Year 2 CMap 1

Year 2 CMap 1

1. Anatomy of external of the heart

   • Boarders
     • Left
       • LV & left auricle
     • Right
       • RA
     • Lower
       • Two ventricles mainly right
     • Upper
       • Two atria mainly left
   • Surface
     • Sternocostal
       • Both atria and ventricles
       • Divided by coronary groove mainly right ventricle
     • Diphramatic
       • Two ventricles mainly left
     • Left
       • LV and RV
     • Right
       • RA
   • Grooves
     • Atrioventicular groove
       • R and L coronary arteries
     • Posterior interventicular groove
       • Posterior interventicular artey
       • Middle Cardiac vein
     • Anterior interventicular groove
       • Anterior interventicular artery
       • Great cardiac vein
     • interatrial groove
   • Surface anatomy
   • Clinical locations of the valves

2. Heart sounds

   • Normal
     • S1
       • Closure of mitra/ tricuspid valve
       • Lub - 1st sound
     • S2
       • Closure of aortic/ pulmanory valves
       • Dub - 2nd sound
   • Abnormal
     • S3
       • Overcompliant ventricle
     • S4
       • Noncompliant ventricle
     • Heart murmurs
       • causes
         • Usually due to valvular disease, could be due to wear & tear in old age or RHD or infective endocarditis

3. Cardiac cycle

4. Causes of Fainting

   • Decreased blood flow to brain
   • Neurally Mediated
   • Orthostatic
   • Drug-induced
   • Cardiac

5. Causes of Chest Pain

   • Heart-related causes
     • eg. Myocardial infarction
   • Lung-related causes
     • eg. Pulmonary embolism
   • Digestive causes
     • eg. GERD
   • Muscle and bone causes
     • eg. Costochondritis

6. Valvular Heart Diseases

   • Degenerative Valve Disease
     • Calcific aortic stenosis
       • Calcification and fibrosis due to age - Will eventually cause heart failure
     • mitral valve prolapse
       • leaflets balloon into the left atrium when the left ventricle contracts.
       • chordea tendinea becomes long and thin
       • Midsystolic click
   • Rheumatic Valvular Disease
     • Acute rheumatic fever
     • Chronic rheumatic disease
       • Is an irreversible valve scaring that will cause stenosis of the valves with a fish mouth or button hole appearance.
   • Infective Endocardaitis
   • Noninfected vegetations
     • Nonbacterial thrombotic endocarditis
       • Cause
         • hyper coagulable state
         • Endocardial trauma
         • Cancer
     • Libman-Sacks endocrditis
       • Endocarditis associate with SLE
   • Carcinoid Heart Disease
     • Carcinoid tumors are rare neuroendocrine malignancies. mostly arising within the gastrointestinal system.
   • Prosthetic Cardiac Valve
     • Mechanical valve
       • Lasts for a lifetime
       • Must use blood thinners routinly
     • Tissue (animal)
       • Doesn't have to use thinners rouitinely
       • Years out after some time, 5-6 years
   • Investigations
     • Electrocardiography
       • Helpful in determining most heart issues, measuring electrical activity of heart
     • Echocardiography
       • Helpful to know the size of the heart and valve issues
     • Chest X-Ray
       • help diagnose and monitor conditions such as pneumonia, heart failure, lung cancer, tuberculosis, sarcoidosis
     • Cardiac Catheterization
       • inserted in an artery or vein in your groin, neck or arm

7. Aortic valve replacement

   • open-heart surgery (not done anymore)
   • Now mainly done by a catheter.

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