Valvular Heart Disease

Mitral Stenosis

-M.C.C is rheumatic fever

-Symptoms & Signs :

.increased left atrial pressure (left atrial enlargement)

.pulmonary edema

.hoarseness of voice

.malar fush

.diastolic murmur (loud S1)

.opening snap (S2)

.pre-systolic murmur

.rumbling mid-diastolic murmur

.dyspnea,orthopnea

.systemic embolism

.righ sided heart failure (hepatomegaly,ascites,perioheral edema)

Mitral Regurgitation

-M.C.C is rheumatic fever

-can cause pulmonary edema / left atrial enlarement / pansystolic murmur

+Rheumatic heart disease affects most commonly Mitral valve

Aortic Valve Disease

Aortic Stenosis

-M.C.C is (in old age calcification) (bicuspid aortic valve-in children)

-Symptoms & Signs :

.angina

.syncope

.heart failure

.left venticular hypertrophy

.sudden death

.slow rising pulse (dec.pulse pressure)

.early systolic murmur (ejection systolic murmur)

.S4 gallop

.A2decreased,S2 single

.aortic ejection click

.cartoid thrill

-Treatment :

.surgery if <0.75cm

Aortic Regurgitation

-Can cause pulmonary edema

-Symptoms & Signs :

.causes wide pulse pressure

.head nodding

.collapsing pulse

.diastolic murmur

.pulse pressure (systolic increased-diastolic decreased)

.left ventricular impulse

.pistol shot femoral pulses

Cardiomyopathy

-"heart muscle disease" is the measurable deterioration for any reason of the ability of the myocardium (the heart muscle) to contract, usually leading to heart failure

-Symptoms & Signs :

.dyspnea

.peripheral edema

.irregular heart rate

.sudden cardiac death

-Types :

1.Dilated Cardiomyopathy DCM

-Is a condition in which the heart becomes enlarged and cannot pump blood efficiently (M.C form)

-Causes heart failure & arrhythmia

2.Hypertrophic Cardiomyopathy HCM

-Is a primary disease of the myocardium (the muscle of the heart) in which a portion of the myocardium is hypertrophied (thickened) without any obvious cause, creating functional impairment of the cardiac muscle

-Familial (autosomal dominant)

-M.C.C of sudden death in young athletes

3.Restrictive Cardiomyopathy RCM

-Is a form of cardiomyopathy in which the walls are rigid,and the heart is restricted from stretching and filling with blood properly

-M.C.C is amyloidosis

4.Constrictive Pericarditis

-Is a medical condition characterized by a thickened, fibrotic pericardium, limiting the hearts ability to function normally

-M.C.C is idiopathic

-Other Causes :

.TB

.sarcoidosis

.Rt side heart failure

.lower limbs edema

.ascities

.hepatomegaly

.chronoc renal failure

.post-myocardial infection

.post-viral pericarditis

.chronic pericarditis

.heart surgery

+Contraindication for thrombolytic therapy :

.stroke (within 2 months)

.HTN (uncontrolled)

.surgery (within 6 days)

.bleeding disorder

.non-STEMI

.post MI (>12hrs)

**End Diastolic Volume EDV

-Is the volume of blood in the right and/or left ventricle at end load or filling in (diastole) or the amount of blood in the ventricles just before systole

-Ejection fraction EF = stroke volume EDV (stroke volume=70cc)

-Hear failure if EF <40%

Date: 2016-04-22; view: 436