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...
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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....
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HYPERSENSITIVITY PNEUMONITIS Clinical features Diagnosis and Treatment of Hypersensitivity HYPERSENSITIVITY PNEUMONITIS (HP) It is also called extrinsic allergic alveolitisis an inflammatory disease of alveolar walls, and terminal airways caused by repeated exposure to organic agents in a susceptible person. It’s also called farmer’s lung, commonly due to the HP caused...
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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,...
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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...
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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...
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Hypertension Hypertension is a serious disease which may be asymptomatic. According to JNC-7 normal blood pressure is 120/80 mmHg and a blood pressure equal to or more than 140 mmHg systolic and 90 mmHg diastolic is hypertension. Etiology is unknown in 90 – 95% cases. Greater than normal tension or...
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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 –...
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Renin and Hypertension Low renin and High Renin essential hypertension Renin is enzyme secreted by juxtaglomerular cells of the kidney. Hypertensives can be low renin essential Hypertensives and high renin essential hypertensives. Low renin essential hypertension : 20% of patients of essential hypertension have low renin essential hypertension. When patients with...
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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...
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