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combination of diuretics may be indicated in patients previously resistant to furosemide alone profound diuresis and clinical improvement may occur
the potassium-sparing agents spironolactone triamterene and amiloride are often useful in combination with the loop diuretics and thiazides
ross operation in this technically demanding operation the aortic valve is replaced by patients own pulmonary valve autograft and a pulmonary or
cryo preserved allografts homograft as these are not mounted a free hand suturing in two layers has to be done the valve is thawed by protocol
tissue valves tissue valves mounted on a frame with a sewing ring are inserted by the same technique as used in the case of prosthetic
diuretic therapyone of the aims of treatment of congestive heart failure is directed toward controlling salt and water retention central or
continuous suture technique monofilament 20 prolene sutures which slide through easily are used for this technique three double armed prolene sutures
in the long term reversible causes of heart failure like valvular lesions myocardial ischemia uncontrolled hypertension arrhythmias alcohol negative
interrupted suture technique synthetic braided 2 0 sutures ethibond with 17mtn needles on either end and a pledget is used alternate green and white
restriction of physical activities to reduce myocardial work and oxygen consumption however care should be taken to prevent deep vein thrombosis-
aortic valve replacement the initial steps of the operation have been described earlier ascending aorta is cannulated a single two-stage
the goals of treating heart failure are relief of symptoms improvement in exercise tolerance and reduction in the number of hospitalizations
over the past decade the conceptual understanding of heart failure has changed significantly several large clinical trials have demonstrated that
pulmonary edema is life-threatening condition and therefore treated as a medical emergency as is the case with chronic stable heart failure
aortic valvotomy these days aortic valvotomy even in neonates and critically ill infants is done under cardio pulmonary bypass through a median
effects of cardiogenic pulmonary edema interference with oxygen transfer in the lungs depression arterial oxygen tension sense of suffocation and
pulmonary edema occurs when movement of liquid from the blood to the interstitial space andor into the alveoli exceeds the return of liquid to the
routine blood tests like haemoglobin creatinine electrolytes are useful to plan treatment more recently the blood natriuretic peptide levels have
both global and regional systolic function are to be checked global measures include ejection fraction stroke volume end systolic volume for
sinus tachycardia is common ecg abnormalities may reflect the underlying coronary artery disease by way of pathological q-waves st-t wave
increase in cardio-thoracic ratio is a relatively specific indicator of left ventricular end-diastolic volume left atrial enlargement is seen as
the initial evaluation of new onset heart failure should include an electrocardiogram chest radiograph and b-type natriuretic peptide assay the
the patient will appear anxious and dyspnoeic patients in chronic heart failure are usually malnourished and even cachectic chronic passive venous
there is a wide spectrum of potential clinical presentations with heart failure most patients have signs and symptoms of pulmonary congestion
supra vulvar aortic stenosis supra valvar aortic stenosis in children with elfin facies mental retardation multiple peripheral pulmonary artery