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Valvular Heart DiseaseMitral 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: 514
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