Question 1

Can there be a myocardial infarction without pain?

admin · Accepted Answer

Yes maybe. Painless ischemia (oxygen starvation) of the myocardium is rare, more often in patients with diabetes mellitus. In this case, arterial hypotension (lowering blood pressure), weakness and cyanosis (blue) of the lips can sometimes be noted.

Question 2

How does a heart attack start?

admin · Accepted Answer

The most common and characteristic symptom of myocardial infarction is pain. In typical cases, it is of a pressing, compressive nature, localized in the left half of the chest, behind the sternum. The pain syndrome may be accompanied by a feeling of heaviness, burning, cold sweat, a feeling of fear of death. Most often, the pain lasts more than 30 minutes, is not stopped by taking nitroglycerin and painkillers, it can proceed in waves, for a long time - then weakening, then again intensifying.

Question 3

Is myocardial infarction pain worse in men or women?

admin · Accepted Answer

The results of studies indicate the presence of gender differences in the symptoms of myocardial infarction. Women are significantly less likely than men to experience chest pain. However, females are more likely to experience fatigue, neck pain, fainting, right arm and jaw pain, and dizziness.

Question 4

What are the signs of an impending heart attack?

admin · Accepted Answer

Often myocardial infarction occurs after physical or emotional stress. This condition does not have any signs that may precede ischemia.

Question 5

Where does it hurt with myocardial infarction?

admin · Accepted Answer

Pain in myocardial infarction is localized in the left half of the chest, behind the sternum. In typical cases, it is of a pressing, compressive nature, it can radiate to the arm, lower jaw, abdomen, shoulder blade.

Question 6

Can pulmonic valve stenosis go away?

admin · Accepted Answer

Stenosis is not functional, i.e. it is always caused by structural disturbances at the tissue level. Therefore, no, it cannot go through such a state on its own.

Question 7

How to measure the severity of pulmonary stenosis?

admin · Accepted Answer

The severity of stenosis is measured by comparing the diameter of the pulmonary trunk with the diameter of the aortic lumen. If the first indicator is more than 80%, then the stenosis is considered mild, if from 50 to 80% - moderate, less than 50% - severe. This indicator is determined by conducting an ultrasound of the heart (EchoCG). In addition, severity can be assessed by the severity of clinical symptoms.

Question 8

What are the types of pulmonary stenosis?

admin · Accepted Answer

Stenosis can be of three varieties according to the level of damage. Valvular stenosis directly affects the leaflets, which become thin; in this case, the adhesions partially grow together, and the ring, i.e. directly the border of the hole that closes the valve is underdeveloped. Supravalvular stenosis is otherwise called peripheral and is a variant of narrowing of the pulmonary artery. Subvalvular, or subvavular, stenosis is a defect that significantly reduces the patency of the outflow tract of the right ventricle.

Question 9

What causes pulmonic valve stenosis?

admin · Accepted Answer

Congenital stenosis of the pulmonary valve can be caused by such causes as genetic abnormalities, multiple heart lesions, infection of the mother with rubella during pregnancy. Risk factors for the development of acquired pulmonary stenosis are operations on the open heart and its valves, heart tumors, and carcinoid syndrome.

Question 10

What is the normal peak velocity of the pulmonary valve?

admin · Accepted Answer

The normal peak velocity of blood flow through the pulmonary valve is in the range of 44 to 78 cm/s.

Question 11

Can an adult develop Ebstein's anomaly?

admin · Accepted Answer

No, this is a congenital heart disease that accompanies a person from birth. However, with mild severity and good compensatory capabilities of the body, the defect may not be detected until adulthood and may be detected by chance as part of a preventive medical examination or during auscultation (listening) of the heart for a different diagnostic purpose.

Question 12

How long do people live with Ebstein's anomaly?

admin · Accepted Answer

Survival of children depends on the severity of the defect, as well as on the treatment that the child receives. With a correctly chosen method of correction, a complete cure is possible, while there is no effect of the defect on survival. With mild severity, survival is close to the average in the population. But without treatment in severe cases, the age of survival is no more than 13 years.

Question 13

What is Ebstein's anomaly?

admin · Accepted Answer

This is a heart disease characterized by pathology of the tricuspid valve. A violation of the location of its valves, as well as a change in the size of the right ventricle, is characteristic.

Question 14

Who gets Ebstein's anomaly?

admin · Accepted Answer

Ebstein's anomaly is a heart defect that affects children of both sexes with equal frequency. This is a congenital anomaly with which a child is born.

Question 15

Why does Ebstein's anomaly develop?

admin · Accepted Answer

The exact cause of this heart defect is unknown. The disease can have both a genetic nature (a mutation in a certain gene) and develop for external reasons (the influence of lithium as an etiological factor is discussed).

Question 16

What causes Fallot's tetrad?

admin · Accepted Answer

This is a congenital malformation, the exact cause of which is unknown. Malnutrition, alcohol use, and infectious diseases of the mother during pregnancy, as well as the presence of certain genetic abnormalities (in particular, Down and DiGeorge syndromes) are likely to play a role. In addition, the risk of developing a defect in a child is higher if the mother is over 40 years old or one of the parents also had such a defect.

Question 17

What is tetralogy of Fallot in young children?

admin · Accepted Answer

Tetralogy of Fallot is a congenital heart disease that includes four anatomical abnormalities: repositioning of the aorta, right ventricular outflow stenosis and/or pulmonary stenosis, ventricular septal defect, and right ventricular hypertrophy. As a result, hemodynamic disturbances occur.

Question 18

What is the most common complication in patients with tetralogy of Fallot?

admin · Accepted Answer

Thrombosis, embolism and cerebrovascular accident often develop. This is due to an increase in blood viscosity due to a compensatory increased level of red blood cells, a decrease in stroke volume, and vascular stenosis.

Question 19

Can there be myocardial infarction during pregnancy?

admin · Accepted Answer

As the age of the pregnant woman increases, the risk of acute myocardial infarction increases (especially for women older than 45-50 years). In addition to other factors, pregnancy increases the risk of a heart attack by 3 to 4 times. The frequency of MI during pregnancy ranges from 3 to 100 per 100,000 births. Maternal mortality reaches 11%, and the associated fetal mortality is 9%.

Question 20

Is acute coronary syndrome and myocardial infarction the same thing?

admin · Accepted Answer

Symptoms of MI of different types are also similar to those of angina pectoris. Without a blood test and an ECG, it will be difficult for the medical team to make an accurate diagnosis, therefore, until a specific pathology (for example, ST-segment elevation myocardial infarction) is identified, the patient's condition is referred to as acute coronary syndrome.

Question 21

What are the types of myocardial infarction?

admin · Accepted Answer

Depending on the cause of MI, 5 types of this pathology are distinguished:

MI as a result of rupture or erosion of atherosclerotic plaques; with the formation of a blood clot or hemorrhage into the plaque.
MI due to a mismatch between oxygen supply and demand for it; without the destruction of plaques and the formation of blood clots (for example, with severe anemia or respiratory failure).
Sudden unexpected cardiac death that occurs before troponin levels can be measured. In this type, a person has recent changes in the ECG or MI is detected at autopsy.
Heart attack associated with percutaneous coronary intervention (subtype 4a), stent thrombosis (subtype 4b), or restenosis (recurrent blockage) in a coronary artery where a stent was previously placed.
MI associated with coronary artery bypass surgery.

Question 22

What is ST elevation?

admin · Accepted Answer

The ST segment is a specific area on a patient's ECG. Identification of its rise is very important for the further management of a patient with a heart attack. Incomplete restriction of blood flow to the site of the heart characterizes unstable angina, which can lead to non-ST elevation myocardial infarction (NSTEMI). Complete and sudden occlusion (contraction) of a coronary artery is usually associated with ST-segment elevation myocardial infarction (STEMI).

Question 23

Why does myocardial infarction have different severity in different people?

admin · Accepted Answer

The amount of myocardial damage (and, as a result, its severity) that is caused by coronary occlusion depends on:

the volume of tissue supplied by the affected vessel;
the degree of blockage of the vessel (full or partial occlusion) and its duration;
the volume of blood supplied through the collateral vessels to the affected tissue;
myocardial oxygen demand;
internal (endogenous) factors that can cause early spontaneous lysis (destruction) of an occlusive thrombus;
the adequacy of myocardial blood supply in the infarction zone when blood flow is restored.

Question 24

How is mitral stenosis different from mitral regurgitation?

admin · Accepted Answer

Mitral stenosis is a narrowing of the lumen between the left ventricle and the atrium, and with mitral insufficiency, there is an excessive expansion of this opening.

Question 25

How many valves does the heart have?

admin · Accepted Answer

The heart has four valves:

mitral (it is also called bicuspid);
tricuspid;
aortic;
pulmonary.

Question 26

What happens with mitral stenosis?

admin · Accepted Answer

With a decrease in the area of the lumen of the opening between the left atrium and ventricle to 2 cm2, blood can flow from the left atrium only due to an abnormally increased gradient of the left atrioventricular pressure.

In patients with severe mitral stenosis (the mitral valve opening in this case is about 1–1.5 cm2), cardiac output at rest is normal or almost normal, but the patient's body lacks oxygen and nutrients during exercise.

In patients with very severe mitral stenosis (when the valve area is less than 1 cm²), especially in patients with markedly increased pulmonary vascular resistance, the heart cannot pump. Left atrial pressure rises at rest and further increases during exercise, which often causes a secondary increase in end-diastolic pressure (pressure in the chambers of the heart during relaxation) and an increase in right ventricular volume.

Question 27

What is mitral valve narrowing?

admin · Accepted Answer

Mitral valve narrowing, or mitral stenosis, is a narrowing of the space between the left ventricle and the atrium.

Question 28

Why is mitral stenosis dangerous?

admin · Accepted Answer

First of all, this condition is dangerous due to the addition of pulmonary hypertension and other pathologies of the heart. Also, patients with mitral stenosis have an increased risk of thrombosis.

Question 29

Can a blood clot dissolve in PE?

admin · Accepted Answer

Yes maybe. In untreated and life-threatening conditions, clots usually resolve. Their organization is rarely observed, in which the thrombus itself and the vascular wall around it change. This leads to the development of chronic thromboembolic pulmonary hypertension.

Question 30

Does genetics affect the development of PE?

admin · Accepted Answer

Several genetic factors are known to increase the risk of developing PE. They are usually associated with disorders in the production or activity of blood clotting factors, namely:

factor V (Leiden);
mutation of the prothrombin gene;
lack of antithrombin;
deficiency of proteins C and S;
an increase in the level of homocysteine in the blood (hyperhomocysteinemia).

Question 31

Is PE always caused by blood clots?

admin · Accepted Answer

No not always. Also, PE can be the result of non-thrombotic material such as fat, tumor, or air.

Question 32

What can worsen the condition of a patient with PE?

admin · Accepted Answer

There are a number of factors that negatively affect the prognosis of the disease, these include:

hemodynamic instability;
dysfunction of the right ventricle;
damage to the heart muscle.

Question 33

What is Virchow's triad?

admin · Accepted Answer

In 1856, Rudolf Virchow postulated a triad of events that cause increased thrombus formation. These include:

Violation of coagulation (blood clotting).
Damage to the endothelium of the vessel (inner layer).
Pathology of blood circulation.

Question 34

How is pericarditis diagnosed?

admin · Accepted Answer

A patient with suspected pericarditis is recommended to perform:

laboratory examination;
ECG (quite often there are ST segment changes and abnormal T waves);
ECHO-KG;
cardiac magnetic resonance imaging (MRI) - this method may be useful when the diagnosis is unclear, echocardiographic imaging is difficult, or myocardial involvement is suspected.

Question 35

What is pericarditis?

admin · Accepted Answer

Pericarditis is an inflammation of the pericardium (serous lining of the heart), which is its most common pathology. Causes can be infectious (tuberculosis remains the most common cause in developing countries) or non-infectious, but remain idiopathic (uncertain) in most cases.

Question 36

What viruses cause pericarditis?

admin · Accepted Answer

The causative agents of this disease can be Coxsackie A or B viruses, influenza, mumps, herpes simplex, chickenpox, as well as echoviruses, adenoviruses or cytomegaloviruses.

Question 37

Who is most likely to get viral pericarditis?

admin · Accepted Answer

Viral pericarditis occurs at any age. However, it is most often detected in young people and is often associated with pleural effusion (fluid accumulation in the pleural cavity) and inflammatory pathology of the lungs.

Question 38

Why is viral pericarditis dangerous?

admin · Accepted Answer

This pathology is dangerous for its complications: cardiac tamponade and constrictive pericarditis.

Cardiac tamponade. The accumulation of fluid in the pericardial space in an amount sufficient to seriously impede the flow of blood into the ventricles of the heart leads to this condition. This complication can be fatal if it is not recognized and treated in time.

Constrictive pericarditis (thickening and fusion of the sheets of the pericardium) is a possible complication of almost any disease of the pericardium. Diagnosis can be difficult and is based on the clinical presentation and characteristic echocardiographic findings. MRI is also used to confirm the diagnosis and evaluate pericardial inflammation.

Question 39

Can atherosclerosis be cured?

admin · Accepted Answer

Thanks to modern methods of treatment, it is possible to stop the growth of atherosclerotic plaques and somewhat reduce their size.

Question 40

Can atherosclerosis cause a stroke?

admin · Accepted Answer

Yes maybe. Atherosclerosis is the leading cause of ischemic stroke, which is often the first manifestation of atherosclerotic vascular changes.

Question 41

How many years do people with atherosclerosis live?

admin · Accepted Answer

Atherosclerotic changes in the arteries can occur over a long period of time (often decades). Life expectancy depends on many factors, including lifestyle, adherence to treatment, the presence of risk factors, etc.

Question 42

Is it possible to understand that you have atherosclerosis?

admin · Accepted Answer

Atherosclerosis usually does not cause any symptoms until there is a strong narrowing of the lumen of the vessel or its complete blockage. Many people do not realize that they have such a pathology. Therefore, a doctor can accurately determine the risk of atherosclerotic damage to the arteries after conducting an examination and obtaining the results of laboratory and instrumental diagnostic methods.

Question 43

Who can develop atherosclerosis?

admin · Accepted Answer

Factors that increase the likelihood of developing atherosclerosis and its symptoms include:

smoking;
diabetes;
hypertonic disease;
increase in the level of cholesterol in the blood (hypercholesterolemia);
overweight.

Also, the symptoms of atherosclerosis are most often detected in males.

Question 44

Can there be a heart attack due to cardiac syndrome?

admin · Accepted Answer

No, in cardiac syndrome there is no damage to large coronary arteries, so even a critical narrowing cannot lead to significant ischemia, i.e. oxygen starvation, myocardial tissue. However, microvascular angina is a risk factor for the development of a more serious disease. Its presence means that there are risk factors that negatively affect the cardiovascular system.

Question 45

Is cardiac syndrome dangerous?

admin · Accepted Answer

By itself, this condition does not pose a significant danger to life. However, it indicates serious changes in the health of the body, which need to be paid attention to.

Question 46

What is cardiac syndrome?

admin · Accepted Answer

Cardiac syndrome is a condition in which blood circulation in the small coronary vessels is disturbed due to vascular spasm.

Question 47

What tests should be done in case of cardiac syndrome?

admin · Accepted Answer

First of all, you should consult a doctor to clarify the diagnosis. Cardiac syndrome requires an electrocardiogram, ultrasound of the heart, and sometimes angiography. General and biochemical blood tests with determination of glucose and cholesterol levels are shown.

Question 48

Why does cardiac syndrome develop?

admin · Accepted Answer

Researchers do not have an exact answer to this question. Perhaps vascular spasm develops due to an imbalance of factors responsible for vasoconstriction (vasoconstrictors) and substances responsible for their expansion (vasodilators).

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Last updates

Clinical Picture of Myocardial Infarction

Classification, Pathophysiology of Valvular Pulmonary Stenosis

Classification, Pathophysiology of Ebstein's Anomaly

Classification, Pathophysiology of Fallot's Tetrad

Myocardial Infarction: Etiology, Pathogenesis

Hemodynamic Disturbances in Mitral Stenosis

Etiology and Pathogenesis of PE

Viral Pericarditis

Clinical Picture of Atherosclerosis

Cardiac Syndrome

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