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Case History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What tests could be performed to show whether Myocardial Infarction (MI) has occurred? ,[object Object]
Test Results  [indicating MI] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chest X-Rays ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Normal Chest X-Ray (4)
Chest X-Rays (fig a. Front View) (fig b. Side View) Chest X-rays Showing Enlargement of Heart (3)
ECG: Electro Cardiogram
ECG: Electro Cardiogram ,[object Object],[object Object]
Arteriogram/Angiogram (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fig. Angiogram
Arteriogram/Angiogram (2) Figure a. Arteriogram  OR  Coronary Angiogram Figure b. Cardiac Catheterization
Magnetic Resonance Imaging  (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Magnetic Resonance Imaging  (6) Panels A–D: MRI study at baseline demonstrates slight apical hypokinesis in end-systolic phase (arrows in D, C = end-diastolic phase). In A and B, short-axis delayed-enhanced MR images show multiple foci in the sub-epicardium and the midwall (arrows in A and B) and the acute ECG shows ST-elevation (arrows).  At 3-months follow-up (E–H), systolic function normalized (G and H) and delayed-enhancement demonstrates resolution of inflammatory foci (E and F, identical location as in A and B) with ECG normalization (F/u).
Radionuclide Imaging (7) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radionuclide Imaging (7) (Fig.) Stress and rest images from single-photon emission computed tomography (SPECT) of a 52-yr-old man with recent-onset angina. Images obtained during stress show a large area of ischemia in the territory fed by the left anterior descending (LAD) artery that is absent at rest. Angiography confirmed a 95 to 99% occlusion involving the bifurcation of the LAD at the first diagonal branch. [Source: http://www.merck.com/mmpe/multimedia/Photo1sec07ch070.html?Ref=t&ItemId=Photo1sec07ch070&RefId=sec07/ch070/ch070i]
Laboratory Testing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Laboratory Testing
To Diagnose MI ,[object Object],[object Object],[object Object],[object Object],[object Object]
Question 2.  ,[object Object]
EDEMA in CHF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EDEMA in CHF Fig A. Pulmonary Edema Fig B. Edema in Extremities Fig C. Edema in Congestive Heart Failure
Cardiomegaly in CHF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiomegaly in CHF Fig a. Cardiomegaly Fig b. Cardiomyopathy Fig c. Cardiac Hypertrophy
Question 3.  How is tissue fluid normally formed, and how is this changed in congestive heart failure?
Formation of Tissue Fluid  Fig A. Normal Formation of Tissue Fluid Fig B.  Fluid Retention in Congestive Heart Failure
Formation of Tissue Fluid (9)   ,[object Object]
Question 4.  What is the mechanism of action of thiazide diuretics, and how may they help patients with heart failure?
Thiazide Diuretics ?? ??
Diuretics
Thiazide Diuretic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thiazides
Thiazides
Thiazides Mechanism of Action of Thiazides ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thiazides Mechanism of Action of Thiazides
[object Object],[object Object],[object Object],[object Object],[object Object],SUMMARY
References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Heart Failure

  • 1.  
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Chest X-Rays (fig a. Front View) (fig b. Side View) Chest X-rays Showing Enlargement of Heart (3)
  • 8.
  • 9.
  • 10. Arteriogram/Angiogram (2) Figure a. Arteriogram OR Coronary Angiogram Figure b. Cardiac Catheterization
  • 11.
  • 12. Magnetic Resonance Imaging (6) Panels A–D: MRI study at baseline demonstrates slight apical hypokinesis in end-systolic phase (arrows in D, C = end-diastolic phase). In A and B, short-axis delayed-enhanced MR images show multiple foci in the sub-epicardium and the midwall (arrows in A and B) and the acute ECG shows ST-elevation (arrows). At 3-months follow-up (E–H), systolic function normalized (G and H) and delayed-enhancement demonstrates resolution of inflammatory foci (E and F, identical location as in A and B) with ECG normalization (F/u).
  • 13.
  • 14. Radionuclide Imaging (7) (Fig.) Stress and rest images from single-photon emission computed tomography (SPECT) of a 52-yr-old man with recent-onset angina. Images obtained during stress show a large area of ischemia in the territory fed by the left anterior descending (LAD) artery that is absent at rest. Angiography confirmed a 95 to 99% occlusion involving the bifurcation of the LAD at the first diagonal branch. [Source: http://www.merck.com/mmpe/multimedia/Photo1sec07ch070.html?Ref=t&ItemId=Photo1sec07ch070&RefId=sec07/ch070/ch070i]
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20. EDEMA in CHF Fig A. Pulmonary Edema Fig B. Edema in Extremities Fig C. Edema in Congestive Heart Failure
  • 21.
  • 22. Cardiomegaly in CHF Fig a. Cardiomegaly Fig b. Cardiomyopathy Fig c. Cardiac Hypertrophy
  • 23. Question 3. How is tissue fluid normally formed, and how is this changed in congestive heart failure?
  • 24. Formation of Tissue Fluid Fig A. Normal Formation of Tissue Fluid Fig B. Fluid Retention in Congestive Heart Failure
  • 25.
  • 26. Question 4. What is the mechanism of action of thiazide diuretics, and how may they help patients with heart failure?
  • 29.
  • 32.
  • 33. Thiazides Mechanism of Action of Thiazides
  • 34.
  • 35.
  • 36.