds are standing still. These clouds stayed like this for more than an hour. This is a common almost daily occurrence here in Mt. Shasta, although this was an entire fleet. It felt like the Silver Fleet of the Ashtar Command. After you watch it once, go back and watch it again, except this time watch the foreground, you will see a woman on a horse riding through the ranch pasture.
Hypokalaemia/long QT/Torsades de pointes
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Annotated Sagittal T1 Midline MRI Scan of Reigh's Brain
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Article by Subramani
Hypertensive heart disease is the response of the heart to the increased demands induced by systemic hypertentsion. Pulmonary hypertension also causes heart disease and is referred to as right sided hypertensive heart disease or corpulmonale.
Systmic (left-sided) Hypertensive heart disease
The minimal criteria for the diagnosis of systemic hypertensive heart disease are the following: (1) left ventricular hypertrophy (usually concentric) in the absence of other cardiovascular pathology that might have induced it and (2) a history or pathologic evidence of hypertension. The Framingham heart study established unequivocally that even mild hypertension (levels only slightly above 140/90) mm Hg) if sufficiently prolonged induces left ventricular hypertrophy. Approximately 25% of the U.S. population suffers from hypertension of at least this degree. In hypertension, hypertrophy of the heart is an adaptive response to pressure overload which can lead to myocardial dysfunction, cardiac dilation, congestive heart failure and sudden death.
Compensated systemic hypertensive heart disease may be asymptomatic and suspected only in the appropriate clinical setting by ECG or echocardiographic indications of left ventricular enlargement. As already emphasized, other causes for such hypertrophy must be excluded. In many causes for such hypertrophy must be excluded. In many patients, systemic hypertensive heart disease comes to attention by the onset of atrial fibrillation (owing to left atrial enlargement) or congestive heart failure with cardiac dilation or both. Depending on the severity of the ypertension its duration the adequacy of therapeutic control and underlying basis, the patient may enjoy normal longevity and die of unrelated causes, may develop progressive IHD owing to the effects of hypertension in potentiating coronary atherosclerosis, may suffer progressive renal damage or cerebrovascular accident, or may experience progressive heart failure or sudden cardiac death. There is substantial evidence that effective control of hypertension can prevent or lead to regression of cardiac hypertrophy and its associated risks.
Pulmonary (Right-sided) Hypertensive heart disease (cor pulmonale)
Cor pulmonale, as pulmonary hypertensive heart disease is frequently called, constitutes right ventricular hypertrophy, dilation, and potentially failure secondary to pulmonary hypertension caused by disorders of the lungs or pulmonary vasculature and is the right sided counterpart of left sided(systemic) hypertensive heart disease. Although quite common, right ventricular thickening and dilation caused either by congenital heart disease or by disease of the left side of the heart and the resultant pulmonary venous hypertension owing to postcapillary obstruction to blood flow are exclude from this definition of cor pulmonale.
Based on the suddenness of development of pulmonary hypertension , cor pulmonale may be acute or chronic Acute cor pulmonale can follow massive pulmonary embolism. Chronic cor pulmonale usually implies right ventricular hypertrophy and dilation) secondary to prolonged pressure overload owing to obstruction of the pulmonary arteries or arterioles or compression obliteration of septal capillaries (e.g., owing to primary pulmonary hypertension or emphysema)
For more information about Hypertensive heart disease visit http://www.medicalhealthcenter.net
Echocardiogram with double inlet left ventricle and post-operative pulmonary artery banding
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My, what a big left ventricular wall you have
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From the Springer article: Venous valves within left ventricular coronary veins www.springerlink.com by: Anderson, Sara E.; Quill, Jason L.; Iaizzo, Paul A.; The video is organized by vein: anterior interventricular veins, great cardiac veins, posterior veins of the left ventricle, and posterior interventricular veins. At the beginning of each vein, a figure shows its anatomical location. Still images with each representative valve color highlighted aid visualization in subsequent video footage (MPG 19.00 MB) Journal: Journal of Interventional Cardiac Electrophysiology Vol. 23 Issue 2 DOI: 10.1007/s10840-008-9282-6 Published: 2008-10-18
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Join us Sunday, December 28th on CTV from 6 to 8 am for a morning of heroism and inspiration. Our special broadcast, Believing in Heroes, will take you on a journey behind-the-scenes where youll meet some of our bravest heroes. ********** Bryce Cormier was born in February 2005 with a had a serious heart defect, right atrial isomerism which brought on numerous other congenital heart conditions: total anomalous pulmonary vein drainage (TAPVD), where the hearts veins connect to the wrong side causing irregular blood flow; double outlet right ventricle (DORV) which caused her main heart vessels to be on one side, rather than on either side of her heart; and atrial ventricular septal defect. She was rushed to SickKids just after her birth. Her family was told to take her home - essentially to die - because she wasnt strong enough for surgery. Miraculously, she thrived and spent the next few months at home. On July 19, 2006, Bryce was finally strong enough for the surgery and when doctors came out of the operating room, they believed it was a success. For a few hours, she was doing well but sadly, she took a turn for the worse. In the middle of the night, Bryces tiny heart stopped. After manually pumping her heart, SickKids doctors hooked her up to a heart and lung machine that performed the essential functions that her body could no longer do. That night, she also suffered from a stroke. Thankfully, Bryce was stronger than most doctors had ever seen and within months, she was ...
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K.Dextrocardia.levo-TGA.DORV
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