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Common diseases of the heart and circulatory system

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Presentation on theme: "Common diseases of the heart and circulatory system"— Presentation transcript:

1 Common diseases of the heart and circulatory system

2 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)

3 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

4 Ischaemic heart diseases
Unstable angina pectoris Complaint Increasing angina or angina at rest– crescendo angina Doesn’t resolves on rest Nitrate may help No specific physical alteration Diagnostics EKG Lab tests (troponine, creatine kinase) Acute coronarography

5 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

6 Ischaemic heart diseases
Acute myocardial infarction Physical alterations Arrhythmia Heart failure Shock Diagnostics EKG Lab tests (troponine, creatine kinase) Coronarography – therapeutical possibility

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

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

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

10 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

11 Valvular diseases

12 Valvular diseases Mitral regurgitation Consequences
Left atrial dilatation Pulmonal hypertension Right side congestion Right heart failure Left ventricular dilatation

13 Valvular diseases Mitral regurgitation Complaint Physical examination
Dyspnea Signs of heart failure Physical examination Mitral configuration Auscultation Systolic murmur – radiates to the left axilla

14 Valvular diseases

15 Valvular diseases Aortic stenosis Consequences Systemic hypoperfusion
Coronary hypoperfusion Left ventricular hypertrophy Myocardial hypoxia Low pulse amplitudo

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

17 Valvular diseases Aortic regurgitation Consequences
Systemic hypoperfusion High pulse amplitudo Left ventricular dilatation

18 Valvular diseases Aortic regurgitation Complaints Physical examination
Dyspnea Signs of heart failure Physical examination Aortic configuration Auscultation Diastolic murmur

19 Valvular diseases

20 Valvular diseases Aortic regurgitation
Consequences of wide pulse amplitudo Corrigan’s pulse (quickly elevating and high) Capillary pulsation

21 Valvular diseases Tricuspidal valve Pulmonal valve
Regurgitation –systolic murmur Stenosis – diastolic murmur Pulmonal valve Regurgitation –diastolic murmur Stenosis – systolic murmur

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

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

24 Heart failure Left heart failure Complaints:
Forward: systemic hypoperfusion Backward: pulmonary congestion Complaints: Dyspnea Orthopnea Coughing Weakness

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

26 Heart failure Right heart failure Complaints:
Backward: systemic congestion Forward: pulmonary hypoperfusion Complaints: Oedema (ankles, in laying position:sacral) Fluid accumulation (pleural transsudate, ascites, pericardial transsudate) Organ congestion (hepatomegaly)

27

28 Heart failure - phases

29 Inflammatory heart diseases
Pancarditis - all the layers are inflamed ie.: rheumatic pancarditis Endocarditis Myocarditis Pericarditis

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

31 Infective endocarditis
Valvular disease + bacterial infection Signs: Change in the signs of valvular disease Heart failure Microembolism Fever Diagnosis Blood culture Echocardiography

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

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

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

35 Hypertension Diagnostic criteria Systolic Diastolic
Normal RR: < < 85 Elevated normal Hypertension ≥ ≥ 90 The cardiovascular risk doubling by every 20/10 Hgmm elevation!

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

37 Aneurysm Depends on the localisation - Heart Arteries

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

39 Arterial embolism Complaint Sign Source of embolism 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

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

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