Jugular Venous Distension
The jugular venous pressure (JVP, sometimes referred to as ''jugular venous pulse'') is the indirectly observed pressure over the venous system via visualization of the internal jugular vein. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections and two downward deflections have been described. * The upward deflections are the "a" (atrial contraction), "c" (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumetric systole) and "v" (venous filling). * The downward deflections of the wave are the "x" descent (the atrium relaxes and the tricuspid valve moves downward) and the "y" descent (filling of ventricle after tricuspid opening). Method Visualization The patient is positioned at a 45° incline. The head is gently turned to the left, and the right external jugular vein should be identified which may be pulsatile and the filling level noted. If the external jugular ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Elevated JVP
An elevated railway or elevated train (also known as an el train or el for short) is a railway with the Track (rail transport), tracks above street level on a viaduct or other elevated structure (usually constructed from steel, cast iron, concrete, or bricks). The railway may be a Broad-gauge railway, broad-gauge, Standard-gauge railway, standard-gauge or Narrow-gauge railway, narrow-gauge railway, light rail, monorail, or a suspension railway. Elevated railways are normally found in urban areas that would otherwise require impracticably many level crossings. Usually, the tracks of elevated railways that run on steel viaducts can be seen from street level. History The earliest elevated railway was the London and Greenwich Railway on a London Bridge-Greenwich Railway Viaduct, brick viaduct of 878 arches, built between 1836 and 1838. The first of the London and Blackwall Railway (1840) was also built on a viaduct. During the 1840s there were other plans for elevated railways in L ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Reflux
Reflux is a technique involving the condensation of vapors and the return of this condensate to the system from which it originated. It is used in industrial and laboratory distillations. It is also used in chemistry to supply energy to Chemical reaction, reactions over a long period of time. Reflux in industrial distillation The term ''reflux'' is very widely used in industries that utilize large-scale Fractionating column, distillation columns and Fractional distillation, fractionators such as oil refinery, petroleum refineries, petrochemical and chemical plants, and natural gas processing plants. In that context, reflux refers to the portion of the overhead liquid product from a distillation column or fractionator that is returned to the upper part of the column as shown in the schematic diagram of a typical industrial distillation column. Inside the column, the downflowing reflux liquid provides cooling and condensation of the upflowing vapors thereby increasing the effi ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Pericardial Effusion
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous Connective tissue, connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity (the potential space) between them. This pericardial space contains a small amount of pericardial fluid, normally 15-50 mL in volume. The pericardium, specifically the pericardial fluid provides lubrication, maintains the anatomic position of the heart in the chest (levocardia), and also serves as a barrier to protect the heart from infection and inflammation in adjacent tissues and organs. By definition, a pericardial effusion occurs when the volume of fluid in the cavity exceeds the normal limit. If large enough, it can compress the heart, causing cardiac tamponade and obstructive shock. Some of the presenting symptoms are shortness of breath, chest pain, chest pressu ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a form of cardiomyopathy in which the walls of the heart are rigid (but not thickened). Thus the heart is restricted from stretching and filling with blood properly. It is the least common of the three original subtypes of cardiomyopathy: hypertrophic, dilated, and restrictive. It should not be confused with constrictive pericarditis, a disease which presents similarly but is very different in treatment and prognosis. Signs and symptoms Untreated hearts with RCM often develop the following characteristics: * M or W configuration in an invasive hemodynamic pressure tracing of the RA * Square root sign of part of the invasive hemodynamic pressure tracing Of The LV * Biatrial enlargement * Thickened LV walls (with normal chamber size) * Thickened RV free wall (with normal chamber size) * Elevated right atrial pressure (>12mmHg), * Moderate pulmonary hypertension, * Normal systolic function, * Poor diastolic function, typically Grade III - IV Dias ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Constrictive Pericarditis
Constrictive pericarditis is a condition characterized by a thickened, fibrotic pericardium, limiting the heart's ability to function normally. In many cases, the condition continues to be difficult to diagnose and therefore benefits from a good understanding of the underlying cause. Signs and symptoms Signs and symptoms of constrictive pericarditis are consistent with the following: fatigue, swollen abdomen, difficulty breathing (dyspnea), swelling of legs and general weakness. Related conditions are bacterial pericarditis, pericarditis and pericarditis after a heart attack. Causes The cause of constrictive pericarditis in the developing world are idiopathic in origin, though likely infectious in nature. In regions where tuberculosis is common, it is the cause in a large portion of cases. Causes of constrictive pericarditis include: * Tuberculosis * Incomplete drainage of purulent pericarditis * Fungal and parasitic infections * Chronic pericarditis * Postviral pericarditis * ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Kussmaul Sign
Kussmaul's sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. It can be seen in some forms of heart disease and is usually indicative of limited right ventricular filling due to right heart dysfunction. Pathophysiology Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity and the increased volume afforded to right ventricular expansion during diastole. Kussmaul sign suggests impaired filling of the right ventricle due to a poorly compliant myocardium or pericardium. This impaired filling causes the increased blood flow to back up into the venous system, causing the jugular vein distention (JVD) and is seen clinically in the internal jugular veins becoming more readily visible. Causes The differential diagnoses of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart fail ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Systematic Review
A systematic review is a scholarly synthesis of the evidence on a clearly presented topic using critical methods to identify, define and assess research on the topic. A systematic review extracts and interprets data from published studies on the topic (in the scientific literature), then analyzes, describes, critically appraises and summarizes interpretations into a refined evidence-based conclusion. For example, a systematic review of randomized controlled trials is a way of summarizing and implementing evidence-based medicine. Systematic reviews, sometimes along with meta-analyses, are generally considered the highest level of evidence in medical research. While a systematic review may be applied in the biomedical or health care context, it may also be used where an assessment of a precisely defined subject can advance understanding in a field of research. A systematic review may examine clinical tests, public health interventions, environmental interventions, social ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Central Venous Catheter
A central venous catheter (CVC), also known as a central line (c-line), central venous line, or central venous access catheter, is a catheter placed into a large vein. It is a form of venous access. Placement of larger catheters in more centrally located veins is often needed in critically ill patients, or in those requiring prolonged intravenous therapies, for more reliable vascular access. These catheters are commonly placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). Central lines are used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), administer fluid or blood products for large volume resuscitation, and measure central venous pressure. The catheters used are commonl ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Central Venous Pressure
Central venous pressure (CVP) is the blood pressure in the venae cavae, near the right atrium of the heart. CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood back into the arterial system. CVP is often a good approximation of right atrial pressure (RAP), although the two terms are not identical, as a pressure differential can sometimes exist between the venae cavae and the right atrium. CVP and RAP can differ when arterial tone is altered. This can be graphically depicted as changes in the slope of the venous return plotted against right atrial pressure (where central venous pressure increases, but right atrial pressure stays the same; VR = CVP − RAP). CVP has been, and often still is, used as a surrogate for preload, and changes in CVP in response to infusions of intravenous fluid have been used to predict volume-responsiveness (i.e. whether more fluid will improve cardiac output). However, there is increasing evidence t ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Heart Failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to Cardiac cycle, fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically presents with shortness of breath, Fatigue (medical), excessive fatigue, and bilateral peripheral edema, leg swelling. The severity of the heart failure is mainly decided based on ejection fraction and also measured by the severity of symptoms. Other conditions that have symptoms similar to heart failure include obesity, kidney failure, liver disease, anemia, and thyroid disease. Common causes of heart failure include coronary artery disease, heart attack, hypertension, high blood pressure, atrial fibrillation, valvular heart disease, alcohol use disorder, excessive alcohol consumption, infection, and cardiomyopathy. These cause heart failure by altering the structure or the function of the heart or in some cases both. There are ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Ventricular Ejection Fraction
Ventricle may refer to: * Ventricle (heart), the pumping chambers of the heart * Ventricular system In neuroanatomy, the ventricular system is a set of four interconnected cavities known as cerebral ventricles in the brain. Within each ventricle is a region of choroid plexus which produces the circulating cerebrospinal fluid (CSF). The ventric ... in the brain * Ventricle of the larynx, a structure in the larynx {{Disambig ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |
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Pulmonary Wedge Pressure
The pulmonary wedge pressure (PWP) (also called pulmonary arterial wedge pressure (PAWP), pulmonary capillary wedge pressure (PCWP), pulmonary artery occlusion pressure (PAOP), or cross-sectional pressure) is the pressure measured by wedging a pulmonary artery catheter with an inflated balloon into a small pulmonary arterial branch. It estimates the left atrial pressure. Pulmonary venous wedge pressure (PVWP) is not synonymous with the above; PVWP has been shown to correlate with pulmonary artery pressures in studies, albeit unreliably. Physiologically, distinctions can be drawn among pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary venous pressure and left atrial pressure, but not all of these can be measured in a clinical context. Noninvasive estimation techniques have been proposed. __TOC__ Clinical significance Because of the large compliance of pulmonary circulation, it provides an indirect measure of the left atrial pressure. For example, it is c ... [...More Info...]       [...Related Items...]     OR:     [Wikipedia]   [Google]   [Baidu]   |