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1 2nd SEMESTER
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INTERNAL MEDICINE TRANS NO. 1 2nd SEMESTER
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BATCH 2021
DISCIMUS SAPIENCIA UT VIRTUS
INTERNAL MEDICINE
BLOCK 1
LECTURER: DR. ESTEPAR
Cardiac Symptoms
- Result mostly from
o Myocardial ischemia
Chest discomfort
o Disturbance of the contraction and/or
relaxation of myocardium
Fatigue, peripheral edema,
ASSESSMENT OF CARDIAC FUNCTION dyspnea
- Ejection Function (F) o Obstruction to blood flow and valvular
o More sensitive index of cardiac function stenosis heart failure
o Ration of SV to end-diastolic volume o Abnormal cardiac rhythm or rate
o Normal value = 67 + 8% Palpitations, dyspnea,
hypotension, syncope
o Systolic function
- Elevated ventricular end-diastolic volume Cardinal Manifestations of Cardiac Diseases
o Normal value = 75 + 20ml/m2 - Can also be manifestations of other organ systems
- Elevated ventricular end-systolic volume - Dyspnea
o Normal value = 25+2ml/m2 o Pulmonary dse, marked obesity and
- Non-Invasive Techniques of measuring Myocardial anxiety
- Chest discomfort
Function o Result from variety of non-cardiac and
o Echocardiography cardiac causes other than myocardial
o Radionulide scintigraphy (nuclear ischemia
medicine) - Edema
o Cardiac MRI o Primary renal and hepatic disease
- End-systolic Left Ventricular Pressure-volume - Syncope
o Neurologic disorder
relationship
o Useful index of ventricular performance Characteristic Findings of Cardiac Patients
o Results are not dependent on the degree - Dyspnea/Chest Discomfort
of preload and afterload o Appears on exertion
o Disappears at rest
Diastolic Function - Heat murmurs
- Elevated arterial pressure
- Assessment of ventricular filling
o Abnormal EXG, CXR, and other imaging
- Increase in ventricular stiffness - Risk factors for CAD
o Ventricular hypertrophy o Cholesterol, DM II, smoking, Hx of stroke,
o Amyloid infiltration of the ventricle biomarkers (C-reactive CHON)
- Continuously measuring the velocity of blood flow Diagnosis
across the mitral valve using Doppler ultrasound - New York Heart Association
1. The underlying etiology
- Is the disease congenital, hypertensive, ischemic,
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