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The role of endomyocardial biopsy in the management of
The role of endomyocardial biopsy in the management of

... heart catheterization before biopsy.3 Sakakibara and Konno4 introduced the use of a flexible bioptome with sharpened cusps that allowed EMB by a pinching as opposed to a cutting technique. Caves et al. 5 modified the Konno biopsy forceps (Stanford Caves-Shulz bioptome) to allow percutaneous biopsies t ...
Relationship between 24- hour Holter variables, chest discomfort
Relationship between 24- hour Holter variables, chest discomfort

... with recurrent palpitation there is a class I recommendation for ambulatory Holter ECG monitoring.1 Despite the recommendation, the cause of syncope is difficult to find since it can occur infrequently but has a large impact on patients´ quality of life. In individuals with apparently healthy hearts ...
2:30pm: CT and MR in Coronary Artery Imaging
2:30pm: CT and MR in Coronary Artery Imaging

... •  “Coronary steal” phenomenon à left-to-right shunt = abnormal left ventricular perfusion •  Myocardial ischemia and infarction •  Infant type: 90%, present in first year of life with heart failure (usually within weeks/months of birth), if untreated results in death •  Adult type: development of s ...
Advanced Systolic Function - Society of Cardiovascular
Advanced Systolic Function - Society of Cardiovascular

... ejection fraction estimated from the transgastric mid-ventricular short axis image should be decreased by approximately 10% in the presence of an akinetic left ventricular apex. Alternatively, a qualitative estimation of global ventricular function can be made based on visual inspection. Global vent ...
Three-dimensional alignment of the aggregated myocytes in the
Three-dimensional alignment of the aggregated myocytes in the

... the level of slice 4. For illustration purposes, the shown slices represent the center of the actual diffusion scans that had a slice thickness of 1 mm but no interslice gaps. The assessment of helical angles (B) and intruding angles (C) is illustrated with the help of a representative chain of myoc ...
Double outlet right ventricle with intact ventricular
Double outlet right ventricle with intact ventricular

... the interventricular septum, endocardial proliferation and fibrosis, and occlusion by thrombus and infected vegetation are among VSD closure mechanisms.[1,9] According to Somerville et al.,[10] chances of spontaneous closure of VSDs that reach the inlet region, have subaortic or subpulmonic localiza ...
Cardiac Patient and Family - Cedars
Cardiac Patient and Family - Cedars

... to this unit have undergone a surgical procedure such as open heart surgery (i.e., coronary artery bypass surgery [CABG] or valvular surgery), left ventricular assist device, repair of aortic aneurysm, heart and/or lung transplant, surgery of the blood vessels in the leg, or surgery of the chest. Th ...
Patent ductus arteriosus in a lamb: A case report
Patent ductus arteriosus in a lamb: A case report

... near term and tightens rapidly after birth in response to lowered pulmonary vascular resistance, increased systemic vascular resistance, increased blood volume, and increased left ventricular pressure when breathing begins and the placental blood circulation is removed. If the ductus arteriosus is l ...
Combined Heart and Liver Transplantation
Combined Heart and Liver Transplantation

... their survival time of 3.7 and 1.7 years at the time of publication [7]. In another study, a Kaplan Meier survival analysis of 36 patients with CHLT from 1998-2005 reported that 84% of the patients survived first year and 74% of the patients survived third year of post transplantation [12]. Recently ...
SA Node: impulse
SA Node: impulse

... Normally the signal for cardiac electrical stimulation starts in the sinus node (also called the sinoatrial or SA node). The sinus node is located in the right atrium near the opening of the superior vena cava. It is a small collection of specialized cells capable of spontaneously generating electri ...
Non-Invasive Assessment of Left Ventricular Diastolic (Dys) Function
Non-Invasive Assessment of Left Ventricular Diastolic (Dys) Function

... Myocardial relaxation encompasses the end of myocardial shortening, the isovolumic relaxation period and the rapid filling phase. The time rate of relaxation is an important determinant of diastolic function and is regulated by active biochemical processes (myocyte inactivation), loading conditions, ...
Bilateral Ventricular Hypertrophy Due to Chronic
Bilateral Ventricular Hypertrophy Due to Chronic

... was five millimeters or over. This standard was adopted in the year 1946 arbitrarily and with full knowledge that for adult males the normal value ascribed to the thickness of the right ventricular wall ranged from two to three millimeters. These figures are still considered to be valid.’ This prese ...
Principles of Cardiac Pacing
Principles of Cardiac Pacing

... Failure to Sense • Causes – Pacemaker not sensitive enough to detect the patient’s intrinsic electrical activity (mV) – Insufficient myocardial voltage – Dislodged, loose, fibrotic, or fractured electrode – Electrolyte abnormalities – Low battery voltage ...
UNIT 2 biomedical
UNIT 2 biomedical

... This action potential is then propagated in all directions along the surface of both atria. The waves terminate at a point near the centre of the heart is called A.V node(Atrioventricular node) At this point some special fiber act as a delay line to provide proper timing between the action of auricl ...
mechanical properties of the heart
mechanical properties of the heart

... terminal phosphate molecule of ATP (myosin ATPase) which provides the energy used for force generation. Force is produced when myosin binds to actin and, with the hydrolysis of ATP, the head rotates and extends the hinge region. Force generated by a single sarcomere is proportional to the number of ...
The index of suspicion of RV infarction should be particularly high in
The index of suspicion of RV infarction should be particularly high in

... ventricular function. It must be taken in the context of the clinical status of the patient, and the level and degree of inotropic support. Hence, the normal range values that apply in the outpatient setting may not be relevant to the ICU[8]. ...
Coupled systolic-ventricular and vascular stiffening with age
Coupled systolic-ventricular and vascular stiffening with age

... Human aging is associated with increased vascular stiffening (1– 4), which results in elevation of systolic blood pressure and progressive widening of the arterial pulse (5,6). Each is a recognized risk factor for cardiovascular disease and stroke (5,7–9), and likely contributes to the independent r ...
12.Disorder of cardiac rhythm
12.Disorder of cardiac rhythm

... ECG : Р amount > QRS amount, P waves and QRS complexes appear independently, some time Р are masked by QRS or T and that causes their deformation ...
The Morphogenesis of Transposition of the Great Vessels
The Morphogenesis of Transposition of the Great Vessels

... descriptive accounts of the heart in transposition, none has approached it in a systemiatic, semi-quantitative way, with use of objective criteria for case selection. The results are described in the presenit paper. While they agree in all regards with the proposed theory, cardiac development is sub ...
PDF - Cardiovascular Ultrasound
PDF - Cardiovascular Ultrasound

... different layers of the myocardium. To the best of our knowledge, this study is the first to demonstrate the deformation of layer-specific myocardium, endocardial, mid-ventricular and epicardial layers during normal pregnancy using the modified 2D STE. During pregnancy, a series of dramatic changes ...
Pulmonary Congestion (White Lungs) on VA ECMO
Pulmonary Congestion (White Lungs) on VA ECMO

... result in left ventricular distention and pulmonary congestion. Creating a retrograde aortic flow, ECMO can increase left ventricular end diastolic pressure and therefore precipitate left ventricular failure, manifesting as pulmonary congestion/edema. The phenomenon analyzed in this paper is referre ...
DETERMINANTS OF CARDIAC FUNCTION: SIMULATION OF A
DETERMINANTS OF CARDIAC FUNCTION: SIMULATION OF A

... heart as a pump. The model exhibits realistic responses to changes in preload, afterload, Cont, and HR while displaying time-dependent changes in pressure and volume in addition to a pressure-volume plot. It differs from previous models (1, 3, 5) by graphing these parameters on a beat-to-beat basis ...
Snímek 1 - med.muni
Snímek 1 - med.muni

... Remodeling of a ventricle and complications (Fig. 12) Remodeling = change of ventricle geometry by a scar and hypertrophy   compliance, dilation, failure Myocardial rupture  hemopericardium  tamponade  death Rupture of papillary muscle  pulm. edema Reentry, automaticity, late afterdepolariza ...
20-1 Anatomy of the Heart
20-1 Anatomy of the Heart

... • Learning Outcomes • 20-1 Describe the anatomy of the heart, including vascular supply and pericardium structure, and trace the flow of blood through the heart, identifying the major blood vessels, chambers, and heart valves. • 20-2 Explain the events of an action potential in cardiac muscle, indic ...
Atrial Flutter
Atrial Flutter

... Radiofrequency ablation interrupts the reentrant circuit in order to prevent the recurrence of atrial flutter. With recurrent symptomatic Type I atrial flutter, there is a success rate of higher than 95% with ablation.  Ablation is commonly performed at the 6:00 position on the tricuspid valve isth ...
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Heart failure



Heart failure (HF), often referred to as congestive heart failure (CHF), occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the body's needs. The terms chronic heart failure (CHF) or congestive cardiac failure (CCF) are often used interchangeably with congestive heart failure. Signs and symptoms commonly include shortness of breath, excessive tiredness, and leg swelling. The shortness of breath is usually worse with exercise, while lying down, and may wake the person at night. A limited ability to exercise is also a common feature.Common causes of heart failure include coronary artery disease including a previous myocardial infarction (heart attack), high blood pressure, atrial fibrillation, valvular heart disease, excess alcohol use, infection, and cardiomyopathy of an unknown cause. These cause heart failure by changing either the structure or the functioning of the heart. There are two main types of heart failure: heart failure due to left ventricular dysfunction and heart failure with normal ejection fraction depending on if the ability of the left ventricle to contract is affected, or the heart's ability to relax. The severity of disease is usually graded by the degree of problems with exercise. Heart failure is not the same as myocardial infarction (in which part of the heart muscle dies) or cardiac arrest (in which blood flow stops altogether). Other diseases that may have symptoms similar to heart failure include obesity, kidney failure, liver problems, anemia and thyroid disease.The condition is diagnosed based on the history of the symptoms and a physical examination with confirmation by echocardiography. Blood tests, electrocardiography, and chest radiography may be useful to determine the underlying cause. Treatment depends on the severity and cause of the disease. In people with chronic stable mild heart failure, treatment commonly consists of lifestyle modifications such as stopping smoking, physical exercise, and dietary changes, as well as medications. In those with heart failure due to left ventricular dysfunction, angiotensin converting enzyme inhibitors or angiotensin receptor blockers along with beta blockers are recommended. For those with severe disease, aldosterone antagonists, or hydralazine plus a nitrate may be used. Diuretics are useful for preventing fluid retention. Sometimes, depending on the cause, an implanted device such as a pacemaker or an implantable cardiac defibrillator may be recommended. In some moderate or severe cases cardiac resynchronization therapy (CRT) may be suggested or cardiac contractility modulation may be of benefit. A ventricular assist device or occasionally a heart transplant may be recommended in those with severe disease despite all other measures.Heart failure is a common, costly, and potentially fatal condition. In developed countries, around 2% of adults have heart failure and in those over the age of 65, this increases to 6–10%. In the year after diagnosis the risk of death is about 35% after which it decreases to below 10% each year. This is similar to the risks with a number of types of cancer. In the United Kingdom the disease is the reason for 5% of emergency hospital admissions. Heart failure has been known since ancient times with the Ebers papyrus commenting on it around 1550 BCE.
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