Faisal works in his garden

External surface of the heart
1. The heart is conical in shape. It has
  1. base
    1. Directed backwards and to the right.
  2. Four borders
    1. upper
    2. right
    3. lower
    4. left
  3. apex
    1. Directed downwards, forwards and to the left.
  4. Four surfaces
    1. sternocostal
    2. diaphragmatic
    3. right pulmonary
    4. left pulmonary
What affects the stroke volume
1. sv
2. co
3. contractility
4. inotropisim
5. preload
6. afterload
Complications of Aortic stenosis
1. Heart Failure
2. Pulmonary Edema
3. Strokes
4. Endocarditis
Aortic Stenosis
1. A condition that causes the heart to work harder than usual.
  1. Congenital Aortic stenosis
  2. Acquired Aortic stenosis
    1. RHEUMATIC
    2. CALCIFIC
Echocardiography
1. AV anatomy (tricuspid, bicuspid, unicusped)
2. thickened, calcified, decreased mobility
3. Assessment of LVH & LV systolic function
4. Calculation / Planimetry of AV area
Management of aortic stenosis
1. Medical therapy
  1. Avoid vigorous exercise
  2. Antibiotic prophylaxis for endocarditis
  3. Regular follow-up +_ echocardiography
  4. Advise to report symptoms
2. Surgical therapy
  1. Aortic valve replacement
endocarditis
1. bacterial infection
2. most common site is the valve
  1. mitral valve
3. having a prosthetic valve is the highest risk
4. traditionally associated with Rheumatic heart disease
Clinical presentations of IE
1. Clinical features include
  1. Fever (>90% cases)
  2. Fatigue ,malaise
  3. dyspnea,cough, pleuritic chest pain
2. combination with signs of pathological cardiac changes:
  1. new or changed heart murmur (>80% cases)
  2. Heart failure signs
3. Manifestations of subsequent damage to other organs
  1. Embolic stroke (>20% cases)
  2. Skin lesions

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Faisal works in his garden

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