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Coronary Artery Spasm
Coronary vasospasm is a sudden, intense vasoconstriction of an epicardial coronary artery that causes occlusion (stoppage) or near-occlusion of the vessel. It can cause Prinzmetal's angina. It can occur in multiple vessels.[1][2] Atropine
Atropine
has been used to treat the condition.[3] See also[edit]Angiography Cardiac CT Myocardial bridgeReferences[edit]^ Ahooja V, Thatai D (July 2007). "Multivessel coronary vasospasm mimicking triple-vessel obstructive coronary artery disease". J Invasive Cardiol. 19 (7): E178–81. PMID 17620681. Archived from the original on 2009-01-16.  ^ Miwa K, Ishii K, Makita T, Okuda N (May 2004). "Diagnosis of multivessel coronary vasospasm by detecting postischemic regional left ventricular delayed relaxation on echocardiography using color kinesis". Circ. J. 68 (5): 483–7. doi:10.1253/circj.68.483. PMID 15118293
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Specialty (medicine)
A specialty, or speciality, in medicine is a branch of medical practice. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.[1]Contents1 History of medical specialization 2 Classification of medical specialization 3 Specialties that are common worldwide 4 List of specialties recognized in the European Union and European Economic Area 5 List of North American medical specialties and others 6 Physician
Physician
compensation 7 Specialties by country7.1 Australia and New Zealand 7.2 Canada 7.3 Germany 7.4 India 7.5 United States 7.6 Specialty and Physician
Physician
Location8 Other uses 9 Training 10 Satisfaction 11 See also 12 ReferencesHistory of medical specialization[edit] To a certain extent, medical practitioners have always been specialized
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Constrictive Pericarditis
Constrictive pericarditis
Constrictive pericarditis
is a medical condition characterized by a thickened, fibrotic pericardium, limiting the heart's ability to function normally.[1] In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause.[2]Contents1 Signs and symptoms 2 Causes 3 Pathophysiology 4 Diagnosis 5 Treatment 6 References 7 Further reading 8 External linksSigns and symptoms[edit] Signs and symptoms of constrictive pericarditis are consistent with the following: fatigue, swollen abdomen, difficulty breathing (dyspnea), swelling of legs and general weakness. Related conditions are bacterial pericarditis, pericarditis and pericarditis after a heart attack.[1] Causes[edit] The cause of constrictive pericarditis in the developing world are idiopathic in origin, though likely infectious in nature
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Myocardial Infarction Complications
Myocardial infarction
Myocardial infarction
complications may occur immediately following a heart attack (in the acute phase), or may need time to develop (a chronic problem). After an infarction, an obvious complication is a second infarction, which may occur in the domain of another atherosclerotic coronary artery, or in the same zone if there are any live cells left in the infarct.Contents1 Congestive heart failure 2 Myocardial rupture 3 Arrhythmia 4 Pericarditis 5 Cardiogenic shock 6 ReferencesCongestive heart failure[edit] Main article: Congestive heart failure A myocardial infarction may compromise the function of the heart as a pump for the circulation, a state called heart failure. There are different types of heart failure; left- or right-sided (or bilateral) heart failure may occur depending on the affected part of the heart, and it is a low-output type of failure
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Hibernating Myocardium
In cardiology, hibernating myocardium is a state when some segments of the myocardium exhibit abnormalities of contractile function.[1] These abnormalities can be visualised with echocardiography, cardiac magnetic resonance imaging (CMR), nuclear medicine (PET) or ventriculography. Echocardiography: A wall motion abnormality at rest which improves during a low-dose dobutamine stress test is classified as "hibernating myocardium". Low dose dobutamine stimulates contractile function and thus helps to predict functional recovery after revascularization. Cardiac magnetic resonance: The most frequently used MR contrast agents based on Gd-chelates accumulate in the extracellular space which is increased in scarred myocardium. This leads to a signal increase which can be visualised with the "late gadolinium enhancement technique". This is probably the most accurate way to visualise scarred myocardium
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Myocardial Stunning
In cardiology, stunned myocardium is a state when some section of the myocardium (corresponding to area of a major coronary occlusion) shows a form of contractile abnormality. This is a segmental dysfunction which persists for a variable period of time, about two weeks, even after ischemia has been relieved (by for instance angioplasty or coronary artery bypass surgery). In this situation, while myocardial blood flow (MBF) returns to normal, function is still depressed for a variable period of time. Myocardial stunning is the reversible reduction of function of heart contraction[1] after reperfusion not accounted for by tissue damage or reduced blood flow.[2] After total ischemia occurs, the myocardium switches immediately from aerobic glycolysis to anaerobic glycolysis resulting in the reduced ability to produce high energy phosphates such as ATP and Creatinine Phosphate
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Myocardial Rupture
Myocardial rupture is a laceration of the ventricles or atria of the heart, of the interatrial or interventricular septum, or of the papillary muscles. It is most commonly seen as a serious sequela of an acute myocardial infarction (heart attack). It can also be caused by trauma.[1]Contents1 Signs and symptoms 2 Causes 3 Diagnosis3.1 Classification4 Treatment 5 Prognosis 6 Incidence 7 ReferencesSigns and symptoms[edit] Symptoms of myocardial rupture are recurrent or persistent chest pain, syncope, and distension of jugular vein
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Ventricular Aneurysm
Ventricular aneurysms are one of the many complications that may occur after a heart attack. The word aneurysm refers to a bulge or ‘pocketing’ of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septum, or within the aorta. In the heart, they usually arise from a patch of weakened tissue in a ventricular wall, which swells into a bubble filled with blood.[1] This, in turn, may block the passageways leading out of the heart, leading to severely constricted blood flow to the body. Ventricular aneurysms can be fatal. They are usually non-rupturing because they are lined by scar tissue. A left ventricular aneurysm can be associated with ST elevation.[2]Contents1 Signs and symptoms 2 Causes 3 Diagnosis3.1 Differential diagnosis4 Treatment 5 See also 6 References 7 Further readingSigns and symptoms[edit] Ventricular aneurysms usually grow at a very slow pace, but can still pose problems
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Dressler Syndrome
Dressler syndrome is a secondary form of pericarditis that occurs in the setting of injury to the heart or the pericardium (the outer lining of the heart). It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion. Dressler syndrome is also known as postmyocardial infarction syndrome[1] and the term is sometimes used to refer to post-pericardiotomy pericarditis. It was first characterized by William Dressler at Maimonides Medical Center in 1956.[2][3][4] It should not be confused with the Dressler's syndrome of haemoglobinuria named for Lucas Dressler, who characterized it in 1854.[5][6]Contents1 Presentation 2 Causes 3 Diagnosis3.1 Differential diagnosis4 Treatment 5 References 6 External linksPresentation[edit] Dressler syndrome was, historically, a phenomenon complicating about 7% of myocardial infarctions;[7] however, in the era of percutaneous coronary intervention, it is very uncommon
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Pericardium
The pericardium is a double-walled sac containing the heart and the roots of the great vessels. The pericardial sac has two layers, a serous layer and a fibrous layer. It encloses the pericardial cavity which contains pericardial fluid. The pericardium fixes the heart to the mediastinum, gives protection against infection, and provides the lubrication for the heart. It receives its name from Ancient Greek
Ancient Greek
peri (περί; "around") and cardion (κάρδιον; "heart").Contents1 Structure1.1 Fibrous pericardium 1.2 Serous pericardium 1.3 Anatomical relationships2 Function 3 Clinical significance 4 Additional images 5 See also 6 References 7 External linksStructure[edit] The pericardium is a tough double layered fibroserous sac which covers the heart.[1] The space between the two layers of serous pericardium (see below), the pericardial cavity, is filled with serous fluid which protects the heart from any kind of external jerk or shock
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Pericarditis
Pericarditis
Pericarditis
is inflammation of the pericardium (the fibrous sac surrounding the heart).[7] Symptoms typically include sudden onset of sharp chest pain.[1] The pain may also be felt in the shoulders, neck, or back.[1] It is typically better sitting up and worse with lying down or breathing deep.[1] Other symptoms may include fever, weakness, palpitations, and shortness of breath.[1] Occasionally onset of symptoms is gradual.[7] The cause of pericarditis is believed to be most often due to a viral infection.[4] Other causes include bacterial infections such as tuberculosis, uremic pericardit
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Acute Pericarditis
Acute pericarditis
Acute pericarditis
is a type of pericarditis (inflammation of the sac surrounding the heart, the pericardium) usually lasting less than 6 weeks[citation needed]. It is by far the most common condition affecting the pericardium.Contents1 Signs and symptoms 2 Causes 3 Pathophysiology 4 Diagnosis 5 Treatment 6 Prognosis 7 References 8 Further readingSigns and symptoms[edit]This section needs more medical references for verification or relies too heavily on primary sources. Please review the contents of the section and add the appropriate references if you can. Unsourced or poorly sourced material may be challenged and removed. (October 2015) Chest pain
Chest pain
is one of the common symptoms of acute pericarditis. It is usually of sudden onset, occurring in the anterior chest and often has a sharp quality that worsens with breathing in or coughing, due to inflammation of the pleural surface at the same time
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Pericardial Effusion
Pericardial effusion
Pericardial effusion
("fluid around the heart") is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion
Pericardial effusion
usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity. Normal levels of pericardial fluid are from 15 to 50 mL.Contents1 Signs and symptoms 2 Causes 3 Diagnosis 4 Treatment 5 References 6 External linksSigns and symptoms[edit] Chest pain or pressure are common symptoms. A small effusion may be asymptomatic
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Acute Coronary Syndrome
Acute coronary syndrome
Acute coronary syndrome
(ACS) is a syndrome (set of signs and symptoms) due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies.[1] The most common symptom is chest pain, often radiating to the left shoulder[2] or angle of the jaw, crushing, central and associated with nausea and sweating
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Cardiac Tamponade
Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium (the sac around the heart) builds up and results in compression of the heart.[2] Onset may be rapid or more gradual.[2] Symptoms typically include those of cardiogenic shock including shortness of breath, weakness, lightheadedness, and cough.[1] Other symptoms may relate to the underlying cause.[1] Common causes include cancer, kidney failure, chest trauma, and pericarditis.[2] Other causes include connective tissue diseases, hypothyroidism, aortic rupture, and following cardiac surgery.[4] In Africa, tuberculosis is a relatively common cause.[1] Diagnosis may be suspected based on low blood pressure, jugular venous distension, pericardial rub, or quiet heart sounds.[2][1] The diagnosis may be further supported by specific electrocardiogram (ECG) changes, chest X-ray, or an ultrasound of the heart.[2] If fluid increases slowly the pericardial sac can expand to contain more than 2 liters; however, i
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Hemopericardium
Hemopericardium
Hemopericardium
refers to blood in the pericardial sac of the heart. It is clinically similar to a pericardial effusion, and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade.[1] The condition can be caused by full-thickness necrosis (death) of the myocardium (heart muscle) after myocardial infarction, chest trauma,[2] and by over-prescription of anticoagulants.[3][4] Other causes include ruptured aneurysm of sinus of Valsalva and other aneurysms of the aortic arch.[5]
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