The most beautiful things in life cannot be seen or even touched, They must be felt with the heart.

-Helen Keller

Heartaches
Gerald P. Valenzuela

Cardiovascular
pertaining to heart and blood vessels Heart Blood vessels Blood

Heart
Pericardium Pericardial fluid Walls

Epicardium Myocardium Endocardium

Heart Chambers
2 Atria Interarterial septum 2 ventricles Interventricular septum

Heart Valves
Tricuspid valve TV Pulmonary semilunar valve Mitral valve or bicuspid valve Aortic or semilunar valve

The Blood Supply of the Heart

The Circulatory System

Be still my beating heart

My Heartbeat

The conduction system Electrical impulses Sinoatrial Node SA Atrioventricular Node AV node Bundle of His Purkinje fibers

Heart Sounds
S1 lubb sound caused by the tricuspid and mitral valve closing between the atria and ventricles S2 dupp sound shorter and higher pitch, caused by closing of semilunar valves as blood is pumped out of the heart

Pulse and Blood Pressure

Pulse Blood Pressure Systolic pressure Diastolic Pressure Hg - mercury

The Blood
Plasma nutrients, hormones and waste products, clotting proteins Serum plasma minus clotting proteins Fibrinogen and prothrombin are clotting proteins

The Blood
Erythrocytes mature RBCs Reticulocyte young Hemoglobin iron containing pigment which binds oxygen Lifespan 120 days

The Blood
Leukocytes immunity & protection Neutrophils Basophils Eosinophils Lymphocytes Monocytes

The Blood
Thrombocytes platelets Not cells, but fragments of megakaryocytes For clotting blood

Blood Types
Blood Type A B AB (universal recipient) O (universal donor) Can Donate to Can Receive From A or AB only B or AB only AB only A or O only B or O only A, B, AB, O

A, B, AB, O

O only

The Rh factor

Rhesus monkeys Rh (+) presence of antigen Rh (-) Mother is Rh- and Father is Rh+ Baby inherits Rh+ Mother develops Ab against Rh antigen 2nd pregnancy will result to erythroblastosis fetalis Tx: Rh immune globulin or Rhogam

Medical Specialties related to Cardiovascular System

Cardiologist Hematologist

Pathology of the Cardiovascular System

Coronary Artery Disease, CAD, is atherosclerosis of the coronary arteries that may cause angina pectoris, myocardial infarction and sudden death. End-stage coronary artery disease is the final phase of CAD characterized by unrelenting angina pain and a severely limited lifestyle in which medication is the only remaining treatment option.

CAD

Atherosclerosis is hardening and narrowing of the arteries due to a buildup of cholesterol plaques or fatty substance.

CAD

An atheroma which is characteristic of atherosclerosis, is a plaque within the arterial wall. This type of plaque (PLACK) is similar to the buildup of rust inside a pipe and it may protrude outward into the opening of the vessel or move inward into the wall of the vessel.

CAD
Ischemia is a deficiency in blood supply due to either the constriction or the obstruction of a blood vessel. Ischemic heart disease, IHD, is a group of cardiac disabilities resulting from an insufficient supply of oxygenated blood to the heart that is usually associated with CAD.

CAD

Angina pectoris is severe episodes of spasmodic choking or suffocating chest pain. incomplete blockage of, the supply of oxygen to the myocardium.

CAD
A myocardial infarction a.k.a. heart attack or MI, is the occlusion of a coronary artery resulting in an infarct of the affected myocardium. Damage to the myocardium impairs the hearts ability to pump blood through the body. An infarct is a localized area of necrosis caused by interruption of the blood supply.

Congestive Heart Failure

CHF, is a syndrome in which the heart is unable to pump enough blood to meet the bodys needs for oxygen and nutrients. In response to the reduced blood flow, the kidneys retain more fluid within the body and this fluid accumulates in the legs, ankles and lungs. The term congestive refers to this fluid buildup.

Carditis

Endocarditis Bacterial endocarditis - inflammation of the lining or valves of the heart caused by bacteria. Myocarditis
Rheumatic heart fever, rheumatic heart disease

Pericarditis

Heart Valves

Valvulitis Mitral valve prolapse is an abnormal protrusion of the mitral value that results in the incomplete closure of the valve. Mitral stenosis - narrowing Tricuspid stenosis A valve that does not function properly may allow blood to flow back into the heart chamber. The sound of this abnormal flow is called a heart murmur.

Ventricular Septal Defects VSD

Tetralogy of Fallot Pulmonary Stenosis

Overriding of the aorta

Ventricular septal defect Right ventricular hypertrophy

Arrythmias

Cardiac arrhythmia a.k.a. dysrhythmia Bradycardia - abnormally slow heartbeat. Flutter - a cardiac arrhythmia in which the atrial contractions are rapid but regular. Palpitation is a pounding or racing heart with or without irregularity in rhythm. This is associated with certain heart disorders or it may be a response accompanying a panic attack. Tachycardia is an abnormally fast heartbeat. This term is usually applied to rates over 100 beats per minute. Paroxysmal tachycardia is a fast heartbeat of sudden onset..

Fibrillation

rapid, random and ineffective contractions of the heart. Atrial fibrillation, A fib, the atria beat faster than the ventricles. This produces an irregular quivering action of the atria and a very rapid ventricular heartbeat. Ventricular fibrillation, V fib, is the result of irregular contractions of the ventricles and is fatal unless reversed by electric defibrillation.

Blood Vessels

Angitis a.k.a. vasculitis is the inflammation of a blood or lymph vessel. Angionecrosis

Angiospasm
Angiostenosis Hemangioma Hypoperfusion is a deficiency of blood passing through an organ or body part.

Arteries

Aneurysm - a localized weak spot or balloon-like enlargement of the wall of an artery. Arteritis Polyarteritis Arteriosclerosis Raynauds phenomenon consists of intermittent attacks of pallor, cyanosis and redness of the fingers and toes. These symptoms are due to arterial and arteriolar contraction and are usually caused by cold or emotion.

Veins

Phlebitis Varicose veins - abnormally swollen veins usually occurring in the legs. A varicosity is one area of swelling.

Thromboses and Embolisms

Thrombosis - an abnormal condition in which a thrombus develops within a blood vessel. Thrombus - blood clot

Thrombotic occlusion
Coronary thrombosis

Embolus - a foreign object, such as a blood clot, quantity of air gas or a bit of tissue or tumor that is circulating in the blood.
Embolism is the blockage of a vessel by an embolus.

Blood Disorders

Dyscrasia bad mixture, any abnormal or pathologic condition of the blood. Hemochromatosis a.k.a. iron overload disease. This is a genetic disorder in which the intestines absorb too much iron. The excess iron enters the bloodstream and accumulates in organs where it causes damage. Septicemia, a.k.a. blood poisoning, is the presence of pathogenic microorganisms or their toxins in the blood.

Cholesterol

These are lipids that travel in the blood in packages called lipoproteins. The presence of cholesterol at certain levels is normal and essential for good health. A pathologic condition is present when these fats are present in excessive amounts.

Cholesterol

Low-density lipoprotein LDL or bad cholesterol because excess quantities contribute to plaque buildup in the arteries. High-density lipoprotein HDL or good cholesterol because it carries unneeded cholesterol back to the liver for processing and does not contribute to plaque buildup.

Triglycerides are combinations of fatty acids attached to glycerol that are also found normally in the blood in limited quantities.
Homocysteine is an amino acid normally found in the blood and used by the body to build and maintain tissues. However, when present in elevated levels, it can damage arterial walls and increase the risk of coronary artery disease. Such increases may be caused by a diet severely lacking in several B vitamins. Hyperlipidemia or hyperlipemia

Blood Cells

Erythrocytosis is an abnormal increase in the number of circulating red blood cells. Thrombocytopenia a.k.a. thrombopenia, is an abnormal decrease in the number of platelets. Leukopenia is an abnormal decrease in the number of white blood cell. Leukemia is a malignancy characterized by a progressive increase of abnormal leukocytes

Anemias

Anemia is a disorder characterized by lower than normal levels of red blood cells in the blood. Aplastic anemia is marked by an absence of all formed blood elements. This is caused by the failure of blood cell production in the bone marrow.

Anemias

Hemolytic anemia - red blood cells are destroyed faster than the bone marrow can replace them.

Iron-deficiency anemia develops if not enough iron is available to bone marrow to make hemoglobin. It may be caused by inadequate iron intake, malabsorption of iron, pregnancy and lactation, or chronic blood loss.

Anemias

Megaloblastic anemia the bone marrow produces megaloblasts. These are large abnormal red blood cells with a reduced capacity to carry oxygen. This type of anemia is almost always caused by a vitamin deficiency. Pernicious anemia an autoimmune disorder results in the inability of the body to absorb vitamin B12 normally.

Anemias

Sickle cell anemia is a genetic disorder that causes abnormal hemoglobin that result in the red blood cells assuming an abnormal sickle shape. This abnormal shape interferes with normal blood flow resulting in damage to most of the body systems. Thalassemia a.k.a. Cooleys anemia, is a group of genetic disorders characterized by short-lived red blood cells that lack the normal ability to produce hemoglobin.

Hypertension

Essential hypertension, a.k.a. primary hypertension or idiopathic hypertension, is consistently elevated blood pressure of unknown origin. Secondary hypertension is caused by a different medical problem such as a kidney disorder or a tumor on the adrenal glands. When the other problem is cured, the secondary hypertension should be resolved. Malignant hypertension is characterized by the sudden onset of severely elevated blood pressure. It can be life-threatening and commonly damages small vessels in the brain, retina, heart and kidneys.

Physical Examination

A2 louder than P2 aortic click aortic regurgitation apical systolic murmur arrhythmias asystole trial fibrillation (often dictated Ay-Fib or AF) atrial flutter bradycardia cardiomegaly click diastolic murmur first heart sound (S1) first and second heart sounds normal; no third or fourth heart sound fourth heart sound ejection murmur ejection systolic murmur gallop

grade 1/6, 2/6, 3/6, 4/6, 5/6* grade I, grade II, grade III, grade IV, grade V, grade VI*) heart sound heave holosystolic murmur intercostal space irregularly irregular knock MAT (multifocal atrial tachycardia) midclavicular line mitral valve prolapse mitral regurgitation multifocal atrial tachycardia (MAT) murmur Graham Steell murmur pulmonary insufficiency Austin Flint murmur aortic insufficiency murmur radiating to the axilla or neck normal sinus rhythm (NSR) P2 louder than A2

Physical Examination

parasternal border pericardial knock physiologic split of S2 PMI - point of maximum impulse point of maximum impulse (PMI) in fifth intercostal space premature ventricular contractions (PVC) prosthetic click/sound PVC - premature ventricular contractions regular sinus rhythm (RSR) rapid ventricular response rub S1, S2, S3, S4 S1 equals S2 S1 and S2 normal, no S3 or S4

S3 gallop second heart sound (S2) supraventricular tachycardia (SVT) systolic ejection murmur tachycardia third heart sound (S3) thrill tricuspid regurgitation ventricular fibrillation (often dictated Vee-Fib) ventricular tachycardia (often dictated Vee-Tak Corrigan, water-hammer pulse Pistol shot pulse Quincke pulse, capillary pulsations Pulsus paradoxus
Aortic insufficiency

Diagnostic Procedures of the Cardiovascular System

Angiography is a radiographic study of blood vessels after the injection of a contrast medium. Angiocardiography Cardiac catheterization - catheter is passed into a vein or artery and is guided into the heart. Phlebography

Electrocardiogaphy

Electrocardiogram ECG or EKG Holter monitor - ECG monitor 24-hour period. Stress tests are ECGs after an exercise

Thalium stress test assess blood flow during stress

Ultrasonic Diagnostic Procedures

Echocardiography ECHO, ultrasound of the heart to measure structures and motion Transesophagial echocardiography TEE

Laboratory Procedures
Creatine phosphokinase (CK) - Levels rise 4
to 8 hours after an acute MI, peaking at 16 to 30 hours and returning to baseline within 4 days 25-200 U/L 32-150 U/L 6 to 10 hours after an acute MI, peaks in 24 hours, and remains elevated for up to 72 hours. < 12 IU/L if total CK is <400 IU/L <3.5% of total CK if total CK is >400 IU/L myocardial infarction in the emergency department This small heme protein becomes abnormal within 1 to 2 hours of necrosis, peaks in 4-8 hours, and drops to normal in about 12 hours. <1 begins to fall off after 1-2 weeks. < 0.4

(LDH) Lactate dehydrogenase - Total LDH

will begin to rise 2 to 5 days after an MI; the elevation can last 10 days. 140-280 U/L

CK-MB CK isoenzyme - It begins to increase

LDH-1 and LDH-2 LDH isoenzymes -

Myoglobin - early and sensitive diagnosis of

Compare LDH 1 and LDH 2 levels. Normally, the LDH-1 value will be less than the LDH-2. In the acute MI, however, the LDH 2 remains constant, while LDH 1 rises. When the LDH 1 is higher than LDH 2, the LDH is said to be flipped, which is highly suggestive of an MI. A flipped pattern appears 12-24 hours post MI and persists for 48 hours. LDH-1 18%-33% LDH-2 28%-40% in 18-30 hours 10-42 U/L

SGOT - will begin to rise in 8-12 hours and peak

Troponin Complex - Peaks in 10-24 hours,

Table of Cardiac markers

Serum Markers of Myocardial Injury

Detected Peak 1-3 1-8

Falls 12-18

Myoglobin

CK/CK-MB
MB Isoforms Troponin Complex

3-8
1-6 3-6

12-16
4-8 10-24

24-48
12-48 cTnI: 5-9 days cTnT: 7-14 days

Typical Marker Values during AMI

R.B.C. (Red Blood Cell Count)

Hematologic Values

Normal Adult Female Range: 3.9 - 5.2 mill/mcl Optimal Adult Female Reading: 4.55 Normal Adult Male Range: 4.2 - 5.6 mill/mcl Optimal Adult Male Reading: 4.9 Lower ranges are found in Children, newborns and infants Normal Adult Range: 130 - 400 thous/mcl Optimal Adult Reading: 265 Higher ranges are found in children, newborns and infants Normal Adult Range: 3.8 - 10.8 thous/mcl Optimal Adult Reading: 7.3 Higher ranges are found in children, newborns and infants this is the main defender of the body against infection and antigens. High levels may indicate an active infection. Normal Adult Range: 48 - 73 % Optimal Adult Reading: 60.5 Normal Childrens Range: 30 - 60 % Optimal Childrens Reading: 45

LYMPHOCYTES and LYMPHOCYTE COUNT Elevated levels may indicate an active viral infections such as measles, rubella, chickenpox, or infectious mononucleosis. Normal Adult Range: 18 - 48 % Optimal Adult Reading: 33 Normal Childrens Range: 25 - 50 % Optimal Childrens Reading: 37.5

PLATELET COUNT

MONOCYTES and MONOCYTE COUNT -

Elevated levels are seen in tissue breakdown or chronic infections, carcinomas, leukemia (monocytic) or ...lymphomas. Normal Adult Range: 0 - 9 % Optimal Adult Reading: 4.5 Elevated levels may indicate an allergic reactions or parasites. Normal Adult Range: 0 - 5 % Optimal Adult Reading: 2.5

W.B.C. (White Blood Cell Count)

EOSINOPHILS and EOSINOPHIL COUNT -

NEUTROPHILS and NEUTROPHIL COUNT -

BASOPHILS and BASOPHIL COUNT -

Basophilic activity is not fully understood but it is known to carry histamine, heparin and serotonin. High levels are found in allergic reactions. Normal Adult Range: 0 - 2 % Optimal Adult Reading: 1

Hematologic Values
HEMATOCRIT (HCT)
Normal Adult Female Range: 37 - 47% Optimal Adult Female Reading: 42% Normal Adult Male Range 40 - 54% Optimal Adult Male Reading: 47 Normal Newborn Range: 50 - 62% Optimal Newborn Reading: 56

MCH (Mean Corpuscular Hemoglobin)

Normal Adult Range: 27 - 33 pg Optimal Adult Reading: 30

MCV (Mean Corpuscular Volume)

HEMOGLOBIN (HGB) Normal Adult Female Range: 12 - 16 g/dl

Optimal Adult Female Reading: 14 g/dl Normal Adult Male Range: 14 - 18 g/dl Optimal Adult Male Reading: 16 g/dl Normal Newborn Range: 14 - 20 g/dl Optimal Newborn Reading: 17 g/dl

Normal Adult Range: 80 - 100 fl Optimal Adult Reading: 90 Higher ranges are found in newborns and infants

MCHC (Mean Corpuscular Hemoglobin Concentration)

Normal Adult Range: 32 - 36 % Optimal Adult Reading: 34 Higher ranges are found in newborns and infants

Lipid Values
CHOLESTEROL - High density lipoproteins
(HDL) is desired as opposed to the low density lipoproteins (LDL), two types of cholesterol. Elevated cholesterol has been seen in artherosclerosis, diabetes, hypothyroidism and pregnancy. Low levels are seen in depression, malnutrition, liver insufficiency, malignancies, anemia and infection. Normal Adult Range: 120 - 240 mg/dl Optimal Adult Reading: 180 correlate the association between high levels of LDL and arterial artherosclerosis Normal Adult Range: 62 - 130 mg/dl Optimal Adult Reading: 81 mg/dl level of HDL is an indication of a healthy metabolic system if there is no sign of liver disease or intoxication. Normal Adult Range: 35 - 135 mg/dl Optimal Adult Reading: +85 mg/dl

TRIGLYCERIDES - Increased levels may be

present in artherosclerosis, hypothyroidism, liver disease, pancreatitis, myocardial infarction, metabolic disorders, toxemia, and nephrotic syndrome. Decreased levels may be present in chronic obstructive pulmonary disease, brain infarction, hyperthyroidism, malnutrition, and malabsorption. Normal Adult Range: 0 - 200 mg/dl Optimal Adult Reading: 100 Normal Adult Range: 1 - 6 Optimal Adult Reading: 3.5

LDL (Low Density Lipoprotein) - studies

CHOLESTEROL/LDL RATIO

HDL (High Density Lipoprotein) - A high

Treatment Procedures of the Cardiovascular system

Antihypertensive Medications Antihypertensive - administered to lower blood pressure. The following are medications used for this purpose.

ACE inhibitors, which are used to treat hypertension and CHF, interfere with the action of the kidney hormone rennin that causes the heart muscles to squeeze. Beta-blockers slow the heartbeat. Calcium channel blockers reduce the contraction of the muscles that squeeze blood vessels tight. These medications are used to treat hypertension, angina, and arrhythmia. Diuretics which increase urine secretion to rid the body of excess sodium and water, are administered to treat hypertension and CHF.

Additional Medications

Statins a type of cholesterol-lowering drug, are used to reduce LDL cholesterol or other lipids in the blood. Digoxin a.k.a. digitalis slows and strengthens the heart muscle contractions and is used in the treatment of atrial fibrillation and CHF. Nitroglycerin a vasodilator, is used to relieve the pain of angina. It may be administered sublingually, through the skin or orally as a spray. Anticoagulant or thrombolytic agent, slows blood clotting and prevents new clots from forming. Antiarrhythmic Tissue plasminogen activator TPA, is a clot-dissolving enzyme used for the immediate treatment of heart attack victims. Vasoconstrictor constricts the blood vessels. Vasodilator dilates the blood vessels.

Cardiac glycosides
digitoxin (Crystodigin) digoxin (Lanoxin, Lanoxicaps)

ACE (angiotensin-converting enzyme) inhibitors

captopril (Capoten) enalapril (Vasotec) fosinopril (Monopril) lisinopril (Prinivil, Zestril) quinapril (Accupril) ramipril (Altace)

Drug used to treat angina

Nitrates

Nitrates given orally:

isosorbide dinirate (Isordil, Sorbitrate) isosorbide mononitrate (Imdur)

Beta blockers

Alpha/beta adrenergic blockers

carvedilol (Coreg)

Nitro-Bid (sustained-release capsule) Nitordisc (transdermal patch) Nitro-Dur (transdermal patch) Nitrogard (transmucosal tablet) Nitrol (topical ointment) Nitrolingual (sublingual spray) Transdermal-Nitro (transdermal patch) Tridil (I.V.)

Calcium channel blockers

atenolol (Tenormin) bisoprolol (Zebeta) carterolol (Brevibloc) metoprolol (Lopressor, Toprol) nadolol (Corgard) propranolol (Inderal)

amlodipine (Norvasc) bepridil (Vascor) diltiazem (Cardizem) mibefradil (Cardene) nifedipine (Adalat, Procardia) verapamil (Calan, Covera-HS, Isoptin, Verelan)

Drugs used to treat myocardial infarction

captopril (Capoten) lisinopril (Prinivil, Zestril) quinapril (Accupril) aspirin atenolol (Tenormin) metoprolol (Lopressor, Toprol) propranolol (Inderal) timolol (Blocadren)

Drugs used to treat arrhythmias

Drugs for atrial and ventricular arrhythmias

Drugs for atrial arrhythmias

flecainide (Tambocor) quinidine (cardioquin, Quinaglute, Quinidex)

ibutilide fumarate (Corvert) adenosine (Adenocard) amiodarone (Cordarone) bretylium (Bretylol) disopyramide (Norpace) lidocaine (Xylocaine) mexiletine (Mexitil) moricizine (Ethmozine) procainamide (Procan SR, Pronestyl) propafenone (Tonocard)

Beta blockers (for ventricular arrhythmias)

Drugs for ventricular arrhythmia

Calcium channel blockers

acebutolol (Sectral) atenolol (Tenormin) bisoprolol (Zebeta) esmolol (Brevibloc) metoprolol (Lopressor) nadolol (Congard) pindolol (Visken) propranolol (Inderal) sotalol (Betapace) timolol (Blocadren)

diltiazem (Cardizem) verapamil (Calan, Covera-HS, Isoptin, Verelan)

Calcium channel blockers

Antihypertensive drugs Antiadrenergic drugs

amlodipine (Norvasc) diltiazem (Cardizem) nifedipine (Adalat, Procardia) verapamil (Calan, Covera-HS, Isoptin, Verelan)

Drugs that block and receptors

Drugs that block receptors in the brain

clonidine (Catapres) guanabenz (Wytensin) guanfacine (Tenex) methyldopa (Aldomet)

carvedilol (Coreg)

ACE inhibitors

Angiotensin II antagonists
irbesartan (Avapro) losartan (Cozaar) valsartan (Diovan)

benazepril (Lotensin) captopril (Capoten) enalapril (Vasotec) fosinopril (Monopril) lisinopril (Prinivil, Zestril) moexipril (Univasc) quinapril (Accupril) ramipril (Altace) trandolapril (Mavik)

Drugs that block receptors in the blood vessels

guanadrel (Hylorel) guanethidine (Ismelin) reserpine

Alpha adrenergic blockers

Vasodilators

doxazosin mesylate (Cardura) prazosin (Minipress) terazosin (Hytrin)

hydralazine (Apresoline) minoxidil (Loniten)

Antihypertensive drugs
Combination drugs (An antihypertensive agent with a diuretic)

Aldoril (methyldopa, hydrochlorothiazide) Apresazide (hydralazine, hydrochlorothiazide) Combipres (clonidine, chlorthalidone) Diupres (reserpine, chlorothiazide) Enduronyl (deserpidine, methylclothiazide) Hydropes (reserpine, hydrochlorothiazide) Inderide (propanolol, hydrochlorothiazide) Renese-R (reserpine, polythiazide) Salutensin (reserpine, hydroflumethiazide) Tenoretic (atenolol, chlorthalidone) Zestoretic (lisinopril, hydrochlorothiazide) peripheral vasodilators beta blockers calcium channel blockers

Drugs used to treat hypertensive crisis

Drugs used to treat peripheral vascular disease

cyclandelate (Cyclan) isoxsuprine (Vasodilan)

Drugs for intermittent claudication

pentoxifylline (Trental)

Drugs used to treat hyperlipidemia

Bile acid sequestrants

Nonprescription dietary supplements used to teat hypercholesterolemia and hyper triglyceridemia

atorvastatin (Lipitor) cerivastatin (Baycol) cholestyramine (Questran) clofibrate (Atromid-S) colestipol (Colestid) fluvastatin (Lescol) gemfibrozil (Lopid) lovastatin (mevacor) pravastatin (Pravachol) simvastatin (Zocor)

niacin (nicotinic acid, Nicolar) omega-3 fatty acids (Promega)

Resuscitation Drugs
Drugs for emergency resuscitation epinephrine (Adrenalin) Licodaine (Xyclocaine) Atropine Sodium bicarbonate Calcium chloride Drugs used after successful resuscitation

Drugs used to treat anaphylactic shock

epinephrine (Adrenalin)

dobutamine (Dobutrex) dopamine (Intropin) isoproterenol (Isuprel) norepinephrine (Levophed)

Anticoagulant drugs

Platelet aggregation inhibitors

abciximab (ReoPro) aspirin dipyridamole (Persantine) ticlopidine (Ticlid)

anisindione (Miradon) ardeparin (Normiflo) dalteparin (Fragmin) danaparoid (Orgaran) dicumarol enoxaparin (Lovenox) heparin warfarin (Coumadin)

Thrombolytic drugs
Tissue plasminogen activators (tPA)
alteplase (Activase) reteplase (Retavase)

Thrombolytic enzymes
anistreplase (Eminase) streptokinase (Kabikinase, Streptase) urokinase (Abbokinase)

Clearing Blocked Arteries

Percutaneous transluminal coronary angioplasty PTCA or balloon angioplasty.

Clearing Blocked Arteries

Stent placement to prevent restenosis

Clearing Blocked Arteries

An atherectomy is the surgical removal of plaque from the interior lining of an artery. After the catheter and balloon are in place, the balloon is inflated and a cutting tool is used to shave off pieces of the plaque buildup.

Clearing Blocked Arteries

Endarterectomy Carotid endarterectomy The artery may be reinforced with a piece of vein taken from the leg. This procedure is performed to reduce the risk of stroke by ensuring the blood flow to the brain.

Coronary Artery Bypass Graft

CABG is also known as bypass surgery. In this surgery which requires opening the chest, a piece of vein from the leg is implanted on the heart to bypass a blockage in the coronary artery and to improve the flow of blood to the heart. Minimally invasive direct coronary artery bypass (MIDCAB), a.k.a keyhole or buttonhole bypass is an alternative technique for some bypass cases. This procedure is performed with the aid of a fiberoptic camera through small openings between the ribs.

Heart

Defibrillation a.k.a. cardioversion Valvoplasty or valvuloplasty Pacemaker for bradycardia and atrial fibrillation Cardiopulmonary resuscitation, CPR,

Defibrillation

Blood Vessels, Blood and Bleeding

Aneurysmectomy Aneurysmorrhaphy Arteriectomy Hemostasis

Blood Vessels, Blood and Bleeding

Transfusion Plasmapheresis - a procedure in which the plasma is removed from donated blood and the remaining components, mostly RBCs, are returned to the donor. This is performed to reduce or eliminate harmful substances present in the plasma.

I must be learning something because it hurts.

-Tom Tompkins