Essay On Heart Failure

Essay on Heart Failure
Situation: Two patients in their 70s present to the office at different times today, each with
documented heart failure: one diastolic and the other systolic, and both are hypertensive. First,
discuss the difference between systolic and diastolic heart failure, providing appropriate
pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to
prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs
and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very
carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate
physiology. Now considering all of the above, describe an appropriate comprehensive plan of ...
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The characteristic beginning signs of HF include inadequate tissue perfusion and signs of volume
overload. Inadequate blood flow to tissues can be evident by fatigue, shortness of breath, and
exercise intolerance. Volume overload is evident by peripheral and pulmonary edema (fluid
collection in the limbs and on the lungs) and venous distention (due to blood pooling in circulation
from back flow in the heart) (Lehne, 2010). Systolic heart failure is characterized by enlarged
ventricles that are unable to fully contract to pump enough blood into circulation to adequately
perfuse tissues. The enlargement in ventricles is due to an increased end–systolic volume. If the
heart is not able to sufficiently pump the expected volume of blood with each contraction, which in
a normal healthy heart is 50–60%, there will be a residual volume left in the heart after every pump
(Heart Healthy Women, 2012). With the next period of filling, the heart will receive the same
amount of blood volume from the atria combined with that residual volume from the previous
contraction. This causes the ventricles to have to dilate to accommodate this increase in volume. The
dilation causes the walls of the ventricles to stretch and become thin and weak. Also the
myocardium, the muscle layer of the heart, will stretch and not be able to adequately make a full and
forceful enough contraction to push blood from the ventricles (Lehne, 2010).
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Symptoms And Treatment Of Chest Pain
Chest pain is a frequent complaint in the emergency department (ED). Patients who are symptomatic
with ST–elevations on ECG are at high risk for ST–elevation MI (STEMI). While this classic ECG
pattern has been identified as high risk for myocardial ischemia, recent literature has reported
various STEMI–equivalents which may be equally threatening.8 One STEMI–equivalent previously
named the de Winter pattern describes ECG changes where there are ST–segment depression in the
precordial leads in association with tall, symmetrical, hyperacute T–waves.3 These changes have
been associated with proximal left anterior descending (LAD) coronary artery occlusion.9 We have
identified and report a case of de Winter ECG pattern immediately following ... Show more content
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There is also occasionally ST–segment elevation in lead aVr.3 These ECG changes have been
described as having an association with left anterior descending (LAD) coronary artery occlusion.
This can subsequently cause anterior wall myocardial infarction.9 The de Winter ECG pattern has
been described in various case reports. Specifically, criteria for the this ECG pattern consistently
includes 1) ST depression ≥1 mm up–sloping at the J–point in leads V1–V6 continuing into tall,
prominent, symmetrical T waves in the precordial leads, and 2) the absence of ST–segment
elevation in the affected leads. Also, prominent J–point elevation producing ST–segment elevation
up to 1.0 mm in lead aVr has also been described.10 De Winter et al illustrate this as a novel ECG
pattern associated with proximal LAD occlusion in 2008.10 We recount a case in which the de
Winter ECG pattern is identified immediately following ventricular fibrillation cardiac arrest. With
non–specific ST changes on the initial ECG at presentation (Figure 1), and subsequently a transient
complete normalization of these changes (Figure 2), the patient developed ventricular fibrillation
requiring electrical defibrillation. Case: A 33–year–old man presented to the ED by ambulance with
a 1–hour history of waxing and waning severe sub–sternal chest pain with shortness of breath, and
diaphoresis. The chest pain radiated to his back. The pain began in the

Study Of The Heart And The Cardiovascular System And Its...
A.Define the field of study
Cardiology is the study of the heart and the Cardiovascular system and its functions and disorders.
(2)
B.What do Practitioners in this field do in their jobs
Practitioners of this field are called Cardiologists.(2)
There are several sub–specialties in Cardiology(1,3,4,5)
Nuclear Cardiology:Uses Radioactive chemicals to assess myocardial blood flow, evaluate the
pumping function of the heart as well as visualize the size and location of a heart attack. (1)
Interventional Cardiology:non–surgical procedures used for treating cardiovascular diseases. They
use catheters for diagnostic testing of the heart and it blood vessels.(3)
Echocardiography:Echocardiography uses standard two–dimensional, three–dimensional, and ...
Cardiologists have to be interested genuinely and take pride in saving people 's lives to live up to the
stresses of the job(18) you have to be good in math because Cardiologists do mathematical
calculations..(18)
You should have dexterity with your hands as you need precision skills when you need to operate.
(18)
You have to know the workings of the heart and its functions comprehensively.(18)
Echocardiogram: It is used by cardiologists to find different functions of the heart and to detect any
diseases.It can identify ventricular septal defects.(6)
D.What education is required to work in this field
All doctors must complete a Doctor of Medicine (M.D.) program. You must have at least three years
of college to enter a M.D. program, but many students complete a bachelor 's degree in a science–
related subject before entering a M.D. program.(7) M.D program takes 4 years to complete.(7)
Typically, the first two years of a program cover biology, anatomy, chemistry, pathophysiology,
organ systems, and disease. (7)
The last two years are usually reserved for on–site clinical experiences
Additionally, entrance into medical school requires passing scores on the Medical College
Admission Test (MCAT).(7)
After completing medical school,you enter three year internal medicine residency program.(7)
During that time, you have the

The And Drug Administration ( Fda )
Background and Introduction:
Clinical trials evaluating the use of Yttrium–90 (Y–90) transarterial radioembolization for hepatic
tumors date back to the 1960s. The U.S. Food and Drug Administration (FDA) approved the use of
TheraSphere® (BTG, Ontario, Canada) particles for hepatocellular carcinoma (HCC) via
humanitarian device exemption (HDE) in 1999 and SIR–Spheres® (SIRTex Technology Pty, Lane
Cove, Australia) particles for colorectal cancer metastases in 2002. Since then....[talk more about
recent vents in the field]. Transarterial radioembolization has been reported to improve overall
survival to 15.4–17.2 months (1). The burgeoning use of Y–90 radioembolization in the treatment of
liver tumors requires interventional radiologists to make clear documentation in procedure reports in
order to obtain authorization and maximize reimbursement.
Traditionally, interventional radiologists performed arterial embolization while radiation oncologists
brachytherapy. However, Y–90 radioembolization unites both these disciplines via Y–90
microspheres that are placed intra–arterially by an interventional radiologist. Over the past decade,
interventional radiologists have been performing increasing numbers of radioembolization
procedures in treatment of intermediate to advanced stage liver–only or liver–dominant hepatic
malignancy. [include statistic] However, unlike more traditional interventional oncologic
procedures, Y–90 radioembolization requires more comprehensive initial

Use of Ramipril and Carvedilol Combination Therapy in...
Assignment: Treatment of Heart Failure: The severity of HF is determined by The New York
Carvedilol and Ramipril Heart Association classification (NYHA), which is Keywords: Heart
failure, beta–blockers, carvedilol, summarized in the table 15. angiotensin–converting enzyme
inhibitors, ramipril. INTRODUCTION Heart failure (HF) is the disease of the elderly. Over 70% of
the patients are older than 65 years. The risk of having the condition rises with age. HF can be
defined as a clinical syndrome. The ability of the heart to pump blood is impaired and it can no
longer meet the body's metabolic requirements Table 1. New York Heart Association Classification
of Heart Failure. Remme WJ, Swedberg K. Guidelines for the diagnosis and ... Show more content
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It was al., 2006) suggests that the drug blocks ATP– proven that these therapies significantly reduce
the sensitive (KATP) and G–protein–activated (KG) risk of mortality and improve the symptoms.
potassium However, by hyperinsulinemia and hypoglycemia. It is believed implementing multi drug
therapy. ACE inhibitors that the KG channel is opened by G protein in can cause hypotension,
cough, and worsen the renal response to stimulation of G–protein–coupled function. Cough can
cause patient noncompliance, muscarinic acetylcholine receptors in atria and sino– which in turn
may result in the need of different atrial node cells. Therefore, the inhibition of this drug therapy.
Beta–blockers can cause bradycardia, channel would result in anti–cholinergic effects in
hypotension, fatigue and fluid retention. Also, in the heart12. Study patients there with and
Australian–New are risks diabetes, associated beta–blockers ion channels. This results in could
potentially mask the symptoms of hypoglycemia7. Pharmacodynamics Carvedilol is a racemic
mixture of R and S Carvedilol enantiomers. Both enantiomers show α1 receptor Carvedilol is a non–
selective beta–blocker (ß1 and inhibition. However, only S enantiomer inhibits ß ß2) has
adrenoreceptors. It competitively blocks both ß1 and vasodilatation and antioxidant effects.
Previously it ß2 receptors. The drug reduces high blood pressure was be mainly due to the α1 and ß
blockage. The

State Medical Association Case Study Nursing
In the United States of America (USA), state medical boards (SMBs) are legislatively established to
ensure that only competent physicians are practicing medicine and that those physicians act
professionally. Typically, the enforcer of laws, rules, and regulations needs to understand and be
compliant with them. Thus, a SMB should be able to demonstrate a fund of medical knowledge
broad enough to discern between competent and negligent patient care. Similarly, SMBs, assessors
of physician professionalism, should demonstrate professional conduct. This report describes the
Missouri (MO) State Board of Registration for the Healing Arts' (SBRHA) numerous efforts to
discipline interventional cardiologist Antoine Adem, MD, during the years of 2012–2014 ... Show
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The SBRHA's effort to discipline Dr. Adem for the allegedly inappropriate patient care was blatantly
unmeritorious as none of the five patient's six epicardial coronary arteries had a lesion luminal area
of more than four mm
.
Count II against Dr. Adem was for alleged negligent and unwarranted medical care of 45–year
Patient E.O. The patient had a stent placed in the left anterior descending coronary artery (LAD) that
had a luminal area of 3.4 mm
, and a stent placed in the right coronary artery (RCA) that had a luminal area of 2.9 mm
. Count III against Dr. Adem also alleged negligent care for his stenting of 70–year Patient L.M.'s
mid–LAD that had an area of 2.8 mm
.
Although two such negligent claims by a state medical board are sufficient to destroy a good doctors
career, the SBRHA did not stop there. Count IV alleged Dr. Adem negligently placed a stent in 53–
year Patient J.E.'s Mid–LAD that had a luminal area of 3.7 mm
. Count V was meant to discipline Dr. Adem for placing a stent in 68–year Patient P.J.'s Mid–LAD
that had a luminal area of 3.8

Pediatric Cardiology Training Response Paper
Thank you very much for your time to meet with you. I am sending this email to emphasis what we
have already discussed during our meeting on Friday 01/12/2018. Nationally, training in
interventional pediatric cardiology is non–ACGME accredited training and no board exam is
required to pass at the end of the training. Therefore, I do not think your program needs to obtain
special accreditation prior to accept training me. As such, good training is the only requisite to
practice as congenital cardiac interventionist in the united states as well as overseas. I really
appreciate your sincerity in explaining potential difficulties in training me as well as your
expectations. Here are my goals to achieve by being trained at Helens De Vos children's

The Medical Science Of Cardiology
Young 1
The Medical Science of Cardiology Have you ever felt your heart race after a run, or when you
watch a movie, your heart stops? Well, your heart is an incredibly important organ within the human
body that keeps you alive and helps run your body. The heart is such an important component of the
body. If something goes wrong, it needs to be taken care of immediately; this urgent job is given to
cardiologists. Cardiology is the medical science of treatment of the heart. This science is filled with
specialists known as cardiologists. "A cardiologist is a doctor with special training and skill in
finding, treating and preventing diseases of the heart and blood vessels" (What is a Cardiologist?).
When becoming a cardiologist, you may choose to specialize in a certain area. Within the broad
spectrum of cardiology, there are many subspecialties, or sub–branches within the field. Sub–
branches within cardiology include the following: electrophysiology, interventional cardiology,
general clinical cardiology, nuclear cardiology, heart failure and transplant cardiology, preventative
cardiology, and many more. Electrophysiology focuses on irregular heartbeats and timing.
Interventional cardiologists specialize in treating cardiovascular disease, heart problems that the
patient has had since birth, and angioplasty and stenting. General clinical cardiologists target
management and prevention of diseases. Nuclear cardiologists use small amounts of radiation to

Letter To A Patient Hospital: A Case Study
It is with great pleasure I write this letter to give my highest recommendation to Ankur Sethi for
your structural heart disease fellowship program. I was introduced to Ankur in July, 2016 in the
capacity of the Director, Endovascular Services of Cardiac Catheterization Laboratory at the Mount
Sinai Hospital and Associate Professor of Medicine at Icahn School of Medicine when he started his
interventional cardiology fellowship. Over the years I had an opportunity to know him both
personally and professionally.
Without a doubt he is one of the brightest interventional fellows I have come across. He came to us
very well trained in diagnostic coronary and peripheral angiography and with a robust background
in clinical cardiovascular medicine.

Introduction Of Sudden Cardiac Death
Introduction
Sudden cardiac death (SCD) is the leading cause of death in exercising young athletes. 1 Current
estimates of the incidence of SCD in athletes range from almost one in a million to 1:23,000 athletes
per year, while some subpopulations of athletes are reported at even higher risk with an incidence of
1 in 3,000. 2 Such deaths often receive more attention because of the youth of the victims and the
perception that physically trained athletes are healthy. 3 SCD is often a result of structural cardiac
abnormalities that can be detected through the use of pre–participation physicals. 1 Pre–participation
cardiovascular screening is the systematic practice of medically evaluating large, general
populations of athletes before participation to eliminate risk of SCD. 3 The National Athletic
Trainers Association (NATA) requires BOC (Board of Certification) certified athletic trainers to be
educated, trained, and evaluated in six major practice domains. 4 Prevention and clinical evaluation
are two of the six domains. The American Heart Association suggests that pre–screening athletes can
improve the detection of cardiac abnormalities. 5 Athletic Trainers are increasingly required to be
the health care professionals administering pre–participation physicals. Athletic trainers need to
have clinical competence such as knowledge and skill, and confidence in performing cardiac
auscultations to effectively detect cardiac abnormalities in athletes. The purpose of this study is

Early Repolarization Pattern (ERP) Essay
Introduction
Early repolarization pattern (ERP) is an enigmatic common electrocardiographic (ECG)
finding,occurring in 1% to 2% of the general population (1). ERP prevalence is decreasing with
advancing age (2) This ECG pattern is frequently observed in healthy persons,particularly
young,male (3,4,5), athletic (6,7), and of African–American origin (4,5,6,7,8).On the 12–lead ECG
the ERP is characterized as "notching" or "slurring" of the terminal portion of the R wave and
beginning of the ST–segment that produces a positive hump known as J wave. The J wave is a
deflection with a dome that appears immediately after the end of QRS complex followed by ST–
segment elevation ≥ 0.1 mV (or 1 mm, varying from 1 to 4 mm) above isoelectric line ... Show more
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These authors proposed three subtypes:
Type 1: ERS observed predominantly in the lateral precordial leads, prevalent among healthy male
athletes and rarely seen in IVF survivors; Type 2: ERS predominantly in the inferior or inferolateral
leads and associated with a higher level of risk; Type 3: ERS globally in the inferior, lateral, and
right precordial leads and associated with the highest level of risk for development of malignant
arrhythmias.Type 3 is often associated with IVF storms.
(21)
Short–QT syndrome is described as a disorder characterized by abbreviated QT interval, ventricular
and atrial arrhythmias,and sudden cardiac death (22)
Recent studies supported an association between short QT syndrome and early repolarization. The
aim of this study was to study the prevalence of ER and its relationship with the QTc interval in
healthy subjects
Methods
Study Population
This study included 80 healthy participants with early repolarization ECG (n=40) and normal ECG
(n=40) . Study population matched one–to–one according to age and gender. Briefly, in addition to
undergoing Standard resting 12–lead electrocardiography, the subjects completed a questionnaire
regarding their health habits, known diseases, and medications. None of the participants were using
medications. All patients

One Beat At a Time Essay
One Beat at a Time
When we think of cardio vascular diseases, we usually always associate them with the loss of a
family member or friend. Almost everyone knows of someone who is affected by these tragic
diseases. Since the ancient times, there have been clues left showing possible cardio vascular
diseases within the Egyptian families. The earliest proof of a cardio vascular disease is of a 3,500
year old Egyptian mummy with a serious case of arthrosclerosis, which was identified via modern
CT scan. During the next few centuries little is known about cardio vascular diseases and the death
rate subsequently is low, until the turn of the Industrial age. Since this period of time cardio vascular
diseases have hit hard at the heart leading ... Show more content on Helpwriting.net ...
Premature atrial contractions are early additional beats that start in the atria and are usually
innocuous and usually don't require medical attention. Premature ventricular contractions are one of
the most prevailing arrhythmia where the heart will skip a beat due to stress, caffeine
overindulgence, or excessive exercise. Some people who have frequent contractions should seek
medical attention, but if it is irregular it is usually harmless. Atrial fibrillation is quite frequent
which causes the atria to contract out of rhythm. Atrial flutter is a more organized version of atrial
fibrillation where it's caused by one or many rapid circuits in the atria. Paroxysmal supraventricular
tachycardia originates above the ventricle and is known as a rapid heart rate. Accessory pathway
tachycardias are a form of rapid heart rate that is due to extra passageway between the ventricles and
atria. AV nodal reentrant tachycardia is another form of rapid heart rate that is caused through more
than one passageway. These can both be treated with special therapy or medication. Ventricular
tachycardia is a hasty heartbeat that begins in the ventricle section of the heart. This hasty beat
prevents the heart from attaining the right amount of blood to fill up, thus causing the body to
receive much less blood than usual. Ventricular fibrillations are inconsistent impulses from the
ventricles

The Catania ™ Coronary Stent System
Testing
The CATANIA™ Coronary Stent System with Polyzene®–F is indicated for patients with coronary
heart disease in coronary vessels, this stent can be applied to coronary vessels which diameter range
from 2.0 mm to 4.0 mm. The CATANIA™ stent with Polyzene®–F is intended to: 1) in both native
coronary arteries and vein bypass grafts, ameliorate the vessel lumen when treating lesions (de novo
and restenotic). 2) treat patients with acute & threatened occlusions, whose PTCA interventional
treatment was unsuccessful.
Method1
12 Months Studies
In this study, the Assessment of The Last Advanced Non–Thrombogenic Angioplasty Stent
(ATLANTA) enrolled 55 patients with:1) stable or unstable angina, 2) documentation of myocardial
ischemia attributable to native coronary artery stenosis, 3)amenable to treatment by percutaneous
stenting from May 2007 to August 2007.[1] The standards of enrollment are:1) patients age must
between 30 to 70 years old with up to 2 de novo type A and/or B American Heart Association/
American College of Cardiology lesions to be treated with the Catania stent in a vessel with a
reference diameter 2.5 and 3.5 mm by visual assessment.[1] This clinical study was completed based
on Declaration of Helsinki. The Primary end points of this study are: Stent Thrombosis, non– target
lesion revascularization, target lesion revascularization, target vessel revascularization, index
vessel–related nonfatal myocardial infraction and cardiac death. Secondary end points are:

Heart Disease Is The Leading Cause Of Death
Abstract In the United States, heart disease is the leading cause of death. Diagnosis and treatment
can involve invasive procedures including coronary angiography and percutaneous coronary
intervention (PCI). The transfemoral artery approach remains the preferred method for coronary
angiography and PCI in the United States despite a growing body of evidence that the use of the
transradial approach (TRA) improves patient safety and efficiency. The purpose of this paper is to
review the current literature, analyze several pertinent articles comparing cost and vascular
complications of the two methods used for PCI, and to discuss the clinical implications of the TRA.
Keywords: transradial catheterization, radial catheterization, coronary angiography, percutaneous
coronary intervention Transradial Artery Access for Percutaneous Coronary Intervention Diagnosis
and treatment of coronary heart disease often includes coronary angiography and percutaneous
coronary intervention (PCI). "Femoral access for coronary angiography has been the dominant
access site for the last two decades" (Jolly, Shoaib, Hamon, Yusuf, & Mehta, 2009, p. 132), and TRA
has been viewed as a "backup plan" for patients without other vascular access (Rao, Cohen,
Kandzari, Bertrand, & Gilchrist, 2010). There is a steep learning curve for physicians who are
performing TRA. Because of this, some studies have shown that the TRA is associated with longer
procedural and fluoroscopy times, higher access site

Chf Essay
Congestive Heart Failure
Introduction
Everyone loses pumping ability in their heart as they age. The serious case of heart failure develops
when other health conditions cause the heart to work harder or become damaged due to increased
stress. Heart failure is usually a chronic disease. It gradually tends to become worse. By the time
someone is diagnosed with it, the heart has most likely begun to lose pumping capacity for quits
some time. Nearly five million Americans are living with heart failure and 550,000 new cases are
diagnosed each year. This paper will discuss what heart failure is, and what nursing interventions
may be of help to patients who suffer from this disease. My grandmother was recently diagnosed
with congestive ... Show more content on Helpwriting.net ...
This excess fluid or congestion is where the term congestive heart failure comes from.
Right – sided failure is often a result of left – sided failure. When the left side fails, increased fluid
pressure develops in the lungs and damages the heart's right side. When pumping power is lost in the
right side, blood backs up in the veins causing swelling in the legs and ankles.
The heart tries to make up for loss of pumping capacity in three ways enlarging, developing more
muscle mass, and pumping faster. By enlarging, the heart contracts more strongly and pumps more
blood. When the contracting cells of the heart increase in size, an increase in muscle mass also
occurs. Pumping faster helps to increase the heart's output.
The body also does other things to help compensate for the loss in power in the heart. Blood vessels
narrow to keep the blood pressure up. The body diverts the majority of the blood to the heart and the
brain. Eventually the heart can't keep up and the person will suffer from fatigue, breathing problems
or various other symptoms such as coughing, wheezing, loss of appetite, nausea, confusion, or
increased heart rate. Factors such as smoking, being overweight, having a diet high in fat and
cholesterol, and not exercising can contribute to heart failure.
Background
After reviewing medical journals related to my topic, I discovered that many physicians and nurses
think that congestive heart failure is

What 's Internal Electrical System Controls The Rate And...
So, what is an arrhythmia? An arrhythmia is a problem with the rate and rhythm of the heart. The
heart can either beat too fast, too slow, or with an irregular rhythm. Arrhythmias can also cause the
heart to inefficiently pump blood to the body and other organs which can lead to damage in the
brain, heart, other organs and can ultimately lead to heart failure. Although most arrhythmias are
non life threatening, they can develop into a serious problem. To better understand arrhythmias, it
helps to understand the heart 's internal electrical system. The heart's internal electrical system
controls the rate and rhythm of each heartbeat. Each heartbeat sends off an electric impulse that tells
the heart to contract and pump blood. The electric signal first begins in a group of cells known as the
sinoatrial cells or to state simply, the SA node. The SA node is located within the wall of the heart's
upper right chamber, the right atrium. In a healthy adult heart, the SA node fires off an electrical
signal to begin each heartbeat 60–100 times per minute.From here, the electrical impulse travels
through special pathways in the atria, making the atria contract and pump blood into the heart's two
lower chambers, the ventricles. The electric signal then passes through a group of cells called the
atrioventricular node or the AV node, located between the atrium and the ventricles. Here, the
electric signal slows down, allowing the ventricles with enough time to finish filling with blood.

My Experience At The Florida Gulf Coast Lacrosse League...
With the blow of a whistle, practice comes to a grinding halt. Tired young men remove their helmets
and gasp for air in the early–but–oppressive Florida summer. I gather with the rest of the coaching
staff and together we prepare one of our final talks to the team before they battle in the Florida Gulf
Coast Lacrosse League Championship game. In the six months leading to this final surge, myself
and the other coaches have worked to instill four key traits into our players: teamwork, dedication,
integrity, and respect. It is these four qualities, we believe, that will allow them to develop a fifth
quality, technical competence, and take them to the top of their sport. More importantly, it is these
four traits that we believe will transform them into mature young men and prepare them for the
rigors of life off of the field. Many of my life's most significant events coincided with my coaching
career. I opened a business, went back to school, and even met my wife. It also marks the period of
my life when I began a maturation process, albeit several years overdue. Prior to the start of my
coaching, I stumbled from one phase of my life to another, my immaturity and lack of direction
fueling each other in a vicious cycle. While coaching may not have been the event that triggered my
maturation, it certainly signified the beginning of a new era in my life, an era punctuated by a
renewed understanding and appreciation of the same traits I worked to pass onto my players. During

A Career As A Cardiologist
Cardiology studies and treats diseases and abnormalities of the heart and blood vessels. There are
two parts to the cardiologist job. The first being a cardiologist specializes in the diagnosing,
preventing and treating the diseases of the heart and blood vessels. The second is an interventional
cardiologist which can perform a number of invasive tests and procedures to assist in the diagnosing
and treatments of the disease. There are also Cardio–vascular surgeons who specialize in the
surgeries of the heart and vascular system. To be able to treat patients cardiologists can perform a
number of tests such as echocardiograms (soundwave picture to look at the structure and function of
the heart), Ambulatory ECG (recording during activity to look for abnormal heart rhythms),
Exercise test (study to measure your heart's performance and limitations), and Cardiac
catheterization (test in which a small tube is placed in or near the heart to take pictures, look at how
the heart is working, check the electrical systems, and help relieve ... Show more content on
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This is just a few of the many tests they may perform to make a determination. Cardiologist may
diagnose a patient with aortic stenosis, which is the narrowing of the aortic valve orifice, caused by
failure of the valve leaflets opening like normal. Another diagnosis could end up being acute
myocardial infarction also known as a heart attack. Which is normally caused by a blockage.
Pulmonary embolic disease may be another diagnosis they may come to a conclusion on based on
symptoms. The two most common causes for this disease is pulmonary embolism and deep venous
thrombosis. Cardiologist have to go through years of training. They will start by completing all their
prerequisite premedical undergraduate courses but not required to complete their bachelors. Most
medical students will complete it though. Medical school is a requirement in order to earn the
Doctor of Medicine degree. This is generally 4

Coca Cola, A Popular Beverage
In 1886 John Pemberton invented the popular beverage known as Coca–Cola and sold it to
customers in a pharmacy in Atlanta, Georgia. People loved the sweet carbonated drink, and sales
skyrocketed. It was not until almost a century later in the summer of 1980 that Jack Carew was
appointed to lead a project to introduce a diet version of Coca–Cola. Since, at the time consumers
were moving to low or no calorie brands. And in 1982 at Radio City in New York Diet Coke made
its debut in the United States. Today, Diet Coke is now a popular beverage consumed by about fifty–
nine percent of Americans every day, according to a study conducted by the University of Texas at
Austin. This drink, containing fewer calories and sugar than regular Coke would ... Show more
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N.d. Liberty Voice. Web. 17 May 2016. In addition to that, Diet coke also contains aspartame
(C14H18N2O5), which is a low calorie sweetener used to replace the sugar found in regular Coca–
Cola. It is composed of two amino acids, phenylalanine and aspartic acid. Although these amino
acids are not found to be harmful by themselves, when aspartame is consumed it is broken down in
the body to aspartic acid, phenylalanine, and methanol, which in large amounts can be harmful. But
since aspartame is about 200 times as sweet as regular sugar, much less of it can be used for the
same amount of sweetness, leading to fewer calories in the food or beverage being consumed. And
although aspartame's main purpose is to reduce weight gain, this artificial sweetener may actually be
doing the opposite. "Some studies suggest that when our taste buds sense sweetness, the body
expects a calorie load to accompany it. When that doesn't happen, it may cause us to overeat
because we crave the energy rush our body was expecting," says Cheryl Forberg R.D., author of
Flavor First. What this means is that after drinking artificial sweeteners, naturally sweet foods such
as apples, blueberries, and strawberries no longer seem sweet enough. The reason for this is because
when your body tastes something sweet it releases insulin into the bloodstream to absorb the sugar.
Normally this would not be a problem, but since aspartame is an artificial sweetener there

Integrated Review For Post Percutaneous Coronary Intervention
Final Paper: Integrated Review
Freddy Laguerre
Florida International University
Nicole Wertheim College of Nursing and Health Sciences
Abstract
Providing care for post percutaneous coronary intervention (PCI) patients has evolved and the
guidelines and protocols have been heavily influenced by research and evidence based practice
(EBP). Unfortunately, coronary heart disease has become a major issue for the health status of
Americans across the lifespan. According to the CDC, "About 610,000 people die of heart disease in
the United States (U.S.) every year – that's 1 in every 4 deaths." In addition, treating coronary heart
disease patients has negatively impacted the economic status of U.S. healthcare. Therefore, to
manage ... Show more content on Helpwriting.net ...
Literature Review PCI has become the procedure of choice by physicians in acute cardiac events
and diagnosing cardiac and vascular abnormalities. As a result, increased research studies have been
conducted in regards to caring for this population. The Centers for Disease Control (CDC) estimates
that annually 735,000 Americans have an MI. Of these, 525,000 are a first MI and 210,000 happen
to people who have already had an MI. This increased rate of individuals is one on the predisposing
factors contributing to the increase in acute cardiac centers nationally. Langabeer et al. (2013)
research showed the number of PCI centers has grown 21.2% over the last eight years, with 39% of
all hospitals having interventional cardiology capabilities. During the same time, the U.S. population
has grown 8.3%, from 217 million to 235 million. Over the past several decades, PCI procedures
have received increased from stakeholders, such as safety groups, research organizations, and
government agencies. This increased recognition has led to the creation of specific safety practice
performance measures. For example, the Centers for Medicare and Medicaid Services (CMS)
created guidelines for hospital organizations to follow in order to receive reimbursement for PCI
procedures. Studies have shown that prescribing patients certain medications can aid in cardiac
health and keeping coronary stents patent after discharge from the hospital post

History and Physical Examination for Putul Barua Essay
CASE STUDY 3
HISTORY AND PHYSICAL EXAMINATION
Patient Name: Putul Barua
Patient ID: 135799
Room No.: CCU–4
Date of Admission: 01/07/2013
Admitting Physician: Simon Williams, MD
Admitting Diagnoses 1. Rule out myocardial infraction 2. History of tuberculosis. 3. Hemoptysis. 4.
Status post embolectomy.
CHIEF COMPLAINT: Tightness in the chest, shortness of breath, fast heart rate.
HISTORY OF PRESENT ILLNESS: Mr. Barua is a 42–year–old gentleman from Bangladesh who
presents with chest tightness, shortness of breath, and tachycardia. Dr. J.K. McClain of cardiology is
evaluating his heart condition. The patient has had the recent onset of hemoptysis. He was treated
for tuberculosis in Bangladesh 15 ... Show more content on Helpwriting.net ...
PHYSICAL EXAMINATION: Vital signs are WNL. Apparently he has had no chills, night sweats,
or favors. Generalized malaise and a lack of energy have been the main concerns. HEART: Regular
rate and rhythm with S1 and S2. No S3 or S4 is heard at this time. LUNGS: Bilateral rhonchi. No
significant amphoric sounds are noted. ABDOMON: Soft nontender. No hepatosplenomegaly or
masses are detected. RECTAL EXAM: Prostate smooth and firm. No stool is present for hemoccult
test.
DIAGNOSIS: Hemoptysis with history of tuberculosis.
PLAN: I have reviewed the chest x–rays available here and agree with the finding of bleb formation
in the right and left upper lobes. Despite the fact that the patient has had a high INR, because of his
history of tuberculosis and hemoptysis I believe obtaining sputum for TB is very, very important.

We should rule out any other endobronchial lesions as the cause for his bleeding. I have discussed
this matter with the patient and his wife. I have told them that there is the possibility of observing
the condition by x–rays and repeated tests of his sputum. They understand that this is an option;
however, they decided that because of concern regarding his repeated hemoptysis, they would
consent to bronchoscopy. We will arrange for the patient to have a bronchoscopy done. He is off
Coumadin.
(Continued)
HISTORY AND PHYSICAL EXAMINATION
Patient Name: Putul Barua
Patient ID: 135799
Date of Admission: 01/07/2013

Congested Heart Failure Case Study Essay
Congested Heart Failure
(adapted from McGraw Hill Case Studies)
Chief Complaint: 74–year–old woman with shortness of breath and swelling.
History: Martha Wilmington, a 74–year–old woman with a history of rheumatic fever while in her
twenties, presented to her physician with complaints of increasing shortness of breath ("dyspnea")
upon exertion. She also noted that the typical swelling she's had in her ankles for years has started to
get worse over the past two months, making it especially difficult to get her shoes on toward the end
of the day. In the past week, she's had a decreased appetite, some nausea and vomiting, and
tenderness in the right upper quadrant of the abdomen.
On physical examination, Martha's jugular veins ... Show more content on Helpwriting.net ...
As the blood quickly flows in, it will hit the hardened walls, creating an extra sound. In congestive
heart failure, preload and contractility are major factors in the improper functioning of the heart as a
pump.
3) Is her history of rheumatic fever relevant to her current symptoms? Explain. Rheumatic fever
caused by Group A Streptococcus bacteria may cause damage to heart tissues including valves.
Overtime, congestive heart failure may have developed. However, the pulmonary semilunar valve
seems to be the issue in this case study, whereas rheumatic fever normally affects left heart tissue.
4) A chest X–ray reveals a cardiac silhouette that is normal in diameter. Does this rule out a possible
problem with Martha's heart? Explain. No, a normal diameter of a cardiac silhouette does not rule
out a problem with Martha's heart. The heart adapts and will compensate for damage in order to still
function optimally. The right ventricle, in this case, will become stronger in order to push the same
amount of blood (stroke volume) through the narrowed pulmonary semi–lunar valve. This
thickening doesn't necessarily change the inner diameter.
5) You examine Martha's abdomen and find that she has an enlarged liver ("hepatomegaly") and a
moderate degree of ascites (water in the peritoneal cavity). Explain these findings.
The increased resistance of blood flow through the pulmonary semilunar valve from the right
ventricle backs up the pressure of blood

Failure Of Congestive Heart Failure
Introduction Almost every one in the United States knows a person suffering from congestive heart
failure. This disease has manifested its way into the lives of so many–the statistics are astounding.
According to the National Heart, Lung and Blood Institute, nearly 5 million people are affected and
it is the main reason for hospital admission in older adults over the age of 65. This is a great cause
for concern. In order to reduce the morbidity and control this epidemic, we must first understand the
risks and causes of this condition. It is of the upmost importance to first understand the risks and
causes of this condition. Education plays a key role in order to recognize the clinical manifestations
and necessary actions to best treat ... Show more content on Helpwriting.net ...
Left sided heart failure causes a decrease in cardiac output and can be further classified as systolic
or diastolic. When the cardiac output is decreased and can not get enough oxygen to important
organs, it is from an imbalance of stroke volume and heart rate. When a person experiences a
myocardial infarction or continuous hypertension, the contractility of the heart decreases which
directly influences the stroke volume. The stroke volume is the amount of blood pumped out of the
heart per contraction so if that decreases, so does the cardiac output which decreases perfusion of
the organs (Huether and McCance, 2012). Diastolic heart failure in the left side is when the ventricle
has trouble filling to its full capacity which is usually caused by a stiffening or loss of contractility
of the ventricle. Right sided heart failure is often times a response to left sided heart failure. When
the left side of the heart has failed, the blood backs up into the lungs due to a decrease in output so
the blood then backs up into the right side of the heart causing problems with it too. Heart failure in
the right ventricle comes from it not being able to eject an adequate amount of blood into the
pulmonary system (Huether and McCance, 2012).
Clinical Manifestation Symptoms of a patient with congestive heart failure differ depending on the
side of the heart that is not functioning properly. Left sided heart failure

Aortic Valve Replacement
Aortic stenosis is the most common valvular heart disease of the developed world. About 7% of the
population over age 65 suffer from degenerative aortic stenosis. The prognosis of patients with
symptomatic severe aortic stenosis is known to be dismal without valve replacement. Even though
American College of Cardiology recommends aortic valve replacement as a class I recommendation
to treat symptomatic severe aortic stenosis, approximately a third of these patients over the age of 75
are still not referred for surgery. Typically, this is due to concern about prohibitive surgical risk due
to patient frailty, co–morbidities, age, and severe left ventricular dysfunction. The advent of
transcatheter aortic valve replacement (TAVR) in Europe raised the hope for an alternative, less
invasive treatment for aortic stenosis in the United States. We present a review of the existing and
emerging literature pertaining to TAVR, including the PARTNER (Placement of AoRTic
TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve) and CoreValve trials.
Although surgical valve replacement (SAVR) remains the modality of choice for patients with
severe aortic stenosis and low to intermediate operative risk for now, TAVR has certainly become
the preferred approach for high risk patients, and it may gain traction for low and intermediate ...
The first successful replacement was performed by Harken et al in 1960.8 Duran and Gunning
described aortic valve replacement in a patient using a xenograft porcine aortic valve in the early
1960s.9–10 Since then, the art of open heart valve surgery has been perfected, resulting in very good
surgical

Cardiac Medical Practice Group Of Approximately 15...
n February 2002, a cardiologist named Dr. Robert Emerick was hired by the Cardiac Study Center as
an employee. Cardiac is a medical practice group of roughly 15 cardiologists. The center has
provided care to patients in Pierce County who have heart disease since 1966. It has four offices,
each one near a hospital that serves as a recommendation source for Cardiac. Dr. Robert Emerick
trained in medicine in Memphis, Tennessee for around three years before getting employed at
Cardiac. Two years after his employment, Emerick became a shareholder of Cardiac. When he
became a shareholder, Emerick signed a shareholder employment agreement. The agreement
included the covenant not to compete, which asserted a promise not to practice competitively in
Pierce County or Federal Way for the duration of five years, if and when he leaves Cardiac. In
August 2005, Cardiac began to get complaints about Emerick's conduct. Several physicians actually
stopped referring patients to Cardiac due to his conduct. When this became a problem, Cardiac's
Professional Conduct Committee met with Emerick to discuss the complaints. Not only did they
meet once, but twice because there were more complaints after the first discussion. Even after
addressing the complaints a second time, Emerick's behavior did not change. In February 2009, the
Conduct Committee suggested that the Board of Directors discipline Emerick because he did not
make an effort to change. Thus, the Board fired Emerick on May 1, 2009. After

The Possibly Detrimental Effects of Cardiac Arrhythmia
Cardiac arrhythmia is defined as, "a condition in which the heart's normal rhythm is disrupted"
(Scholarpedia). A heart usually beats anywhere from 60 to 100 times a minute. If there is a palpation
or a fluttering rarely, the person should usually be fine. If these occur more often or on a frequent
manner, this cardiac arrhythmia could be very severe (Hopkinsmedicine). The hearts electrical
system is what controls the speed and pace of the heartbeat (NHLBI,NIH). Sinoatrial node or SA
node is located in the right atrium and controls the rhythm of the heart. The SA node is cardiac
muscle cells, and it acts as a pacemaker. Sinus rhythm is the regular heart rhythm (Scholarpedia).
Atrial tachycardia is when the heart beats too fast. On the other hand, bradycardia is when the heart
beats too slowly. The heart can also beat irregularly (Hopkinsmedicine). The electrical signal goes
from the SA node to the left and right atria. This allows the atria to pump and contract blood to the
ventricles. Then, the signal goes to the atrioventricular or AV node. The electrical signal slows down
here, so the ventricles have time to fill themselves with blood. After the AV node, the electrical
signal goes to the bundle of His, where the signal is eventually transported to the ventricles. In this
phase, the signal causes the ventricles to contract and pump blood to the lungs and the other parts of
the body (NHLBI, NIH). The reason I described this whole process was for the reader to

Cause Slower Heart Rates On Diabetes
cause slower heart rates [95]. We cannot rely solely on reduced heart rates only to diagnose CAN
because with advanced nerve dysfunction, heart rates can be normal [95] but it persists in higher
rates than patients without any diseases [96]. As a result, heart rate cannot be a reliable factor to
determine CAN; however, decreased heart rate is the primary manifestation of CAN [95]. CAN is
considered as a common chronic complication of diabetes mellitus that threatens life of patients with
diabetes [97]. Its worldwide prevalence varies from 1.6% to 90% [98]. Dysfunction of autonomic
nerve fibers that regulate heart rate, cardiac output, myocardial contractility, cardiac
electrophysiology, blood vessel constriction and dilatation can be defined as CAN [97, 99]. There
are many cardiac disorders that are associated with CAN such as resting tachycardia, intraoperative
cardiovascular instability, arrhythmias, asymptomatic myocardial infarction and ischemia and
increased rate of mortality after myocardial infarction [97, 99]. CAN is diagnosed by several clinical
symptoms, such as postural hypotension, dizziness, light headedness, presyncope, syncope and early
fatigue and exhaustion during exercise; all of these are demonstrated in later stages [98]. The first
finding of CAN is, decreased heart rate variability (HRV), which is a subclinical finding and can be
diagnosed through deep respiration [100]. It can occur even in normal heart rate conditions [100].
Increased resting heart

Leadership Approaches For Problem Solving
Running head: LEADERSHIP APPROACHES FOR PROBLEM SOLVING 1
Leadership Approaches For Problem Solving
Wheaton Franciscan Healthcare is a Catholicbased healthcare organization. It has been operating in
Southeastern Wisconsin, as well as Iowa, Illinois, and Colorado for over 150 years. In Southeast
Wisconsin, Wheaton operates 8 hospital campuses, has 996 hospital beds, over 10,000 employees,
1,474 affiliated physicians, and 330 employed physicians. There were over 225,000 emergency
room visits, more than 1 million outpatient visits, and over 42,000 hospital admissions in the 2014
fiscal year.
(Southeast Wisconsin Statistics, 2014)
Currently, the Wheaton System in southeast Wisconsin is divided into the North,
Central, and South markets. Each market has its own management team that reports to the system as
a whole. Each market also has different department directors such as
Radiology, Emergency, Surgical, Nursing, etc.
My role in this organization is the coordinator for interventional radiology at one of the three
hospitals in the North market. I report to my supervisor at my hospital, who in turn reports to the
North market radiology director. In the last two years, radiology services in Southeast Wisconsin has
begun to standardize practices among the different interventional radiology departments. This
became necessary when the system hired a large group of radiologists that will work between sites.
Because we are now sharing the same physicians, standardizing our supplies has

Changes Associated With Left Ventricular Hypertrophy With...
Electrocardiographic changes can include left ventricular hypertrophy with repolarisation changes
with T wave inversion and deep Q waves. In family members carrying HCM gene mutations, the
electrocardiogram may demonstrate only minor abnormalities. The presence of non–sustained
ventricular tachycardia, a risk factor for sudden death, should be tested for by means of Holter
monitoring (Maron et al., 2003). At present, the diagnosis of HCM relies on echocardiography
revealing symmetric or asymmetric hypertrophy. Secondary causes of hypertrophy, including
valvular disease or systemic hypertension, should be excluded. 2D imaging of the left ventricle by
echocardiography can confirm the diagnosis in affected patients. The ejection fraction, a measure of
left ventricular systolic function, is typically preserved but there is usually evidence of diastolic
dysfunction. These can be measured by tissue Doppler ultrasonography, which can show diastolic
dysfunction before the development of hypertrophy (Maron, 2002). Histologically, HCM is
characterized by cardiac myocyte disarray and fibrosis. Myocyte death and myocardial scarring may
be present and coronary arteries may have thickened walls. This pathology can promote ventricular
tachycardia and ventricular fibrillation (Maron, 2002). More recently, echocardiographic techniques
have been developed to refine diagnosis (and risk stratification) e.g. Tissue Doppler Imaging (TDI)
(Nunez J et al 2004) and Doppler 2D Strain velocities

Job Aspests of Anesthesiologists, Radiologists, and...
What three jobs interest me? Personally I'm interested in being a Radiologist of course, but I'm also
intrigued with being an Anesthesiologist or a physician's assistant. During this mini research project
I will be discussing general core requirements, and just general aspects of the job itself. For instance
the salary for each of the profession and expected job prospects. The medical field is quite vast in its
selection of job careers even within the same job you can be many different titles while doing the
same thing. One of the careers I had chosen was to be a radiologist. Radiologists are physicians who
use cutting–edge imaging technology to examine organs and tissues inside the body in gentle,
noninvasive ways. Their expertise in ... Show more content on Helpwriting.net ...
Granted when you look for a career you also have to think about job outlook. For the field in
radiology there are plenty of job openings and even a shortage in specialist for this field. Now there
is training involved to become a radiologist you have to go to medical school, then apply for a
residency which can last between 1–3 years. Also state licensure is mandatory for all practicing
physicians including radiologists. In the year 2013 government mandated the requirement for
passage of a two part examination covering medicine, anatomy, imaging modalities and physics.
Another career I am interested in is the field of Anesthesiology. To become an anesthesiologist there
are several course that are required as prerequisites such as calculus, general chemistry, organic
chemistry, biology, and physics. As well as completing a bachelor's degree. Then after completing
the four year bachelor's degree medical school is required to further on in this career. After medical
school, a physician choosing anesthesiology as his or her specialty completes a year of internship
and then three years of residency. Some anesthesiologists choose to specialize in pain management,
as opposed to traditional surgical anesthesia. Pain management anesthesiologists generally run an
office–based practice, administering a variety of injections, pain blocks, and medications to help
patients manage chronic or

Acute Failure And Chronic Failure
CHF occurs when the heart is no longer able to adequately pump blood causing a decrease in
nutrients and oxygen to the body. The term CHF has widely been replaced by the terms acute failure
and chronic failure because not all types of heart failure are accompanied by pulmonary congestion.
However, in this pt's case, she suffered from severe edema and fluid build–up in the lungs due to the
failure. CHF is generally precipitated by other cardiac related conditions including, HTN, CAD, and
past MIs, all of which are present in this pt's history (Lewis, Heitkemper, Dirksen, Bucher, &
Camera, 2014). The heart is responsible for moving the body's blood, and is primarily composed of
cardiac muscle. Similar to skeletal muscle, the cells are ... Show more content on Helpwriting.net ...
This transfer of ions is what generates the electrical impulse of the heart and causes the heart to act
as a single unit instead of individual cells (Marieb & Hoehn, 2013). Cardiac conduction occurs
because there are gap junctions for ions to pass through and because of the heart's intrinsic
conduction system, which is composed of non–contractile cardiac cells that are specifically designed
to start and distribute electric impulses through the cardiac cells so that depolarization and
contractions are orderly and sequential. The contractile cells sustain stable membrane resting
potential when they are unstimulated, however, the resting potential of the autorhythmic cells, that
create the intrinsic conduction system, is unstable and is constantly depolarizing, which is called
pacemaker potentials and initiate the action potential that causes the heart to contract (Marieb &
Hoehn, 2013). The pace maker potential occurs because of the ion channels which causes
hyperpolarization at the end of the action potentials. This hyperpolarization causes the K+ channels
to close while simultaneously opening the Na+ channels, which allows an imbalance of K+ and Na+
to occur making the cardiac cells to become more positive. When the pacemaker potential is reached
at around

The Diagnosis Of Heart Disease
DATA MINING IN THE DIAGNOSIS OF HEART DISEASE
Data mining as it has been established is simply a way of getting hidden knowledge or information
from data, the technique(s) employed search for concurrency, relationships, and outliers in this data
that they present as knowledge [4]. This knowledge can then be used in different applications.
Prediction is one of the ways that the hidden knowledge gotten from the data can be used. The main
aim is to use a large number of past values to consider probable future [9]. Heart disease is the
common term for a variety of diseases, conditions, and disorders that affect the heart and the blood
vessels [6]. Symptoms of heart disease vary depending on the type of heart disease. Congenital heart
disease suggests to a problem with the heart 's structure and function due to abnormal heart
development before birth. Congestive heart failure is when the heart does not pump adequate blood
to the other organs in the body [8]. Coronary heart disease or in its medical term Ischemic heart
disease is the most frequent type of heart problem [24]. Coronary heart disease is a term that refers
to damage to the heart that happens because its blood supply is decreased; it leads to fatty deposits
build up on the linings of the blood vessels that provide the heart muscles with blood, resulting in
heart failure. Heart disease prediction using data mining is one of the most interesting and
challenging tasks. Shortage of specialists and high wrongly diagnosed

A Multi System Disease Of Unknown Etiology
Sarcoidosis is a multi–system disease of unknown etiology. The diagnosis is confirmed when non–
caseating granulomas are identified in tissue biopsies, predominantly from the lung parenchyma or
the mediastinal lymph nodes and is supported by compatible clinical and radiological features. [1]
Cardiac manifestations may occur in isolation or may precede, follow or occur concurrently with the
involvement of the lungs and other organs. All components of the heart may potentially be involved.
The most common are conduction abnormalities leading to bradyarrhythmias and syncope,
ventricular tachycardias and the development of congestive heart failure. [2, 3]
The location and extent of granulomatous infiltration accounts for variations in cardiac ... Show
[5, 6] Japanese Ministry of Health (JMH) published criteria are the current established method for
non–invasive clinical diagnosis. [2, 5] Imaging modalities suggested by the JMH criteria include
gallium–67 scintigraphy and late gadolinium–enhanced cardiovascular magnetic resonance (LGE–
CMR). [2] However, only 5–10% of patients with sarcoidosis present with clinical evidence of
myocardial involvement based on the above criteria while autopsy studies indicate that cardiac
involvement is present in up to 25–50% of cases implying that there is a significant proportion of
sub–clinical cardiac sarcoidosis not detected with the existing criteria. [1, 7] Nuclear imaging
modalities have shown significant advances and rapid growth in the field of the diagnosis and
monitoring of cardiac involvement in sarcoidosis. Promising results show high sensitivity for
identifying pathophysiological activity at an early stage before structural changes have occurred as
well as value of reproducible activity quantification when emphasizing in therapy monitoring.
Although gallium–67 scintigraphy has traditionally been used in sarcoidosis patients, cardiac
positron emission tomography (PET) along with myocardial perfusion scans have shown superiority
that mostly includes higher sensitivity in detecting active

Characteristics Of A Stable Angina
Stable Angina
What is stable angina?
Stable angina is another term for chest pain that occurs with activity and improves with rest or a
medication called nitroglycerine. This is an extremely common condition that typically affects older
individuals with high blood pressure, diabetes, and elevated cholesterol. People with angina are at
increased risk for cardiovascular conditions such as heart attack, peripheral vascular disease, and
stroke. As opposed to stable angina, unstable angina is an emergency that can lead to heart attack
very quickly.
Since stable angina is so important, it is critical that patients be educated about the causes and
treatment of this condition. By the end of this article you will know the answers to these ... Show
Other symptoms that may occur during angina attacks include:
Difficulty breathing
Low energy
Exercise intolerance
Profuse sweating
Nausea or vomiting
There are no specific signs on physical examination that can diagnose angina.
How is angina diagnosed?
Angina is suspected based on symptoms and the diagnosis is typically confirmed with a stress test.
There are various types of stress tests. Your doctor may have you exercise on a treadmill while
monitoring your symptoms, blood pressure, heart rate, and electrocardiogram (stress EKG). If you
have an abnormal EKG at baseline, they might not be able to interpret the EKG during exercise, so
they may perform other tests that provide similar information – a stress echocardiogram or nuclear
stress test.
During a stress echocardiogram, your doctor will look at an ultrasound of your heart before and after
exercise. Similarly, during a nuclear stress test, you doctor will evaluate your heart before and after
exercise using nuclear imaging. If your heart pumps abnormally with exercise, this can suggest that
it is not receiving enough blood during physical activity.
Sometimes, individuals might not be able to use a treadmill due to severe arthritis in the hips or
knees, or because they are paraplegic or unable to walk. During these circumstances, your doctor
can administer an intravenous medication (eg, adenosine, dobutamine) to mimic physical activity. In
other words, your doctor will

Myocardil Effusion
The aim of this essay is to explore an acute deterioration in the health of an adult I have encountered
during a clinical placement, in an acute care setting. The essay will begin with a definition of acute
care, followed by the introduction of my patient and predisposing factors. This essay will include an
explanation of the significant pathophysiological changes and related clinical manifestations and a
critical analysis of the nursing interventions implemented during the acute episode of care, focusing
on holistic care, rationale and evidence base. It will then describe the actual deterioration in the
patient's condition, and discuss the nurse's role in the recognition and assessment of the actual
deteriorating condition following the ... Show more content on Helpwriting.net ...
According to the framework, CHD is common frequently preventable and largely fatal (CHD NSF
2006), it is responsible for more 84,600 deaths in England in 2009, including 26.4 per 100,000
under the age of 75. Age is important as the target for reduction in mortality from CHD, stroke and
related disorders of 40% of the year 2010, established in Saving Lives: Our Healthier Nation (DoH
1999), referred to the under 75 age group. The key areas identified for intervention in the national
service framework are: reducing smoking, promoting healthy eating, promoting physical activity
and reducing obesity, although several other factors are known to contribute to the development of
CHD. Smoking has long been known to be a factor in the development of CHD. According to
Smeltzer and Bare (2000), smoking decreases blood flow to the extremities and increases heart rate
and pressure via stimulation of the sympathetic nervous system, causing vasoconstriction. In
addition, it raises the chances of clot formation by increasing the aggregation of platelets. Campbell
(2006) suggests that the toxic components of cigarette smoke damage the endothelial lining of the
blood vessels, which may initiate the development of atherosclerosis. Because carbon dioxide from
the cigarette burns readily with haemoglobin, it deprives oxygen of

Cardiologist Essay
My vocation of enthusiasm after my 4 years in four–year education in science in biomedical science,
is to function as a cardiologist. A profession way as a cardiologist is identified with biomedical
sciences from numerous points of view, first they are both concentrating on contemplating the
human body and its illnesses, where a biomedical science degree stipends learning on the primary
standards of how the human body functions and to discover new cures or treat ailments by creating
progressed indicative devices or new helpful procedures. A biomedical science degree prepares the
understudy in science, especially with regards to prescription where cardiology is one of numerous
other diverse segments of the solution.
A cardiologist is a therapeutic ... Show more content on Helpwriting.net ...
The substance of this preparation relies on upon whether you sub represent considerable authority in
grown–up or pediatric cardiology. In both cases, three years of inhabitant preparing in an endorsed
grown–up cardiology or pediatric cardiology residency program is required, comprising of a mix of
clinical, lab and research preparing. Applicants must demand a preparation appraisal coordinated by
the Royal College of Physicians and Surgeons of Canada. Taking after fruition of this residency
preparing, hopefuls get warning of their qualification to take the exam, which is offered once every
year and comprises of a three–hour composed paper, a down to earth realistic part and an oral test in
light of case situations. Cardiology is a highly constrained occupation, which include long working
hours. Once in a while, cardiologists need to work in the weekend. In the event that you need to
wind up a cardiologist; you should likewise consider the future patterns in this field. It is on account
of, turning into a cardiologist is a long haul system and this field profoundly relies on upon
pharmaceutical headways and innovation. Rather than seeking the present pattern, you should search
for the patterns following 10 years. A quarter century, sidestep surgery was exceptionally,
mainstream since it was the best way to treat a blockage. Because of this reason, doctors wished to
seek after a vacation in cardio–thoracic surgery. Presently, loads of different techniques are
accessible, which incorporate inflatables and stents embedded by non–specialist cardiologists, and
so on. In this way, numerous cardiovascular specialists are confronting challenges to locate a great

Artificial Heart Devices Essay
Artificial Heart Devices
In its never ending pursuit of advancement, science has reached a crucial biotechnological plateau,
the creation of artificial organs. Such a concept may seem easy to comprehend until one considers
the vast knowledge required to provide a functional substitute for one of nature's creations. One then
realizes the true immensity of this breakthrough. Since ancient times, humans have viewed the heart
as more than just a physical part of the body. It has been thought the seat of the soul, the source of
emotion, and the center of each individual's existence. For many years, doctors and researchers left
the heart untouched because they thought it was too delicate, too crucial to withstand the rigors of
surgery. ... Show more content on Helpwriting.net ...
Artificial heart devices are indeed a biotechnical wonder. Although they are not yet perfected for
permanent implantation, they are the most reliable substitutes for bad heart parts until other
functional, transplantables can be located. The Jarvik–7 was the first artificial device heart which
was created by Symbion Incorporated. This system was used to replace the heart of Dr.
Barney Clark, the first artificial heart patient. The device lasted for one– hundred and twelve days
before Mr. Clark sank into an agony of complications and died. The Jarvik–7 was implanted four
more times to replace failing hearts, with similar results, before the federal authorities halted the
procedure.
Other devices have made progress since the Jarvik–7. One of the more successful inventions is the
left ventricle assist device (LAVD). This device incorporates a host of hard won technological
advances. Perhaps the most important is its
"bio–compatible" materials, which have allowed the LAVD to function without
problems for well over a year in a patient's body. The LAVD has been implanted in more than seven
hundred people for up to seventeen months, as they have awaited human heart transplants(Stipp 38).
It is difficult to fathom the great scientific ingenuity that was required to develop these devices.
However, we must not be blinded from seeing the whole picture. In assuming its role as a
boost

Why I Am A Successful Nurse
Cardiac Care Nursing Specialty Nursing is a valuable profession in which nurses provide care for
individuals, families, and community groups. In order to be a successful nurse, a person has to be
able to combine people skills like communication, compassion, commitment, and trust with an
adequate amount of science and new technology knowledge. On the other hand, nurses are highly
responsible for educating their patients about different medication, diseases, treatments, and healthy
lifestyle choices to help clients maintain and improve their health and well–being. Nursing consists
of a wide range of specialties and practices among which every nurse can choose depends on her/his
interest and skills. Personally, I am really interested in ... Show more content on Helpwriting.net ...
Most of coronary care units deliver a high level of very specialized cardiac care. Nurses are
responsible to monitor and care for acutely ill patients or they may take charge of cardiac
rehabilitation and help patients who are chronically ill to make lifestyle changes in order to prevent
the worsening of their health condition. A variety of healthcare team member work together to
provide continuous cardiac and hemodynamic monitoring and deliver expert care to all patients
during the recovery stage either from a cardiac surgery, a heart failure, an angina, or any cardiac
dysrhythmias. Coronary care nurses play a huge part in the unit. They are required to use their
nursing skills, knowledge, and best judgment in interpreting patient's rhythm and monitoring
hemodynamics. On the other hand, like all nurses; cardiac care nurse follows the five nursing
process "Assessment, Diagnosis, Planning, Implementation, and Evaluation" and the six rights of
medication administration "right patient, right medication, right dose, right time, right route, and
right documentation". Also, they might assist doctors with different procedures and provide
education and support to patients and family. All of the coronary

Waldo Reflection
Where is Waldo? This question has been occupying my mind for years. Sometimes, I would spot
him right away in those crowded pictures. For the times I couldn't, I wouldn't give up or get bored;
I'd turn the book to see the picture from a different angle. I would spend hours if I had to, ignoring
my sore muscles just to spot a red–and–white shirt. Over the years, this particular question has
changed numerous times and possessed a myriad of disparate forms, but my childhood attitude and
resilience towards a question, any type of question, would stay unchanged. In the end, Waldo was
always there... waiting to be found.
As I learned more about radiology, my troubling question of what I want to become was answered.
Finding a needle in the ... Show more content on Helpwriting.net ...
Finding answers can be very fulfilling, and so can finding new questions. There are yet more
questions out there. The idea of incorporating the abstractness of radiology and its depth of
knowledge on the human body with an actual body needing intervention was something that
genuinely intrigued me. Consequently, after I graduated from medical school, I joined the research
team of the Interventional Radiology Section at the University of Wisconsin, Madison to study
intra–arterial therapies. My hard work as a volunteer was appreciated, and I was offered a paid
research position to investigate novel imaging modalities and thermal ablation treatments.
In the pursuit of my destination, I've learned a lot from my experiences through my competencies
and curiosity. However, good mentoring and teamwork have also been vital in my development as a
doctor and a scientist. Can Waldo still hide for long if I have extra eyes and know where to look at?
That is why I want to pursue my training in the US, where I can most resourcefully shape myself to
become a competent radiologist. To this end, I believe spending my preliminary year in surgery
would further enhance my motor skills and the patient care I provide while it would advance my
knowledge of anatomy and give me the opportunity to personally experience the dynamics of the
human body.
I understand that real life is a lot more

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