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What is cardiovascular disease?
Cardiovascular disease (CVD) is a general term used to describe disorders that can affect the heart (cardio) and/or the body's system of blood vessels (vascular).

What are the main types of heart disease?
  1. Abnormal heart rhythms, or arrhythmias.

  2. Congenital heart disease resulting from malformation of the heart structure during development (includes some valvular diseases)

  3. Inflammatory heart disease

  4. Valvular disease defects in the structure or function of a heart valve; may be either congenital or acquired

  5. Vascular disease

  6. Cardiomyopathy weakening of the heart muscle / Heart failure

  7. Vasculitis inflammation of blood vessels

  8. Blood clots that develop in the veins (thrombosis) and that detach and go to other organs (embolism)

  9. Stroke

  10. Hypertensive heart disease diseases of the heart secondary to high blood pressure or hypertension

  11. Pulmonary heart disease a failure at the right side of the heart with respiratory system involvement

  12. Rheumatic heart disease heart muscles and valves damage due to rheumatic fever caused by Streptococcus pyogenes a group A streptococcal infection.

What's your diagnosis?
What is a management plan for good care?

Q: Do you have better answer?
Q: Does anyone else have a better answer?
Q: Would you like to print Dr. Qureshi's research and development in Cardiology?
Q: Would you like to add anything?
Q: What questions do we need to follow up on?
Have an interesting case?

* Accelerated Idioventricular Rhythm
* Ashman Phenomenon
* Asystole*
* Atrial Fibrillation
* Atrial Fibrillation, Diagnosis and Management
* Atrial Flutter
* Atrial Tachycardia
* Atrioventricular Block
* Atrioventricular Dissociation
* Atrioventricular Nodal Reentry Tachycardia (AVNRT)
* Brugada Syndrome
* Carotid Sinus Hypersensitivity
* Digitalis Toxicity
* Electrical Alternans
* Endomyocardial Fibrosis
* First-Degree Atrioventricular Block
* Heart Block, First Degree*
* Heart Block, Second Degree*
* Heart Block, Third Degree*
* Holiday Heart Syndrome
* Junctional Rhythm
* Long QT Syndrome
* Lown-Ganong-Levine Syndrome
* Multifocal Atrial Tachycardia
* Paroxysmal Supraventricular Tachycardia
* Pediatrics, Tachycardia*
* Premature Ventricular Contraction*
* Pulseless Electrical Activity
* Second-Degree Atrioventricular Block
* Sinus Bradycardia*
* Sinus Node Dysfunction
* Sudden Cardiac Death
* Syncope
* Third-Degree Atrioventricular Block
* Torsade de Pointes
* Ventricular Fibrillation
* Ventricular Premature Complexes
* Ventricular Tachycardia
* Wolff-Parkinson-White Syndrome

Atherosclerosis and Risk Factors

* Atherosclerosis
* Coronary Artery Atherosclerosis
* Hypertension*
* Hypertension, Malignant*
* Hypertensive Emergencies*
* Hypertensive Heart Disease
* Macroaneurysm*
* Metabolic Syndrome
* Nephrosclerosis*
* Primary and Secondary Prevention of Coronary Artery Disease
* Renal Artery Stenosis*
* Renovascular Hypertension*
* Risk Factors for Coronary Artery Disease

Cancer and the Heart

* Atrial Myxoma
* Benign Cardiac Tumors
* Cardiac Neoplasms, Primary*
* Cardiac Sarcoma*
* Carney Complex

Congenital Heart Disease in the Adult

* Aortic Coarctation
* Atrial Septal Defect
* Congenitally Corrected Transposition
* Cor Triatriatum
* Ebstein Anomaly
* Eisenmenger Syndrome
* Endocardial Cushion Defects
* Holt-Oram Syndrome
* Lutembacher Syndrome
* Patent Ductus Arteriosus
* Patent Foramen Ovale
* Sinus of Valsalva Aneurysm
* Tetralogy of Fallot
* Ventricular Septal Defect

Coronary Artery Disease

* Acute Coronary Syndromes
* Angina Pectoris
* Complications of Myocardial Infarction
* Coronary Artery Vasospasm
* Isolated Coronary Artery Anomalies
* Myocardial Infarction
* Myocardial Rupture
* Pharmacologic Stress Testing*
* Right Ventricular Infarction
* Saphenous Vein Graft Aneurysms
* Treadmill Stress Testing*
* Unstable Angina
* Ventricular Septal Rupture Following Myocardial Infarction*

Electrophysiology Procedures

* Catheter Ablation*
* Diagnostic Programmed Electrical Stimulation
* Implantable Cardioverter-Defibrillators
* Pacemaker Malfunction
* Pacemaker Syndrome
* Pacemaker-Mediated Tachycardia
* Programmed Electrical Stimulation
* Synchronized Electrical Cardioversion*

Invasive Diagnostic, Interventional, and Surgical Procedures

* Aortoiliac Occlusive Disease*
* Arteriovenous Fistulas*
* Cardiac Catheterization (Left Heart)*
* Central Venous Access, Subclavian Vein, Subclavian Approach*
* Central Venous Access, Subclavian Vein, Supraclavicular Approach*
* Comparison of Revascularization Procedures in Coronary Artery Disease
* Emergency Bedside Thoracotomy*
* Heart Transplantation*
* Heart-Lung Transplantation*
* Intravascular Stents, Thoracic Aorta*
* Percutaneous Transluminal Coronary Angioplasty
* Pericardiocentesis*
* Pulmonary Artery Catheterization*
* Superior Vena Cava Syndrome*
* Transmyocardial Laser Revascularization*
* Tube Thoracostomy*
* Tube Thoracostomy, Management*
* Venous Air Embolism*

Myocardial Disease and Cardiomyopathies

* Acute Coronary Syndrome*
* Cardiac Cirrhosis and Congestive Hepatopathy
* Cardiogenic Shock
* Cardiomyopathy, Alcoholic
* Cardiomyopathy, Cocaine
* Cardiomyopathy, Dilated
* Cardiomyopathy, Hypertrophic
* Cardiomyopathy, Peripartum
* Cardiomyopathy, Restrictive
* Congestive Heart Failure, Surgical Options*
* Cor Pulmonale
* Heart Failure
* Myocardial Abscess*
* Myocarditis
* Myopathies*
* Pulmonary Edema, Cardiogenic
* Shock, Cardiogenic*

Pericardial Disease

* Cardiac Tamponade
* Pericardial Effusion
* Pericarditis, Acute
* Pericarditis, Constrictive
* Pericarditis, Constrictive-Effusive


* Bedside Ultrasonography, Cardiac Evaluation*
* Defibrillation & Cardioversion*
* Ocular Hypertension*
* Portal Hypertension*
* Prosthetic Heart Valves*
* Shock, Hypovolemic*

Peripheral Vascular Disease

* Aneurysm, Abdominal*
* Aneurysm, Thoracic*
* Aortic Dissection*
* Aortitis
* Bedside Ultrasonography, Abdominal Aortic Aneurysm*
* Bedside Ultrasonography, Deep Vein Thrombosis*
* Dissection, Aortic*
* Dissection, Carotid Artery*
* Dissection, Vertebral Artery*
* Peripheral Vascular Disease*
* Subclavian Artery Thrombosis*
* Subclavian Vein Thrombosis*
* Thoracic Aortic Aneurysm*

Valvular Heart Disease

* Aortic Regurgitation
* Aortic Stenosis
* Aortic Stenosis*
* Infective Endocarditis*
* Libman-Sacks Endocarditis
* Loeffler Endocarditis
* Mitral Regurgitation
* Mitral Stenosis
* Mitral Valve Prolapse
* Pulmonary Hypertension, Primary*
* Pulmonic Regurgitation
* Pulmonic Stenosis
* Pulmonic Valvular Stenosis*
* Rheumatic Fever*
* Tricuspid Atresia
* Tricuspid Regurgitation
* Tricuspid Stenosis
Cardiac Medications

Common Heart Medications and What They Do

Antiplatelet Agents
Angiotensin-Converting Enzyme (ACE) Inhibitors
Angiotensin II Receptor Blockers (or Inhibitors)
Antiarrhythmic Medications
Beta Blockers
Calcium Channel Blockers
Digitalis Preparations
For Patients
Cardiology Research
Who and where are the manufacturers of catheters and contrast?
Can cardiac arrhythmias be induced?
Vascular disease
They are known as vascular diseases.
  1. Coronary artery disease (also known as coronary heart disease and ischemic heart disease)

  2. Peripheral arterial disease disease of blood vessels that supply blood to the arms and legs

  3. Cerebrovascular disease disease of blood vessels that supply blood to the brain (includes stroke)

  4. Renal artery stenosis

  5. Aortic aneurysm

  1. Cardiovascular Glossary of Terms

  2. Cardiovascular System Anatomy

  3. Symptoms of Heart Disease

    What are the symptoms of heart disease?
    Here are further guidelines.

  4. Clinical Topics

  5. Heart and Cardiovascular Diseases

      Angina (Coronary artery disease)
      Arrhythmias / dysrhythmias -(irregular heartbeats)
      Cardiomyopathies (problems with heart muscle)
      Congestive Heart Failure
      Congenital Heart Disease (defects present at birth)
      Heart Murmurs
      Myocardial Infarction (heart attack)
      Valvular Heart Disease - including mitral valve conditions

      DISEASE OF BLOOD VESSELS (Arteries and Veins)

      Arterial Disorders

      Aneurysms (abnormal stretching of blood vessels ) Hypertension (high blood pressure) Stroke (Brain Attack)
      Venous Disorders
      Deep Venous Thrombosis (DVT)- deep blood clots in the legs
      Varicose Veins
    Here are further guidelines.

  6. Coronary Artery Disease

Symptoms of Heart Disease
What are the symptoms of heart disease?
  1. Chest pain or discomfort during activity that goes away with rest

  2. Chest pain.

  3. Constant dizziness or lightheadedness

  4. Extreme fatigue or less able to complete daily activities

  5. Fainting (syncope)

  6. Fast heart rate (above 100 beats per minute)

  7. Fatigue.

  8. Feeling of fullness in the stomach with a loss of appetite or nausea

  9. Gets restless or confused

  10. Irregular heartbeat.

  11. Nausea or poor appetite

  12. New, irregular heartbeat

  13. Not sleeping well

  14. Pees less than usual

  15. Respiratory infection or cough that gets worse

  16. Shortness of breath.

  17. Swollen feet or ankles.

  18. Trouble breathing during regular activities or at rest

  19. When to Call a Doctor About Heart Disease Symptoms

    Emergency Symptoms Not to Miss

  20. Faints and loses consciousness

  21. Fast heart rate (more than 150 beats per minute), especially if he is short of breath, too

  22. New chest pain or discomfort that is severe and unexpected. It can happen with or without shortness of breath, sweating, nausea, or weakness.

  23. Shortness of breath that doesn't go away when he rests

  24. Sudden weakness or can't move his arms or legs

  25. Sudden, severe headache

I am Asif Qureshi.
I am the founder of Qureshi University.
I will educate you from a distance.
This type of education can be imparted from a distance.

Who should diagnose and treat a cardiac medical emergency?

On June 27, 2011, in Casualty Ward SMHS Hospital, Srinagar, Kashmir, a heart patient named Mugli died.
She needed an immediate temporary pacemaker for survival.
The medical consultant on call was not available.

If you have properly educated emergency medical doctors with proper resources, he or she can place a temporary or permanent pacemaker.
Many ER medical doctors are required.
While one places the pacemaker, another can diagnose and treat a medical emergency.
Do you have temporary and permanent pacemakers in the hospital?
Are the temporary and permanent pacemakers of the latest, recent advanced technology?
How many temporary and permanent pacemakers are there in the hospital?
What type of temporary and permanent pacemakers are there in the hospital?

Delay in correct diagnosis and treatment means the patient will be harmed.

Who has the duty to enhance programs like this?

We stop it here. Once you get answers to these questions, we proceed again.
Resources for Health Professionals
    Medical Students
Resources for Patients and the Public
What is a Cardiologist?
When should you see a cardiologist?
What does a cardiologist do?
Do all cardiologists perform cardiac catheterizations?
Where do cardiologists work?
What are cardiology medical emergencies?
How should you do a quick assessment, diagnosis, and treatment of a person reported as a cardiology medical emergency?
Here are further guidelines.
Who should participate in a Preventive Cardiology Program?
Here are further guidelines.
For Cardiologists, Courts, Policy makers, Law Enforcement
What is the importance of having a primary care physician?
Are you at risk for heart disease?
What does an Interventional Cardiologist do?
What do vascular and cardiac surgeons do?
What is Cardiology?
Patient Intake Form
Interventional Cardiology

1. Cardiac Chamber Anatomy
    What is the heart's structure?
    How does the heart pump blood?
2. Coronary Artery Anatomy for the Interventionalist
    Where does your heart get its own oxygen?
3. Congenital Heart Defects
    How are congential heart defects diagnosed?
    How are congenital heart defects treated?
4. The Coronary Circulation
5. Physiological Evaluation of Renal Artery Stenosis: A Hemodynamic Approach
6. Valvular Pathophysiology
7. Arterial Disease

    Q) What is Coronary Artery Disease?
    Q) What is Peripheral Vascular Disease?
    Q) Are You At Risk For Heart Disease?
    Q) How Can You Reduce Your Risk For Heart Disease?
    Q) What is cholesterol?
    Q) What affects blood cholesterol levels?
    Q) How Does High Cholesterol Increase Your Risk For Heart Disease?
    Q) What Affects Blood Cholesterol Levels?
    Q) Do All Types Of Fats Raise Blood Cholesterol Levels?
    Q) Is Your Blood Cholesterol Level Too High?
    Q) What Is High Blood Pressure?
    Q) How Does High Blood Pressure Increase Your Risk For Heart Disease?
    Q) Is Your Blood Pressure Too High?
    Q) How Does Smoking Increase Your Risk For Heart Disease?
    Q) Will I gain weight if I quit smoking?
    Q) How Does Being More Active Lower Your Risk For Heart Disease?
    Q) Are You Active Enough?
    Q) Which Types Of Activities Are Best?
    Q) How Does Excess Body Weight Increase Your Risk For Heart Disease?
    Q) Do You Weigh More Than You Should?
    Q) Is excess fat in the upper or lower body more harmful?
    Q) How can I Iose weight and keep it off?
    Q) Why Do You Need To Exercise?
    Q) Are there any dangers with dieting?
    Q) Does Stress Increase The Risk For Heart Disease?
    Q) What Are The Symptoms Of Stress?
    Q) Is stress harmful for you?
    Q) Does a diet high in sugar increase the risk for coronary heart disease?
    Q) Should I take antioxidant supplements to reduce my risk for coronary heart disease?
    Q) Once cholesterol-rich deposits form in my arteries, do they ever go away?
    Q) What Is Angina?
    Q) What Causes Angina?
    Q) Does chest pain always mean a heart problem?
    Q) When is angina an emergency?
    Q) How Is Angina Diagnosed?
    Q) What Type Of Treatment Is Available?
    Q) What does "unstable" angina mean?
    Q) How do nitroglycerin pills stop angina?
    Q) What Is an Electrocardiogram?
    Q) Who Needs an Electrocardiogram?
    Q) What Happens During an Electrocardiogram?
    Q) What Does an Electrocardiogram Show?
A Chest x-ray is very valuable in answering the following questions:
    Q) Is the heart enlarged or normal?
    Q) Are there signs of heart failure and fluid overload?
    Q) Does the patient have pneumonia or a collapsed lung?
    Q) Is there evidence of emphysema?
    Q) Are there findings of an aneurysm involving the aorta (the major blood vessel that arises from the heart and supplies oxygenated blood to the body)?
    Q) Is there fluid in the sac that surrounds the lung?
    Q) Is there free air under the diaphragm (the partition that separates the chest from the abdomen) to suggest a hole in the bowel wall?
    Q) Is there a tumor in the lung that could represent cancer?
    Q) Are there changes of bronchitis or emphysema?
Stress Test
    Q) What Is an Exercise Stress Test?
    Q) Why do I need a stress test?
    Q) What happens during the test?
    Q) What is monitored during the test?
    Q) What equipment is used?
    Q) Is there a risk?
    Q) What Types of Stress Tests Are There?
    Q) How Should I Prepare for the Exercise Stress Test?
    Q) What If I Have Diabetes?
    Q) What Should I Wear the Day of the Test?
    Q) What Happens During the Exercise Stress Test?
    Q) How does a Regular Stress Test work?
    Q) How is a Treadmill Stress Test performed?
    Q) How safe is it?
    Q) What is the reliability of the test?
    Q) When is a Regular Stress Test ordered?
    Q) How is a Regular Treadmill Stress Test Performed?
    Q) How quickly will I get the results and what will it mean?
    Q) What is echocardiography?
    Q) What are the different types of echocardiography?
    Q) What problems can echocardiography diagnose?
    Q) How is an echocardiogram performed?
Computed tomography (CT)
    Q) Is exploring the coronary arteries using computed tomography (CT) almost as good as exploring them directly with a catheter?
    Q) Have you tried this method?
    Q) Isn't this the better method?
    Q) What are the merits and demerits of this method?
    Q) What Are Holter and Event Monitors?
    Q) Who Needs a Holter or Event Monitor?
    Q) What Does a Holter or Event Monitor Show?
    Q) What Are the Risks From Using a Holter or Event Monitor?
    Q) What is Angiography?
    Q) When is coronary angiography required?
    Q) Are there any risks involved?
    Q) What happens during an Angiogram?
    Q) How do you prepare for an Angiogram?
    Q) What will you feel during the Angiogram?
    Q) What is angioplasty?
    Q) What is a stent?
    Q) What are the different kinds of Angiogram?
    Q) What Is a Coronary Angiogram?
      Q) Why do I need this test?
      Q) What happens in the test?
      Q) What might I feel?
      Q) What happens after the test?
    Q) How important or necessary is this test for diagnosis?
    Q) Do any tests need to be done prior to the angiogram?
    Q) What type of angiography will be performed?
    Q) What will happen during the procedure?
    Q) What are the risks?
    Q) What should be expected after the procedure?
    Q) Will any medication be given?
    Q) What are the side effects?
    Q) Will any anesthesia be given?
    Q) What should I do to prepare for my procedure?
    Q) What is my expected recovery time and will I have any activity restrictions?
    Q) Will the procedure be painful?
    Q) What is conscious sedation?
    Q) What are the risks of my procedure?
    Q) What happens after I check in at the hospital?
    Q) What is an angiogram?
    Q) What is an angioplasty?
    Q) Why do I need an angiogram, angioplasty and/or stent?
    Q) What signs should I watch for, following the procedure, which may indicate a problem?
    Q) What is peripheral vascular disease (PVD)?
    Q) What are the symptoms of PVD?
    Q) What are the risk factors of PVD?
    Q) What should I do to prepare for my procedure?
    Q) What is my expected recovery time and will I have any activity restrictions?
    Q) Will the procedure be painful?
    Q) What is conscious sedation?
    Q) What are the risks of my procedure?
    Q) What happens after I check in at the hospital?
    Q) What is an angiogram?
    Q) What is an angioplasty?
    Q) Why do I need an angiogram, angioplasty and/or stent?
    Q) What signs should I watch for, following the procedure, which may indicate a problem?
    Q) What is peripheral vascular disease (PVD)?
    Q) What are the symptoms of PVD?
    Q) What are the risk factors of PVD?
    Q) What is Ultrasound?
    Q) What is an Echocardiogram?
    Q) What is Doppler?
    Q) What information does it provide?
    Q) How safe is it?
    Q) How long does it take?
    Q) How quickly do I get the results and what do they mean?
    Q) What is a Doppler Examination?
    Q) What information does Echocardiography and Doppler provide?
8. Ventricular Pathophysiology
9. Equipment for Percutaneous Coronary Intervention
10. Design and Construction of Stents
11. Adjunctive Devices: Atherectomy, Thrombectomy, Embolic Protections, IUVS, Doppler, and Pressure Wires
12. X-Ray Cinefluorographic Systems
13. Operational Radiation Management for Patients and Staff
14. General Principles of Coronary Artery Brachytherapy
15. X-Ray Computed Tomography and Magnetic Resonance Imaging of the Coronary Arteries
16. Intracardiac Echocardiography in the Catheterization Laboratory
17. Cardiac Catheterization Laboratory Physiologic Recorders
18. Digital Image Formats and Archiving Practices
19. Antithrombin Therapies
20. Antiplatelet Therapies in Contemporary Percutaneous Coronary Intervention
21. Thrombolytic Therapy
22. Radiographic Contrast Media
23. Renal Complications of Contrast Media
24. Patient Sedation in the Cardiovascular Catheterization Laboratory
25. Diagnostic Procedures: Special Considerations
26. Diagnostic Procedures: Peripheral Angiography
27. Adjunctive Diagnostic Techniques
28. Coronary Guidewire Manipulation
29. Coronary Balloon Angioplasty
30. Coronary Stenting, Bare Metal Stents, and Drug-Eluting Stents
31. Rotational Atherectomy: Concepts and Practice
32. Brachytherapy
33. Basic Wire-Handling Strategies for Chronic Total Occlusion
34. Percutaneous Intervention in Chronic Total Coronary Occlusions
35. Directional Coronary Atherectomy
36. Distal Embolic Protection Devices
37. Intervention in Venous and Arterial Grafts
38. Special Considerations: Acute Myocardial Infarction
39. Complex Lesion Intervention: Bifurcation, Left Main Coronary Artery, and Ostial Lesions
40. Special Considerations: Small Vessel and Diffuse Disease
41. Special Patient Subsets: Diabetic and Elderly
42. Inoue-Balloon Mitral Valvuloplasty
43. Aortic Valvuloplasty and Future Solutions to Aortic Valve Disease
44. Balloon Pulmonary Valvuloplasty
45. Percutaneous Closure of Atrial Septal Defect and Patent Foramen Ovale
46. Septal Ablation for Obstructive Hypertrophic Cardiomyopathy
47. Coronary Vein Device Insertion
48. Device Retrieval Systems
49. Percutaneous Treatment of Coronary Artery Fistulas
50. Renal Artery Angioplasty and Stenting
51. Iliac Angioplasty and Stenting
52. Endovascular Abdominal Aortic Aneurysm Repair
53. Carotid and Vertebral Artery Intervention
54. Risk Stratification in Interventional Cardiology
55. Acute Threatened Coronary Closure
56. Subacute Closure
57. Coronary Artery Perforation
58. Embolization and No-Reflow During Percutaneous Coronary Intervention
59. Emergency Surgery
60. Complications of Peripheral Procedures
61. Lipid-Lowering Therapy and the Interventional Cardiologist
62. Hypertension
    Q) Should beta blockers be used as first-line treatment for lowering blood pressure?
    Q) What is high blood pressure?
    Q) How are normal blood pressure, prehypertension, and high blood pressure defined?
    Q) What causes high blood pressure?
    Q) What causes secondary high blood pressure?
    Q) What are the symptoms of high blood pressure?
    Q) What happens if I have high blood pressure?
    Q) What increases my chances of getting high blood pressure?
    Q) What is isolated systolic high blood pressure?
    Q) Who is affected by high blood pressure?
    Q) Can a test detect high blood pressure early?
    Q) Can I prevent high blood pressure?
    Q) What kind of treatment will I need for high blood pressure?
    Q) Will I have to take medicine?
    Q) How is secondary hypertension treated?
    Q) Should I take medicine for high blood pressure?
    Q) How do other health problems affect the choice of high blood pressure medicines?
    Q) How does high blood pressure cause heart disease?
    Q) What lifestyle changes will I have to make?
    Q) Will I need a special diet?
    Q) Are there alternative treatments for high blood pressure?
    Q) What is bradycardia?
    Q) What are the types of bradycardia?
    Q) How does the heart's electrical system work?
    Q) What is heart block?
    Q) What causes bradycardia?
    Q) What are the symptoms of bradycardia?
    Q) Who gets bradycardia?
    Q) How can portable (ambulatory) EKG monitors help diagnose bradyarrhythmia?
    Q) How is bradycardia treated?
    Q) What recent advances have been made in pacemaker technology?
    Q) What are the different types of bradycardia, and how are they treated?
    Q) What are the risks of complications with different types of bradycardias?
    Q) How is it treated?
63. Diabetes and Cardiovascular Disease
64. Nontraditional Risk Factors for Atherosclerosis
65. Preclinical Laboratory Functions
66. The Core Laboratory: Quantitative Coronary Angiography and Intravascular Ultrasound
67. How to Read Clinical Trials
68. Cost-Effectiveness
69. Quality Assurance and Quality Improvement in Interventional Cardiology
70. Innovation and Interventional Cardiology: Looking Back, Thinking Ahead
    Q) For what conditions are beta-blockers prescribed?
    Q) What are the side effects?
    Q) Can elderly people take beta-blockers?
    Q) Who should avoid using ACE inhibitors?
71. Principles of Innovation: Transforming Clinical Needs into Viable Inventions
72. Pacemaker
    Q) What is electromagnetic interference?
    Q) What is radio frequency interference?
    Q) How does interference propagate?
    Q) What are some common sources of conducted interference?
    Q) What are some common sources of radiated interference?
    Q) What is heart block?
    Q) What is sick sinus syndrome?
    Q) What is AV block?
    Q) What doctors treat arrhythmias?
    Q) Why do I need a pacemaker?
    Q) What kind of pacemaker will be implanted?
    Q) What is a pacing lead?
    Q) What is a pacemaker?
    Q) Are there different kinds of pacemakers for different activity levels?
    Q) Can pacemaker patients live an active lifestyle? What if they do something that is too strenuous for the pacemaker to handle?
    Q) Can people hear and feel pacemakers tick inside of them?
    Q) Are there any diet restrictions?
    Q) What is a pacemaker identification card?
    Q) How long does a pacemaker last?
    Q) How many can a person expect to have in a lifetime?
    Q) Are there different kinds of pacemakers for different activity levels?
    Q) Can I go back to my normal activities after my implant?
    Q) What does my pacemaker feel like when it's working?
    Q) When should I call my doctor?
    Q) How often should my pacemaker be checked?
    Q) Will my pacemaker ever need to be replaced?
    Q) What should I do to prepare for the procedure?
    Q) How are pacemakers implanted?
    Q) What happens during the procedure?
    Q) What happens after the procedure?
    Q) Will I be able to move around after the procedure?
    Q) How often will I need to see my doctor?
      Pacemaker problems can rarely occur long after the implantation procedure. These "late" complications include generator failure (extremely rare), and lead failure (rare). Treating doctors, Manufacturers are required to report device failures to the FDA. which will order companies to issue either "advisories" or recalls if a particular model seems prone to failure.
    While handling such cases, the following questions need to be answered.
    Q) Who is the manufacturer of the pacemaker?
    Q) Who among the regulators were involved?
    Q) How is pacemaker sabotage carried out?
    Q) What devices can interfere with pacemakers?
    Q) Who has these devices?

73. Legal & Ethical Issues
    A. Utilization
    B. Reimbursement
    C. Regulation of Herbals & Supplements
    D. Legal & Ethical Issues
    E. How to Integrate Complementary/Alternative Medicine Into Your Cardiology Practice
    F. Cholesterol
    G. Stress
    H. Congestive Heart Failure
    I. Systemic Hypertension
    J. Obesity
    K. Coronary Artery Disease
    L. Sudden Death & Arrhythmias
    M. Sexual activity and cardiology
    N. Estrogen Replacement Therapy
    O. Percutaneous Coronary Interventions
    P. Bioenergetic Techniques
    Q. Acupuncture
    R. The Indo-Mediterranean Diet – A Primer
    S. Integrating Herbs Into Practice
    T. Herbal/Drug Interactions
    U. Quality Control
    V. Reliable Sources of Information For You and Your Patients
    W. Joy, Sadness, & Vascular Biology
    X. Neuroendocrine & Immune Effects
    Y. Spirituality

74. Angioplasty and Valvuloplasty
    Q) What Is Coronary Angioplasty?
    Q) Why Is Angioplasty Done?
    Q) What is variant angina?
    Q) What Are The Advantages Of Angioplasty Over Bypass Surgery?
    Q) Who Does Angioplasty Benefit?
    Q) How effective is this operation/procedure?
    Q) What happens during angioplasty?
    Q) What types of interventional procedures are used in angioplasty?
    Q) What happens after the procedure?
    Q) Can this procedure cure coronary artery disease?
    Q) What kind of stent are you intending to use?
    Q) Why is angioplasty necessary?
      Swab anesthesia at the site of catheterization.
      Q) What is the advantage of swabbing anesthesia at the site of catheterization?
      It prevents painful catheterization during the procedure.
      Q) What questions should the patients be asked after the procedure?
      Q) Did you feel any pain?
      Q) Did you feel any discomfort?
      Interventional Cardiologists.
      Q) What have you done in this regard?
      Q) What are you doing in this regard?
      Q) What are you going to do in this regard?


    Q) What is cardiac arrhythmia?
    Q) What types of cardiac arrhythmias are there?
    Q) What causes cardiac arrhythmias?
    Q) What're the symptoms of cardiac arrhythmia?
    Q) How is cardiac arrhythmia diagnosed?
    Q) What're the treatments for cardiac arrhythmia?
      1 Ventricular Fibrillation
      2 Sinus Rhythm with PJC's
      3 2nd Degree Heart Block Mobitz Type I
      4 Atrial Fibrillation
      5 Sinus Rhythm with Multifocal PVC's
      7 Sinus Rhythm with Unifocal PVCs
      6 1st Degree Heart Block
      8 Sinus Rhythm with PAC's
      9 Accelerated Junctional Rhythm
      10 Asystole
      11 Junctional Escape Rhythm
      12 Normal Sinus Rhythm
      13 Ventricular Tachycardia
      14 Sinus Bradycardia
      15 Ventricular Bigeminy
      16 Sinus Tachycardia
      17 3rd Degree Heart Block (complete)
      18 Idioventricular Rhythm
      19 Atrial Flutter
      20 2nd Degree Heart Block Mobitz Type II
    a. Airway management
    b. Arrythmias, Defibrillation, and Pacing
    c. IV Access, Resuscitation, Circulatin, and Monitoring
    d. Infant CPR and Ventilation
    e. Review Questions
    f. Appedices: Pharmacology, Algorithm Protocols
    g. Chamber Abnormalities and Intraventricular Conduction Defects
    h. SA and AV Nodal Block
    i. Ischemia and Infarction
    j. Reentrant Supraventricular Tachycardias
    k. Ectopic Supraventricular Tachycardias
    l. Extrasystoles and Pre-excitation Syndromes
    m. Differential Diagnosis of Wide QRS Tachycardias
    n. Medication and Electrolyte Effects, Miscellaneous Conditions
    o. Electronic Pacemakers

    A. Diagnostic cardiac catheterization and angiography
    B. Coronary angioplasty (PTCA)
    C. Cutting balloon angioplasty
    D. Coronary stenting
    E. Intravascular radiation therapy (brachytherapy)
    F. Directional and rotational atherectomy
    G. Intravascular ultrasound (IVUS)
    H. Mitral and Aortic Valvuloplasty (PTAV/PTMV)
    I. Closure of Patent Foramen Ovale (PFO)
    J. Closure of Atrial Septal Defects (ASD)
    K. Ventricular Septal Defect (VSD)
    L. Amplatzer Device
    M. Hypertrophic Cardiomyopathy (HOCM) treatment and Septal Ablation
Under what circumstances is cardiac catheterization indicated?
What is Interventional Cardiology?
What are Interventional Procedures?

Placing an implantable heart device is an invasive procedure, but in cases where it really is indicated, it is life-saving.

Those claiming to perform PTCA and CABG procedures must answer following questions.
What is it?
How is it done?
What are the indications of this procedure?
How many such procedures have you done?
Who among medical doctors witnessed this procedure?
How did you do this procedure?
How does the patient benefit from this procedure?

I do recommend placing implantable heart devices in cases where it really is indicated; It is life-saving.
I do not recommend PTCA and CABG procedures unless the likely advantage to patient is discussed and verified.

Angioplasty procedures and stenting

Do you know anyone who underwent angioplasty procedures and/or coronary stenting?
Do you know of coronary angioplasty procedures and stents inserted in patients who did not need them?

What should a cardiologist be able to answer about cardiac angioplasty procedures?
How does one prove scientifically the usefulness of coronary angioplasty procedures before and after the procedure?

What should a cardiologist be able to answer about cardiac coronary stenting?

How did the regulator and you verify the effectiveness of coronary stenting?
How does one prove scientifically the usefulness of coronary stenting before and after placing the stent?
Cardiovascular Glossary of Terms

Cardiovascular Glossary of Terms

Aortic: Relating to the aorta, which is the major vessel that carries oxygenated blood from the heart to the body. Sometimes this term is used to denote the aortic valve, which is the valve that prevents back-flow of blood from the aorta into the left ventricle. (For example, "aortic stenosis.")

Artery: A vessel that carries blood away from the heart. Arteries generally carry oxygenated blood. In mammals, the exception is the pulmonary artery, which carries deoxygenated blood to the lungs.

Atrium: The chamber of the heart that collects blood returning from the rest of the body. In all vertebrates but fish, there are two atria, left and right. The right atrium collects deoxygenated blood from the body and passes it to the right ventricle. The left atrium collects oxygenated blood from the lungs and passes it to the left ventricle.

Coronary: Relating to the heart, or to one of the two arteries that originate in the aorta and supply blood directly to heart tissue.

Mitral Valve: Valve that separates the left atrium and the left ventricle and prevents back-flow from the ventricle to the atrium. Derived from "miter," which it resembles. (A miter is a tall, pointed hat with peaks in front and back which is worn by a bishop.)

Pulmonary: Relating to the lungs. Sometimes this term is used to denote the pulmonary valve, which is the valve that prevents back-flow of blood from the pulmonary artery into the right ventricle. (For example, "pulmonary regurgitation.").

Tricuspid Valve: Valve that separates the right atrium and the right ventricle and prevents back-flow from the ventricle to the atrium. It is composed of three leaf-like parts.

Vein: A vessel that carries blood toward the heart.

Ventricle: The chamber of the heart that is responsible for pumping blood out to the rest of the body. In mammals and birds, there are two ventricles, left and right. The right ventricle pumps deoxygenated blood to the lungs via the pulmonary artery; the left ventricle pumps oxygenated blood to the body via the aorta.

Brief Description of Selected Clinical Terms:

Anemia: A deficiency in the oxygen-carrying material of the blood.

Aneurysm: A pathological blood-filled dilatation of a blood vessel.

Angina pectoris: Chest pain caused by insufficient blood flow to the heart muscle.

Arrhythmia: Irregular heartbeat.

Atherosclerosis: An accumulation of fat-containing deposits on arterial walls.

Bradycardia: Excessively slow heartbeat.

Cyanosis: A condition in which a person's skin is discolored to a bluish hue because of inadequate oxygenation of the blood.

Diastole: Normal period of relaxation and dilatation of the heart cavities.

Dilatation: the condition of being abnormally dilated or enlarged.

Dyspnea: Difficulty in breathing.

Cardiomyopathy: This is the general term for diseases of the heart muscle. The most common of these diseases is the dilated cardiomyopathy in which the disease weakens the heart muscle and causes left ventricular dilation leading to increased diastolic pressure and volume.

Hypertension: A condition in which a person's blood pressure is abnormally high. For normal adults, the pressure should be less than 130 mmHg systolic and less than 85 mmHg diastolic. Pressures above 140/90 indicate a mild form of hypertension; above 180/110 is considered severe.

Insufficiency: Describes a condition in which a valve is not able to prevent back-flow of blood. The resulting back-flow is termed a regurgitation.

Ischemia: Localized loss of blood supply due to a mechanical obstruction.

Prolapse: Floppy valve, associated with regurgitation.

Regurgitation: Back-flow of blood through an insufficient valve. (For example, mitral valve regurgitation.).

Stenosis: Constriction of a passage. Used typically when there is a narrowing of a valve opening (for example, mitral valve stenosis) or of a blood vessel.

Syncope: A brief loss of consciousness caused by temporary lack of oxygenated blood.

Systole: Period of contraction of the heart during which blood is ejected from the ventricles.

Tachycardia: Excessively rapid heartbeat.

Angina: Chest pain due to an inadequate supply of oxygen to the heart muscle. The term angina is now used almost exclusively to denote angina pectoris, the medical term for chest pain or discomfort that is most often due to coronary heart disease. Stable angina refers to episodes of chest discomfort that are usually predictable, and which occur on exertion or under mental or emotional stress. Unstable angina refers to episodes of chest discomfort that are unpredictable and usually occur while at rest.

Angioplasty: A procedure with a balloon-tipped catheter to enlarge a narrowing in a coronary artery. (Also known as PCTA.)


1. Counteracting high blood pressure.

2. An agent that reduces high blood pressure.


An agent used to prevent or interfere with the formation of a thrombus (a blood clot in a blood vessel or within the heart

Blood clot: A semi-solidified mass of blood, either in or out of the body.

Blood pressure: The pressure of the blood on the walls of the arteries, produced primarily by contraction of the heart muscle. Its measurement is recorded as two numbers: the first (systolic pressure) is measured after the heart contracts and is highest; the second (diastolic pressure) is measured before the heart contracts and is lowest.

Body mass index (BMI): An index for relating a person's body weight to his or her height. The body mass index (BMI) is a person's weight in kilograms (kg) divided by the person's height in meters (m) squared.

Cardiomyopathy: A general diagnostic term for disease of the heart muscle (myocardium).

Cardiovascular: Pertaining to the heart and blood vessels.

Carotid endarterectomy: A surgical procedure designed to clean out material blocking the carotid artery, a major artery in the neck that supplies blood to the brain. The aim of the procedure is to restore normal blood flow to the brain, thereby preventing a stroke.

Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain.

Cholesterol (also known as total cholesterol): A fatlike substance that is a building block of the outer layer of cells (cell membranes). It is essential to the formation of bile acids, cell membranes, vitamin D and certain hormones. Cholesterol is not dissolved in the blood, but is transported in the bloodstream as water-soluble molecules known as lipoproteins. The lipoproteins are characterized by their density: high density lipoprotein (HDL) and low density lipoprotein (LDL).

Congestive heart failure: Inability of the heart to pump blood with normal efficiency. When this happens, the heart is unable to supply enough blood to the body's other organs such as the brain, liver and kidneys. Symptoms can include shortness of breath, pooling of fluid in the legs and feet, swelling and enlargement of the heart.

Coronary artery bypass: A surgical procedure whereby a new route is created around plaque within a coronary artery, using part of a vein as a graft. The procedure permits increased blood flow to deliver oxygen and nutrients to the heart muscle.

Coronary heart disease (CHD): A condition that begins when hard cholesterol substances (plaques) are deposited within a coronary artery. The plaques in the coronary arteries can rupture and cause the formation of a tiny clot, which can obstruct the flow of blood to the heart muscle, producing symptoms and signs of CHD that may include chest pain (angina), heart attack or sudden death due to a fatal disturbance of the heart rhythm. Also known as coronary artery disease (CAD).

Diastolic pressure: The minimum blood pressure, measured before the heart contracts. Usually the second number recorded in a blood pressure reading.

Electrocardiogram (EKG or ECG): A recording of the electrical activity of the heart. It is a simple, non-invasive procedure whereby electrodes are placed on the skin of the chest and connected to a machine that, when turned on, measures electrical activity all over around the heart. An example of its clinical use is in the initial diagnosis of a heart attack, which is usually made by a combination of clinical symptoms and characteristic EKG changes; the EKG can detect areas of muscle ischemia (muscle deprived of oxygen) and/or dead tissue in the heart.

Gastrointestinal (GI) bleed: An occurrence of bleeding in the gastrointestinal tract, which refers to the stomach and intestines.

Heart attack: Death of the heart muscle due to the loss of blood supply, usually caused by a complete blockage of a coronary artery, one of the arteries that supplies blood to the heart muscle. Death of the heart muscle, in turn, causes chest pain and electrical instability of the heart muscle tissue. Also known as myocardial infarction (MI).

Hemorrhagic stroke: Rupture of a blood vessel in or near the brain. This type of stroke accounts for 20% of all strokes that occur. There are two types of hemorrhagic stroke: subarachnoid hemorrhage, which occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and skull; and intracerebral hemorrhage, which occurs when a blood vessel bleeds into the cerebrum, the main portion of the brain.

High blood pressure: A repeatedly elevated blood pressure exceeding 140 over 90 mmHg - a systolic pressure above 140 with a diastolic pressure above 90. Also known as hypertension.

High density lipoprotein (HDL): A fat-like substance that transports cholesterol from the tissues of the body to the liver so it can be excreted in the bile. HDL is the so-called "good cholesterol"; the higher the HDL cholesterol level, the lower the risk of coronary heart disease (CHD).

Low density lipoprotein (LDL): A fat-like substance that transports cholesterol from the liver to the tissues of the body. LDL is the so-called "bad" cholesterol; elevated LDL levels are associated with increased risk of coronary heart disease (CHD).

Myocardial infarction (MI): The medical term for heart attack. It refers to changes that occur in the heart muscle (myocardium) due to the sudden deprivation of circulating blood. The main change is necrosis (death) of myocardial tissue.

Obesity: The state of being well above one's normal weight. Traditionally defined as being more than 20% above one's ideal weight (based on a person's height, age, sex and build), obesity has been more precisely defined by the National Institutes of Health as a body mass index (BMI) of 30 or above. Obesity is a significant contributor to and increases the risk of a number of diseases including diabetes, high blood pressure, stroke, heart attack and congestive heart failure.

Platelet Inhibitor: An agent/therapy which prevents or interferes with the formation of blood clots in blood vessels.

Polyunsaturated fat: A fat containing polyunsaturated (a term used to denote more than one unsaturated bond - that is, more than one place where hydrogen can be added to the

molecule) fatty acids, molecules derived from animal and vegetable fats and oils. Unlike saturated fats, polyunsaturated fats are considered beneficial in that they lower cholesterol

Risk factor: Something that increases a person's chances of developing a disease.

Stress: Forces from the outside world impinging on the individual. Stress releases powerful neurochemicals and hormones that prepare the individual for action. If no action is taken, the stress response can lead to health problems such as depression, high blood pressure or heart attack.

Stress test: Any of various tests that assess cardiovascular health and function after application of a stress to the heart, usually exercise but sometimes others such as atrial pacing (regulation of the heartbeat by means of an electrode inserted in the atrium of the heart) or specific drugs. In an exercise cardiac stress test (ECST), the patient exercises on a treadmill according to a standardized protocol, with progressive increases in the speed and elevation of the treadmill (typically changing at three-minute intervals). During the ECST, the patient's electrocardiogram (EKG), heart rate, heart rhythm, and blood pressure are continuously monitored. If a coronary arterial blockage results in decreased blood flow to a part of the heart during exercise, certain changes may be observed in the EKG, as well as in the response of the heart rate and blood pressure.

Stroke: The sudden death of some brain cells due to a lack of oxygen when the blood flow to the brain is impaired by blockage (ischemic stroke) or rupture of an artery to the brain (hemorrhagic stroke). A medical emergency, stroke is also called a cerebrovascular accident (CVA). Stroke symptoms depend on the area of the brain affected. The most common symptom is weakness or paralysis of one side of the body, with partial or complete loss of voluntary movement or sensation in a leg or arm; other symptoms can include speech problems, confusion, weak facial muscles, numbness or tingling. A stroke involving the base of the brain can affect balance, vision, swallowing and breathing, and may even cause unconsciousness.

Systolic pressure: The maximum blood pressure, measured after the heart contracts. Usually the first number recorded in a blood pressure reading.

Transient ischemic attack (TIA): A neurological event with the signs and symptoms of a stroke, but which go away within a short period of time. Also known as a mini-stroke, a TIA is due to a temporary lack of adequate blood and oxygen (ischemia) to the brain. This is often caused by the narrowing (or, less often, ulceration) of the carotid arteries (the major arteries in the neck that supply blood to the brain). TIAs typically last from 2 to 30 minutes and can produce problems with vision, dizziness, weakness or trouble speaking. If not treated, a TIA carries a high risk of having a major stroke in the near future; people who have a TIA have a 25% risk of stroke or other serious complication within 90 days.

Trans fat: An unhealthy substance, also known as trans fatty acid, made through the chemical process of hydrogenation of oils. Hydrogenation solidifies liquid oils and increases the shelf life and the flavor stability of oils and foods that contain them. Trans fats drive up levels of LDL ("bad") cholesterol, which increases the risk of heart attack and stroke.

Triglyceride: The major form of fat. A triglyceride consists of three molecules of fatty acid combined with a molecule of the alcohol glycerol. Triglycerides serve as the backbone of many types of lipids (fats). Triglycerides come from foods and are also produced by the body. Triglyceride levels do not provide clinically significant information about the risk of coronary heart disease (CHD) beyond that provided by levels of HDL and LDL cholesterol.

Clinical Topics
Acute Coronary Syndromes
Anticoagulation Management
Arrhythmias and Clinical EP
Cardiac Surgery
Chronic Angina
Congenital Heart Disease and Pediatric Cardiology
Diabetes and Cardiometabolic Disease
Geriatric Cardiology
Heart Failure and Cardiomyopathies
Invasive Cardiovascular Angiography and Intervention
Mitral Regurgitation
Noninvasive Imaging
Pericardial Disease
Pulmonary Hypertension and Venous Thromboembolism
Sports and Exercise Cardiology
Stable Ischemic Heart Disease
Valvular Heart Disease
Vascular Medicine
Last Updated: May 30, 2018