ginghina mic tratat de cardiologie 2017 pdf download

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The right ventricle and pulmonary circulation: basic concepts.

Eduard Apetrei. CC Iliescu Department of Cardiology A short history.

Clinical, hemodynamic, mono and twodimensional echocardiographic features.

These values must be judged in the diagnosis algorithm and the associated clinical probability assessment should be revised by applying valid scores such as Wells or Ginghima.

Frequently, right cardiac chambers are dilated in PE, the interventricular septum is flattened or even a leftward displacement is seen creating a D shape left ventricular aspect.

Ed Academiei Romane; Echocardiography in the Management of Pulmonary Embolism.

Additional laboratory tests can be requested in young patients with RVMI or PE in order to establish their coagulation status.

Right bundle branch block or transient incomplete right bundle branch block.

Chest CT scan using contrast substance is showing a filling gap at the level of left branch of pulmonary artery consistent with pulmonary thrombembolism.

It is very important to know the risk factors and the associated comorbidities for these two clinical entities in order to be able to interpret them contextually.

In almost one third of the patients with both conditions, the electrocardiogram is within normal limits.

Both the sensitivity and the specificity of the chest Xray are low.

As a rule, when a characteristic electrocardiogram is present, it is suggestive of PE, but a normal aspect does not exclude the diagnostic.

Wells Ginghian 2.

Echocardiography Because of the challenges that the differential diagnosis poses, based on clinical assessment, performing an echocardiogram is very important.

The complexity of the right ventricular structure makes the evaluation of the ejection fraction difficult.

In patients with clinically suspected PE, the initial clinical evaluation is concomitant with the risk stratification and clinical probability assessment.

Doppler recording indicating tricuspid regurgitation, with an estimated RV-RA gradient of 37mmHg pulmonary embolism.

The specific signs identified in patients with PE are not as specific and they are useful to confirm PE only by associating them with the clinical context Table 1.

Xray changes where pulmonary infarction is associated distal site periferic shadow more often in the shape of a triangle small pleural effusion on the same side crdiologie diaphragm on the same side.

Table 1 Clinical symptoms and signs described in pulmonary embolism 2.

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Ginghina Mic Tratat De Cardiologie 2017 Pdf Download