Heart Failure: Systolic vs. Diastolic Dysfunction

General Considerations Heart failure­ is defined as the inability of the heart to provide sufficient output to meet the metabolic demands of the body. Heart failure may be classified by symptom severity (NYHA classification) and by stage of evolution...

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Functional Classification of Heart Failure

Functional Classification Systems The New York Heart Association (NYHA) functional classification is based on the amount of activity needed to elicit symptoms from the patient. The American College of Cardiology/American Heart Association...

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Heart Failure: Pathophysiology

General Features and Pathophysiology Heart failure (HF)­ is defined as the inability of the heart to provide sufficient output to meet the metabolic demands of the body. Most often a chronic condition, but may also be acute. Heart failure leads to tissue...

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Pulmonary Hypertension

Pulmonary hypertension (PH) refers to increased pressure in the pulmonary circulation. It develops when pulmonary vessels become constricted and/or obstructed, which can occur in a wide variety of conditions. The increase in pressure is measured by right...

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Aortic Stenosis

Causes of aortic stenosis (AS) include degenerative sclerosis with calcification of a trileaflet aortic valve, calcification of a congenital aortic bicuspid valve, or rheumatic fever. Narrowing of the aortic valve obstructs blood flow from the left ventricle to the...

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Heart Sounds

The first heart sound (S1) represents mitral and tricuspid valve closure as the ventricular pressure exceeds atrial pressure at the beginning of systole. The second heart sound (S2) represents aortic and pulmonary valve closure at the end of systole/beginning of...

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Cardiac Tamponade

Cardiac tamponade is an accumulation of fluid in the pericardial sac that compresses the heart, impairs diastolic filling, and leads to a reduction in cardiac output. Tamponade is most often caused by penetrating trauma. Other causes of acute cardiac tamponade include...

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Wolff–Parkinson–White syndrome

Wolff-Parkinson-White syndrome (WPW) is a pre-excitation syndrome of intermittent tachycardia that results from an accessory pathway (the bundle of Kent) directly connecting the atria and the ventricles. The anomalous pathyway allows electrical activity to bypass the...

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Abdominal Aortic Aneurysm

An abdominal aortic aneurysm (AAA, or “triple A”) is an abnormal dilation of the abdominal aorta, usually due to atherosclerosis. An aneurysm is considered to be present when the diameter exceeds 3 cm and the most common site is the infrarenal aorta. Risk factors...

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Statins (HMG-CoA reductase inhibitors) are the most effective drugs available for lowering LDL cholesterol, with reductions in the range of 30 to 60 percent. They also reduce levels of VLDL and increase levels of HDL. In addition, statins are used in the primary and...

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Holiday Heart Syndrome

Holiday Heart Syndrome (HHS) describes the occurrence of an acute cardiac arrhythmia after an episode of acute alcohol excess or alcohol withdrawal. The condition may also occur in predisposed individuals that consume a small amount of alcohol. The name of the...

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Hypertrophic cardiomyopathy (HCM) is a genetic disorder with autosomal-dominant in­heritance but variable penetrance. There is thickening of the left ventricle and septum. The disorder causes diastolic dysfunction and can result in a diverse clinical course including...

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