Scottish Doctor, author, speaker, sceptic

There is letter from Dr. In short, Rosetans were nourished by people. The warm weather has dispelled some of the rheumatic pains in my back, but I perceive no change in the stricture in my chest. Memoirs by Roentgen, Stokes and J, coronary heart disease essay. This plaque buildup is known as atherosclerosis. Little, Brown, and Company, No benefit was found in patients with a relatively small probability of AMD progression.

Specializations[ edit ] All cardiologists study the disorders of the heart, but the study of adult and child heart disorders are through different training pathways. Therefore, an adult cardiologist often simply called "cardiologist" is inadequately trained to take care of children, and pediatric cardiologists are not trained to take care of adult heart disease. The surgical aspects are not included in cardiology and are in the domain of cardiothoracic surgery.

For example, coronary artery bypass surgery CABG , cardiopulmonary bypass and valve replacement are surgical procedures performed by surgeons, not cardiologists. However the insertion of stents, pacemakers are performed by cardiologists Adult cardiology[ edit ] Cardiology is a specialty of internal medicine. To be a cardiologist in the United States , a three-year residency in internal medicine is followed by a three-year fellowship in cardiology.

It is possible to specialize further in a sub-specialty. Recognized sub-specialties in the United States by the ACGME are cardiac electrophysiology , echocardiography , interventional cardiology , and nuclear cardiology. Cardiac electrophysiology Cardiac electrophysiology is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to describe studies of such phenomena by invasive intracardiac catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation PES.

These studies are performed to assess complex arrhythmias , elucidate symptoms, evaluate abnormal electrocardiograms , assess risk of developing arrhythmias in the future, and design treatment. These procedures increasingly include therapeutic methods typically radiofrequency ablation , or cryoablation in addition to diagnostic and prognostic procedures. Other therapeutic modalities employed in this field include antiarrhythmic drug therapy and implantation of pacemakers and automatic implantable cardioverter-defibrillators AICD.

Sometimes a series of EPS drug trials must be conducted to enable the cardiologist to select the one regimen for long-term treatment that best prevents or slows the development of VT or VF following PES. Such studies may also be conducted in the presence of a newly implanted or newly replaced cardiac pacemaker or AICD. Clinical cardiac electrophysiology Clinical cardiac electrophysiology is a branch of the medical specialty of cardiology and is concerned with the study and treatment of rhythm disorders of the heart.

Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances arrhythmias.

They are trained to perform interventional and surgical procedures to treat cardiac arrhythmia. The training required to become an electrophysiologist is long and requires 7 to 8 years after medical school in the U.

Three years of internal medicine residency, three years of Clinical Cardiology fellowship, and one to two in most instances years of clinical cardiac electrophysiology.

Cardiogeriatrics Cardiogeriatrics or geriatric cardiology is the branch of cardiology and geriatric medicine that deals with the cardiovascular disorders in elderly people. Cardiac disorders such as coronary heart disease including myocardial infarction, heart failure, cardiomyopathy, arrhythmias as atrial fibrillation and others are common and are a major cause of mortality in elderly people.

Vascular disorders such as atherosclerosis and peripheral arterial disease cause significant morbidity and mortality in aged people. Echocardiography Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.

Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic tests in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart internal chamber size quantification , pumping capacity, and the location and extent of any tissue damage.

An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic function how well the heart relaxes. Echocardiography can help detect cardiomyopathies, such as hypertrophic cardiomyopathy, dilated cardiomyopathy, and many others. The use of stress echocardiography may also help determine whether any chest pain or associated symptoms are related to heart disease.

The biggest advantage to echocardiography is that it is not invasive does not involve breaking the skin or entering body cavities and has no known risks or side effects. Interventional cardiology Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology after the development of angioplasty by interventional radiologist Charles Dotter.

A large number of procedures can be performed on the heart by catheterization. This most commonly involves the insertion of a sheath into the femoral artery but, in practice, any large peripheral artery or vein and cannulating the heart under X-ray visualization most commonly fluoroscopy. The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery.

Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute myocardial infarction. It involves the extraction of clots from occluded coronary arteries and deployment of stents and balloons through a small hole made in a major artery, which has given it the name "pin-hole surgery" as opposed to "key-hole surgery".

Pediatric cardiology[ edit ] Helen B. Taussig is known as the founder of pediatric cardiology. She became famous through her work with Tetralogy of Fallot , a congenital heart defect in which oxygenated and deoxygenated blood enters the circulatory system resulting from a ventricular septal defect VSD right beneath the aorta.

This condition causes newborns to have a bluish-tint, cyanosis , and have a deficiency of oxygen to their tissues, hypoxemia. She worked with Alfred Blalock and Vivien Thomas at the Johns Hopkins Hospital where they experimented with dogs to look at how they would attempt to surgically cure these "blue babies. Congenital cyanotic heart diseases is where something is wrong with the heart of a newborn and it is not oxygenating the blood efficiently.

Tetralogy of Fallot Tetralogy of Fallot[ edit ] Tetralogy of Fallot is the most common congenital heart disease arising in 13 cases per 1, births. The cause of this defect is a ventricular septal defect VSD and an overriding aorta. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system.

The modified Blalock-Taussig shunt is usually used to fix the circulation. This procedure is done by placing a graft between the subclavian artery and the ipsilateral pulmonary artery to restore the correct blood flow.

Pulmonary Atresia[ edit ] Pulmonary Atresia happens in 78 per , births and is characterized by the aorta branching out of the right ventricle. This causes the deoxygenated blood to bypass the lungs and enter the circulatory system. Surgeries can fix this by redirecting the aorta and fixing the right ventricle and pulmonary artery connection. There are two types of pulmonary atresia, classified by whether or not the baby also has a ventricular septal defect. This type of pulmonary atresia is associated with complete and intact septum between the ventricles.

This type of pulmonary atresia happens when a ventricular septal defect allows blood to flow into and out of the right ventricle. The surgeries that can be done to fix this defect can vary due to the different physiology and blood flow in the defected heart.

One way it can be cured is by a VSD closure and placing conduits to restart the blood flow between the left ventricle and the aorta and between the right ventricle and the pulmonary artery. Another way is systemic-to-pulmonary artery shunt in cases associated with pulmonary stenosis. Transposition of Great Arteries[ edit ] Dextro-transposition of the Great Arteries There are two different types of transposition of the great arteries , Dextro-transposition of the great arteries and Levo-transposition of the great arteries , depending on where the chambers and vessels connect.

Dextro-transposition happens in about 1 in 4, newborns and is when the right ventricle pumps blood into the aorta and deoxygenated blood enters the blood stream. The temporary procedure is to create an atrial septal defect ASD. A permanent fix is more complicated and involves redirecting the pulmonary return to the right atrium and the systemic return to the left atrium, which is known as the Senning procedure.

The Rastelli procedure can also be done by rerouting the left ventricular outflow, dividing the pulmonary trunk, and placing a conduit in between the right ventricle and pulmonary trunk. Levo-transposition happens in about 1 in 13, newborns and is characterized by the left ventricle pumping blood into the lungs and the right ventricle pumping the blood into the aorta.

This may not produce problems at the beginning, but will eventually due to the different pressures each ventricle uses to pump blood. Switching the left ventricle to be the systemic ventricle and the right ventricle to pump blood into the pulmonary artery can repair levo-transposition.

Persistent Truncus Arteriosis[ edit ] Persistent truncus arteriosus is when the truncus arteriosus fails to split into the aorta and pulmonary trunk. This occurs in about 1 in 11, live births and allows both oxygenated and deoxygenated blood into the body. The repair consists of a VSD closure and the Rastelli procedure. The surgical repair varies depending on the severity of the disease.

To become a pediatric cardiologist in the United States , one must complete a three-year residency in pediatrics, followed by a three-year fellowship in pediatric cardiology.

Low-Dose Aspirin Late in Life? Healthy People May Not Need It. Millions take aspirin to prevent heart attacks, strokes and cancer. Hence coronary heart disease is also called ischemic heart disease. Angina, heart attack and heart failure and are all clinical forms of coronary heart disease.1 Overall, coronary heart disease is the leading cause of death in the Western world.2 In the UK, heart attacks are responsible for around , deaths every year and cost the NHS approximately .

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#1 20.09.2018 13:35 Ctheczar718:
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