Medicaltalks
Medicaltalks
in General
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
That septum definitely looks thick! Hypertrophic cardiomyopathy is a condition in which the myocardium becomes thickened, making the heart muscle stiff, especially of the septum and ventricles (lower heart chambers), which is seen very clearly in this picture. The pathophysiology behind it is that the sarcomeres (contractile elements) in the heart replicate causing heart muscle cells to increase in size, which results in the thickening of the heart muscle. In addition, the normal alignment of muscle cells is disrupted, a phenomenon known as myocardial disarray. The average left ventricular wall thickness in normal adults is 1.1 cm, but there are exceptions. Trained athletes have hearts that have left ventricular mass up to 60% greater than untrained subjects, with an average left ventricular wall thickness of 1.3 cm. The most common cause is hypertension. As many as 1/3 of patients show left ventricular hypertrophy of any degree along with hypertension. Symptoms are quite variable and range from no symptoms, to the development of heart failure, to the occurrence of sudden cardiac death. Symptoms include dyspnea (shortness of breath) due to stiffening and decreased blood filling of the ventricles, exertional chest pain (angina) due to reduced or restricted blood flow to the coronary arteries, uncomfortable awareness of a fluttering or pounding heart beat (palpitations) due to the ischemia to the heart muscle, disruption of the electrical system running through the abnormal heart muscle, lightheadedness, fatigue, fainting (called syncope) and sudden cardiac death. Treatment goals are to minimize diastolic dysfunction, reducing LV outflow tract obstruction, optimizing heart failure management, maintaining normal sinus rhythm, rate control and anticoagulation in the presence of atrial fibrillation, and implantation of an automatic implantable cardiac defibrillator in those patients who survive sudden cardiac death.
Abdulrahman Muhammad Sabir
Abdulrahman Muhammad Sabir
in Learning Materials
Incentive spirometer
Incentive spirometer
Incentive Spirometer : is a useful device that improves ability to take deep and slow breaths, also it's helpful to clear secretions that stuck in airway tract. In which situation we need this device? 1)Postoperative : after a surgery patient may afraid of breathing as a normal way because of pain and opening of stitchs especially in abdominal and Thoracic surgeries so using this device will be really helpful to motivate them and increase quality of breathing, or after long stay under anesthesia (general or local) lungs became really lazy and secretions start to accumulate, recommending complete bed rest is worsening the condition if we don't do anything about, one of several ways is using incentive spirometer until the patient can move and cough without any problem, it can prevent these common problems : -Pneumonia -Atelectasis -Bronchospasm -Respiratory failure 2)Pneumonia : if patient already have pneumonia using this incentive spirometer will decrease the amount of accumulated fluid by improve proper coughing. 3)Chronic obstructive pulmonary disease (COPD) : Most affected people are smokers and till now there is not any treatment that eradicate it completely just symptomatic treatment and changing lifestyles by quiet smoking, some special exercises and using this device will improve breathing. 4)Cystic fibrosis : this disease causes accumulating thick mucus inside lungs that lead to partial or complete closure of bronchioles and bronchials this device prevent worsening by destroy this huge accumulated mucus particles to tiny ones and removing it by coughing. 5)Some other conditions that make doctor recommend incentive spirometer are : -Sickle cell anemia : patient will have lack of oxygen because of abnormal shape and function of red blood cells. -Rib fractures : pain and overcarefullness may prevent proper breathing. -Atelectasis -Asthma --------------------------------------- References : 1)https://rb.gy/bqpkmf 2)https://rb.gy/toy0oz 3)https://rb.gy/sywhc7
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