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HeartDiseases

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12
0
1869

Why is pericarditis relieved by sitting forwards and worsened on lying down?

Why would this happen? It seems very odd to me!  
Lisa Caldrick
almost 8 years ago
12
0
14

Does non-invasive ventilation worsen or improve patients with concurrent heart failure?

I have heard that non-invasive ventilation can worsen heart failure. However I have also heard it can improve those with heart failure, I think because it redces the preload on the heart by reducing venous return as there is an increased intrathoracic pressure. Anyone know for certain?  
Semhar Abraha
almost 8 years ago
6
0
8

Atrial fibrillation and dilated cardiomyopathy

How often have you encountered AF in a patient with dilated cardiomyopathy and a strong history of ethanol abuse? (I recently worked in a department where this is a very common phenomenon. I have consulted the web, but would like to hear what you guys have experienced.)  
Lize De Klerk
almost 8 years ago
13
0
10

What are the main types of cardiomyopathy? I am confused!

Some books say it is 3: dialated, restrictive and hypertrophic but others say also oblitaterive or arrhythrogenic :S Help!  
Charlie Luck
over 7 years ago
0
0
15

Cardiac arrest in organophosphorus poisoning

I work in an intensive care unit. Recently I was monitoring a patient with organophosphorus poisoning who was intubated and on ventilator. When I walked into duty, I auscultated the patient and found reduced breath sounds on either side. Presuming that the ET tube was blocked, I removed the ET tube and reintubated the patient, after which the air entry in both lungs was very good. Initially the patient regained saturation but after an interval of 30 minutes she desaturated, developed bradycardia and then went into cardiac arrest. She had been receiving about 10-12 g of atropine per day to counter the organophosphorus. What may be the cause of this cardiac arrest?  
avijit dutta
over 7 years ago
8
0
16

surgery in aortic stenosis

whats point to be considered during the management of asymptomatic aortic stenosis patients ? when surgery is considered?  
sampath kumar
over 7 years ago
8
0
9

What are the influencing factors of blood pressure?

My Professor asked on the first day of my semester "What are the influencing factors of blood pressure?" I only know a few and there are more. Correct me if I am wrong but I believe: Stress Smoking Alcohol Obesity Haemorrhage Heart disease High body temperature Can someone help me please?  
Keysha Mendoza
over 7 years ago
12
0
2

Does it matter what your Cholesterol is when you are in your 20's?

BP and cholesterol are major contributors to cardiovascular disease. Most people only start becoming aware of how high their BP and cholesterol is in middle age. Often by then there has already been significant damage to the cardiovascular system. Would it be sensible for health conscious young people to ask their GP for a cholesterol blood test roughly once a year? Therefore, enabling them to alter their diet and control their weight at a younger age and potentially reduce later heart disease.  
jacob matthews
about 7 years ago
10
0
13

Does hypertension correlate more with increased risk of ischaemic heart disease or stroke?

Does hypertension correlate more with increased risk of ischaemic heart disease or stroke? What's the answer and is there a reason why?  
James Wong
over 6 years ago
Foo20151013 2023 1eqve0g?1444774030
1
94

LWW: Case Of The Month - May 2013

This month’s case is by Barbara J. Mroz, M.D. and Robin R. Preston, Ph.D., author of Lippincott’s Illustrated Reviews: .Physiology (ISBN: 9781451175677). For more information, or to purchase your copy, visit: http://tiny.cc/PrestonLIR, with 15% off using the discount code: MEDUCATION. The case below is followed by a choice of diagnostic tests. Select the one lettered selection that would be most helpful in diagnosing the patient’s condition. The Case A 54-year-old male 2 pack-per-day smoker presents to your office complaining of cough and shortness of breath (SOB). He reports chronic mild dyspnea on exertion with a daily cough productive of clear mucus. During the past week, his cough has increased in frequency and is now productive of frothy pink-tinged sputum; his dyspnea is worse and he is now short of breath sometimes even at rest. He has had difficulty breathing when lying flat in bed and has spent the past two nights sleeping upright in a recliner. On physical examination, he is a moderately obese male with a blood pressure of 180/80 mm Hg, pulse of 98, and respiratory rate of 22. His temperature is 98.6°F. He becomes winded from climbing onto the exam table. Auscultation of the lungs reveals bilateral wheezing and crackles in the lower posterior lung fields. There is pitting edema in the lower extremities extending up to the knees.  Question Which if the following tests would be most helpful in confirming the correct diagnosis? A. Spirometry B. Arterial blood gas C. Complete blood count D. B-type natriuretic peptide blood test E. Electrocardiogram Answer? The correct answer is B-type natriuretic peptide blood test. Uncomfortable breathing, or feeling short of breath, is a common medical complaint with multiple causes. When approaching a patient with dyspnea, it is helpful to remember that normal breathing requires both a respiratory system that facilitates gas exchange between blood and the atmosphere, and a cardiovascular system that transports O2 and CO¬2 between the lungs and tissues. Dysfunction in either system may cause dyspnea, and wheezing (or bronchospasm) may be present in both cardiac and pulmonary disease. In this patient, the presence of lower extremity edema and orthopnea (discomfort when lying flat) are both suggestive of congestive heart failure (CHF). Elevated blood pressure (systolic of 180) and a cough productive of frothy pink sputum may also be associated symptoms. While wheezing could also be caused by COPD (chronic obstructive pulmonary disease) in the setting of chronic tobacco use, the additional exam findings of lung crackles and edema plus systolic hypertension are all more consistent with CHF. What does the B-type natriuretic peptide blood test tell us? When the left ventricle (LV) fails to maintain cardiac output (CO) at levels required for adequate tissue perfusion, pathways are activated to increase renal fluid retention. A rising plasma volume increases LV preload and sustains CO via the Frank-Starling mechanism. Volume loading also stimulates cardiomyocytes to release atrial- (ANP) and B-type (BNP) natriuretic peptides. BNP has a longer half-life than ANP and provides a convenient marker for volume loading. Plasma BNP levels are measured using immunoassay; levels >100 pg/mL are suggestive of overload resulting in heart failure. How does heart failure cause dyspnea? Increasing venous pressure increases mean capillary hydrostatic pressure and promotes fluid filtration from the vasculature. Excess filtration from pulmonary capillaries causes fluid accumulation within the alveoli (pulmonary edema) and interferes with normal gas exchange, resulting in SOB. Physical signs and symptoms caused by high volume loading include: (1) Lung crackles, caused by fluid within alveoli (2) Orthopnea. Reclining increases pulmonary capillary hydrostatic pressure through gravitational effects, worsening dyspnea when lying flat. (3) Pitting dependent edema caused by filtration from systemic capillaries, an effect also influenced by position (causing edema in the lower legs as in our ambulatory patient or in dependent areas like the sacrum in a bedridden patient). What would an electrocardiogram show? Heart failure can result in LV hypertrophy and manifest as a left axis deviation on an electrocardiogram (ECG), but some patients in failure show a normal ECG. An ECG is not a useful diagnostic tool for dyspnea or CHF per se. Wouldn’t spirometry be more suitable for diagnosing the cause of dyspnea in a smoker? Simple spirometry will readily identify the presence of airflow limitation (obstruction) as a cause of dyspnea. It's a valuable test to perform in any smoker and can establish a diagnosis of chronic obstructive pulmonary disease (COPD) if abnormal. While this wheezing patient is an active smoker who could have airflow obstruction, the additional exam findings above point more to a diagnosis of CHF. What would an arterial blood gas show? An arterial blood gas measures arterial pH, PaCO¬2, and PaO2. While both CHF and COPD could cause derangements in the values measured, these abnormalities would not necessarily be diagnostic (e.g., a low PaO2 could be seen in both conditions, as could an elevated PaCO¬2). Would a complete blood count provide useful information? A complete blood count could prove useful if anemia is a suspected cause of dyspnea. Test result BNP was elevated (842 pg/mL), consistent with CHF. Diuretic treatment was initiated to help reduce volume overload and an afterload reducing agent was started to lower blood pressure and improve systolic function.  
Lippincott Williams & Wilkins
over 7 years ago
Foo20151013 2023 y4lule?1444774066
1
2628

Staying Active with Diabetes

Many know that engaging in regular physical activity and exercise will tremendously improve one’s health and overall well-being. This goes the same, if not tenfold, for individuals suffering with diabetes. However, before rushing in a high intensity or physically straining physical régime, consult with your diabetes care provider. Make sure to discuss your plans take note of any precautions that may be needed to be made prior or during these activities. It will be interesting to know that individuals with type 2 diabetes who do participate in some exercise (even at work) reduce their risk for heart disease. Remember that a physical examination that focuses on the signs and symptoms of diseases affecting the heart and blood vessels, eyes, feet, nervous system, and kidneys must be made in advance before any extensive work out plan takes into action. Any strenuous strength training or high-impact exercise is generally not recommended for people with uncontrolled diabetes. Such strain caused by these exercises can weaken blood vessels in the eyes of patients who suffer from the common diabetic complication known as retinopathy. High-impact exercise can also injure blood vessels in the feet. In fact, diabetes can contribute to foot problems in several ways: diabetic neuropathy; which is a nerve disorder that causes numbing and pain in the hands, legs and feet as well as damage to internal organs; also poor circulation to the feet is another problem that can be associated due to diabetes. Keeping this in mind it is imperative to keeping your feet healthy, investing in some great therapeutic footwear like these can be a great step in moving toward healthy feet! One thing is for sure, physical activity can increase the health in anyone’s life. Always make sure to take care of your body and take the extra precautions needed in order to maintain proper health.  
Camille Mitchell
over 7 years ago
Foo20151013 2023 4k257s?1444774255
7
398

A Review of My Psychiatry Rotation

This field of medicine requires much more physiological and pathophysiological knowledge than most people give it credit for. Psychiatric illness DO have physical manifestations of symptoms; in fact those symptoms help form the main criteria for differential diagnoses. For example, key physical symptoms of depression, besides having a low mood for more than two weeks (yes, two weeks is all it takes to be classified as 'depressed'), include fatigue, change in appetite, unexplained aches/pains, changes in menstrual cycle if you're a female, altered bowel habits, abnormal sleep, etc. Aside from this, studies suggest that psychiatric illnesses put you at higher risk for physical conditions including heart disease, osteoarthritis, etc. (the list really does go on) Although some mental health conditions, like cognitive impairments, still do not have very effective treatment options; most psychiatric medications work very well, and are necessary for treating the patient. The stigma surrounding them by the public causes a huge problem for doctors. Many patients are reluctant to comply with medications because they are not as widely accepted as the ones for non-mental health conditions. A psychiatrist holds a huge responsibility for patient education. It can be tough to teach your patients about their medication, when many of them refuse to belief there is anything wrong with them (this is also because of stigma). Contrary to my previous beliefs, psychiatrists DO NOT sit around talking about feelings all day. The stereotypical image of someone lying down on a couch talking about their thoughts/feelings while the doctor holds up ink blots, is done more in 'cognitive behavioural therapy.' While this is a vital healthcare service, it's not really what a psychiatrist does. Taking a psychiatric history is just like taking a regular, structured medical history; except you have to ask further questions about their personal history (their relationships, professional life, significant life events, etc), forensic history, substance misuse history (if applicable), and childhood/developmental history. Taking a psychiatric history for a new patient usually takes at least an hour. The interesting thing about about treating a psychiatric patient is that the best guidelines you have for making them healthy is their personality before the symptoms started (this is called 'pre-morbid personality'). This can be difficult to establish, and can often be an ambiguous goal for a doctor to reach. Of course, there is structure/protocol for each illness, but each patient will be unique. This is a challenge because personalities constantly evolve, healthy or not, and the human mind is perpetual. On top of this, whether mental or physical, a serious illness usually significally impacts a person's personality. Most psychiatric conditions, while being very treatable, will affect the patient will struggle with for their whole life. This leaves the psychiatrist with a large portion of the responsibility for the patient's quality of life and well-being; this can be vey rewarding and challenging. The state of a person's mind is a perpetual thing, choosing the right medication is not enough. Before I had done this rotation, I was quite sure that this was a field I was not interested in. I still don't know if it is something I would pursue, but I'm definitely more open-minded to it now! PS: It has also taught me some valuable life lessons; most of the patients I met were just ordinary people who were pushed a little too far by the unfortunate combination/sequence of circumstances in their life. Even the ones who have committed crimes or were capable of doing awful things.. It could happen to anyone, and just because I have been lucky enough to not experience the things those people have, does not mean I am a better person for not behaving the same way as them.  
Mary
over 6 years ago
Preview
1
12

UK funding for stroke and dementia research still too low, study says

Sums spent on conditions bear little relation to their costs to health services, as compared with cancer or heart disease, say researchers  
theguardian.com
over 5 years ago
Preview
1
23

Encyclopedia of Stress: A-D

Stress is generally defined as a strain upon a bodily organ or mental power. Depending on its duration and intensity, stress can have short- or long-lasting effects: it has been linked to heart disease, immune deficiency, memory loss, behavioral disorders, and much more. These effects on the individual also have a major impact on health care costs and services, employee productivity, and even violent crime.The Encyclopedia of Stress is the first comprehensive reference source on stressors, the biological mechanisms involved in the stress response, the effects of activating the stress response mechanisms, and the disorders that may arise as a consequence of acute or chronic stress. While other books focus on specific aspects of stress, this three-volume set covers the entire spectrum of topics, with nearly 400 articles in all. In addition to the subjects traditionally associated with the hypothalamic-pituitary-adrenal axis (whereby the brain sends a message to the body to react), the Encyclopedia includes a wide range of related topics such as neuroimmune interactions, cytokines, enzymatic disorders, effects on the cardiovascular system, immunity and inflammation, and physical illnesses. It also goes beyond the biological aspects of stress to cover topics such as stress and behavior, psychiatric and psychosomatic disorders, workplace stress, post-traumatic stress, stress-reduction techniques, and current therapies. The Encyclopedia of Stress makes information easy to find and understand for a broad audience of researchers, clinicians, professionals, and students.Key Features* Presenting the first-ever encyclopedia on stress* Brings together the latest information on stressors, stress responses, and the disorders that can result* Covers stress from molecules to man to societies* Contains nearly 400 articles, covering a wide range of stress-related topics* Arranges topics in easily found alphabetical order* Supplements each article with a glossary and further reading list* Provides the most comprehensive coverage of stress available* Includes extensive cross-referencing between articles and a complete subject index* Covers hot topics, ranging from stress in the workplace and post-traumatic stress disorder to stress-related diseases* Edited by one of the world's leading authorities on stress* Written by more than 560 experts from 20 different countries* Appeals to a wide audience seeking information on topics within and outside their areas of expertise  
books.google.co.uk
over 5 years ago
Www.bmj
0
14

Air pollution, stroke, and anxiety

The effects of air pollution on the lungs and heart are now widely appreciated, with expanding evidence for an important role in cardiac disease.1 The Global Burden of Disease Study identified fine particulate matter (PM2.5) in outdoor air and household air pollution from use of solid fuels as the ninth and fourth leading risk factors, respectively, for disease worldwide,2 and the World Health Organization attributes one in every eight deaths to air pollution.3 The effects of air pollution are not limited to cardiopulmonary diseases. Recent evidence suggests a role in diverse outcomes, including diabetes,4 low birth weight, and preterm birth.5 This research stems from improved understanding of the role of air pollution in initiating systemic inflammation, a response that may affect multiple organ systems. Two linked studies (doi:10.1136/bmj.h1295, doi:10.1136/bmj.h1111) add to growing evidence that air pollution is an important risk factor for an increasing number of common diseases.6 7  
feeds.bmj.com
over 5 years ago
Www.bmj
0
16

Most common cause of death in England and Wales in 2013 was heart disease in men and dementia in women

The leading cause of death among men in England and Wales in 2013 was ischaemic heart disease, accounting for 15.4% of deaths, while among women it was dementia and Alzheimer’s disease, which caused 12.2% of deaths, show the latest statistics.1 Dementia and Alzheimer’s disease overtook heart disease as the leading cause of death among women in 2012.  
feeds.bmj.com
over 5 years ago
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33

Aortic Stenosis and General Valvular Principles with Dr. Brown

Dr. Brown is an Assistant Professor at the University of Louisville and is the Associate Director of the Cardiovascular Medicine fellowship. In this lecture,...  
youtube.com
over 5 years ago
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2
99

Arrhythmia Concepts,Tachy with Dr. Espinosa

Dr. Martin Espinosa gave this lecture during his Cardiology fellowship at the University of Louisville. He is currently completing a fellowship in Electrophy...  
youtube.com
over 5 years ago
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0
0

Arrhythmia Concepts,Tachy with Dr. Espinosa - YouTube

Dr. Martin Espinosa gave this lecture during his Cardiology fellowship at the University of Louisville. He is currently completing a fellowship in Electrophy...  
youtube.com
over 5 years ago
Preview
0
9

Cardiac Tamponade Part 5/5

Visit http://www.DrNajeebLectures.com for 600+ videos on Basic Medical Sciences!  
youtube.com
over 5 years ago