The small giraffe heart normalises ventricular wall tension, but
... high intraventricular blood pressure by having a lower left ventricular radius and a thicker ventricular wall (Mitchell and Skinner, 2009). This can be achieved by a typical mammalian heart mass relative to body mass, but must entail a lower stroke volume (SV) per unit of cardiac mass than in simila ...
... high intraventricular blood pressure by having a lower left ventricular radius and a thicker ventricular wall (Mitchell and Skinner, 2009). This can be achieved by a typical mammalian heart mass relative to body mass, but must entail a lower stroke volume (SV) per unit of cardiac mass than in simila ...
A Complex Congenital Case
... main pulmonary arterial atresia. In the mildest forms the main pulmonary and branch pulmonary arteries are of normal caliber and pulmonary blood flow is supplied by a tortuous PDA or by major aortopulmonary collaterals (MAPCAs). In the most severe forms the branch pulmonary arteries are discontinuou ...
... main pulmonary arterial atresia. In the mildest forms the main pulmonary and branch pulmonary arteries are of normal caliber and pulmonary blood flow is supplied by a tortuous PDA or by major aortopulmonary collaterals (MAPCAs). In the most severe forms the branch pulmonary arteries are discontinuou ...
Bundle Branch Block and Benefit from Cardiac Resynchronization
... Since CRT aims at correcting the delay in activation between the LV septal and LV free wall, the presence of a truly significant delay between both walls is necessary for CRT to exert its benefits. The most ideal example of such a delay is LBBB, in which the LV septum is activated approximately 100 ...
... Since CRT aims at correcting the delay in activation between the LV septal and LV free wall, the presence of a truly significant delay between both walls is necessary for CRT to exert its benefits. The most ideal example of such a delay is LBBB, in which the LV septum is activated approximately 100 ...
Noninvasive epicardial and endocardial mapping of premature
... of 224 MRI or CT compatible electrodes) were placed onto the patient’s torso, followed by same-day contrast MRI (Magnetom Avanto, 1.5 T, Siemens, Germany) or EKG-gated CT (Somatom Definition Flash 128, Siemens, Germany) scanning of the heart and thorax. Computed tomography or MRI data imported in th ...
... of 224 MRI or CT compatible electrodes) were placed onto the patient’s torso, followed by same-day contrast MRI (Magnetom Avanto, 1.5 T, Siemens, Germany) or EKG-gated CT (Somatom Definition Flash 128, Siemens, Germany) scanning of the heart and thorax. Computed tomography or MRI data imported in th ...
Lethal Arrhythmias
... Tracey currently works in cardiac care as an Advanced Clinician in an intermediate care unit at Sharp Memorial Hospital in San Diego, California. As an Advanced Clinician, Tracey's love for patient care meets with her passion for teaching. ... Tanna R. Thomason, RN, MS, CCRN, contributor to this cou ...
... Tracey currently works in cardiac care as an Advanced Clinician in an intermediate care unit at Sharp Memorial Hospital in San Diego, California. As an Advanced Clinician, Tracey's love for patient care meets with her passion for teaching. ... Tanna R. Thomason, RN, MS, CCRN, contributor to this cou ...
First heart sound
... Physiological reduplication of the second sound is mostly connected with various respiratory phases: the filling of the right and left ventricles differs during inspiration and expiration and the length of their systole changes, as well as the tinted of closure of the valve of the aorta and pulmonar ...
... Physiological reduplication of the second sound is mostly connected with various respiratory phases: the filling of the right and left ventricles differs during inspiration and expiration and the length of their systole changes, as well as the tinted of closure of the valve of the aorta and pulmonar ...
A Rare Complication of Electric Shock: Myocardial Infarction
... shock (17). ST elevation of inferior derivations is, however, observed more often, as in our case. As we know from the literature, inferior myocardial infarction is the most common injury t caused by electric shock. This seemingly higher predominance is explained by the right coronary artery’s close ...
... shock (17). ST elevation of inferior derivations is, however, observed more often, as in our case. As we know from the literature, inferior myocardial infarction is the most common injury t caused by electric shock. This seemingly higher predominance is explained by the right coronary artery’s close ...
Effective Closure of the Mitral Valve without Atrial Systole
... excellent quality, the left ventricle was densely opacified and no detectable opacification of the left atrium occurred (figs. 1-3). Special attention was directed to the area of the left atrium and mitral valve to ensure that the projection and exposure factors would have allowed recognition of eve ...
... excellent quality, the left ventricle was densely opacified and no detectable opacification of the left atrium occurred (figs. 1-3). Special attention was directed to the area of the left atrium and mitral valve to ensure that the projection and exposure factors would have allowed recognition of eve ...
Brain natriuretic peptide based strategy to detect left ventricular
... few patients (six in sample 1 and five in sample 2) were in NYHA functional class III or IV. 2.3. Procedures The reference standard of LV systolic function was the LV ejection fraction (LVEF), estimated using the Simpson rule and obtained by a standardized echocardiogram. All studies were performed ...
... few patients (six in sample 1 and five in sample 2) were in NYHA functional class III or IV. 2.3. Procedures The reference standard of LV systolic function was the LV ejection fraction (LVEF), estimated using the Simpson rule and obtained by a standardized echocardiogram. All studies were performed ...
AHA Scientific Statement
... he early repolarization (ER) pattern (ERP), initially described as elevation of the ST segment of ≥1 leads on the 12-lead ECG, has long been considered a benign phenomenon. However, more recent studies have demonstrated positive, negative, and neutral associations between an ERP and various end poin ...
... he early repolarization (ER) pattern (ERP), initially described as elevation of the ST segment of ≥1 leads on the 12-lead ECG, has long been considered a benign phenomenon. However, more recent studies have demonstrated positive, negative, and neutral associations between an ERP and various end poin ...
12. Anesthesia For Patients With Congenital Heart
... Physical examination is best performed when the child is calm. One effective way to calm young children is to have her/him sit in the parent’s lap; distracting them with toys is also effective. Vital signs are measured, including arterial blood pressure (BP) in four extremities, heart rate (HR), res ...
... Physical examination is best performed when the child is calm. One effective way to calm young children is to have her/him sit in the parent’s lap; distracting them with toys is also effective. Vital signs are measured, including arterial blood pressure (BP) in four extremities, heart rate (HR), res ...
Precordial T wave Inversions on - e
... embolism amongst others. The case discussed below is of a 73 year old man who presented to a cardiologist with chest pain and shortness of breath. He had an initial ECG that showed a normal sinus rhythm with T wave inversions across the right precordial leads. He had an unrevealing coronary angiogra ...
... embolism amongst others. The case discussed below is of a 73 year old man who presented to a cardiologist with chest pain and shortness of breath. He had an initial ECG that showed a normal sinus rhythm with T wave inversions across the right precordial leads. He had an unrevealing coronary angiogra ...
A Missed Malignant Right Coronary Artery Anomaly Detected Post
... chest exam demonstrated normal bronchial sounds, with no wheezing, rhonchi, or rales. The remainder of the exam was unremarkable. His wife was able to provide his medical history which was only significant for an aortic mechanical valve replacement in 2009. He underwent aortic valve replacement with ...
... chest exam demonstrated normal bronchial sounds, with no wheezing, rhonchi, or rales. The remainder of the exam was unremarkable. His wife was able to provide his medical history which was only significant for an aortic mechanical valve replacement in 2009. He underwent aortic valve replacement with ...
Transient Left Bundle Branch Block: An Unusual Electrocardiogram
... precordial leads, but it may be seen in the inferior or lateral leads, nonspecific T-wave abnormality, or new bundle branch block, and in some cases, a normal ECG may be the finding at presentation.8 A recent study by Dib et al. showed that new onset of LBBB was found in 1 of 105 patients with TTC.8 ...
... precordial leads, but it may be seen in the inferior or lateral leads, nonspecific T-wave abnormality, or new bundle branch block, and in some cases, a normal ECG may be the finding at presentation.8 A recent study by Dib et al. showed that new onset of LBBB was found in 1 of 105 patients with TTC.8 ...
Cardiovascular malformations in DiGeorge syndrome
... indicates that this sign may be completely lacking. Defective cell-mediated immunity did not lead to serious clinical complications in the present series. However, no specific studies of immune function were performed, which might have disclosed an abnormally low percentage of thymusdependent lympho ...
... indicates that this sign may be completely lacking. Defective cell-mediated immunity did not lead to serious clinical complications in the present series. However, no specific studies of immune function were performed, which might have disclosed an abnormally low percentage of thymusdependent lympho ...
Heart rate variability depression in patients with unstable angina
... Previous studies of HRV in acute coronary syndromes have also shown depressed measures, but discrepancies exist. Myers et al. 2° were the first group to show low values after MI using spectral analysis, whereas Kleiger et al. 5 found low values of SDNN. Bigger et al. 21 performed a comprehensive ana ...
... Previous studies of HRV in acute coronary syndromes have also shown depressed measures, but discrepancies exist. Myers et al. 2° were the first group to show low values after MI using spectral analysis, whereas Kleiger et al. 5 found low values of SDNN. Bigger et al. 21 performed a comprehensive ana ...
Assessment of longitudinal left ventricular systolic function by
... tethering effects than Doppler tissue imaging, but it is markedly load-dependent (8). Different from S and SR rate, TDV is dependent of whole heart translation and tethering (9). Although some analysts claim that myocardial SR imaging is a superior method for the evaluation of longitudinal left vent ...
... tethering effects than Doppler tissue imaging, but it is markedly load-dependent (8). Different from S and SR rate, TDV is dependent of whole heart translation and tethering (9). Although some analysts claim that myocardial SR imaging is a superior method for the evaluation of longitudinal left vent ...
PART 15 - Mike South
... Ryan was a 2-month-old infant with recent onset of episodic cyanosis when distressed. He had been noted to have a heart murmur a few days ago but had been feeding well and gaining weight normally. His mother thought that his colour was normal most of the time but when he cried his lips and fingers b ...
... Ryan was a 2-month-old infant with recent onset of episodic cyanosis when distressed. He had been noted to have a heart murmur a few days ago but had been feeding well and gaining weight normally. His mother thought that his colour was normal most of the time but when he cried his lips and fingers b ...
SDL 13- Ischemic Heart Disease Ischemic Heart Disease AKA
... infarctions (such as obstruction of LAD). Patients with inferior/posterior infarctions (such as obstruction of RCA) usually have histologically normal conducting systems. The main cause of the AV block in patients with posterior infarction is necrosis of the atrial prenodal myocardium. Massive A ...
... infarctions (such as obstruction of LAD). Patients with inferior/posterior infarctions (such as obstruction of RCA) usually have histologically normal conducting systems. The main cause of the AV block in patients with posterior infarction is necrosis of the atrial prenodal myocardium. Massive A ...
EKG2: dDiagnosis of Cardiac Rhythms
... C. P-waves may be inverted in leads II, III & aVF & may occur before, during or after the QRS complexes D. Junctional Rate = 40 – 55 bpm E. This is usually an escape rhythm due to SA node dysfunction or digitalis toxicity! ...
... C. P-waves may be inverted in leads II, III & aVF & may occur before, during or after the QRS complexes D. Junctional Rate = 40 – 55 bpm E. This is usually an escape rhythm due to SA node dysfunction or digitalis toxicity! ...
Adenosine - paramediclab
... are found in every cell of the human body & have a wide range of metabolic roles. Adenosine slows conduction through the AV node without causing negative inotropic effects. It also acts directly on sinus pacemaker cells & vagal nerve terminals to decrease chronotropic (heart rate) activity. Adenosin ...
... are found in every cell of the human body & have a wide range of metabolic roles. Adenosine slows conduction through the AV node without causing negative inotropic effects. It also acts directly on sinus pacemaker cells & vagal nerve terminals to decrease chronotropic (heart rate) activity. Adenosin ...
Expiratory flow limitation as a determinant of orthopnea in
... enrolled (Table 1, Appendix 1). At the time of the study, which took place within the first 24 h after admission in all cases but two (Patients #2 and #8 were studied seven and 10 days after admission, respectively), all patients were treated with oxygen and diuretics. Other treatments are listed in ...
... enrolled (Table 1, Appendix 1). At the time of the study, which took place within the first 24 h after admission in all cases but two (Patients #2 and #8 were studied seven and 10 days after admission, respectively), all patients were treated with oxygen and diuretics. Other treatments are listed in ...
A Note from the Chief 3 CIVT 5 Heart Failure and Transplant
... The blood vessels in the heart aren’t the only ones that can become clogged and need to be reopened. Throughout the body—mainly in the arteries that lead to the brain, kidneys, and legs—fatty deposits can build up, restricting circulation. Approximately 20% of people over age 55 have such blockages ...
... The blood vessels in the heart aren’t the only ones that can become clogged and need to be reopened. Throughout the body—mainly in the arteries that lead to the brain, kidneys, and legs—fatty deposits can build up, restricting circulation. Approximately 20% of people over age 55 have such blockages ...
The DAVID (Dual Chamber and VVI Implantable Defibrillator) II Trial
... Statistical design and analysis. The DAVID II trial was designed as a 1-sided (noninferiority) trial testing the null hypothesis that the effect of atrial pacing, like DDDR-70 in the DAVID trial, will worsen the combined end point of total mortality and heart failure hospitalization, as compared wit ...
... Statistical design and analysis. The DAVID II trial was designed as a 1-sided (noninferiority) trial testing the null hypothesis that the effect of atrial pacing, like DDDR-70 in the DAVID trial, will worsen the combined end point of total mortality and heart failure hospitalization, as compared wit ...
Cardiac contractility modulation
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Cardiac contractility modulation (CCM) is a treatment for patients with moderate to severe left ventricular systolic heart failure (NYHA class II–IV). The short- and long-term use of this therapy enhances both the strength of ventricular contraction and the heart’s pumping capacity. The CCM mechanism is based on stimulation of the cardiac muscle by non-excitatory electrical signals (NES). CCM treatment is delivered by a pacemaker-like device that applies the NES, adjusted to and synchronized with the electrical action in the cardiac cycle.In CCM therapy, electrical stimulation is applied to the cardiac muscle during the absolute refractory period. In this phase of the cardiac cycle, electrical signals cannot trigger new cardiac muscle contractions, hence this type of stimulation is known as a non-excitatory stimulation. However, the electrical CCM signals increase the influx of calcium ions into the cardiac muscle cells (cardiomyocytes). In contrast to other electrical stimulation treatments for heart failure, such as pacemaker therapy or implantable cardioverter defibrillators (ICD), CCM does not affect the cardiac rhythm directly. Rather, the aim is to enhance the heart’s natural contraction (the native cardiac contractility) sustainably over long periods of time. Furthermore, unlike most interventions that increase cardiac contractility, CCM is not associated with an unfavorable increase in oxygen demand by the heart (measured in terms of Myocardial Oxygen Consumption or MVO2). This may be explained by the beneficial effect CCM has in improving cardiac efficiency. A meta-analysis in 2014 and an overview of device-based treatment options in heart failure in 2013 concluded that CCM treatment is safe, that it is generally beneficial to patients and that CCM treatment increases the exercise tolerance (ET) and quality of life (QoL) of patients. Furthermore, preliminary long-term survival data shows that CCM is associated with lower long-term mortality in heart failure patients when compared with expected rates among similar patients not treated with CCM.