Proceedings of the British Cardiac Society

Total Page:16

File Type:pdf, Size:1020Kb

Proceedings of the British Cardiac Society Br Heart J: first published as 10.1136/hrt.33.1.142 on 1 January 1971. Downloaded from British Heart Journal, 1971, 33, I42-I5 I. Proceedings of the British Cardiac Society THE FORTY-NINTH ANNUAL post. The names receiving the most would be merged with the contingency GENERAL MEETING of the British votes shall be elected in each case at fund. Cardiac Society was held in the Konin- the next Annual General Meeting. In klijk Institut voor de Tropen, Mauri- the event of a draw for any office, the 4 The following resignations were ac- tskade 63, Amsterdam, on Thursday Council shall decide the member to be cepted with regret: Bingham, J. G. M. and Friday, 23 and 24 April I970 as a elected. Hamilton, A. C. Macdonald. joint meeting with the Dutch Society. Rule 25 to be amended as follows: 5 Hamer was elected as Secretary of The President, SIR JOHN Mc- Three Ordinary Members shall be the Society. MICHAEL, took the Chair at 9.oo elected in accordance with Rule I4 a.m. during Private Business before (as amended above) as Secretary, 6 Sowton was elected as Assistant handing over to the Chairman, R. W. D. Assistant Secretary and Treasurer Secretary of the Society. TURNER. respectively. The Secretary shall 7 The following two new Members of hold office for not more than two Council were elected in place of Tubbs years and the Assistant Secretary for Business and A. J. Thomas: Donald Ross and Private not more than two years; the Trea- Byron Evans. i The Minutes of the Annual General surer shall hold office for five years Meeting having been published in the and shall be eligible for re-election. 8 J. H. Wright was elected an Hono- Journal (1970, 32, 55i) were taken as They will all be ex officio Members of rary Member of the Society. read and confirmed. the Council. 9 The following were elected Extra- 2 The following amendments to the The remaining Rules will be amended Ordinary Members of the Society: Rules of the Society were agreed: to omit any mention of Associate Mem- Cookson, Muir, Bruce Perry, and Sir Rule 4 to be amended to: bers, and this will necessitate arranging George Pickering. them in a slightly different order. There shall be a President of the So- 3 The Treasurer reported that there Io The following Corresponding Mem- ciety who shall be elected by the bers were elected: Gotthard Schettler, members from one of the names put was an excess of income over expendi- Heidelberg, and Velva Schrire, Cape forward by the Council. If, however, ture in I969, but that this was smaller http://heart.bmj.com/ any member wishes to submit an than in I968: £58i.17.-. as compared Town. additional name his nomination must with £673. The decrease was due to in- ii In accordance with the amendment be signed by ten members and re- creased cost of meetings, secretarial to the Rules of the Society adopted at ceived by the Council at least six help, and subscriptions to the Inter- this meeting, whereby the category of weeks before the Annual General national Society and European Society Associate Member had been abolished, Meeting. The President shall be elec- of Cardiology. the present Associate Members (with ted for two years and may be eligible At the present rate of financial tur- the exception of Rahimtoola and Sey- for re-election for further periods of over, there would continue to be an ex- mour) were elected Ordinary Members. one year to a total of five years. He cess of income over expenditure as the Shaper was elected an Ordinary on September 25, 2021 by guest. Protected copyright. shall be ex officio a member of the increase in the number of subscriptions Member from Overseas Membership, a Council. He will represent the So- from new members would counter- and the following new Ordinary Mem- ciety at home and abroad and may balance the increasing costs. But in bers were elected: Peter Fletcher Bin- preside over meetings of the Council three to four years the income would nion, Belfast; Peter Carson, North but not at the Scientific Meetings of equal the expenditure unless the size of Staffordshire; Douglas Anthony Cham- the Society for which a local Chair- the Society was enlarged, or the sub- berlain, London; Bernard Melville man will be elected for each meeting. scription was increased. Council felt Groden, Glasgow; John Reynolds Rules Io and iI to be omitted. that it was essential to form a con- Hampton, Nottingham; Alexander Har- tingency fund to provide a solid financial ley, Manchester; Robin Brian Hed-o Rule 14 to be amended to: backing for the Society, and it was worth-Whitty, London; Marian Ion The Council shall nominate up to ten planned to reinvest the capital to obtain Ionescu (SM), Leeds; Brian Kirby, names from the Ordinary Members better growth of capital, and to invest Edinburgh; John Robert Muir, Lon- of the Society for each of the Offices funds from the deposit account of the don; Eckhardt G. J. Olsen, London;' (President, Secretary, Assistant Se- Society in similar stock. If there were Lionel Hentry Opie, London; Harry A. cretary and Treasurer) and for Coun- funds available from the VI World Con- Rees, Swansea; Philip Slade (SM), cil Members as holders retire, in gress of Cardiology for the Society, Leicester; Michael Webb-Peploe, Lon- accordance with Rules 4 (as amended these would be used to strengthen the don; John Donald Whiteside, Chiches.- above), 21 (previously 22) and 24 (as contingency fund. The Congress Fund, ter; Magdi H. Yacoub (SM), London. amended below). In the normal which had been used to help with course of events the Assistant Secre- members' expenses at the V World I2 The following Overseas Members tary shall succeed the Secretary. Congress of Cardiology in I966 would were elected from Associate Member-; These names shall be sent out to all also be available for the VI World Con- ship: Rahimtoola and Seymour, and Ordinary Members who shall vote by gress. After this, the Congress Fund the following were re-elected: David- Br Heart J: first published as 10.1136/hrt.33.1.142 on 1 January 1971. Downloaded from Proceedings of the British Cardiac Society I43 son, Hywel Davies, Fulton, Harries, present, this proposal would be tried of 50-i86 mm. Hg were found and Parry, Resnekov, Somers, and Wilson. out for the Annual General Meeting in angiocardiographic studies were avail- 1971. able. Mild aortic regurgitation was pre- 13 Shillingford, Chairman of the The Dutch and British Societies sent in 8. Though symptoms noted Organizing Committee, reported that dined together under the Chairmanship before operation in 7 disappeared in 6, the arrangements for the VI World of Dr. Erkelens. The President thanked clinical assessment was difficult as the Congress of Cardiology to be held in our Dutch hosts for excellent arrange- physical signs were unchanged in I0, London in September I970 were mov- ments and emphasized the intercon- and the electrocardiogram improved in ing ahead according to plan. Registra- nexions of Dutch and British medicine only 7. tions were coming in satisfactorily, and and the continuing influence of Ein- Postoperative haemodynamic and an- it looked as though there would be thoven. giocardiographic studies were carried 4-5000 delegates including wives. out in 8 and showed reduction or aboli- 14 It was confirmed that there would tion of the gradient in the area of the be no Autumn Meeting of the Society in Natural history of Ebstein's resected membrane. Small subaortic I970. anomaly of the tricuspid valve in gradients usually below the site of the childhood and adolescence original obstruction of 5-15 mm. Hg 15 The Annual General Meeting in were found in 4, and 20-60 mm. Hg in 1971 would be a two-day meeting in Hamish Watson 4, rising in 3 with isoprenaline. In 4 Sheffield on Wednesday and Thursday, patients without electrocardiographic April 14 and I5; this would in part Interest in Ebstein's anomaly of the improvement the left ventricle was as compensate for the lack of an Autumn tricuspid valve has been quickened by thick or thicker than before operation Meeting in 1970, but was not meant to the successful replacement of severely and showed some features seen in establish a precedent for a two-day damaged valves. Patients with Eb- obstructive cardiomyopathy, though the spring meeting. stein's anomaly, however, are noto- membrane had been well removed. Fac- riously bad operative risks, and the tors present before operation in those I6 Career Structure in Cardiology nature of the malformation itself makes with and without this disappointing The President reported that a question- its surgical treatment not only difficult postoperative course were compared. It ary had been sent to members of the but hazardous. Because of this and was concluded that in a number of British Cardiac Society by the Cardio- because the insertion of a prosthesis - it- patients the disease is not a simple prob- logy Committee of the Royal College of self with a doubtful prognosis - into a lem of a well-defined obstruction and Physicians asking for details of the growing child seems advisable under its removal, but that there may be a establishment, of the promotion to only the direst of circumstances, an congenital abnormality of the whole left consultant grade, and of emigration, of attempt has been made by the Associa- ventricular outflow tract. Senior Registrars in Cardiology. The tion of European Paediatric Cardiolo- results of this questionary had come in gists to determine the natural history of http://heart.bmj.com/ and had been discussed by the Cardio- Ebstein's anomaly in childhood and Beta adrenergic blockade with logy Committee.
Recommended publications
  • 2.3. Heart Sound and Auscultation
    Dinesh Kumar Dinesh Dinesh Kumar CARDIOVASCULAR DISEASE ASSESSMENT DISEASE CARDIOVASCULAR AUTOMATIC HEART FOR SOUND AUTOMATIC ANALYSIS AUTOMATIC HEART SOUND ANALYSIS FOR CARDIOVASCULAR DISEASE ASSESSMENT Doctoral thesis submitted to the Doctoral Program in Information Science and Technology, supervised by Prof. Dr. Paulo Fernando Pereira de Carvalho and Prof. Dr. Manuel de Jesus Antunes, and presented to the Department of Informatics Engineering of the Faculty of Sciences and Technology of the University of Coimbra. September 2014 OIMBRA C E D NIVERSIDADE NIVERSIDADE U September 2014 Thesis submitted to the University of Coimbra in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Information Science and Technology This work was carried out under the supervision of Professor Paulo Fernando Pereira de Carvalho Professor Associado do Departamento de Engenharia Informática da Faculdade de Ciências e Tecnologia da Universidade de Coimbra and Professor Doutor Manuel J Antunes Professor Catedrático da Faculdade de Medicina da Universidade de Coimbra ABSTRACT Cardiovascular diseases (CVDs) are the most deadly diseases worldwide leaving behind diabetes and cancer. Being connected to ageing population above 65 years is prone to CVDs; hence a new trend of healthcare is emerging focusing on preventive health care in order to reduce the number of hospital visits and to enable home care. Auscultation has been open of the oldest and cheapest techniques to examine the heart. Furthermore, the recent advancement in digital technology stethoscopes is renewing the interest in auscultation as a diagnosis tool, namely for applications for the homecare context. A computer-based auscultation opens new possibilities in health management by enabling assessment of the mechanical status of the heart by using inexpensive and non-invasive methods.
    [Show full text]
  • Very Important Extra Information
    Very important Extra information * Guyton corners, anythingthat is colored with grey is EXTRA explanation Heart sounds &Murmurs Objectives : • Enumerate the different heart sounds. • Describe the cause and characteristic features of first and second heart sounds. • Correlate the heart sounds with different phases of cardiac cycle. • Define murmurs and their clinical importance. 2 Contact us : [email protected] Areas of Auscultation • Guyton corner : ( Normal Heart Sounds ) : Listening with a stethoscope to a normal heart, onehears a sound usually described as “lub, dub, lub, dub.”The “lub”is associated with closure of the atrioventricular (A-V) valves at the beginning of systole, and the “dub”is associated with closure of the semilunar (aortic and pulmonary) valves at the end of systole. The “lub” sound is called the first heart sound, and the “dub”is called the second heart sound, because the normal pumping cycle of the heart is considered to start when the A-V valves close at the onset of ventricular systole. 3 Heart Sounds There are four heart sounds SI, S2, S3 & S4. Two heart sound are audible with stethoscope S1&S2 (Lub - Dub). S3 &S4 are not audible with stethoscope Under normal conditions because they are low frequency sounds. Ventricular Systole is between First and second Heart sound. Ventricular diastole is between Second and First heart sounds. 4 Heart Sounds • Guyton corner : Phonocardiogram If a microphone specially designed to detect low-frequency sound is placed on the chest, the heart sounds can be amplified and recorded by a high-speed recording apparatus. The recording is called a phonocardiogram, and the heart sounds appear as waves, as shown schematically .
    [Show full text]
  • An Audio Guide to Pediatric and Adult Heart Murmurs
    Listen Up! An Audio Guide to Pediatric and Adult Heart Murmurs May 9, 2018 Dr. Michael Grattan Dr. Andrew Thain https://pollev.com/michaelgratt679 Case • You are working at an urgent care centre when a 40 year old recent immigrant from Syria presents with breathlessness. • You hear the following on cardiac auscultation: • What do you hear? • How can you describe what you hear so another practitioner will understand exactly what you mean? • What other important information will help you determine the significance of your auscultation? Objectives • In pediatric and adult patients: – To provide a general approach to cardiac auscultation – To review the most common pathologic and innocent heart murmurs • To emphasize the importance of a thorough history and physical exam (in addition to murmur description) in determining underlying etiology for heart problems Outline • A little bit of physiology and hemodynamics (we promise not too much) • Interactive pediatric and adult cases – https://pollev.com/michaelgratt679 – Get your listening ears ready! • Systolic murmurs (pathologic and innocent) • Diastolic murmurs • Continuous murmurs • Some other stuff Normal Heart Sounds Normal First & Second Sounds Splitting of 2nd heart sound Physiological : • Venous return to right is increased in inspiration – causes delayed closure of the pulmonary valve. • Simultaneously, return to left heart is reduced - premature closure of the aortic valve. • Heart sounds are unsplit when the patient holds breath at end expiration. Fixed: • No alteration in splitting with respiration. • In a patient with ASD – In expiration there is reduced pressure in the right atrium and increased pressure in the left atrium. • Blood is shunted to the right and this delays closure of the pulmonary valve in the same way as would occur in inspiration.
    [Show full text]
  • Ministry of Health of Ukraine Kharkiv National Medical University
    Ministry of Health of Ukraine Kharkiv National Medical University AUSCULTATION OF THE HEART. NORMAL HEART SOUNDS, REDUPLICATION OF THE SOUNDS, ADDITIONAL SOUNDS (TRIPLE RHYTHM, GALLOP RHYTHM), ORGANIC AND FUNCTIONAL HEART MURMURS Methodical instructions for students Рекомендовано Ученым советом ХНМУ Протокол №__от_______2017 г. Kharkiv KhNMU 2017 Auscultation of the heart. normal heart sounds, reduplication of the sounds, additional sounds (triple rhythm, gallop rhythm), organic and functional heart murmurs / Authors: Т.V. Ashcheulova, O.M. Kovalyova, O.V. Honchar. – Kharkiv: KhNMU, 2017. – 20 с. Authors: Т.V. Ashcheulova O.M. Kovalyova O.V. Honchar AUSCULTATION OF THE HEART To understand the underlying mechanisms contributing to the cardiac tones formation, it is necessary to remember the sequence of myocardial and valvular action during the cardiac cycle. During ventricular systole: 1. Asynchronous contraction, when separate areas of myocardial wall start to contract and intraventricular pressure rises. 2. Isometric contraction, when the main part of the ventricular myocardium contracts, atrioventricular valves close, and intraventricular pressure significantly increases. 3. The ejection phase, when the intraventricular pressure reaches the pressure in the main vessels, and the semilunar valves open. During diastole (ventricular relaxation): 1. Closure of semilunar valves. 2. Isometric relaxation – initial relaxation of ventricular myocardium, with atrioventricular and semilunar valves closed, until the pressure in the ventricles becomes lower than in the atria. 3. Phases of fast and slow ventricular filling - atrioventricular valves open and blood flows from the atria to the ventricles. 4. Atrial systole, after which cardiac cycle repeats again. The noise produced By a working heart is called heart sounds. In auscultation two sounds can be well heard in healthy subjects: the first sound (S1), which is produced during systole, and the second sound (S2), which occurs during diastole.
    [Show full text]
  • Triple Heart Rhythm*
    TRIPLE HEART RHYTHM * BY WILLIAM EVANS From the Cardiac Department of The London Hospital Received August 28, 1943 Triple heart rhythm stands for the cadence produced when three sounds recur in successive cardiac cycles, just as two sounds compose the familiar dual rhythm of cardiac auscultation, and more rarely, four sounds a quadruple rhythm. The conflicting views on the subject have long served to discourage attempts at a clinical perception of the problem. Disagreement is perhaps best illustrated by recounting the varied terminology employed to describe it. Thus we have gallop rhythm, canter rhythm, and trot rhythm; presystolic gallop, systolic gallop, protodiastolic gallop, and mesodiastolic gallop; complete summation gallop and incomplete summation gallop; auricular gallop, ventricular gallop, and auriculo-ventricular gallop; true gallop; left-sided gallop and right-sided gallop; rapid-filling gallop; diastolic echo; mitral opening snap; reduplication of first sound and reduplication of second sound; Potain's murmur; third heart sound and fourth heart sound. Others may have escaped my notice. This muddled nomenclature, as long as it stands, will frustrate any attempt to unify the many views held on triple rhythm. There is need of a simplified terminology based on clinical findings. It is indeed clear that a neglect of the clinical aspect on the one hand, and a persistence on the part ofmany to explain the mechanism of the supernumerary sound on the other hand, and to classify triple rhythm in accordance with sound records, have been largely responsible for obscuring this common form of cardiac rhythm. Phonocardiography need not become a routine test in clinical cardiology; when it has helped to establish a classification of triple rhythm it will have achieved its main purpose, though it will still serve in other auscultatory problems.
    [Show full text]
  • AUSCULTATION SKILLS for ATHLETIC TRAINERS
    AUSCULTATION SKILLS for ATHLETIC TRAINERS Dennis A. Cardone, DO, CAQSM Director, Sports Medicine and Sports Medicine Fellowship UMDNJ-Robert Wood Johnson Medical School New Brunswick, NJ The Athletes Heart (Athletic Heart Syndrome) I. History a. Dietlen 1908: excessive and continued strain could lead to collapse of the cardiovascular system b. Medical community early 1900s: increased cardiac size in athletes was a pathologic response to the increased cardiac stress of exercise c. Frieberg 1972: cardiovascular changes noted among athletes were more a function of disease (acquired or congenital) than a physiologic response to the adaptations caused by the athlete’s training d. 2004: athletic heart syndrome represents normal physiologic adaptations to training that allows normal or improved cardiac function in contrast to the cardiac dysfunction of pathologic hypertrophy. II. Physiologic response of cardiovascular system to exercise a. Exercise training i. Peripheral response 1. increased number of capillaries, mitochondria, oxidative enzymes 2. improved uptake and utilization of O2 in skeletal muscles ii. Central response (Heart adaptations) 1. increased stroke volume due to cardiac dilation and hypertrophy 2. decrease in resting HR (CO=SV x HR) 3. maximal HRs are same in trained and untrained athletes 4. increased vagal tone III. History: negative IV. Physical examination a. Bradycardia b. Lower BP c. Laterally displaced PMI (because of LVH) d. Auscultation i. Systolic ejection murmur (most intense supine b/c increased left ventricular filling; less intense standing or squatting b/c decreased left ventricular filling) ii. Sinus arrhythmia iii. Wide splitting first heart sound iv. Wide splitting second heart sound v. Filling sounds – S3 ventricular gallop vi.
    [Show full text]
  • Triple Heart Rhythm*
    Br Heart J: first published as 10.1136/hrt.5.4.205 on 1 October 1943. Downloaded from TRIPLE HEART RHYTHM * BY WILLIAM EVANS From the Cardiac Department of The London Hospital Received August 28, 1943 Triple heart rhythm stands for the cadence produced when three sounds recur in successive cardiac cycles, just as two sounds compose the familiar dual rhythm of cardiac auscultation, and more rarely, four sounds a quadruple rhythm. The conflicting views on the subject have long served to discourage attempts at a clinical perception of the problem. Disagreement is perhaps best illustrated by recounting the varied terminology employed to describe it. Thus we have gallop rhythm, canter rhythm, and trot rhythm; presystolic gallop, systolic gallop, protodiastolic gallop, and mesodiastolic gallop; complete summation gallop and incomplete summation gallop; auricular gallop, ventricular gallop, and auriculo-ventricular gallop; true gallop; left-sided gallop and right-sided gallop; rapid-filling gallop; diastolic echo; mitral opening snap; reduplication of first sound and reduplication of second sound; Potain's murmur; third heart sound and fourth heart sound. Others may have escaped my notice. This muddled nomenclature, as long as it stands, will frustrate any attempt to unify the many views held on triple rhythm. There is need of a simplified terminology based on clinical findings. It is indeed clear that a neglect of the http://heart.bmj.com/ clinical aspect on the one hand, and a persistence on the part ofmany to explain the mechanism of the supernumerary sound on the other hand, and to classify triple rhythm in accordance with sound records, have been largely responsible for obscuring this common form of cardiac rhythm.
    [Show full text]
  • 6 Heart Sounds
    Chapter 6 / Heart Sounds 141 6 Heart Sounds CONTENTS PRINCIPLES OF SOUND FORMATION IN THE HEART FIRST HEART SOUND (S1) CLINICAL ASSESSMENT OF S1 AND COMPONENTS SECOND HEART SOUND (S2) NORMAL S2 ABNORMAL S2 CLINICAL ASSESSMENT OF S2 OPENING SNAP (OS) THIRD HEART SOUND (S3) CLINICAL ASSESSMENT OF S3 FOURTH HEART SOUND (S4) CLINICAL ASSESSMENT OF S4 REFERENCES PRINCIPLES OF SOUND FORMATION IN THE HEART In the past, many theories have been advanced to explain the origins of sounds during the cardiac cycle. These included simple concepts of sound originating from the actual contact of valve cusps upon closure. When it was realized that the strength of contraction of the left ventricle had a significant effect on the intensity of the first heart sound, the myocardial theory of the origin of the sound was postulated. Some even had suggested extracardiac origin of sounds such as the third heart sound. It is now, however, well established by several investigators and accepted that the formation of all sounds in the heart can be explained by a “unified concept” (1–10). It is a common experience to hear sound produced when a pipe half-filled with water is moved back and forth, splashing the water against the two palms of the hands held against the ends of the pipe. We have all heard banging sounds sometime produced in the water pipes of the plumbing systems of our homes when air is introduced into the plumb- ing. In both examples, the mechanism of sound production is the same. When the moving column of water in either case comes to sudden stop or marked deceleration, the energy of the column dissipates and in the process generates vibration of the pipes as well as the column of water.
    [Show full text]
  • Cardiac Auscultation: Normal and Abnormal
    This is a repository copy of Cardiac auscultation: normal and abnormal. White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/145443/ Version: Accepted Version Article: Warriner, D., Michaels, J. and Morris, P.D. orcid.org/0000-0002-3965-121X (2019) Cardiac auscultation: normal and abnormal. British Journal of Hospital Medicine, 80 (2). C28-C31. ISSN 1750-8460 10.12968/hmed.2019.80.2.C28 This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Hospital Medicine, copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see https://doi.org/10.12968/hmed.2019.80.2.C28 Reuse Items deposited in White Rose Research Online are protected by copyright, with all rights reserved unless indicated otherwise. They may be downloaded and/or printed for private study, or other acts as permitted by national copyright laws. The publisher or other rights holders may allow further reproduction and re-use of the full text version. This is indicated by the licence information on the White Rose Research Online record for the item. Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing [email protected] including the URL of the record and the reason for the withdrawal request. [email protected] https://eprints.whiterose.ac.uk/ Cardiac Auscultation: normal and abnormal Dr David Warriner1, Dr Joshua Michaels2, Dr Paul D Morris3,4 Dr Warriner is a senior cardiology registrar (St7), Dr Michaels is a Foundation Year 2 (FY2) doctor and Dr Morris is NIHR Clinical Lecturer and BCIS Fellow.
    [Show full text]
  • Physical Examination Cardiovascular System Physical Examination Cardiovascular System
    The Wiggers Diagram PHYSICAL EXAMINATION CARDIOVASCULAR SYSTEM Mervyn Gotsman M.D. Department of Cardiology, Hadassah x y University Hospital, Hebrew University - Hadassah Medical School, Jerusalem, Israel PHYSICAL EXAMINATION CARDIOVASCULAR SYSTEM CARDIOVASCULAR SYSTEM General examination • Walking and gait • General examination • Sitting or lying • Arterial pulse – brachial, • Orthopnoea carotids, peripheral • Cyanosis (central or peripheral), anaemia, • Jugular Venous Pressure jaundice • Fever and embolic signs • The heart • • • Right heart failure (JVP, dependent oedema, • Inspection hepatomegaly, ascites, pleural effusions) • Palpation • Left heart failure (dyspnoea, tachypnoea, • Percussion orthopnoea, cough, basal crepitations • Pulmonary disease • Auscultation • Sytemic disease: thyrotoxicosis, scleroderma, lupus erythematosis, etc Left Heart Failure Right Heart Failure •Elevated LVEDP • LAP JVP • PVP •Pulmonary congestion Hepar •Dyspnoea Ascites •Orthopnoea •Cough Ankle Edema •Tiredness and lethargy Weight 1 PHYSICAL EXAMINATION AArterialrterial pulse CARDIOVASCULAR SYSTEM Radial artery • Arterial pulse • Jugular Venous Pressure • Cardiac Examination: • Inspection • Palpation • Percussion • Auscultation Arterial pulse 120 Arterial pulse Radial artery 80 Carotid artery Amplitude/Contour: • Heart rate: ( 60-100 ). • Hypokinetic ↓ ( weak ) - Hypovolemia • Rhythm: Regular 120 Irregular: Sinus arrhythmia Heart failure Occasional - Premature beats 80 Aortic stenosis - Dropped beats • Hyperkinetic ↑ increased stroke volume Totally -
    [Show full text]
  • SAM II, on Line Menu of Sounds Heart Sounds Group Description Heart
    SAM II, On Line Menu of Sounds Heart Sounds Group Description Heart Sounds, Normal & Variants Normal Heart Sounds, 60 bpm Normal Heart Sounds, 75 bpm Normal Heart Sounds, 90 bpm Normal Heart Sounds, 110 bpm Third Heart Sound, Pediatric, 90 bpm Fourth Heart Sound, 80 bpm Physiological Splitting of Second Sound Paradoxical Splitting of Second Sound Aortic Heart Sounds Aortic Stenosis, Mild Aortic Stenosis, Severe, S2 Absent Ex1 Aortic Stenosis, Severe Ex2 Aortic Stenosis and Regurgitation Congenital Aortic Stenosis Acute Aortic Regurgitation Mitral Heart Sounds Mitral Valve Prolapse Mitral Regurgitation, Mild Mitral Regurgitation, Marked Mitral Stenosis Mitral Stenosis and Regurgitation Pediatric Heart Sounds Innocent Systolic Murmur Innocent Systolic Murmur - Vibratory Ventricular Septal Defect Atrial Septal Defect Patent Ductus Arteriosus Pulmonary Hypertension Tetralogy of Fallot Summation Sound Eisenmenger's Syndrome Other Heart Sound Pulmonary Stenosis with Intact Septum Acute Pericarditis Hyptertrophic Cardiomyopathy Congestive Heart Failure Atrial Fibrillation Venous Hum Coarctation of the Aorta BRUITS BRUITS Carotid Bruit, Mild I Carotid Bruit, Medium I Carotid Bruit, Mild II Carotid Bruit, Medium II Aortic Aneurysm Renal Bruit HEART-LUNG COMBINATIONS Heart-Lung Combinations Aortic Stenosis with normal breath sounds Aortic Stenosis with Crackles Atrial Fibrillation Fourth Heart Sound with respiatory variation Mitral Regurg with normal breath sounds Mitral Regurg with crackles Mitral Valve Proplapse with breath sounds Normal Heart
    [Show full text]
  • Cardiovascular
    Large Animal Internal Medicine Cardiovascular Diseases Nusdianto Triakoso Hardany Primarizky triakoso History and signalement • Aged • Information on the animal • Sex appetite, attitude and • Environment symptoms • Management • Time of onset of the current problem, • Use of the animal attempted treatments and • Problem with other disease pregression animal in contact with affected animal • Vaccination and deworming, previous illness triakoso Physical examination • Examine all body system. Animal’s attitude, body weight, body condition • Examine mucous membrane (color), moisture, CRT, determine distension of peripheral veins. The level filling of jugular vein and the patency of vein. Peripheral arterial pulse (quality, rhythm) • Evidence of edema along ventral abdomen, brisket, submandibular, over pectoral muscle. Edema of limbs (horse), udder (cow) are less reliable signs of heart disease • Auscultation (most important) Rate, Rhythms, Murmurs triakoso triakoso Physical examination • Type of heart sound – The first heart sound (S1) is caused by the initial ejection of the blood from the ventricles, the closure of the atrioventricular (AV) valve, and the opening of the semilunar (SL) valve – The second heart sound (S2) is associated with closure of SL valve, rapid reversal of blood flow (blood stop moving out of heart) and the opening of AV valve – The third heart sound (S3) is associated with the end of the rapid filling the ventricles with blood – The fourth heart sound (S4) is associated with atrial contraction. It is closely followed by S1 triakoso triakoso triakoso Physical examination • Heart sound – In pigs, goat and sheep only S1 and S2 are heard normally – In horses and cattle, all four heart sound can be heards • Heart rate – Varies dependent on the animal’s age and species.
    [Show full text]