By Leszek Rutkowski, Jörg Siekmann, Ryszard Tadeusiewicz, Lotfi A. Zadeh
This textbook covers all of the major subspecialties in cardiology, together with a wide share of case stories that illustrate the foundations of medical perform. Self trying out questions accompany every one case. Authored via top cardiologists, this is often an up-to-the-minute, good illustrated, center cardiological textual content for these getting ready for the expert examinations.
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Additional resources for Cardiology Core Curriculum: A Problem Based Approach
Coronary blood flow limitation and distribution at rest remains normal until a coronary artery stenosis exceeds 90–95% of the vessel diameter. Thus, echocardiographic regional left ventricular wall motion abnormalities may be absent at rest and only develop when there are multiple, similarly severe stenoses in more than one coronary artery, or when myocardial oxygen requirements are increased, as occurs with musculoskeletal exercise.
8 Chronic aortic regurgitation. S1, first heart sound; S2, second heart sound; S3, third heart sound; SEM, systolic ejection flow murmur; EDM, early diastolic decrescendo murmur; LSE, left sternal edge; MDM, Austin–Flint middiastolic murmur diastolic, decrescendo murmur6 beginning with A2 (best heard using the diaphragm of the stethoscope at the left sternal edge, or base, with the patient leaning forward during expiration). Severe aortic regurgitation can affect the anterior leaflet of the mitral valve in diastole and create a mid-diastolic, rumbling murmur (heard best at the apex with the patient in the left lateral decubitus position), called the Austin–Flint murmur (which is almost always preceded by an S3).
The loud S1 is the reciprocal sound of the OS and is due to abrupt completion of atrioventricular valve closure. Both sounds arise when the mitral valve apparatus is mobile and pliable, and are lost when it becomes relatively immobile. On chest examination, crepitations or rales are present with pulmonary congestion. Abdominal examination reveals a normal liver span or pulsatile liver with pulmonary hypertension and secondary tricuspid regurgitation. Peripheral edema may be noted if the patient is pregnant or in the presence of tricuspid regurgitation.
Cardiology Core Curriculum: A Problem Based Approach by Leszek Rutkowski, Jörg Siekmann, Ryszard Tadeusiewicz, Lotfi A. Zadeh