Medical Blog

Cardiomyopathy, Dilated

Introduction
Background

Cardiomyopathies are an important and heterogeneous group of diseases. The concept of heart muscle disease has a notable and evolving history. In the mid 1850s, chronic myocarditis was the only recognized cause of heart muscle disease. In 1900, the designation of primary myocardial disease was introduced, and it was not until 1957 that the term “cardiomyopathy” was used for the first time. Over the subsequent years, a number of definitions for cardiomyopathies have been advanced in concert with an increasing understanding of these diseases.
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Atrial Fibrillation

Introduction
Background

Atrial fibrillation (AF), the most commonly encountered arrhythmia in clinical practice, is defined by the absence of coordinated atrial systole. AF results from multiple reentrant electrical wavelets that move randomly around the atria.

P waves are replaced by irregular, chaotic fibrillatory waves, often with a concomitant irregular ventricular tachycardia. The rate at which the atrial electrical impulses are transmitted to the ventricle is determined by a number of factors including relative refractory period within the atrioventricular (AV) node, hydration status, and presence or absence of pharmacologic agents used to control the rate. When ventricular rate increases to tachycardic levels, a situation of atrial fibrillation with rapid ventricular response (AF with RVR) ensues. This in turn can lead to decompensation in the form of either myocardial ischemia or creation of congestive heart failure (CHF).
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Asystole

Introduction
Background

Asystole is cardiac standstill with no cardiac output and no ventricular depolarization; it eventually occurs in all dying patients.

Pulseless electrical activity (PEA) is the term applied to a heterogenous group of dysrhythmias unaccompanied by a detectable pulse. Bradyasystolic rhythms are slow rhythms; they can have a wide or narrow complex, with or without a pulse, and often are interspersed with periods of asystole. When discussing PEA, ventricular fibrillation (VF) and ventricular tachycardia (VT) are excluded.
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Aortic Regurgitation

Introduction
Background

Aortic regurgitation is the diastolic flow of blood from the aorta into the left ventricle. Regurgitation is due to incompetence of the aortic valve or any disturbance of the valvular apparatus (eg, leaflets, annulus of the aorta) resulting in diastolic flow of blood into the left ventricular chamber.
Pathophysiology
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Khojaly Genocide

At night from February 25 to 26 the Armenian armed forces occupied the town of Khojaly. The occupation was carried out with active support of several units of the Russian Army’s 366th regiment.
Occupation of Khojaly was followed with unprecedented brutalities against the civilian population. In a few hours the aggressors killed 613 innocent and unarmed people. Among them were 106 women, 83 children. 56 people were killed with special brutality. 8 families were totally exterminated. 25 children were totally, and 130 children were partly orphaned. 476 people became disabled persons (of them 76 were minors). 1275 people were taken into hostage and even though afterwards most of the hostages were released from captivity, the fates of 150 of them are still unknown. Read more…

Xocalı soyqırımı

Xocalı soyqırımı - 1992-ci il fevralın 25-dən 26-na keçən gecə Ermənistan Silahlı Qüvvələri Rusiyanın 366-cı motoratıcı alayının iştirakı ilə Xocalı şəhərini işğal edərkən, etnik azərbaycanlılara qarşı baş vermiş soyqırım.

Bu faciə Dağlıq Qarabağ münaqişəsi zamanı baş vermiş ən dəhşətli hadisələrdən biridir.

fevralın 25-dən 26-na keçən gecə Ermənistan silahlı qüvvələri SSRİ dövründən Xankəndi (Stepanakert) şəhərində yerləşən 366-cı motoatıcı alayın zirehli texnikası və hərbi heyətinin köməkliyi ilə Xocalı şəhərini işğal etdi. Hücumdan əvvəl, fevralın 25-i axşam şəhər toplardan və ağır artileriyadan şiddətli atəşə tutuldu. Nəticədə, fevralın 26-ı səhər saat 5 radələrində Xocalı tam alova büründü. Mühasirəyə alınan şəhərdə qalmış təqribən 2500 nəfər xocalılı Ağdam rayonunun mərkəzinə çatmaq ümidi ilə şəhəri tərk etdi. Amma bir günün içində yer üzündən silinən şəhəri tərk edən 2500 Xocalı sakinindən 613-ü düşmən gülləsinə tuş gəlib qətliamın qurbanı oldu. Bu soyqırım nəticəsində 63-ü uşaq, 106-sı qadın, 70-i qoca və qarı olmaqla - 613 nəfər Xocalı sakini qətlə yetirildi, 8 ailə tamamilə məhv edildi, 25 uşaq hər iki valideynini, 130 uşaq valideynlərindən birini itirdi. Düşmən gülləsinə tuş gəlib yaralanan 487 nəfərdən 76-sı uşaq idi. 1275 xocalılı əsir, 150 xocalılı itkin düşdü. Dövlətin və əhalinin əmlakına 1 aprel 1992-ci il tarixinə olan qiymətlərlə 5 mlrd. rubl dəyərində ziyan vurulmuşdur: Read more…

Angina Pectoris

Introduction
Background

Angina pectoris (AP) represents the clinical syndrome occurring when myocardial oxygen demand exceeds supply. The term is derived from Latin; the literal meaning is “the choking of the chest;” angere, meaning “to choke” and pectus, meaning “chest.” The first English-written account of recurrent angina pectoris was by English nobleman Edward Hyde, Earl of Clarendon. He described his father as having, with exertion, “a pain in the left arm…so much that the torment made him pale”.1 The first description of angina as a medical disorder came from William Heberden. Heberden, a prodigious physician, made many noteworthy contributions to medicine during his career. He presented his observations on “dolor pectoris” to the Royal College of Physicians in 1768. Much of his classic description retains its validity today.2
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Aneurysm, Thoracic

Introduction
Background

Thoracic aortic aneurysm (TAA) is a life-threatening condition that causes significant short- and long-term mortality due to rupture and dissection. Aneurysm is defined as dilatation of the aorta of greater than 150% of its normal diameter for a given segment. For the thoracic aorta, a diameter greater than 3.5 cm is generally considered dilated, whereas greater than 4.5 cm would be considered aneurysmal.

Aneurysms may affect one or more segments of the thoracic aorta, including the ascending aorta, the arch, and the descending thoracic aorta. As many as 25% of patients with TAA also have an abdominal aortic aneurysm. Thoracic aortic aneurysm most commonly results from degeneration of the media of the aortic wall as well as from local hemodynamic forces.
Pathophysiology
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Aneurysm, Abdominal

Introduction
Background

Abdominal aortic aneurysm (AAA) is a relatively common, potentially life-threatening condition. It has a wide spectrum of presentations and should be considered in the differential diagnosis for a number of symptoms. AAA is usually the result of degeneration in the media of the arterial wall, resulting in a slow and continuous dilatation of the lumen of the vessel. In fewer than 5% of cases, AAA is caused by mycotic aneurysm of hematogenous origin. In these cases, local invasion of the intima and media gives rise to abscess formation and aneurysmal dilation of the vessel. Gram-positive organisms most commonly cause mycotic aneurysm. As with aneurysm of the thoracic aorta, AAA may be described as fusiform, which is circumferential, or saccular, which is more localized. Read more…

Acute Coronary Syndrome

Introduction
Background

The initial diagnosis of acute coronary syndrome (ACS) is based on history, risk factors, and, to a lesser extent, ECG findings. The symptoms are due to myocardial ischemia, the underlying cause of which is an imbalance between supply and demand of myocardial oxygen.

Patients with ACS include those whose clinical presentations cover the following range of diagnoses: unstable angina, non–ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). This ACS spectrum concept is a useful framework for developing therapeutic strategies.

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