cardiac disorders | MedicScientist :: Total Health Portal

Approach to Chest Pain Differential diagnosis of chest pain

Chest pain or chest discomfort  may occur due to some minor illness or may be due to some serous illness, or may be an emergency condition.   chest pain   Causes of serious chest pain – Acute ischemic heart disease, or aortic coronary syndrome, Aortic dissection, Tension pneumotherix, Pulmonary pneumothorex, Pulmonary embolism. The different condition […]

Glycogen Storage Diseases von Gierke disease, Andersen’s disease, McArdle’s disease

Glycogen Storage Diseases Carbohydrate metabolism provides energy for meta­bolic functions of cell. Metabolism of glucose generates ATP by glycolysis and oxidative phosphorylation. Any one of several heritable diseases characterized by the abnormal storage and accumulation of glycogen in the tissues, esp. in the liver Dietary sources of glucose: · Polysaccharide (starch) · Disacchride (lactose, maltose, […]

Sarcoidosis Causes Diagnosis Symptoms and Treatment

Sarcoidosis It is a chronic, multisystem disorder of unknown cause. chronic multisystem disease of unknown etiology, characterized by noncaseating (hard) granulomas and lymphocytic alveol, Sarcoidosis is a noninfectious, multisystem granulomatous disease of unknown cause, commonly affecting young and middle-aged adults. Almost any other organ may be involved, including liver, spleen, lymph nodes, heart, and CNS. […]

Cardiac Arrest Causes Symptoms Features and Management

Cardiac Arrest Death is an irreversible cessation (stoppage) of all biologic functions. Cardiac arrest is an abrupt cessation of cardiac pump function which may be reversible by prompt intervention; otherwise it leads to cer­tain death. Cardiac arrest is due to ventricular fibrillation in 80% of cases. Rest are due to bradyarrhythmias, asystole, pulseless electrical activity […]

Sepsis (Septic Shock) Prognosis Prevention TREATMENT

Sepsis (Septic Shock) Prognosis Prevention TREATMENT TREATMENT Sepsis (Septic Shock) Admit in ICU Treat local site of infection Monitor hemodynamics. Sepsis is a clinical syndrome characterized by systemic inflammation due to infection. There is a continuum of severity ranging from sepsis to severe sepsis and septic shock. Antimicrobial therapy in Sepsis (Septic Shock) Ceftriaxone 2gjday […]

Ebstein’s anomaly of the tricuspid valve Physical examination Clinical features and Treatment

Ebstein’s anomaly of the tricuspid valve Ebstein’s anomaly Physical examination with Clinical features Ebsetin’s anomaly of the tricuspid valve is a congeni­tal heart disease in which the tricuspid valve is placed at a lower level so that there is atrialization of the rigFit ventricle. A congenital heart condition resulting from downward displacement of the tricuspid […]

Ostium Primum ASD (Inter atrial communication)

Ostium Primum ASD (Inter atrial communica­tion) The opening in the first septum of the embryonic heart; it closes as the ventricles form. There is right to left shunt and mitral valve regurgita­tion. Symptoms occur in childhood itself with congestive heart failure and retarded growth and development. There is atrial fibrillation commonly. Due to mitral regurgitation, […]

TREATMENT OF HYPERTENSION Lifestyle modification WITH Drug treatment

TREATMENT OF HYPERTENSION Lifestyle modification For normal persons and prehypertensives life style modification is advised. For patients with compelling indications like heart fail­ure, post MI, high coronary artery disease risk, dia­betes, chronic kidney disease and recurrent strokes adequate drug treatment to keep the blood pressure < 130/80 is advisable for prehypertension, stage 1 and 2 […]

CONGENITAL HEART DISEASES General HEART Malformations defects or structural problem

CONGENITAL HEART DISEASES General defects structural problem in the heart  Acyanotic congenital heart diseases with nor­mal or decreased pulmonary arterial blood flow (no shunt). Left sided HEART Malformations or structural problem in the heart  Cardiac mal positions – Dextrocardia etc. Congenitally corrected transposition of great ar­teries .(CTGA). Coarctation of aorta Mitral stenosis. Mitral regurgitation Obstruction at […]

CYANOTIC CONGENITAL HEART DISEASE Coarctation of the Aorta with Clinical features

CYANOTIC CONGENITAL HEART DISEASE Coarctation of the Aorta Clinical features coarctation of aorta means a narrowing of the aorta just distal to left subclavian artery, proximal (preductal) or distal (post ductal) to insertion of duc­tus arteriosus. A narrowing (discrete or of varying lengths) of the aorta at any point but usually located just distal to the […]

Examination and Investigations of coarctation of aorta CYANOTIC CONGENITAL HEART DISEASE with Complications

Examination and Investigations of CYANOTIC CONGENITAL HEART DISEASE       Collateral circulation / anastomoses in coarcta­tion of aorta       Examination of precordium : A systolic thrill may be felt in the suprasternal notch. There is a heaving left ventricular apical impulse due to pressure over­load of LV. A systolic murmur may be […]

Risk factors in hypertension for adverse prognosis with Etiology of hypertension

Risk factors for adverse prognosis in hyperten­sion  with Etiology Non-whites Youth (young) and Males Diastolic blood pressure consistently more than 115 mmHg Smoking and Alcoholism Diabetes mellitus Hypercholesterolemia Obesity End organ damage Cardiac enlargement ECG showing ischemia or LVH with strain pattern MI (myocardial infarction) 9< CHF (heart failure) Eyes – retinal haemorrhages, exudates and papilledema […]

Clinical features and Diagnosis of Unstable Angina(UA) / NSTEMI with Cardiac Biomarkers in Angina

Clinical features of Unstable Angina(UA) / NSTEMI — There is chest pain in the substernal lesion or epigas­trium radiating to neck, left shoulder and left arm. There is severe discomfort or pain. Anginal equivalents like dyspnoea and epigastric dis­comfort are also frequently present. There is diaphoresis (increased sweating), pale skin, sinus tachycardia, third and fourth […]

Management of Unstable Angina (UA) / NSTEMI Anti-ischemic treatment

Management of UA / NSTEMI ,with Anti-ischemic treatment -,uses of  Nitrates  and Beta adrenergic blockers . Risk stratification and Prognosis Early risk within 30 days for death and new infarction is about 10%. Patients at high risk are age more than 65 years, 3 or more risk factors for CAD, documented CAD, angina inspite of aspirin, […]


PRINZMETAL’S VARIANT ANGINA This is a syndrome of ischemic pain at rest and with ECG showing transient ST elevation. This sydrome is caused by spasm of coronary artery leading to severe ischemia. It may occur in patients who may not have any coronary artery stenosis. It is a kind of vasospastic disease like Raynaud’s phe­60menon. […]

AORTIC DISSECTION Etiology and Clinical manifestations with Treatment

AORTIC DISSECTION Etiology Clinical manifestations Treatment Aortic dissection is a tear of the intima transversely or circumferentially . relatively uncommon, though catastrophic illness often presenting with severe chest pain and acute hemodynamic compromise It is commonly seen along the right lateral wall of ascending aorta. primary event in aortic dissection is a tear in the aortic […]


ADVICE TO DIABETICS AND CAD (CORONARY TERY DISEASE) PATIENTS Sodium reduction in diet Weight loss Combined weight loss and sodium reduction. Weight loss By exercise By diet control Drugs for obesity Lifestyle changes Control blood sugar Control blood pressure Control lipids. Dietary advice , Rich in fruits Rich in vegetables ow fat dairy products Low […]

COMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2

Some other COMPLICATIONS OF AMI AND TREATMENT ARRHYTHMIAS RECURRENT ANGINA PERICARDITIS THROMBOEMBOLISM LV ANEURYSM Other measures: – Control of Hypertension – Physical activity – Avoid physical emotional stress. – Cessation of smoking – Control of blood lipids AND OTHER COMPLICATIONS ARE  complications-of-ami-and-treatment-1   1. COMPLICATIONS OF AMI ARRHYTHMIAS Ventricular premature beats (VPB) : No prophy­lactic […]

Unstable Angina Pathophysiology Definition STEMI and NSTEMI

Unstable Angina Pathophysiology Definition STEMI and NSTEMI   Unstable Angina Patients with ischemic heart disease can be divided into two groups:   Patients with stable angina due to chronic coronary artery disease Patients with acute coronary syndrome Stable angina pectoris is characterized by chest pain or discomfort radiating to left or both arms, on physi­cal […]

Atrial Septal Defect ASD Clinical features Physical Exam with Treatment

Atrial Septal Defect Clinical features Physical Exam with Treatment                    Ostium secundum atrial septal defect Most common is ostium secundumASD, located at mid interatrial septum. It is a simple and common type of ASD with shunt from LA to RA. Usually asymptomatic and acyanotic in children and young adults. Atrial Septal Defect Clinical features More […]

Common atrioventricular canal defect or complete atrioventricular septal defect

Common atrioventricular canal defect or com­plete atrioventricular septal defect There is congestive heart failure in infancy. There may be cyanosis commonly. Isolated ASDs result from abnormal development of the septa that partition the common atrium of the developing heart into right and left chambers. There may be Down’s syndrome. There is marked parasternal heave or […]

Ventricular Septal Defect (VSD) CLINICAL FEATURES and examination Investigations with Treatment

Ventricular Septal Defect (VSD) CLINICAL FEATURES General examination with Treatment There is a shunt from LV to RV due to a defect in the interventricular septum. VSD also occurs in combination with other congenital heart defects, as in an atrioventricular canal (AVC),transposition of the great arteries (D-TGA),tetralogy of Fallot (TOF) and occasionally, CLINICAL FEATURES Presentation […]

Patent Ductus Arteriosus (PDA) Clinical features Diagnosis with Treatment

Patent Ductus Arteriosus (PDA) Complications Clinical features and Diagnosis The ductus normally closes at birth. When the ductus remains patent then a left-to-right shunt exists between the aorta to the pulmonary ar­ery. The ductus is attached to the aorta just after he origin of the left subclavian artery. he ductus is attached to the pulmonary […]

Eisenmenger syndrome (ASD, VSD, PDA With PAH with reversal of shunt – Right-to-Ieft shunt) with Treatment

Eisenmenger syndrome (ASD, VSD, PDA With PAH with reversal of shunt – Right-to–Ieft shunt) Eisenmenger described a syndrome in which pulmonary vascular disease developed in patients with a nonrestrictive ventricular septal defect, There is cyanosis, JVP is normal, there is no paraster­nal heave, palpable pulmonary trunk in left second intercostal space. There are signs of […]

Fallot’s Tetralogy Clinical features Symptoms Complications WITH Treatment

Fallot’s Tetralogy Clinical features of Fallot’s Tetralogy Symptoms Complications WITH Treatment it is the commonest congenital cyanotic heart dis­ease. This congenital heart disease consists of ventricular septal defect, pulmonary stenosis, overriding of aorta and right ventricular hypertrophy. When there is moderate PS and small VSD, there is acyanotic Tetralogy of Fallot. As these chil­dren survive […]


AORTIC ANEURYSM Etiology Symptoms with Treatment Aneurysm is a pathological dilatation of a seg­ment of vessel. An aneurysm affecting any part of the aorta from the aortic valve to the iliac arteries. True aneurysm involves all 3 layers of an ar­tery or vein or heart. Pseudo aneurysm is a breakage of intima and media of […]


  COMPLICATIONS OF AMI AND TREATMENT TRICULAR DYSFUNCTION RV INFARCTION RUPTURE OF FREE WALL CARDIOGENIC SHOCK VENTRICULAR SEPTAL DEFECT (VSD) MITRAL REGURGITATION (MR)   1. VENTRICULAR DYSFUNCTION Ventricular remodeling is a series of changes in shape, size and thickness of ventricular myocar­dium after infarction. This leads to global LV dys­function and CHF.   Killip’s classification […]


CLINICAL PRESENTATION Acute Myocardial Infarction is precipitated by exer­tion, exercise, emotional stress, medical and surgical disease and interventions. Circadian variation – AMI is more common in early morning hours due to increase in sympathetic tone and increased thrombolytic tendency from 4 to 12 AM. Acute myocardial infarction (AMI) is the rapid development of myocardial necrosis […]

CARDIAC MARKERS IN MI, AMI and Myocardial Injury

CARDIAC MARKERS IN MI Serum proteins released in blood from necrotic heart muscles after AMI are called serum markers .   Creatinine phosphokinase (CK) Rises in 4 – 8 hours. Returns to normal in 48 – 72 hours.   CK increased in : IM injections Stroke Surgery Trauma Skeletal muscle diseases Electrical cardioversion Hypothyroidism Convulsions, […]

MANAGEMENT of Acute Myocardial Infarction (AMI) -1

  MANAGEMENT of Acute Myocardial Infarction (AMI)   MANAGEMENT Management involves Prompt attention and diagnosis. Reperfusion therapy Management of pain. MI is a medical emergency; Typical treatment for the patient includes: diagnosis and treatment should not be delayed. administering oxygen immediately, and giving aspirin and beta blockers, unless there are strong contraindications. ordering fibrinolytic drugs […]


COMPLETE MANAGEMENT OF AMI Coronary Care Unit (CCU) Patients of AMI are admitted to CCU for monitoring of all vital parameters, management of arrhythmias, thrombolytic therapy. For more  management-of-acute-myocardial-infarction-ami and  acute-myocardial-infarction-management-regime-for-management-of-ami Sedation DiazeRam Lorazepam Reassurance Quiet surroundings. Diet Liquids for 1St 12 hours. Fat <30 % of total calories, carbohydrate – 50% of total calories, […]

Acute Myocardial Infarction (AMI) Causes PATHOPHYSIOLOGY and Etiology

Acute Myocardial Infarction AMI Causes PATHOPHYSIOLOGY  Atherosclerosis and Etiology Acute coronary syndrome (ACS) may present as unstable angina (no ST segment elevation), or acute myocardial infarction. Acute myocardial infarction (AMI) implies irreversible damage to the myocardium. MI Causes usually occurs when an atheromatous plaque in a coronary artery ruptures, and the resulting clot obstructs the […]

Acute Myocardial Infarction CLINICAL PRESENTATION

Acute Myocardial Infarction CLINICAL PRESENTATION Acute Myocardial Infarction is precipitated by exer­tion, exercise, emotional stress, medical and surgical disease and interventions. Circadian variation – AMI is more common in early morning hours due to increase in sympathetic tone and increased thrombolytic tendency from 4 to 12 AM.   Acute Myocardial Infarction Pain: Pain is the […]

Aortic Regurgitation Symptoms of Aortic Regurgitation Aortic Regurgitation TREATMENT

Aortic Regurgitation SYMPTOMS of Aortic Regurgitation Aortic Regurgitation  PHYSICAL FINDINGS Aortic Regurgitation TREATMENT Aortic Regurgitation or aortic incompetence is a regurgitation of blood into the left ventricle dur­ing diastole due to defective closure of the aortic valve. A backward flowing, as in the return of solids or fluids to the mouth from the stomach or […]

Tricuspid Stenosis and Tricuspid Regurgitation Symptoms Investigations and Treatment

Tricuspid Stenosis and Tricuspid Regurgitation   Symptoms of Tricuspid Stenosis and Tricuspid Regurgitation with Physical findings Treatment     Tricuspid stenosis is an uncommon valvular abnormality that most commonly occurs in association with other valvular lesions. Regurgitation caused not by valvular disorder but by dilatation of ventricles, the great vessels, or valve rings. Tricuspid Regurgitation […]

Pulmonary Hypertension CLASSIFICATION Physical Examination Causes Pulmonary Hypertension Treatment

Pulmonary Hypertension Causes of Pulmonary Hypertension ,Physical Examination and Symptoms of Pulmonary Hypertension with Pulmonary Hypertension Treatment Pulmonary hypertension means an increase in pulmonary artery pressure. Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure and secondary right ventricular failure. Elevated blood pressures in the pulmonary arteries (above 25-30 mm Hg). Normal pulmonary artery […]

Cardiomyopathy Clinical features Etiology Diagnosis Dilated Hypertrophic Restrictive cardiomyopathy with Treatment

Cardiomyopathy Diagnosis Signs and Symptoms CARDIOMYOPATHY Causes Etiology Types Diagnosis of Cardiomyopathy  with Treatment Cardiomyopathy Cardiomyopathies are a group of diseases which involve the heart muscles and affect cardiac functions. Any disease that affects the heart muscle, diminishing cardiac performance There is primary involvement of heart muscles. There is no evidence of any heart disease […]

Cor pulmonale Causes of Cor pulmonale Symptoms of COR PULMONALE and Treatment

  Cor pulmonale Causes of Cor pulmonale Symptoms with Types and Treatment  — Cor pulmonale is enlargement of right ventricle . secondary to diseases of lungs, thorax, pulmo­nary ventilation or pulmonary circulation. Living for an extended period at a high altitude also may cause this condition. Cor pulmonale is the alteration of right ventricular structure […]

Rheumatic Fever Causes of Rheumatic fever Diagnosis Rheumatic fever TREATMENT

Rheumatic Fever Signs and symptoms Diagnosis of Rheumatic fever Causes with treatment — Rheumatic fever is acute or first presentation of infection by Streptococcus leading to sore throat, fever, arthritis and/or carditis. A multisystem, febrile inflammatory disease that is a delayed complication of untreated group A streptococcal pharyngitis. Pharyngitis usually occurs two to four weeks […]

Mitral Stenosis Causes Symptoms of Mitral Stenosis Etiology of Mitral Stenosis Treatment of Mitral Stenosis

  Mitral Stenosis Treatment of Mitral Stenosis causes and Etiology of Mitral Stenosis with Symptoms of Mitral Stenosis Mitral Stenosis is narrowing of the mitral valve due to which there is a restriction of blood flow from left atrium to left ventricle. It is more com­mon in females. Mitral stenosis (MS), resulting from thickening and […]

Mitral Regurgitation (MR)Causes Symptoms Mitral Regurgitation Treatment of Mitral Regurgitation ACC/AHA guideline

  Mitral Regurgitation (MR) Causes, Mitral Regurgitation (MR) Symptoms ,ACC/AHA guideline for Mitral Regurgitation (MR) Physical findings Treatment of Mitral Regurgitation Mitral regurgitation is the regurgitation or back flow of blood from left ventricle to left atrium during left venticular systole. It is also called Mitral incompetence. A backward flowing, as in the return of […]

Aortic Stenosis Symptoms Aortic Stenosis Physical Findings Auscultation TREATMENT

  Aortic Stenosis PHYSICAL FINDINGS Aortic Stenosis SYMPTOMS, PATHOPHYSIOLOGY  with Aortic Stenosis TREATMENT   Aortic Stenosis Definition — Aortic stenosis is the narrowing of the left venticular outlet usually at the valve. Aortic stenosis is the commonest valvular heart dis­ease in adults and elderly persons. It is more com­mon in males. Aortic Stenosis An impairment […]

Heart Failure Causes Symptoms NYHA classification with Heart Failure Treatment

  Heart Failure Heart failure is a state wherein the heart is un­able to pump blood adequately to meet the needs of all the tissues and organs of the body at nor­mal pressures.   Heart Failure Definition —     Inability of the heart to circulate blood effectively enough to meet the body’s metabolic needs. […]

Heart Failure Treatment Heart Failure GENERAL PRINCIPLES

  Heart Failure Treatment PHARMACOLOGICAL THERAPY Heart failure (HF) is a common clinical syndrome representing the end-stage of a number of different cardiac diseases. Heart failure may result from arrhythmias, heart valve lesions,myocardial infarction, myocardial ischemia,  congenital malformation of the heart or great vessels, pericarditis, cardiomyopathy, constrictive or conditions that affect the heart indirectly,   […]

ATRIAL FLUTTER Symptoms Causes Diagnosis with Treatment

ATRIAL FLUTTER  TACHYARRHYTHMIAS ARRHYTHMIAS marked by rapid (about 300 beats per minute) regular atrial beating   SINUS TACHYCARDIA —     ·Heart rate exceeds 100 beats/min ·Gradual onset and offset ·Normal PQRST.   ATRIAL FLUTTER — Cardiovascular examination cardiac disorders   ATRIAL FLUTTER Definition cardiac dysrhythmia — marked by rapid (about 300 beats per minute) […]

Ventricular Tachycardia VT Diagnosis Causes Clinical features with Treatment

  Cardiac Arrhythmias —   Ventricular Tachycardia VT – Three or more consecutive ventricular ectopic complexes (duration greater than 120 ms) occurring at a rate of 100 to 250 beats per minute.   Diagnosis of VT (ventricular tachycardia)     At least 3 consecutive wide QRS complexes Rate at least 100 per minute Usually rhythm […]