Posts Tagged ‘ECG’

SURGICAL ACCESS TO THORACIC VISCERA Thoracocentesis (pleural aspiration) Thoracocentesis or pleural aspiration is an essential step in the assessment of pleural effusions. A chest radiograph will confirm the location and extent of the effusion and clinical examination will identify the best position for aspiration: the posterior midscapular line is a common site. The skin of […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier APPROACH TO THE PATIENT Patients commonly have complaints (symptoms). These symptoms may or may not be accompanied by abnormalities on examination (signs) or on laboratory testing. Conversely, asymptomatic patients may have signs or laboratory abnormalities, and laboratory abnormalities can occur in the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 176 – EOSINOPHILIC SYNDROMES Marc E. Rothenberg Definition Eosinophilic syndromes are a heterogeneous group of disorders that involve eosinophilia, which is defined as the accumulation of eosinophils in peripheral blood or tissues, or both. Circulating eosinophils normally account for only 1 to 3% of […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 112 – ELECTRIC INJURY Basil A. Pruitt Jr.    ELECTRIC CURRENT INJURY Definition The tissue damage caused by electric current ranges from a transient increase in cell membrane permeability to immediate coagulation necrosis of large volumes of tissue. The clinical consequences include disturbances in the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 108 – CARDIOGENIC SHOCK David R. Holmes Jr. Definition Cardiogenic shock describes tissue hypoperfusion as a result of an acute myocardial infarction (MI) or end-stage heart failure from any cause. Cardiogenic shock can be defined by clinical parameters alone ( Chapter 107 ), including the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier SPECIFIC COMMON TREATMENT SCENARIOS Initiation of Mechanical Ventilation The initiation of mechanical ventilation involves several steps in clinical decision making ( Table 106-1 ). Despite the utility of such guidelines, each patient must be evaluated for specific factors that could modify the […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 77 – PERICARDIAL DISEASE Warren J. Manning The pericardium is composed of two distinct layers. The fibrous parietal pericardium provides a protective sac around the heart to prevent sudden cardiac dilation and to minimize bulk cardiac motion. The inner, visceral pericardium is intimately related […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 75 – VALVULAR HEART DISEASE Blase A. Carabello The cardiac valves permit unobstructed forward blood flow through the heart when they are open while preventing backward flow when they are closed. Most valvular heart diseases cause either valvular stenosis with obstruction to forward flow […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 71 – ACUTE CORONARY SYNDROME: UNSTABLE ANGINA AND NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION David D. Waters Definition Acute coronary syndrome (ACS) describes the continuum of myocardial ischemia that ranges from unstable angina at one end of the spectrum to non–ST segment elevation myocardial infarction […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 72 – ST SEGMENT ELEVATION ACUTE MYOCARDIAL INFARCTION AND COMPLICATIONS OF MYOCARDIAL INFARCTION Jeffrey L. Anderson Definition Conceptually, myocardial infarction (MI) is myocardial necrosis caused by ischemia. Practically, MI can be diagnosed and evaluated by clinical, electrocardiographic, biochemical, radiologic, and pathologic methods. Technologic advances […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 70 – ANGINA PECTORIS Pierre Théroux Definition Angina is the most frequent clinical expression of myocardial ischemia. Ischemia, which rapidly develops when a mismatch arises between myocardial oxygen needs and myocardial oxygen supply, can be manifested clinically in many different ways besides angina, from […]

Goldman: Cecil Medicine, 23rd ed. Copyright © 2007 Saunders, An Imprint of Elsevier Chapter 68 – CONGENITAL HEART DISEASE IN ADULTS Ariane J. Marelli The convergence of major progress in medicine, pediatrics, and cardiovascular surgery has resulted in the survival to adulthood of an increasingly large number of patients with complex structural heart lesions. Adult physicians are becoming […]

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