MICRO
CARDIOVASCULAR SYSTEMppt.pptx

Remember that increased vasoconstriction and sodium

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REMEMBER THAT INCREASED VASOCONSTRICTION AND SODIUM WATER RETENTION CAUSES INCREASED CAPILLARY HYDROSTATIC PRESSURE. 108
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109
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CONGESTIVE HEART FAILURE 110 Ans. is 'a' i.e., Increased sympathetic tone; 'c' Increased hydrostatic pressure . [Ref Hurst ltF"/ep. 673; Harrison 18t1'/ep. 1902, 1903, 1904; 17/ep. 1444, 1445, 1446]
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370 111 Ans. is 'a' i.e., Oliguria [Ref :Harrison 18th/ep. 1902-1904] Renal retention of salt and water The hallmark of heart failure is renal retention of Na and H20 resulting in signs and symptoms of fluid retention. e.g. (peripheral edema and oliguria).
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374 112 Ans. is 'a' i.e., Massive pulmonary embolism [Ref. Harrison 18th/ep. 1913, 1914, 1915; 1 71h/ep. 1454] Acute right ventricular failure is usually caused by acute corpulmonale. Most common cause of acute corpulmonale is pulmonary embolism. M. C. cause of chronic corpulmonale is pulmonary embolism.
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375 113
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DIASTOLIC HEART FAILURE (DHF) IS A CLINICAL SYNDROME IN WHICH PATIENTS HAVE: - SYMPTOMS AND SIGNS OF HEART FAILURE (HF). - NORMAL OR NEAR NORMAL LEFT VENTRICULAR (L V EJECTION - FRACTION (EF). - NORMAL OR NEAR NORMAL LV VOLUME, AND EVIDENCE OF DIASTOLIC DYSFUNCTION ('E.G., ABNORMAL PATTERN OF LV FILLING AND ELEVATED FILLING PRESSURES). 114
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BY CONTRAST, SYSTOLIC HEART FAILURE (SHF) IS CHARACTERIZED BY INCREASED LV VOLUME AND REDUCED EF. AMONG ALL PATIENTS WITH HF AS MANY AS HALF HAVE A NORMAL OR NEAR NORMAL LVEF. THIS CONDITION HAS BEEN TERMED "HEART FAILURE WITH NORMAL EJECTION FRACTION " (HFNEF) OR - "HEART FAILURE WITH PRESERVED EJECTION FRACTION" (HF-PEF). 115
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ETIOLOGY OF HF 116
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117
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375 118 B
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376 119
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SIGNS OF PULMONARY VENOUS HYPERTENSION: (IN ORDER OF APPEARANCE WITH INCREASING PULMONARY VENOUS PRESSURE) 1. VASCULAR REDISTRIBUTION - UPPER LOBE VENOUS DISTENSION 2. INTERSTITIAL OEDEMA - KERLY B LINES 3. ALVEOLAR EDEMA - AIRSPACE OPACITIES - PERIHILAR BAT WING DISTRIBUTION - CLEARS RAPIDLY WITH DIURETICS 4. PLEURAL EFFUSIONS 120
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376 121 Ans. is 'c' i.e. Oligemic lung fields [Ref Grainger & Allison Diagnostic Radiology 41h/ep874, Pathophysiology]
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377 122
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123
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377 124 Ans. is 'a' i.e., BNP [Ref Harrison 18th/e p. 2216, 2236]. The natriuretic peptide system impacts salt and water handling and pressure regulation and may influence myocardial structure and function. - Brain natriuretic peptide (BNP) A natriuretic hormone initially identified in the brain but released primarily from the heart, particularly the ventricles. - Atrial natriuretic peptide (ANP) A hormone that is released from myocardial cells in the atria and in some cases the ventricles in response to volume expansion and possibly increased wall stress.
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378 125
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TREATMENT OF HF ALWAYS REMEMBER THESE IMPORTANT POINTS ABOUT THE MANAGEMENT OF HEART FAILURE – ONCE THE CLINICAL DIAGNOSIS OF HEART FAILURE IS CONFIRMED ASSESS FOR FLUID RETENTION. IT IS IMPORTANT TO TREAT THE PATIENTS FLUID RETENTION BEFORE STARTING AN ACE INHIBITOR.
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  • Winter '16
  • jean grey
  • Cardiology, Ans., Constrictive pericarditis

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