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Cardiovascular Medicine

Cardiovascular Medicine. Overall chapter. 3.1 – The Heart & Circulation 3.2 – Evaluation of Cardiac Function 3.3 – Therapeutic Interventions. 3.1 - Anatomy. The Heart The Conduction System of the Heart Innervation of the Heart and Blood Vessels Blood Supply of the Heart

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Cardiovascular Medicine

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  1. Cardiovascular Medicine

  2. Overall chapter • 3.1 – The Heart & Circulation • 3.2 – Evaluation of Cardiac Function • 3.3 – Therapeutic Interventions

  3. 3.1 - Anatomy • The Heart • The Conduction System of the Heart • Innervation of the Heart and Blood Vessels • Blood Supply of the Heart • Systemic Circulation

  4. Physiology • Basic Functions • Important Relationships • CO = HR x SV (Know Table 3-2) • Heart Rate (Chronotropy) • Preload • Afterload • Contractility (Inotropy) • Compliance • EF • MVO2 • BP = CO x TPR (TPR assoc with radius, compliance, viscosity of blood

  5. Physiology • Cardiac Cycle (Know Figure 3-7) • Heart Sounds • S1, S2, S3, S4, Adventitious • Exercise Physiology • Effects of Aging

  6. 3.2 – Evaluation of Cardiac Function • S&S’s - Know Table 3-3 • Physician’s physical examination • Blood Pressure • Chest x-ray • Electrocardiography • Rhythm Strips • 12 Lead • Ambulatory / Holter monitor • Signal Averaged • Spatial Vectorcardiography

  7. 3.2 – Evaluation of Cardiac Function • Exercise & Stress Testing • Exercise Testing • Walk Tests • Pharmacologic Stress Testing • Echocardiography • M-mode • Two-dimensional Echocardiography / Sector Scanning • 3 D Echo • Doppler Echo • Transesophageal Echo (TEE) • Contrast Echocardiography • Intravascular • Stress Echo • Duplex Ultrasound

  8. 3.2 – Evaluation of Cardiac Function • Cardiac Imaging • CT • Myocardial perfusion imaging • SPECT (Single Photon Emission CT) • Infarct-avid Imaging • Radionuclide Angiography & Ventriculography • Cardiac MRI • PET Scan

  9. 3.2 – Evaluation of Cardiac Function • Invasive Monitoring • Intra-arterial catherization (a line) • Pulmonary artery catheter • Thermodilution catheter • Combination catheters • Central Venous Pressure Line (CVP; Central line)

  10. 3.2 – Evaluation of Cardiac Function • Cardiac Catheriterization • Right Heart • Left Heart • Endomyocardial Biopsy • Have an understanding of Table 3-5 (I will provide normal ranges in cases) • Electrophysiological Studies

  11. 3.3 Therapeutic Interventions • Medical Management • Pharmacological • Diet • Risk Factor Reduction • Cardiac Rehabilitation • Enhanced Extracorporeal Counterpulsation (EECP) • CPR • Cough CPR • Cardioversion / Defibrillation

  12. 3.3 Therapeutic Interventions • Surgical interventions • Myocardial Revascularization • PTCA (Percutaneoustransluminal coronary angioplasty) • Stents • Atherectomy • Laser Angioplasty • CABG (Coronary artery bypass graft) • Hybrid Revascularization • Transmyocardial revascularization

  13. 3.3 Therapeutic Interventions • Treatment of Arrhythmias • Cardiac Ablation • Pacemaker insertion • Paced, Sensed, Response, RM, Multisite • DDD, DDDR, VVIR, DDI • AICD • Surgical Treatment of Tachyarrhythmias • Maze Surgery

  14. 3.3 Therapeutic Interventions • Valve Repairs & Replacement • Percutaneous Balloon Valvuloplasty • Open Valvotomy & Commisurotomy • Valvectomy • Annuloplasty • Replacement • Ross procedure

  15. 3.3 Therapeutic Interventions • Surgical treatment of heart failure • Intraaortic balloon counterpulsation • Extracorporeal life support (ELS) • Ventricular assist devices (VAD) • Cardiac resynchronization • Mitral valve annuloplasty • Heart and Heart/Lung transplation • Endoventricular patch plasty • Cardiomyoplasty • Left ventricular reduction – Batista procedure • Improving myocardial efficiency (sleeve/ splint) • Aneurysectromy / Myectomy • Septalmyectomy

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