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Nursing Diagnosis
 
03:41
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Forensic examination in cases of firearm injuries
 
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Interventions for patients with HIV AIDS
 
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Forensic thanatology
 
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Medical informatics basics
 
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Views: 1207 Medverdict
Asphyxia Birth trauma
 
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Nursing Research
 
05:22
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An Introduction to Inverse Problems Geophysical inverse problems
 
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Views: 730 Medverdict
Organism reactivity  Role of reactivity in human pathology
 
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Functions and biochemistry of blood
 
05:01
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Views: 791 Medverdict
Definition about Bacillary Dysentery shigellosis Complete Details about Bacillary Dysentery shigello
 
05:51
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Views: 895 Medverdict
Physiological properties of heart
 
02:58
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Disorders of water balance
 
07:52
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Views: 768 Medverdict
Skeletal system Explained | What is Skeletal system | How It Works
 
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Digestion, absorption
 
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Views: 1941 Medverdict
Chloroplast Genome Evolution
 
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Views: 1358 Medverdict
Liver cirrhosis clinical features
 
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Views: 4751 Medverdict
cyclohexane cyclohexene lab answers
 
00:57
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Pneumonia in children
 
14:45
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сhronic pancreatitis
 
05:37
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The main methods of investigation of cardiovascular disease
 
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biochemistry of Hormones
 
05:42
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Interventions for Clients with Burns
 
03:06
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Altered Cell Growth and Cancer Development
 
04:41
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Medical helminthology Flatworms—human parasites
 
12:33
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The etiology, pathogenesis, classification  of diabetes mellitus
 
11:33
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Enzymes classification structure
 
05:11
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General arthrology Anatomy of joints
 
06:22
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Complete details about Cesarean hysterectomy
 
02:26
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Fluid, Electrolyte, and Acid Base Balance electrolyte disturbances
 
11:13
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Introduction to Nursing Practice Nurse practice Acts
 
03:11
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Introduction to splanchnology
 
06:02
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Tertiary and congenital syphilis Principles of therapy and prophilaxis
 
07:02
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Microbial ecology
 
11:53
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Physical Examination in Respiratory System
 
08:02
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Rheumatoid arthritis
 
18:17
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Etiology and Introductin about Bacillary Dysentery shigellosis
 
05:42
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Algorithmic Problem Solving
 
05:42
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Critical Thinking and Delegation
 
04:31
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HYPERTROPHIC, CARDIOMYOPATHY, DIAGNOSIS AND MANAGEMENT
 
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For More Medical and Healthcare related Services Visit : http://www.medverdict.com HYPERTROPHIC CARDIOMYOPATHY DIAGNOSIS AND MANAGEMENT Symptoms Symptoms of heart failure preserved LV functionat any age Exertional dyspnea Fatigue Orthopnea or PND Chest pain typical angina pectoris or atypical silent myocardial ischemia Syncope or nearsyncope and lightheadedness arrhythmias and outflow obstruction. Symptoms and LV obstruction – No correlation Physical Findings With outflow obstruction Arterial pulses rapid rise with bisferiens contour Double or triple apical impulses may be palpable Outward systolic thrustventricular contraction Presystolic accentuated atrial contraction. Mediumpitch ESM at the lower left sternal border and apex Loud murmurs 36LV outflow gradients 30 mm Hg Without subaortic gradients Subtle with no or soft systolic murmur Forceful apical impulse ECG Abnormal90% of pts &75% of asymptomatic relatives Increased voltages consistent with LV hypertrophy STT changes marked T wave inversion in the lateral precordial leads Left atrial enlargement Deep and narrow Q waves Diminished R waves in the lateral precordial leads. Normal ECG 5% of pts Less severe phenotype and favorable course Not predictive of future sudden death Increased voltages Weakly correlated with the magnitude of LV hypertrophy Do not distinguish the obstructive and nonobstructive forms Holter Supraventricular tachycardia 46 percent Premature ventricular contractions 43 percent Nonsustained ventricular tachycardia 26 percent Atrial fibrillation 25 to 30 percent Preexcitation has also been associated with HCM Serum Cterminal propeptide of type I procollagen PICP Elevated levels PICP indicated increased myocardial collagen synthesis in sarcomeremutation carriers without overt disease. Profibrotic state preceded left ventricular hypertrophy or fibrosis visible on MRI. ECHOCARDIOGRAPHY Diffuse hypertrophy of the ventricular septum and anterolateral free wall 70% to 75% Basal septal hypertrophy 10% to 15% Concentric hypertrophy 5% Apical hypertrophy 5% Hypertrophy of the lateral wall 1% to 2%. Mitral annulus velocity, Ea status of myocardial relaxation reduced in most patients with HCM Latepeaking daggershaped appearance Dynamic LVOT obstruction DDs Elderly patients with hypertension treated with vasodilators, diuretics or digoxin Postoperative period intravascular volume depletion and inotropic use. AS after AVR Mitral valve prolapse after MVR Acute anteriorapical MI Some patients with apical ballooning Mimicking Hypertrophic Cardiomyopathy Chronic hypertension RV hypertrophy cardiac amyloidosis Athlete's heart Pheochromocytoma Longterm hemodialysis Fabry disease Friedreich ataxia. Apical hypertrophyapical cavity obliteration caused by hypereosinophilic syndrome or noncompaction. Athlete's Heart Vs Hypertrophic Cardiomyopathy HCM Can be asymmetric Wall thickness: 15 mm LA:40 mm LVEDD :45 mm Diastolic function: always abnormal Athletic heart Concentric & regresses 15 mm 40 mm 45 mm Normal CMR More accurate than echo Can detect 6% more hypertrophy Accurate measurement of thickness Should be done in Poor echo window Discrepancy between Clinical findings ECG Echo CMR Increased LV mass index – not sensitive – 20% HCM normal Better differentiation between physiologcal & pathological LVH Enddiastolic wall thickness–to–cavity volume ratio 0.15 mmmLm2 Lack of LGE of the ventricular myocardium CMRPoor Prognostic factors Markedly elevated LV mass index men 91 gm2; women 69 gm2 was sensitive 100% Maximal wall thickness of more than 30 mm was specific 91% for cardiac deaths Right ventricular RV hypertrophy Myocardial edema by T2weighted imaging LGE has been associated with Ventricular arrhythmias Progressive ventricular dilation CMR CATH Dynamic intraventricular pressure gradient Swan neck deformity in a bananashaped ventricle Spikeanddome configuration – proximal aorta BrockenbroughBraunwald sign CATH Natural History Normal life expectancy Mortality Adults – 1% yr Children 2% yr Subgroups at higher risk for important disease complications sudden and unexpected death progressive heart failure atrial fibrillation AF Heart failure NYHA III IV 10 15 % LV outflow obstruction AF Diastolic dysfunction Microvascular dysfunction BURNT OUT HCM Burnt out HCM3% Systolic dysfunction EF 50% Associated with AF Wall thinning and cavity dilation Diffuse transmural scarring Progression to refractory heart failure or sudden death is frequent 10%year Most reliable risk marker a family history of the end stage MANAGEMENT General guidelines Screening all firstdegree relatives is recommended Echocardiography Children & participating in competitive athletics Every 12 to 18 months Adults no competitive athletics every 5 years Counseled against engaging in competitive athletics http://www.phwiki.com/
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Disorder of carbohydrate metabolism
 
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Advanced Oxidation Processes
 
06:27
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Molecular basis of heredity.Realization of hereditary information
 
11:23
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Introduction to bioethics, bioethics principles bioethics lecture
 
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Immune and Hemopoietic Organs
 
03:51
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Biochemical principles of infertility
 
08:22
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FEMALE GENITAL INFLAMMATORY DISEASES
 
06:32
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Medical helminthology Roundworms human parasites
 
08:11
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HYPERCORTISOLISM Cushing Syndrome
 
03:45
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Renaissance Medicine
 
04:21
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