tailieunhanh - Ebook Fundamentals of cardiology: Part 2

(BQ) Part 2 book "Fundamentals of cardiology" presents the following contents: Venous pathology, cardiac pathology, congenital heart disease, arrhythmias, cardiac tumors, cardiac pharmacology. Invite you to consult. | LOCATION Most common site is a Superficial Saphenous vein. However it can be present in any venous system. SYMPTOMS Skin thickening lipodermatosclerosis Ulceration Ache Heavy legs and ankle swelling often worse at night and after exercise Telangiectasia COMPLICATIONS Most varicose veins are benign but severe varicosities can lead to major complications due to the poor circulation through the affected limb. Inability to walk Stasis dermatitis and venous ulcers especially near the ankle Severe bleeding from minor trauma Superficial thrombophlebitis more serious problem if extended into deep veins Acute fat necrosis INVESTIGATION Confirm by duplex ultrasound Venography 1 2 1 I p a g e MANAGEMENT Compression hosiery is not best but best initial management. It can help temporarily by keeping the veins empty. It includes support stocking Ace bandages or Unna boot. Varicose veins is treated with interventional therapy like - Endothermic ablation and endovenous laser treatment of greater saphenous vein. If endothermal ablation is unsuitable offer ultrasound guided foam sclerotherapy medicine is injected which makes varicose vein to shrink . If foam sclerotherapy is unsuitable offer surgery - Ligation and Stripping removal of vein is not a major problem because superficial vein drains only about 10 of blood from legs . Consider treating incompetent varicose tributaries at the same time. THUNDERNOTE Portal Hypertension Referred as high pressure in hepatic portal venous system. Causes - Pre9hepatic portal vein thrombosis congenital atresia Intra9hepatic liver cirrhosis fibrosis Post9hepatic due to cardiac problems like right heart failure constrictive pericarditis Symptoms - Ascites Anorexia fatigue nausea vomiting Hepatic encephalopathy Splenomegaly Gastric varicosities Dilated sub mucosal veins in stomach . Esophageal varicosities Dilated sub mucosal veins in lower 1 3rd esophagus . Both have high tendency to bleed diagnose by endoscopy. Anorectal varicosities Not to be .