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📝My Medical Notes👨🏻‍⚕

@mymednot

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Internal Medicine

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📝My Medical Notes👨🏻‍⚕

5 May 2023, 20:38

مشاهدة "Hypertension- causes, symptoms, diagnosis, treatment, pathology" على YouTube
https://youtu.be/Qm5kB5X70oA

#Cardiovascular

Hypertension- causes, symptoms, diagnosis, treatment, pathology

What is Hypertension? Hypertension, or high blood pressure, affects over a billion people around the world, and over time is a major risk factor for heart disease and stroke. Find our full video library only on Osmosis Prime: http://osms.it/more. Join over 3 million current & future clinicians who...

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♨️Pericardial Tamponade♨️
.
💠Patient will be complaining of dyspnea and chest pain
💠PE will show muffled heart sounds, JVD and hypotension (Beck’s triad), pulsus paradoxus
💠ECG will show low voltage QRS, electrical alterans
💠Echocardiography will show diastolic collapse of RV
💠Treatment is pericardiocentesis.

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

5 May 2023, 20:27

✍In HTN with ASTHMA or COPD
✅Use : One of ANTIHTN
🚫Avoid : Beta blocker

✍In HTN with DM
✅Use : ACEI, Ca blocker
🚫Avoid : Beta blocker

✍In HTN with RENAL Impairment
✅Use : One of ANTIHTN
🚫Avoid :ACEI In bilateral renal stenosis

✍In HTN with pregnancy
✅Use : alpha methyl dopa, Ca blocker, labetolol or hydralazine
🚫Avoid : Beta blocker, ACEI,Diuretics

✍In HTN with 💔 failure
✅Use : ACEI, Diuretics
🚫Avoid : Ca channel blocker

✍In HTN with Ischemia
✅Use : Beta or Ca Blocker
🚫Avoid : hydralazine

✍In HTN with Peripheral vascular lesion
✅Use : Ca or alpha blocker
🚫Avoid : beta blocker

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

5 May 2023, 20:26

📌Beta Blocker & HTN 📌

🔥Avoid BETA BLOCKER in :
🌵HTN with asthma
🌵HTN with diabetes
🌵HTN with pregnancy
🌵HTN with peipheral vascular disease

⭐️You can Use BETA BLOCKER in :
💥HTN with Ischemia
💥HTN with Thyrotoxicosis
💥HTN with Renal failure
💥HTN with Heart failure

#Cardiovascular

23 0 0

📝My Medical Notes👨🏻‍⚕

5 May 2023, 20:20

00:14

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Kussmaul's sign- a paradoxical increase in pressure in the jugular vein in inspiration.

Kussmaul's sign is more common in pathologies of the right ventricle.‌‌

......... _........ _...... _..... _..... _.... _..... _........ _
#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

5 May 2023, 16:17

🔰What should you be looking for?

💥Clinical signs of end organ damage:
• Fundoscopy: hypertensive retinopathy grades I–IV
• LVH: forceful/displaced apex beat, loud A2
• Proteinuria.

💥Causes of secondary HT:
• Coarctation of the aorta: have you felt the femorals, especially in the young patient?
• Renal disease: renal bruits/proteinuria/urea and electrolytes
• Cushing’s syndrome: obesity, striae; might have low K+
• Conn’s syndrome: no signs; usually low K+ and high normal Na+
• Phaeochromocytoma: presentation often atypical (e.g. acute pulmo-nary oedema, sweating attacks) rather than textbook flushing/palpitations.

💥Baseline investigations:
• U&Es, eGFR and glucose: look for electrolyte imbalances (e.g. Conn’s, renal disease and diabetes)

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📝My Medical Notes👨🏻‍⚕

3 May 2023, 00:17

🤔🛑medical case 🛑

An anxious 33-year-old woman comes to A&E with a bad migraine. Her BP has been recorded as 180/120 on a number of occasions while she is waiting to be seen by the medical team.

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 19:42

😁 Common indications for echocardiography

①Assessment of left ventricular function

②Diagnosis of severity of valve disease

③Identification of vegetations in endocarditis

④Identification of structural heart disease in
atrial fibrillation, cardiomyopathies or congenital heart disease

⑤Detection of pericardial effusion

⑥Identification of intracardiac thrombus in systemic embolism

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 17:50

🌌Echocardiography
①Transthoracic echocardiography
②Transoesophageal echocardiography

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 17:42

🌌Heart contour in the posteroanterior (PA) view

🎯Right border (from caudal to cranial): right atrium, superior vena cava

🎯Left border (from caudal to cranial): left ventricle, left atrial appendage, pulmonary trunk aortic knuckle

🎯Inferior border: right ventricle

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 17:39

🌌The heart shadow can be viewed on a chest x-ray.

🌌Heart contour in the lateral view
Anterior border: right ventricle
Inferior border: left ventricle
Posterosuperior border: left atrium

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 01:16

🫀Chest X-ray
🌌useful for determining the size and shape of the heart, and the state of the pulmonary blood vessels and lung field
🌌Most infor-mation is given by a postero-anterior (PA)
🌌projection taken in full inspiration.
🌌 Anteroposterior (AP) projections can be performed when patient movement is restricted but result in magnification of the car-diac silhouette.

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:53

⚡️ECG

🌟assess cardiac rhythm and conduction
🔥diagnosis of myocardial ischaemia and infarction.

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:53

🩸Haemodynamic effects of respiration

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

How to read a 12-lead electrocardiogram:
🤔

🎯lead II
determine heart rate and rhythm
🎯Cardiac axis
Normal if QRS complexes +ve in leads I and II
............

🌊P-wave shape
①Tall P waves
denote right atrial enlargement (P pulmonale)
②notched P waves
denote left atrial enlargement (P mitrale)
................
⛳️PR interval
①Prolongation
denotes impaired atrioventricular nodal conduction
②A short PR interval
occurs in Wolff–Parkinson–White syndrome
............
⏰QRS duration
If > 0.12 sec
①ventricular conduction is abnormal
(left or right bundle branch block)
.......................
🔋QRS amplitude
occur in
①slim young patients
②patients with left ventricular hypertrophy
...........
🌊Q waves
①signify previous myocardial infarction
.............
🧩ST segment
①ST elevation
signify
myocardial infarction,
pericarditis
left ventricular aneurysm

②ST depression
signify ischaemia or
infarction
........................
🌊T waves
T-wave inversion
①myocardial ischaemia or infarction
②electrolyte disturbances
Hypokalemia
Hypocalcaemia
Hypomagnesaemia
..............................
⛳️QT interval
①electrolyte disturbances
hypoK+
hypoMg2+
hypoCa2+,

②Antiarrhythmic class (Ia, Ic,III)
💊Disopyramide
💊Flecainide
💊Amiodarone💊sotalol
③Tricyclic antidepressants
💊Amitriptyline
④Antibiotic. macrolides.
💊Erythromycin
⑤ Antimalarial
💊Quinidine
⑥Ototoxic drug
💊Aminoglycoside
...............

#Cardiovascular

https://t.me/mymednot

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

☑️ 3 common Investigation for CVS cases:-

ECG
Chest X ray.
Echo – cardiographs

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

🫀Intermittent claudication

is pain felt in the legs on walking due to arterial insufficiency and
is the most common symptom of PAD.

🔰Patients describe
cramp-like’ pain that develops after a relatively constant distance
🔰The pain disappears completely within a few minutes of rest but recurs on walking.

🛑claudication distance’ is how far patients say they can walk before the pain comes on.
🔰The calf muscle is most commonly affected and this is due to femoropopliteal disease

👨🏻‍⚕ Claudication
marker for wide spread atherosclerotic disease

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

🫀كيف نميز ما اذا كانت ال Generalized edema
due to Fluid overload or Hypoproteinemia🤔

①Fluid overload 😎
*heart faliure
*renal disease
*excessive fluid replacement
☞ elevated JVP
......
②Hypoproteinemia 🤓
زيادة فقد
nephrotic syndrome
قلة تصنيع
liver faliure
صعوبة في الإدخال
malnutrtion or malabsorption

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

🫀cardic causes of LL. edema

🔰Heart failure
is a common cause of bilateral lower limb oedema
🔰other causes include
. chronic venous disease,
. vasodilating calcium channel antagonists (such as amlodipine)
🧐 elevated jugular venous pressure strongly suggests a cardiogenic cause of oedema

🧐تحقق من ال
💥associated symptoms
dyspnoea, orthopnoea and abdominal distension.

#Cardiovascular

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📝My Medical Notes👨🏻‍⚕

1 May 2023, 00:52

🫀 Syncope
sudden transient loss of consciousness 2°ry to decrease cerebral perfusion.
Usually cardiovascular cause .
①Vascular
Postural hypotension (orthostatic)
Neuro cardiogenic [v asovagal]
Carotid sinus hypersensitivity
......
②obstructive of cardiac out let
A.S, M.S. but Aortic stenosis common
HOCM
....
③Arrhythmias
Brady arrhythmia .
tachyarrhythmia
......
④Faliure of artificial pacemaker.
........................
💊Drugs
beta – blockers , CCBs , Antiarrhythmic , Diuretic , ACEI .
............. __................__
🧠Neurological
transient ischemic attack
🔥Metabolic
anemia
hypoglycemia
........_.........._

#Cardiovascular

39 0 0

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