114 topics with concise breakdowns: definitions, key facts, and class questions.
This section focuses on the fundamentals of cardiovascular disease diagnostics. Here, we break down the journey from the patient's initial presentation to making a preliminary diagnosis: how to properly take a medical history, evaluate chest pain, palpitations, and syncope, as well as perform a general physical examination and physical assessment of blood vessels and pulse.
The material is structured logically, moving from clinical practice to instrumental methods. First comes classic propaedeutics: palpation, percussion, auscultation (changes in heart sounds, systolic and diastolic murmurs). Then we move on to equipment: ECG basics (leads, waves, QRS complex, interpretation algorithm), echocardiography, stress tests, and coronary angiography. In the clinical section, we analyze basic syndromes and diseases: CAD, myocardial infarction, arterial hypertension, as well as rhythm disorders (ranging from extrasystoles to atrial fibrillation and bundle branch blocks).
During practical classes, examiners are most rigorous about the ECG interpretation algorithm, the ability to differentiate heart sounds and murmurs at the bedside, and the clinical signs of acute and chronic heart failure. This is the foundation without which clinical thinking cannot be formed.
Under what conditions does the AV junction become the pacemaker?
This occurs in pathology: either upon loss of sinus node function or during a block of impulse conduction from the atria.
What does the QRS complex reflect on an electrocardiogram?
It fully reflects the process of electrical depolarization (excitation) of the heart ventricles.
What causes the difference in compensatory pauses?
With an incomplete pause, the impulse reaches the SA node and resets it, causing a new cycle to start prematurely. With a full pause, the impulse does not reach the atria, the SA node is not reset, and the next normal sinus impulse falls into the refractory period of the ventricles, causing one contraction to drop out.
What must be monitored when prescribing diuretics?
When treating with any diuretics, strict and regular monitoring of daily diuresis and body weight is mandatory to assess the elimination of hypervolemia.
How to differentiate subclinical renal damage from an associated clinical condition (ACC)?
The difference lies in blood creatinine levels. In subclinical target organ damage, the elevation is moderate (1.2–2.0 mg%), whereas in associated clinical conditions (ACC), renal failure is recorded with creatinine greater than 2.0 mg% or diabetic nephropathy.
Why is heavy athletics contraindicated in hypertension?
Weightlifting refers to isometric exercises, which can trigger a sharp rise in blood pressure, posing a danger to patients with cardiovascular diseases.
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