Common diseases of the heart and circulatory system

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Common diseases of the heart and circulatory
system
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Ischaemic heart diseases

• Acute coronary syndrome (ACS)
• Acute myocardial infarction (AMI)
• Unstable angina pectoris
• Sudden cardiac death
• Stable angina pectoris
• Variant angina pectoris (Prinzmetal-angina
  vasospastic angina)
• Silent ischaemia
• X-syndrome (small vessel diseases)

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Ischaemic heart diseases

• Stable angina pectoris
• Complaint
• the same effort the same complaint
• resolves on rest or on nitrates
• Physical alteration no
• Diagnostics
• EKG
• Stress EKG or other stress tests
• Coronarography

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Ischaemic heart diseases

• Unstable angina pectoris
• Complaint
• Increasing angina or angina at rest crescendo
  angina
• Doesnt resolves on rest
• Nitrate may help
• No specific physical alteration
• Diagnostics
• EKG
• Lab tests (troponine, creatine kinase)
• Acute coronarography

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Ischaemic heart diseases

• Acute myocardial infarction
• Complaints
• Longer and more serious pain
• It relives on morphin only
• Sweating, pallor
• Acute heart failure
• Dyspnea
• Decreased blood pressure
• Shock
• Arrhythmia premature beat

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Ischaemic heart diseases

• Acute myocardial infarction
• Physical alterations
• Arrhythmia
• Heart failure
• Shock
• Diagnostics
• EKG
• Lab tests (troponine, creatine kinase)
• Coronarography therapeutical possibility

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Valvular diseases

• Stenosis
• Pressure load hypertrophy
• Isufficiency regurgitation
• Volume load dilatation
• Combined valvular disease
• More than one valve affected
• Stenosis and regurgitation on the same valve

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Valvular diseases

• Diagnostics
• Physical examination
• Shape alterations
• Murmurs
• Signs of heart failure
• Instrumental diagnostics
• Echocardiography
• EKG
• Heart angiography-catheterisation

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Valvular diseases

• Mitral valve stenosis
• Consequences
• Left atrium dilatation
• Sec.pulmonary hypertension
• Right side congestion
• Right ventricle hypertrophy
• and dilatation
• Chr.right heart failure

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Valvular diseases

• Mitral valve stenosis
• Complaints
• Dyspnea
• Signs of heart failure
• Physical examination
• Mitral configuration
• Auscultation
• Loud S1
• Opening snap
• Protomesodiastolic and praesystolic murmur
• Pulmonal S2 louder

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Valvular diseases
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Valvular diseases

• Mitral regurgitation
• Consequences
• Left atrial dilatation
• Pulmonal hypertension
• Right side congestion
• Right heart failure
• Left ventricular dilatation

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Valvular diseases

• Mitral regurgitation
• Complaint
• Dyspnea
• Signs of heart failure
• Physical examination
• Mitral configuration
• Auscultation
• Systolic murmur radiates to the left axilla

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Valvular diseases
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Valvular diseases

• Aortic stenosis
• Consequences
• Systemic hypoperfusion
• Coronary hypoperfusion
• Left ventricular hypertrophy
• Myocardial hypoxia
• Low pulse amplitudo

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Valvular diseases

• Aortic stenosis
• Coplaints
• Angina pectoris
• effort angina
• Sudden death
• Signs of heart failure
• Physical examination
• Aortic configuration
• Auscultation
• Systolic murmur radiates to the carotid artery

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Valvular diseases

• Aortic regurgitation
• Consequences
• Systemic hypoperfusion
• High pulse amplitudo
• Left ventricular dilatation

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Valvular diseases

• Aortic regurgitation
• Complaints
• Dyspnea
• Signs of heart failure
• Physical examination
• Aortic configuration
• Auscultation
• Diastolic murmur

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Valvular diseases
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Valvular diseases

• Aortic regurgitation
• Consequences of wide pulse amplitudo
• Corrigans pulse (quickly elevating and high)
• Capillary pulsation

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Valvular diseases

• Tricuspidal valve
• Regurgitation systolic murmur
• Stenosis diastolic murmur
• Pulmonal valve
• Regurgitation diastolic murmur
• Stenosis systolic murmur

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Heart failure

• Not disease itself syndrome
• Causative diseases
• Acute
• Myocardial infarction
• Myocarditis
• Chronic
• Valvular diseases
• Chr. ischaemic diseases
• Chr. arrhythmias
• Heart muscle abnormities

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Heart failure

• Components
• Forward hypoperfusio
• Backward congestion, pressure elevation
• Subtypes
• Left heart failure
• Right heart failure
• Combined (global) heart failure

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Heart failure

• Left heart failure
• Forward systemic hypoperfusion
• Backward pulmonary congestion
• Complaints
• Dyspnea
• Orthopnea
• Coughing
• Weakness

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Heart failure

• Left heart failure
• Signs
• Inspection
• Dyspnea, cyanosis, othopnea
• Auscultation
• Crackles
• During inspiration and expiration
• Early bibasal
• Later extensive crackles
• Most serious form pulmonary edema

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Heart failure

• Right heart failure
• Backward systemic congestion
• Forward pulmonary hypoperfusion
• Complaints
• Oedema (ankles, in laying positionsacral)
• Fluid accumulation (pleural transsudate, ascites,
  pericardial transsudate)
• Organ congestion (hepatomegaly)

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Heart failure - phases
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Inflammatory heart diseases

• Pancarditis - all the layers are inflamed
• ie. rheumatic pancarditis
• Endocarditis
• Myocarditis
• Pericarditis

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Rheumatic fever

• 1. Streptococcal infection (ie. tonsillitis)
• 2. Pancarditis
• Endo-, myo- and pericarditis
• Most important endocarditis
• Consequence valvular disease

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Infective endocarditis

• Valvular disease bacterial infection
• Signs
• Change in the signs of valvular disease
• Heart failure
• Microembolism
• Fever
• Diagnosis
• Blood culture
• Echocardiography

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Myocarditis

• Complaints
• Weakness
• Decreased loadibility
• Signs
• Tachycardia (on res)
• Soft heart sounds
• Sometimes arrhythmia, heart failure

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Pericarditis

• 1.Pericarditis sicca
• Pericardial friction rub
• Chest pain
• 2.Exsudative pericarditis
• Enlarged heart
• Soft heart sounds

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Hypertension

• Functional phase
• Headache
• Fatigue
• Troubled
• Sleeping disorders
• Phase of organic failures
• Vascular disease
• Heart
• Brain
• Kidney

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Hypertension

• Diagnostic criteria
• Systolic
  Diastolic
• Normal RR lt 130 lt 85
• Elevated normal 130-139 85-89
• Hypertension 140 90
• The cardiovascular risk doubling by every 20/10
  Hgmm elevation!

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Arteriosclerosis

• The signs depends on the affected site
• Ischaemic heart disease
• Cerebral vascular disease
• Abdominal angina
• Intermittent claudication

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Aneurysm

• Depends on the localisation
• - Heart
• Arteries

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Aneurysm

• Complaints
• Symptomless
• Pain
• Dissection
• Rupture
• Signs due to compression
• Thrombosis - Embolism
• Physical examination
• Sometimes palpable (abdominal)
• Systolic murmur

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Arterial embolism

• Complaint
• Sudden, heavy pain
• Pale, cold extremity, later cyanosis
• General symptomps
• Sign
• Unpalpable pulse on the cold, pale extremity
• Source of embolism
• Atrial fibrillation
• After myocardial infarction
• Aneurysm
• Valvular disease
• Endocarditis

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Venous thrombosis

• Superficial vein - thrombophlebitis
• Painful, inflamed, palpable vein
• Deep vein thrombosis
• Unilateral swelling
• Pain
• Signs of inflammation