Cardiac Shunting in Reptiles (Review)
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Pulmonary Arteriopathy in Patients with Mild Pulmonary Valve Abnormality Without Pulmonary Hypertension Or Intracardiac Shunt Karam Obeid1*, Subeer K
Original Scientific Article Journal of Structural Heart Disease, June 2018, Received: September 13, 2017 Volume 4, Issue 3:79-84 Accepted: September 27, 2017 Published online: June 2018 DOI: https://doi.org/10.12945/j.jshd.2018.040.18 Pulmonary Arteriopathy in Patients with Mild Pulmonary Valve Abnormality without Pulmonary Hypertension or Intracardiac Shunt Karam Obeid1*, Subeer K. Wadia, MD2, Gentian Lluri, MD, PhD2, Cherise Meyerson, MD3, Gregory A. Fishbein, MD3, Leigh C. Reardon, MD2, Jamil Aboulhosn, MD2 1 Department of Biological Sciences, Old Dominion University, Norfolk, Virginia, USA 2 Department of Internal Medicine, Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California, USA 3 Department of Pathology, Ronald Reagan/UCLA Medical Center, Los Angeles, California, USA Abstract benign course without episodes of dissection or rup- Background: The natural history of pulmonary artery ture despite 6/11 patients with PAA ≥ 5 cm. PA dilation aneurysms (PAA) without pulmonary hypertension, progresses slowly over time and does not appear to intracardiac shunt or significant pulmonary valvular cause secondary events. Echocardiography correlates disease has not been well studied. This study looks to well with magnetic resonance imaging and computed describe the outcome of a cohort of adults with PAA tomography and is useful in measuring PAA over time. without significant pulmonic regurgitation and steno- Copyright © 2018 Science International Corp. sis. Imaging modalities utilized to evaluate pulmonary artery (PA) size and valvular pathology are reviewed. Key Words Methods: Patients with PAA followed at the Ahmanson/ Pulmonary artery aneurysm • Pulmonary stenosis • UCLA Adult Congenital Heart Disease Center were in- Pulmonary hypertension • Aortic aneurysm cluded in this retrospective analysis. -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
Arterial Switch Operation Surgery Surgical Solutions to Complex Problems
Pediatric Cardiovascular Arterial Switch Operation Surgery Surgical Solutions to Complex Problems Tom R. Karl, MS, MD The arterial switch operation is appropriate treatment for most forms of transposition of Andrew Cochrane, FRACS the great arteries. In this review we analyze indications, techniques, and outcome for Christian P.R. Brizard, MD various subsets of patients with transposition of the great arteries, including those with an intact septum beyond 21 days of age, intramural coronary arteries, aortic arch ob- struction, the Taussig-Bing anomaly, discordant (corrected) transposition, transposition of the great arteries with left ventricular outflow tract obstruction, and univentricular hearts with transposition of the great arteries and subaortic stenosis. (Tex Heart Inst J 1997;24:322-33) T ransposition of the great arteries (TGA) is a prototypical lesion for pediat- ric cardiac surgeons, a lethal malformation that can often be converted (with a single operation) to a nearly normal heart. The arterial switch operation (ASO) has evolved to become the treatment of choice for most forms of TGA, and success with this operation has become a standard by which pediatric cardiac surgical units are judged. This is appropriate, because without expertise in neonatal anesthetic management, perfusion, intensive care, cardiology, and surgery, consistently good results are impossible to achieve. Surgical Anatomy of TGA In the broad sense, the term "TGA" describes any heart with a discordant ven- triculoatrial (VA) connection (aorta from right ventricle, pulmonary artery from left ventricle). The anatomic diagnosis is further defined by the intracardiac fea- tures. Most frequently, TGA is used to describe the solitus/concordant/discordant heart. -
Anomalies of the Aorta and Pulmonary Arteries Complicating Ventricular Septal Defect
Br Heart J: first published as 10.1136/hrt.24.3.279 on 1 May 1962. Downloaded from ANOMALIES OF THE AORTA AND PULMONARY ARTERIES COMPLICATING VENTRICULAR SEPTAL DEFECT BY J. MORGAN, R. PITMAN, J. F. GOODWIN, R. E. STEINER, AND A. HOLLMAN From the Departments of Medicine and Radiodiagnosis, Postgraduate Medical School and Hammersmith Hospital Received August 15, 1961 Ventricular septal defect is not always a simple lesion, but may be associated with other congenital cardiac disorders. The object of this paper is to present anomalies of the great vessels that have been found on angiocardiography or at operation in a series of patients with a ventricular septal defect investigated and treated at Hammersmith Hospital. During the last three years selective angiocardiography has been performed on 165 patients diagnosed as having ventricular septal defect. In 24 of them associated anomalies of the aorta and pulmonary arteries have been found. These patients will be presented in three groups according to the type of anomalies found; Group 1, corrected transposition of the great vessels, Group 2, double outlet right ventricle, Group 3, anomalies of the pulmonary arteries. 1. CORRECTED OF THE GREAT VESSELS GROUP TRANSPOSITION http://heart.bmj.com/ In this anomaly there is anatomical transposition. Viewed from above the aorta is anterior and to the left and the pulmonary trunk posterior and to the right. This is corrected functionally by bulboventricular inversion. Corrected transposition is usually associated with other defects, but the circulation is normal, for venous blood enters the pulmonary circulation and arterial blood the systemic circulation. The systemic ventricle from which the aorta arises has the anatomical features of a right ventricle, and the venous ventricle, from which the pulmonary artery arises, has the anatomical characteristics of a left ventricle. -
Risk of Necrotizing Enterocolitis in Very-Low-Birth-Weight Infants with Isolated Atrial and Ventricular Septal Defects
Journal of Perinatology (2014) 34, 319–321 & 2014 Nature America, Inc. All rights reserved 0743-8346/14 www.nature.com/jp ORIGINAL ARTICLE Risk of necrotizing enterocolitis in very-low-birth-weight infants with isolated atrial and ventricular septal defects J Bain1,2, DK Benjamin Jr1,2, CP Hornik1,2, DK Benjamin3, R Clark4 and PB Smith1,2 OBJECTIVE: Necrotizing enterocolitis (NEC) is associated with a significant morbidity and mortality in premature infants. We sought to identify the frequency of NEC in very-low-birth-weight infants with isolated ventricular septal defects (VSDs) or atrial septal defects (ASDs) using a large multicenter database. STUDY DESIGN: We identified a cohort of infants with birth weight o1500 g cared for in 312 neonatal intensive care units (NICUs) managed by the Pediatrix Medical Group between 1997 and 2010. We examined the association between the presence of an ASD or a VSD with development of NEC using logistic regression to control for small-for-gestational age status, antenatal steroid use, antenatal antibiotic use, gestational age, sex, race, Apgar score at 5 min and method of delivery. RESULT: Of the 98 523 infants who met inclusion criteria, 1904 (1.9%) had an ASD, 1943 (2.0%) had a VSD and 146 (0.1%) had both. The incidence of NEC was 6.2% in infants without septal defects, 9.3% in those with an ASD, 7.8% in those with a VSD, and 10.3% in infants with both an ASD and a VSD. Compared with infants without septal defects, the adjusted odds ratios for developing NEC for each group—ASD alone, VSD alone and ASD with VSD—were 1.26 (95% confidence interval 1.07 to 1.49), 1.27 (1.07 to 1.51) and 1.79 (1.03 to 3.12), respectively. -
Vagal Tone Regulates Cardiac Shunts During Activity and at Low Temperatures in the South American Rattlesnake, Crotalus Durissus
J Comp Physiol B (2016) 186:1059–1066 DOI 10.1007/s00360-016-1008-y ORIGINAL PAPER Vagal tone regulates cardiac shunts during activity and at low temperatures in the South American rattlesnake, Crotalus durissus Renato Filogonio1,2 · Tobias Wang2 · Edwin W. Taylor1,3 · Augusto S. Abe1 · Cléo A. C. Leite4 Received: 2 February 2016 / Revised: 18 May 2016 / Accepted: 3 June 2016 / Published online: 13 June 2016 © Springer-Verlag Berlin Heidelberg 2016 Abstract The undivided ventricle of non-crocodilian rep- pulmonary and systemic blood flow in both groups, but tiles allows for intracardiac admixture of oxygen-poor and net cardiac shunt was reversed in the vagotomized group oxygen-rich blood returning via the atria from the sys- at lower temperatures. We conclude that vagal control of temic circuit and the lungs. The distribution of blood flow pulmonary conductance is an active mechanism regulating between the systemic and pulmonary circuits may vary, cardiac shunts in C. durissus. based on differences between systemic and pulmonary vas- cular conductances. The South American rattlesnake, Cro- Keywords Reptiles · Snakes · Cardiac shunt · Vagus talus durissus, has a single pulmonary artery, innervated nerve · Arterial pressure · Blood flow · Vascular regulation by the left vagus. Activity in this nerve controls pulmonary conductance so that left vagotomy abolishes this control. Experimental left vagotomy to abolish cardiac shunting Introduction had no effect on long-term survival and failed to identify a functional role in determining metabolic rate, growth or The undivided ventricle of the non-crocodilian reptile resistance to food deprivation. Accordingly, the present heart enables variable proportions of cardiac output to investigation sought to evaluate the extent to which car- bypass the systemic or pulmonary circulations, resulting diac shunt patterns are actively controlled during changes in either left-to-right (L–R) or right-to-left (R–L) cardiac in body temperature and activity levels. -
Prevalence of Migraine Headaches in Patients with Congenital Heart Disease
Prevalence of Migraine Headaches in Patients With Congenital Heart Disease Tam Truong, MD, Leo Slavin, MD, Ramin Kashani, BA, James Higgins, MD, Aarti Puri, BS, Malika Chowdhry, BS, Philip Cheung, BS, Adam Tanious, BA, John S. Child, MD, FAHA, Joseph K. Perloff, MD, and Jonathan M. Tobis, MD* The prevalence of migraine headaches (MH) is 12% in the general population and increases to 40% in patients with patent foramen ovale. This study evaluated the prevalence of MH in patients with congenital heart disease (CHD). Of 466 patients contacted from the UCLA Adult Congenital Heart Disease Center, 395 (85%) completed a questionnaire to determine the prevalence of MH. Patients were stratified by diagnosis of right-to-left, left-to-right, or no shunt. A group of 252 sex-matched patients with acquired cardiovascular disease served as controls. The prevalence of MH was 45% in adults with CHD compared to 11% in the controls (p <0.001). Of the 179 patients with MH, 143 (80%) had migraines with aura and 36 (20%) had migraines without aura versus 36% and 64% observed in the controls (p <0.001). The frequency of MH was 52% in the right-to-left shunt group, 44% in the left-to-right, and 38% in the no ,NS). In patients with a right-to-left shunt who underwent surgical repair ؍ shunt group (p 47% had complete resolution of MH, whereas 76% experienced >50% reduction in headache days per month. In conclusion, the prevalence of MH in all groups of adults with CHD is 3 to 4 times more than a sex-matched control population, with increasing prevalence of MH in patients with no shunt, left-to-right, and right-to-left shunt. -
Grown up Congenital Heart Disease Patient Presenting for Non Cardiac Surgery: Anaesthetic Implications Mohammad Hamid Aga Khan University
eCommons@AKU Department of Anaesthesia Medical College, Pakistan November 2010 Grown up congenital heart disease patient presenting for non cardiac surgery: anaesthetic implications Mohammad Hamid Aga Khan University Mansoor Ahmed Khan Aga Khan University Mohammad Irfan Akhtar Aga Khan University Hameedullah Aga Khan University Saleemullah Aga Khan University See next page for additional authors Follow this and additional works at: http://ecommons.aku.edu/pakistan_fhs_mc_anaesth Part of the Anesthesiology Commons, and the Surgery Commons Recommended Citation Hamid, M., Khan, M., Akhtar, M., Hameedullah, ., Saleemullah, ., Samad, K., Khan, F. (2010). Grown up congenital heart disease patient presenting for non cardiac surgery: anaesthetic implications. Journal of the Pakistan Medical Association, 60(11), 955-9. Available at: http://ecommons.aku.edu/pakistan_fhs_mc_anaesth/19 Authors Mohammad Hamid, Mansoor Ahmed Khan, Mohammad Irfan Akhtar, Hameedullah, Saleemullah, Khalid Samad, and Fazal Hameed Khan This article is available at eCommons@AKU: http://ecommons.aku.edu/pakistan_fhs_mc_anaesth/19 Review Article Grown up Congenital Heart Disease patient presenting for non cardiac surgery: Anaesthetic implications Mohammad Hamid, Mansoor Ahmed Khan, Mohammad Irfan Akhtar, Hameedullah, Saleemullah, Khalid Samad, Fazal Hameed Khan Department of Anaesthesia, Aga Khan University Hospital, Karachi. Abstract chances of survival6 and reduces complications associated with heart defects. Congenital heart disease patients surviving to adulthood have -
Norman H. Silverman, M.D., D. Sc. (Med.), FACC, FAHA, FASE
Norman H. Silverman, M.D., D. Sc. (Med.), FACC, FAHA, FASE IDENTIFYING DATA Date of Birth Sept. 29, 1942 Citizenship: U.S.A. Ethnicity: Caucasian California Medical License #: A25867 ACADEMIC HISTORY Education Date Institution and Location Degree or Title Major 1960–1967 University of the Witwatersrand M.B., B.Ch. Medicine Johannesburg, South Africa Post-doctoral and Residency Training 1967–1968 Johannesburg General Hospital Surgery Intern Medical Intern 1969 Johannesburg Children’s Hospital Senior House Officer Pediatrics 1969–1972 University of the Witwatersrand Residency Pediatrics Hospitals 1970 South African College Fellow Pediatrics of Medicine, F.C.P. (S.A.) 1972–1974 University of California, Fellow Cardiology San Francisco 1985 University of the Witwatersrand, D.Sc.Med. Medicine Johannesburg, South Africa Thesis title: Two-dimensional Echocardiography in Congenital Heart Disease Licenses and Boards 1972 ECFMG # 080-243-9 1973 Diplomate of the American Board of Pediatrics 1975 Certified, Sub-board of Pediatric Cardiology 1994 BNDD #AS6050215 1994 Radiation operator license #RHD-121449 Other Study and Research Opportunities 1977–1979 Granting Agency: National Foundation of March of Dimes Title: Echocardiographic Evaluation of Pulmonary Hypertension in Children with Congenital Heart Disease Role: PI 1978–1980 Granting Agency: California Heart Association Title: Two-dimensional Echo Volume Analysis in Congenital Heart Disease Role: PI 1987 Granting Agency: Academic Senate of the University of California, San Francisco Title: Fetal -
Quantification of Left-To-Right Cardiac Shunt
QUANTIFICATION OF LEFT-TO-RIGHT CARDIAC SHUNT Quantification of Left-to-Right Cardiac Shunt VJR Schelfhout, Rijnstate, Arnhem 1. Introduction In conditions with a left-to-right (L-R) shunt, blood from the systemic arterial circulation mixes with systemic venous blood. This results in oxygenated blood flowing into the right side of the heart and back to the lungs. To maintain an adequate amount of blood circulating throughout the body, cardiac output from the left side of the heart must increase to maintain normal forward flow through the aorta in the setting of abnormal flow being shunted to the right side of the heart. Output from the right side of the heart is also increased, as it must eject both the normal volume of blood returning from the body plus the volume being shunted from the left side of the heart. These effects can lead to elevated pulmonary pressure and heart failure. Nuclear medicine assessment of an L-R shunt uses a first pass analysis technique, in which an intravenous bolus of a radiopharmaceutical is tracked using rapid dynamic imaging through the heart and lungs. The study is predicated on demonstrating early return of activity to the lungs after the initial flow. 2. Methodology This guideline is based on available scientific literature on the subject, the previous guideline (Aanbevelingen Nucleaire Geneeskunde 2007), international guidelines from EANM and/or SNMMI if available and applicable to the Dutch situation. 3. Indications a. Quantification of an intracardiac shunt diagnosed by echographic Doppler b. Follow-up examination after treatment c. Assessment for further angiographic analysis 4. -
CYANOTIC CONGENITAL HEART DISEASE by JAMES W
.-51.I Postgrad Med J: first published as 10.1136/pgmj.25.289.511 on 1 November 1949. Downloaded from CYANOTIC CONGENITAL HEART DISEASE By JAMES W. BROWN, M.D., F.R.C.P. Physician, General Hospital, Grimsby, and Grimsby and Lindsey Rheumatism and Heart Clinics The last 15 years have witnessed a very re- it was possible to build up a clinical picture and so markable change in the attitude of the clinician arrive at a reasonably correct anatomical diagnosis. towards cyanotic congenital heart disease. It is At the same time knowledge of the natural history within the memory of many that it was the custom of congenital heart disease has also increased, and to make a simple diagnosis of congenital heart some idea of its prognosis has been ascertained. abnormality with cyanosis, and express the opinion Lastly, the conception of Taussig that an in- that little or nothing could be done about it. Then adequate pulmonary blood supply was the critical there appeared the pioneer work of Abbott and abnormality in many cyanotic cases, and the de- others which produced not only a classification of velopment of an anastomotic operation between the the various abnormalities, but furnished a mass of systemic and pulmonary circulations so as to clinical and postmortem observations from which furnish an artificial ductus arteriosus, by Blalock Protected by copyright. http://pmj.bmj.com/ on September 23, 2021 by guest. FIG. i.-Tetralogy of Fallot. Female aged 3 years. Right ventricle opened. An arrow marks the subvalvular stenosis. of the pulmonary artery. Ventricular septal defect with probe passing into it behind the crista supraventricularis. -
Guidelines for Performing a Comprehensive Transesophageal
ASE GUIDELINES AND STANDARDS Guidelines for Performing a Comprehensive Transesophageal Echocardiographic Examination in Children and All Patients with Congenital Heart Disease: Recommendations from the American Society of Echocardiography Michael D. Puchalski, (Chair), MD, FASE, George K. Lui, MD, FASE, Wanda C. Miller-Hance, MD, FASE, Michael M. Brook, MD, FASE, Luciana T. Young, MD, FASE, Aarti Bhat, MD, FASE, David A. Roberson, MD, FASE, Laura Mercer-Rosa, MD, MSCE, Owen I. Miller, BMed (Hons), FRACP, David A. Parra, MD, FASE, Thomas Burch, MD, Hollie D. Carron, AAS, RDCS, ACS, FASE, and Pierre C. Wong, MD, Salt Lake City, Utah; Stanford, San Francisco and Los Angeles, California; Houston, Texas; Seattle, Washington; Chicago, Illinois; Philadelphia, Pennsylvania; London, United Kingdom; Nashville, Tennessee; Boston, Massachusetts; and Kansas City, Missouri This document is endorsed by the following American Society of Echocardiography International Alliance Partners: Argentina Society of Cardiology, Asian-Pacific Association of Echocardiography, British Society of Echocardiography, Department of Cardiovascular Imaging of the Brazilian Society of Cardiology, Echocardiography Section of the Cuban Society of Cardiology, Indian Academy of Echocardiography, Indian Association of Cardiovascular Thoracic Anaesthesiologists, Indonesian Society of Echocardiography, Italian Association of Cardiothoracic Anesthesiologists, Japanese Society of Echocardiography, Korean Society of Echocardiography, National Society of Echocardiography of Mexico,