By Atul Luthra
This booklet presents postgraduate trainees with 50 actual medical cardiology instances. Divided into fourteen sections, numerous instances are offered lower than every one type overlaying a number of problems of the cardiac method, together with congenital middle ailments, aortic valve illnesses, pulmonary ailments, ECG abnormalities, cardiac arrhythmias, coronary artery affliction and lots more and plenty extra. starting with a quick historical past and findings in response to actual exam, every one case then contains analytical dialogue on bedside investigations and recommendations for remedy. Authored through a regarded specialist within the box, this sensible ebook is extremely illustrated with echocardiographic, radiographic and electrocardiographic facts. Key issues * provides 50 genuine scientific cardiology circumstances * Covers quite a few issues of the cardiac approach * Authored via regarded heart specialist * contains greater than 217 photos, illustrations and tables
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This publication presents postgraduate trainees with 50 actual scientific cardiology instances. Divided into fourteen sections, a number of instances are offered less than every one class masking numerous problems of the cardiac method, together with congenital middle illnesses, aortic valve illnesses, pulmonary ailments, ECG abnormalities, cardiac arrhythmias, coronary artery ailment and lots more and plenty extra.
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Additional info for 50 Cases in Clinical Cardiology
The length of the murmur correlates with the severity of stenosis. The murmur undergoes presystolic accentuation due to atrial contribution to ventricular filling. In mild MS, the murmur may be only presystolic. If MS is associated with atrial fibrillation the S1 is variable in intensity due to variable duration of diastole. Also, presystolic accentuation is lost due to lack of atrial contribution to ventricular filling. Presystolic accentuation is also absent in a calcified valve and after commissurotomy.
Complications of MS are pulmonary congestion, respiratory infections, hemoptysis, right heart failure and systemic thrombo-embolism due to atrial fibrillation associated with left atrial thrombus. 2: Causes of mitral stenosis • Rheumatic heart disease (commonest) • Congenital parachute valve • Mitral annular calcification • Connective tissue disorder • Hurler’s mucopolysaccharidosis 27 28 Section 2 Mitral Valve Diseases PERTINENT INVESTIGATIONS Since rheumatic heart disease is the predominant cause of mitral stenosis, all patients who are febrile should be investigated for rheumatic fever, infective endocarditis and respiratory tract infection.
Diuretics reduce pulmonary congestion, especially in patients with associated mitral or aortic regurgitation. Rate control with digoxin, beta-blocker or verapamil improves left ventricular diastolic filling, in patients who are in sinus rhythm and controls the ventricular response, in whom the rhythm is atrial fibrillation. Since atrial fibrillation in patients with mitral stenosis is associated with a high risk of thrombo-embolism, these patients should also be on a long-term oral anticoagulant agent like warfarin.