Monday, February 22, 2010
Acute Myocardial Infarction
Acute MI
Any degree of myocardial necrosis caused by myocardial ischemia and detected using a sensitive and specific preferred biomarker, such as cardiac troponin.
Acute Myocardial Infarction
=Annual incidence in US: 900,000
=Mortality: 225,000
=Pre-admission mortality: 125,000
Congestive Heart Failure
http://www.slideworld.org/slidestag.aspx/physiology
Objectives
Review cardiac physiology and pathophysiology of CHF
Early recognition of CHF
Management of CHF
Use of CPAP
Terminology
Heart Failure: The inability of the heart to maintain an output adequate to maintain the metabolic demands of the body.
Pulmonary Edema: An abnormal accumulation of fluid in the lungs.
CHF with Acute Pulmonary Edema: Pulmonary Edema due to Heart Failure (Cardiogenic Pulmonary Edema)
Objectives
Review cardiac physiology and pathophysiology of CHF
Early recognition of CHF
Management of CHF
Use of CPAP
Terminology
Heart Failure: The inability of the heart to maintain an output adequate to maintain the metabolic demands of the body.
Pulmonary Edema: An abnormal accumulation of fluid in the lungs.
CHF with Acute Pulmonary Edema: Pulmonary Edema due to Heart Failure (Cardiogenic Pulmonary Edema)
Stem Cell Therapy: Clinical Results
Stem cell therapy
=are primitive cells
=can renew themselves
=can develop into different cell types
=have the potential to become more differentiated cells
Embryonic stem cells
=derived from the early embryo
=are totipotent (can differentiate into all cell types of all organs)
=used to create gene knockout (KO) animal models for CVD study
Friday, February 19, 2010
Cardiac CTCalcium
Taylor et al – PACC Study – JACC 2005
-2000 patients, mean age 43
-Coronary calcium was associated with an 11.8-fold increased risk for incident coronary heart disease (CHD) (p 0.002) in a Cox model controlling for the Framingham risk score.
-In young, asymptomatic men, the presence of coronary artery calcification provides substantial,
cost-effective, independent prognostic value in predicting incident CHD that is incremental to measured coronary risk factors.
TREATMENT OF HYPERTENSION
to alter favorably the hemodynamic pattern associated with high blood pressure.
Simulation training Curriculum
Constrictive Pericarditis
-64 year old female
-1 Year s/p 3-vessel CABG
-Presents with 6 months of progressive dyspnea and atypical chest pain
-At angiography, all grafts are patent
-Hemodynamics
Restrictive Cardiomyopathy
-43 year old female presented with predominant right heart failure (peripheral edema, ascites)
-Hemodynamic tracings suggest constrictive-restrictive physiology
-Exploratory thoracotomy excluded the presence of constrictive pericarditis
Click here to read more
Sex and the Heart
When can I start having sex again?
After myocardial infarction or CABG
After angioplasty or stent
After myocardial infarction or CABG
--After 2-3 weeks
After angioplasty or stent
--After 2-3 days
What about sex with my angina?
If stable angina and
-Can walk 1 mile in 20 minutes on the flat or
-Can walk down 13 steps in 10 seconds
ACC Heart Failure Guidelines
LIMITNG/CONTROLLING FACTORS IN THE MARINE ENVIRONMENT
-OCEAN CURRENTS/CIRCULATION
-TEMPERATURE
-DEPTH
-LIGHT
-SALINITY
-NUTRIENTS
TEMPERATURE
-Temperature as the most important abiotic factor in the environment for most marine organisms.
-It regulates metabolism growth and reproduction
-It limits geographic ranges and regulates interactions with other environmental variables.
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