Follow-up after Cardiovascular Surgery - ECAB
Follow-up after Cardiovascular Surgery - ECAB

Author: O P Yadava

Publisher: Elsevier Health Sciences

Published: 2013-01-10

Total Pages: 166

ISBN-13: 8131231739

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Follow-up of patients after surgery is of utmost importance as results of the surgery heavily depend on the treatment of patient in the follow-up period. A good follow-up and proper treatment also provides protection to the patient from various complications and recurrence of the disease. Therapeutic guidelines and algorithms for treatment of the patients after discharge from the hospitals exist for a number of cardiovascular disorders. Still, follow-up and postdischarge treatment is very often found to be inappropriate and incomplete. This results in many avoidable complications for both the patient as well as the treating clinician. This book is designed to update the readers on follow-up regimens for some of the important cardiovascular surgical procedures. Typical supportive case scenarios are included to exemplify and highlight the various points discussed. Thus it provides an excellent opportunity to widen one’s perspective in this area.

Interventional Cardiology - ECAB
Interventional Cardiology - ECAB

Author: Nakul Sinha

Publisher: Elsevier Health Sciences

Published: 1920-12-15

Total Pages: 325

ISBN-13: 8131231798

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Interventional Cardiology came into being during early 1950s. Interventional cardiology has seen substantial advances in last couple of decades, be it World or India. Interventional Cardiology started as brachial artery coronary cine angiography. The initial decade after the advent of interventional cardiology was only dedicated to its diagnostic use; it was in late seventies when the horizon of interventional cardiology broadened. In 1977 Andreas Gruentzig introduced the cardiologist to therapy, with percutaneous transluminal coronary angioplasty (PTCA). This initially slender spectrum of balloon dilatation has broadened into the large spectrum of interventional cardiology, which now encompasses both diagnostic and therapeutic modalities for coronary artery disease. The main advantages of interventional cardiology are the avoidance of the pain, scars, and long postoperative recovery associated with surgery. The book is a comprehensive guide to understand the clinical application of Interventional Cardiology with special reference and experience in India. The authors have put together the most relevant facts about the disease for an easy comprehension and understanding of the same by practitioners and students across the specialty.

Left to Right Shunts - ECAB
Left to Right Shunts - ECAB

Author: Nagaraj Desai

Publisher: Elsevier Health Sciences

Published: 2012-07-05

Total Pages: 97

ISBN-13: 8131231747

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Patients born with cardiac defects need to be identified early and the severity of symptoms also needs to be identified. In children with larger defects or with more symptoms, early institution of treatment is warranted, since in absence of treatment, the disease progresses to pulmonary hypertension and a simple pathology gets complicated. Presence of congestive cardiac failure in infancy or of pulmonary artery hypertension is indication for early surgical treatment (prior to 6 months of age). Untreated ASD may at times allow the child to grow and reach adulthood, but can cause complications in adulthood also. These issues related to understanding of natural history of the shunts and its implications in management decisions need to be addressed in clear terms. Also the role and timing of surgical therapy need to be emphasized. This book is designed to address such questions with supportive clinical scenarios. Thus, it provides an excellent opportunity to widen one’s perspective in this area.

Acute Coronary Syndrome - ECAB
Acute Coronary Syndrome - ECAB

Author: R R Kasliwal

Publisher: Elsevier Health Sciences

Published: 2012-07-26

Total Pages: 176

ISBN-13: 8131231771

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Acute coronary syndrome (ACS) is the term for the clinical signs and symptoms of myocardial ischemia: unstable angina, non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). Unstable angina and NSTEMI normally result from a partially or intermittently occluded coronary artery, whereas STEMI results from a fully occluded coronary artery. The patients present with a wide arena of signs and symptoms like chest pain, nausea/vomiting, exertional pain, palpitation, shortness of breath, fatigue, etc. Angina, or chest pain, continues to be recognized as the classic symptom of ACS. In unstable angina, chest pain normally occurs either at rest or with exertion and results in limited activity. Chest pain associated with NSTEMI is usually longer in duration and more severe than chest pain associated with unstable angina. The diagnosis of ACS is based on triad of clinical presentation, electrocardiography and cardiac biomarkers. Electrocardiography is the most important initial diagnostic procedure when doctors suspect an acute coronary syndrome. Findings on a 12-lead ECG help the practitioner to differentiate between myocardial ischemia, injury, and infarction, locate the affected area and assess related conduction abnormalities. But at the same front, the definition of unstable angina, NSTEMI and STEMI is based on the levels of cardiac biomarkers too. Acute coronary syndromes are medical emergencies that need prompt action. Half of deaths due to a heart attack occur in the first 3–4 hours after symptoms begin. The sooner treatment begins, the better the chances of survival. Anyone having symptoms that might indicate an acute coronary syndrome should obtain prompt medical attention. Management of ACS involves a spectrum of interventions. It encompasses cardiac monitoring, thrombolysis, antiplatelet therapy, anticoagulant therapy, reperfusion therapy and invasive investigation and revascularization therapy. Reperfusion therapy (percutaneous coronary intervention) mainly holds for the ST-elevation myocardial infarction. Prognosis of the ACS patients depends on the post-myocardial risk stratification. The main highlights of risk stratification are risk stratification scores, assessment of cardiac function and stress testing, and management.

Dilated Cardiomyopathy - ECAB
Dilated Cardiomyopathy - ECAB

Author: Ashok Seth

Publisher: Elsevier Health Sciences

Published: 2008-12-08

Total Pages: 121

ISBN-13: 8131231755

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Dilated cardiomyopathy (DCM) is traditionally referred to as idiopathic dilated cardiomyopathy (IDC), which includes genetic forms of DCM. The patients present with a wide range of symptoms like dyspnea, orthopnea, paroxysmal nocturnal dyspnea, arrhythmias or complications associated with DCM. The diagnosis is based on exclusion of the various identifiable causes of systolic left ventricular dysfunction, such as ischemic cardiomyopathy, hypertensive cardiomyopathy, alcoholic cardiomyopathy, myocarditis secondary to viral or other causes, peripartum cardiomyopathy and cardiomyopathies secondary to amyloidosis, hemochromatosis, sarcoidosis, and due to drug toxicity. The sophisticated and expensive diagnostic tests might not be feasible for a typical Indian patient. This prompts us to emphasize the need for corroborating the clinical clues with the available affordable investigative tests that also offer reasonably valid results. The medical management of congestive heart failure is vital to the management protocol of DCM. The roles of heart transplant, cardiomyoplasty and surgical devices have to be weighed from patient to patient with a clear understanding of the etiology of the disease. The recent improvement in the prognosis of DCM presents an encouraging picture to the researchers and practitioners dedicated to the development of drugs and devices to improve the life expectancy of patients of DCM. This clinical update module has been formulated to update the readers on the existing and emerging treatment strategies widely followed and recommended by practitioners of international repute. The essential features of the medical and surgical management have been discussed in detail. Moreover, a comprehensive discussion on the occurrence and management of DCM in pediatric patients has also been incorporated in this book. The book is an honest attempt to provide the medical practitioner with a wide knowledge platform about DCM and its clinical implications.

Pulmonary Hypertension - ECAB
Pulmonary Hypertension - ECAB

Author: Sheila Glennis Haworth

Publisher: Elsevier Health Sciences

Published: 2008-12-26

Total Pages: 182

ISBN-13: 8131231763

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Pulmonary hypertension is defined as a mean pulmonary artery pressure (mPAP) ≥25 mmHg, with Pulmonary Capillary Wedge Pressure ≤ 15 mmHg, measured by cardiac catheterization. The etiology of PH has a varied spectrum extending right from Drugs, toxins and portal hypertension to HIV, Collagen Vascular Diseases and Persistent Pulmonary Hypertension of Newborn, etc. The estimation of disease prevalence has been nearly impossible owing to the geographic distribution and economic diversity, along with significant regional variations in human development and healthcare infrastructure. A large number of patients with PH never reach the health centers capable of diagnosing the disease condition correctly. Advance pulmonary vascular disease as a result of uncorrected CHD is a major health challenge in the developing world. PH exists as a major component of many forms of cardiac and pulmonary disease. While breathlessness is the most common feature of PH, patients often also present with chest pain, syncope, fatigue, weakness and abdominal distension. The precordial signs include a right ventricular lift, accentuated pulmonary component of S2, a pansystolic murmur of Tricuspid regurgitation, a diastolic murmur of pulmonary regurgitation and a right ventricular S3. The standard diagnostic workup in developed countries includes a series of investigations to rule out the secondary causes. Additional tests are required to estimate the disease severity and plan the appropriate treatment. These include the cardiac catheterization, selective pulmonary angiography by direct injection of pulmonary arteries, high resolution CT scan, cardiac magnetic resonance, ABGs, nocturnal O2 saturation, etc. While most of the basic management is feasible in the Indian conditions, most of the newly introduced drugs are either not available or are available at costs that far exceed the paying capacity of an average citizen of a developing economy. An underdeveloped health insurance system adds further to the financial burden of the treatment. Measures like formulation of guidelines for diagnosis and treatment of PAH, educating clinicians and scientists and making medications affordable to poor patients might ensue a breakthrough in the overall management of pulmonary hypertension.

Healing across Boundaries
Healing across Boundaries

Author: Makarand R. Paranjape

Publisher: Routledge

Published: 2015-08-12

Total Pages: 269

ISBN-13: 1317324730

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This unique volume initiates a dialogue between bio-medicine and alternative therapeutics. Undertaking a multidisciplinary exploration of the science and spirituality of healing and wellness, it offers varied perspectives from doctors, medical researchers, Ayurvedic practitioners, philosophers, psychologists, sociologists, and cultural critics. It expands the horizons of health sciences in engaging with diverse traditions — bio-medicine, Ayurveda, Siddha, and Jaina bio-ethics. The book will interest scholars and researchers in social and community medicine, biological sciences, sociology and social anthropology, as well as cultural studies.