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معليش على التأخير ي شباب 🚶‍♀❤️

Myocarditis:~
The myocardium is the middle layer of the cardiac wall
It consists of cardiac muscle(myocytes)
⚪️myocarditis : is inflammation of the myocardium it can be caused by many causes or it could be idiopathic.
🔵Infective myocarditis:
Caused by infection by:
~virus: which is the most common type of myocarditis, many viruses can cause myocarditis but the most common are enteroviruses especially Coxsackie A&B viruses
~Protozoan: like
~toxoplasma gondii: that infect
human from cats, usually in immunocompromised people.
~tryponosoma cruzi :in chagas myocarditis : the parasite invades the myocytes and cause lymphocytic and neutrophilic infiltrate.
~Trichinosis: most common helminthic (ديدان) disease with cardiac involvement
~Bacteria:
~spirochete Borrelia burgdorferi:as rare complication of lyme disease
🔵Non infective myocarditis: could be caused by:
~Autoimmune disease : like systematic lupus erythromatous.
~Hypersensitivity by drugs: which is a very rare complication, cause eosinophilic infiltration and has a poor prognosis (the patient may die😢)
🔵 Idiopathic myocarditis(the cause is unknown) : either
~1-deffuse myocarditis : which is more common and have infiltration of many types of cells (lymphocyte, macrophage, neutrophile..etc)
~2-giant cell myocarditis: granuloma, multi nucleated giant cell
Has bad prognosis, necrosis may occur
▪️Thrombosis is common in idiopathic myocarditis.
🔊Myocarditis could be acute or chronic
🔊It could heal on its own or progress into cardiac failure and cardiomyopathy.
Diagnosis:~
🔵Serological and molecular methods: to identify the Infective agent if it is infective myocarditis.
🔵ECG: in the case of heart failure and arrhythmia.
🔵Markers of myocyte damage(cardiac enzymes) :like treponin
🔵Biobsy: gold standard (but its difficult to take biobsy from the HEART)
⬛️Clinical manifestation:
Myocarditis could be:
$Asymptomatic
$cause HF
$cause sudden death 😔
~consider in young patients (especially children) who doesn't have prevous cardiac complication.
~upper respirotary symptoms like dyspnea
~in sudden onset cardiac failure and arrhythmia
~cardiac complications after systemic illness.
⬛️Treatment :
Supportive by :ionotropes(which increase the contractility thus strengthen the heart beat)
Diuretics :to decrease the workload of the heart (diuretics cause urination by that we decrease the amount of blood then the heart won't work hard to pump the blood)
هنا شرحت كتير بس حتساعدكم في الفارما😉
treat the complications.
🌸مع تحياتي:فلق🌸

myocarditis👆👆

❤️❤️💙مساكات بروبلمز 💙💙❤️

💙💙❤️Vascular pathology💙💙❤️


🧨Older adult presented with headache visual disturbance flue like symptoms and giant cell on the biopsy of blood vessel
Temporal( giant cell) artritis

🧨Granulomatous vasculitis in older adult present with weak absent pulse in the upper extremity (pulsless disease)
Takayasu arteritis +++++

🧨Young adult present with hypertension melena neurological disturbance and high serum HBsAg
Polyarteritis nodosa

🧨Child <4 year old present with fever conjunctivitis rash of sole and palms enlarged cervical lymph node
Kawazaki disease +++++

🧨Asthma peripheral eosinophilia and high serum p_ANCA
Churg strauss syndrome

🧨Sharp tearing chest pain radiate to the back
Aortic dissection
Patients present with tertiary syphilis and dilation of aortic root
Thoracic Aneurysm +++++

🧨 Patient present with pulsatile Abdominal mass that grow with time
Abdominal Aortic Aneurysm +++++

🧨 Patient with sever hypotension flank pain and pulsatile Abdominal mass
Rupture of Abdominal aortic Aneurysm

👇 مساكات بروبلم cardio pathology ❤️🔥🔥🔥

#Acut coronary syndrome=
1. MI
2. Un stable angina
3. Prezmental angina
#Stable angina =
1. Pain increase with exercise
2. ECG = ST elevation
3. Pain radiated to left arm or jaw+ diapherosis
4. Pain lasting <20 Minutes

#Most common artery Involve in MI =LAD

#Most senstive marker for MI=
=Troponin

#Management of MI =MONA
1. Morphin
2. Oxygen
3. Nitroglycerin
4. Asprin

#Complication of MI =
1. 0–24 hours=Ventricular arrhythmia
2. 1–3 days =fibrinous
pericarditis
3. 3–14 days=tamponade;
papillary muscle rupture
4. 2 weeks to several
months =Dressler syndrome

#Most common cause of death in MI=
Fatal Arrhythmia

#Gold standard test in MI=
ECG

#Most common cause of CHF=
IHD

#Most common cause OF Left side heart failure = IHD

#Most common cause of right side heart failure = LHF

#Most common cause of CHF in neonatal = congental heart disease

#Clinical features of Left side heart failure =
1. Dyspnea
2 Paroxysmal Nocturnal dyspnea
3. Orthopnoea

#Clinical features of Right side heart failure =
1.JVC
2. Hepatosplenomegaly
3. Pitting edema

#Cyanotic congental disease= =5Ts
1.TOF
2.TAG
3.Truncus arterilosus
4. Tricuspid atresia

#Acyanotic congental disease =
1.VSD
2.ASD
3.PDA

#Most common congenital heart disease =
VSD

#Most common Asyanotic congenital heart disease =
TOF

#Most common Cyanotic CHD in neonatal period=
TAG

#CHD associated with fetal alcohol syndrome =
VSD

#CHD associated with down syndrome =
ASD

#CHD associated with rebulla=
PDA

# high pressure in upper extremities with Low pressure in lower extremities =
Coarctation of aorta

🌸Most common valvular abnormalities=Mitral valve prolapse

🌸 Holosystolic murmur + hypertrophy of both LA and LV +dyspnea, Fatiuge, palpitations = mitral valves regurgitation

🌸Diastolic murmur +Only LA hypertrophy➡️pulmonary edema +dysphagia, +atrial fibrillation + stroke = mitral stenosis

🌸Commonest cardiac condition in pregnancy=
Mitral stenosis

🌸Most common cause of aortic stenosis =
Senile calcification

🌸Triad of aortic stenosis=
Syncope
Angina
Dyspnea

🌸 Elderly +angina +Syncope +dyspnea + systolic ejection murmur = aortic stenosis

🌸Diastolic murmur +collapsing Pulse + wide Pulse pressure +sound over over femoral arteries = aortic reguergitation

🌸 Holosystolic murmur +أعراض heart failure (ascites hepatmegaly, jaubdice, splenomegally) = tricuspid regurgitation

🌸Most common cause of tricuspid stenosis=
RF

🌸Most common cause of pulmonary stenosis=
Congenital

🌸Holosystolic murmur :
Mitral regurgitation, tricuspid regurgitation

🌸Systolic murmur=
*Mitral valve prolapse
Systolic murmur with midsystolic click
*aortic stenosis
Systolic ejection murmur
*Pulmonary stenosis

🌸Diastolic murmur=
Mitral stenosis
Tricuspid stenosis
Aortic reguergitation
Pulmonary regurgitation

Valvular disorder 💙🔥

🌸Causes of reumhatic fever=
Group A beta hemolytic sterptococcus
🌸Diagnosis of ARF require=
A) 2 major criteria
B) 1 major and 2 minor criteria
C) All 5 minor criteria
Either A or B or C + evidence of streptococcus pyogenes

🌸What is Major criteria.=
Pancaritis
Erythema marginatum
Subcutaneous nodules
Sydenham’s chorea
Migrarory polyarthritis

🌸Minor criteria:=
Fever.
Raised ESR or CRP.
Arthralgia
Prolonged PR interval
Previous rheumatic fever..

🌸Evidence of RF confirmed by=
Anti streptolysin O teter(ASO teter
Anti DNas B titer

🌸RF is hypersenstivity type!= 2

🌸Most common cause of death in ARF!!=
Myocarditis

🌸Common valve involve in ARF =
Mitral valve

🌸What is Histological finding in Reumhatic fever=
Aschoff bodies

🌸Treatment of reumhatic fever=
Penicillin