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tobagotwo

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As the Acronym list and Glossary were introduced at the same time, some folks might think they are one item. The Glossary is a more detailed item with a different approach and purpose, and has now been moved to a separate thread. You need to click on the link to download it, as it's too long to view in the Forums. Here are a couple of sample pages:

B

Bacterial Endocarditis or Endocarditis - an infection inside the heart, often unrecognized until after valve or other damage has occurred. While a valve may sometimes be harmed immediately, it often takes years to show damage, generally by calcifications forming on and around it. Endocarditis is not always bacterial, but is frequently referred to in general as bacterial endocarditis. See also Calcification.

Balloon Angioplasty ? see Angioplasty.

BAV/BAVD - see Bicuspid Aortic Valve/Bicuspid Aortic Valve Disease.

Bentall Procedure - an open heart surgery to replace the aortic valve, aortic root, and ascending aorta all at one time. This may be done by attaching chosen parts together during the operation, or with an all-inclusive tissue valve and aorta replacement or prefabricated, single mechanical valve and aorta replacement piece. The coronary arteries are reattached at the new structure. The replacement aorta portion may be animal or human tissue, or may be sleeves of Dacron velour that the patient's own tissue will grow on and through. See also Aorta, Ascending Aorta, Aortic Root, Endothelium.

Bicuspid Aortic Valve/Bicuspid Aortic Valve Disease ? When a person is born with two cusps instead of three on their aortic valve, or two of the three are fused into one. The cusps are the leaflets that close the valve opening to keep blood flowing in only one direction. This may lead to early breakdown or calcification of the valve, and is sometimes associated with other connective tissue disorders. See also Cusps, Aortic Valve, Connective Tissue Disease.

Bigeminy ? when a premature ventricular contraction follows every regular ventricular contraction, making a kind of double beat. See also Ventricle.

Blood Clot ? a mass of blood that has congealed to plug a leak in the body. If it occurs improperly within an artery and blocks blood flow through it, it can cause a stroke or heart attack, particularly if formed in conjunction with loose arterial plaque. In a vein, it can cause deep vein thrombosis. See also troke, Heart Attack, Plaque, Anticoagulation Therapy.

Bleed ? a hemorrhage, especially one that is slow to stop. See also Hemorrhage, AntiCoagulation Therapy.

Blood culture ? when bacteria in a blood sample is encouraged to grow, to determine if bacteria are present, and if so, what kind of bacterium may be causing an undetermined infection. Used to determine forms of endocarditis. See also Subacute Bacterial Endocarditis, Endocarditis.

Blood Flow Through the Heart ? The right side sends blood to the lungs for oxygen, then the left side sends the oxygenated blood to the body. Path: Stale, deoxygenated blood comes from the vena cava into the right atrium at the top of the heart. At the contraction of the atria (the lub of the heartbeat?s lub-dub), the blood is pushed through the tricuspid valve into the right ventricle below. In the contraction of the ventricles (the dub of the lub-dub), the blood is pushed through the pulmonary valve into the pulmonary artery to the lungs. From the lungs, the reoxygenated blood returns through the pulmonary veins to the left atrium in the upper part of the heart. When the atria contract (lub), the blood is pushed through the mitral valve into the left ventricle below. When the ventricles contract (dub), the blood is pushed through the aortic valve into the aorta to the brain, heart, and body. See also Vena Cava, Right Atrium, Tricuspid Valve, Right Ventricle, Pulmonary Valve, Pulmonary Artery, Pulmonary Veins, Left Atrium, Mitral Valve, Left Ventricle, Aortic Valve, Aorta, Lub-dub.

Blood pressure ? the measurement of the pressure inside the blood vessels. Displayed as the systolic pressure (high pressure during the beat of the heart) over the diastolic pressure (resting pressure between heartbeats). See also Diastolic Pressure, Systolic Pressure.

Blue Baby Syndrome ? when a baby is born with a defect that causes the blood not to have sufficient oxygen. The deoxygenated blood in the body causes a bluish appearance to the skin. This can be from malformed or mixed up blood vessels, or from a lack of the proper type of red blood cells. See also Tetralogy of Fallot, Ventricular Septal Defect.

BP - see Blood Pressure.

BPM ? Beats per Minute ? the measurement used for heart rate. See also Heart Rate.

Bradycardia ? an abnormally slow heartbeat, less than 60 BPM at rest. Normal for some athletes, but in less athletic people, can cause fainting or other symptoms at below 50 BPM.

Bridge Therapy ? See Bridging.

Bridging ? the use of some form of heparin (such as Lovenox) or other reversible anticoagulant to continue anticoagulation therapy through an intrusive medical or dental procedure or surgery. The bridging injections are started some days before the procedure, when the patient stops taking warfarin (Coumadin). They continue until just before the procedure, because heparin?s anti-clotting effect can be reversed during the surgery to avoid excessive bleeding, then restarted to keep the likelihood of strokes down. After the procedure, the patient starts taking warfarin again. The injections stop when the patient?s INR reaches the desired level. See also AntiCoagulation Therapy, Heparin, Low Molecular Weight Heparin, Warfarin, International Normalization Ratio, Lovenox.

Bundle Branch Block ? an electrical conduction problem leading from the atrio-ventricular node to one of the ventricles that causes it to contract slightly later than the other one. See Ventricle, AtrioVentricular Node.


C

CABG - see Coronary Artery Bypass Graft.

CAD - see Coronary Artery Disease.


Still soliciting thoughts for more items and possible corrections or improvements.

Best wishes,
 
This will be a valuable resource. Thanks for your work on it, Bob.
 
Very,very handy..... thank-you for it and your time
to put it together for us.:)


zipper2 (DEB)
 
I appreciate the time taken to look through the glossary. I've sent an update to Ross, and here are my current thoughts...

Number 1 In Glossary:
Atherosclerosis - the accumulation of plaques within the walls of the arteries that supply heart muscle with oxygen and nutrients. Pieces of these plaques can break free and block arteries, causing a stroke or heart attack. Also see Coronary Artery Disease, stroke, heart attack.

Correction: Atherosclerosis can occur in any of the arterial systems. This definition implies that it only occurs in the coronary arteries of the heart.

Explanation: A good point. This has been reworded.

Number 2 In Glossary:
Bacterial Endocarditis or Endocarditis - an infection inside the heart, often unrecognized until after valve or other damage has occurred. While a valve may sometimes be harmed immediately, it often takes years to show damage, generally by calcifications forming on and around it. Endocarditis is not always bacterial, but is frequently referred to in general as bacterial endocarditis. See also Subacute Bacterial Endocarditis, Calcification.

Correction: It is more properly referred to as ?Infective? Endocarditis. It also does not mention the other category which is Noninfective Endocarditis.

Explanation: This struck me as odd. I have almost always seen this as endocarditis or bacterial endcarditis. In paging through the various sources, including Mayo, CCF, NIH, and many others, I find they run 95% Bacterial Endocarditis, 5% Infective Endocarditis, with all the big players in the 95% BE mode. Then I stumbled across this topic title in the American Heart Assn website: ?Infective Endocarditis (previously referred to as bacterial endocarditis).? So it plainly is an effort to change the name. And a new one at that, as the big players haven?t changed the name on their websites at all yet. It may even still be in contention. However, we will go with your (and the AHA's) new version.

Number 3 In Glossary:
Cardiac Catheterization - when a small wire with a transducer or other tool is threaded to the heart through a groin or neck blood vessel to perform an angiogram or other work, such as electrical ablation, angioplasty, or placement of a trans-catheter type heart valve. See also Transducer, Cardiac Ablation, Coronary Angioplasty.

Correction: It forgets to mention the catheter that is used, not just the guide wire. It does not mention the arm as a possible access site also and that stent placements are also done in the cardiac catheterization lab.

Explanation: These have been added, but there is a certain brevity that a glossary is intended to maintain. However, this isn?t the only topic that runs long. There were a number of other functions not mentioned, some of which have now been included.

Number 4 In Glossary:
Cardiomyopathy ? when the heart begins an incurable cycle of failure without an obvious cause.

Correction: Cardiomyopathy has known causes, while this states otherwise. It is known as primary and secondary cardiomyopathy.

Explanation: I don?t know what I was thinking when I wrote this. This is idiopathic cardiomyopathy. This has been rewritten and expanded.

Number 5 In Glossary:
Coronary Artery Disease - the accumulation of plaques within the walls of the arteries that supply heart muscle with oxygen and nutrients, also called atherosclerosis. Coronary artery disease is the most common cause of coronary heart disease, but is not the only cause. See also Coronary Heart Disease, Atherosclerosis, Arteriosclerosis.

Correction: The statement ?Coronary artery disease is the most common cause of coronary heart disease, but is not the only cause.? makes no sense. Coronary artery disease and coronary heart disease is the same thing. The causes can be congenital or from things such as smoking, high blood pressure, high blood cholesterol, etc.

Below this definition is Coronary Heart Disease, however, it should just simply say: Coronary Heart Disease ? see Coronary Artery Disease.

Explanation: Coronary Heart Disease is discernable from Coronary Artery Disease inthat Coronary Vasospasm can cause Coronary Heart Disease. Coronary Vasospasm is not considered Coronary Artery Disease, although it?s often aligned with atherosclerotic arterial segments. This is loose usage, similar to Insufficiency being used in place of Regurgitation, where the result is confounded with one of the causations. It?s becoming common usage for them to be used interchangeably. Not sure which way this should go.

Number 6 In Glossary:
Deep Vein Thrombosis ? when a blood clot blocks a vein, often in the leg. Warfarin is used to reduce the risk of this during long periods of restricted activity, such as during air or car travel. Aspirin-type anticoagulants do not help to prevent for DVT. See also Blood Clot, Warfarin.

Correction: It implies that Warfarin is used for everyone with DVT whereas many do not require Warfarin. The goal is to prevent a pulmonary embolism. As far as activity, compression stockings and other treatment options are also used, which it fails to mention.

Explanation?Grammatically, it doesn?t state that warfarin is always used or the only thing used for that purpose. And it?s correct: warfarin is used for that purpose. However, this will be restructured for clarity. Note: you also fail to mention the other treatment options in your correction...

Number 7 In Glossary:
ECG ? see Echocardiogram, or sometimes Electrocardiogram.

Correction: ECG is NOT an abbreviation for Echocardiogram, only Electrocardiogram. ECG and EKG both mean Electrocardiogram. If ECG mean?t both, it would get awful confusing communicating in medical records with multiple doctors.

Explanation?It's already confusing, because different doctors use the same terms differently and also use different terms for the same items (notoriously so in different doctors? ECHO reports, coincidentally). I?ve seen ECG used this way in numerous places. However, this will be removed as loose usage.

Number 8 In Glossary:
Echocardiogram ? a noninvasive ultrasound scan of the heart and valves. In a standard ECG, a transducer is placed in various positions on the lubricated chest to obtain the readings. In a Transesophogeal echocardiogram, the transducer is placed into the patient?s anesthetized throat. See also Transducer, TransEsophogeal Echocardiogram.

Correction: ECG should not be used in this definition. It should also mention the word transthoracic relating to the noninvasive version of the echocardiogram.

Explanation?Transthoracic has been added, ECG was altered to ECHO.

Number 9 In Glossary:
Endocarditis or Bacterial Endocarditis - an infection inside the heart, often unrecognized until after valve or other damage has occurred. While a valve may sometimes be harmed immediately, it often takes years to show damage, generally by calcifications forming on and around it. Endocarditis is not always bacterial, but is frequently described that way. See also Calcification.

Correction: The same as above with it not mentioning Infective Endocarditis instead of Bacterial and the other category being Noninfective Endocarditis.

Explanation: See Bacterial Endocarditis (#2)

Number 10 In Glossary:
Hemorrhagic Stroke ? a stroke caused by a leaking blood vessel in the brain, rather than a blocked blood vessel. Risks for occurrence and severity of this type of stroke in older people may be raised by Anticoagulation Therapy. See also Anticoagulation Therapy, Cerebral Hemorrhage.

Correction: The risk of warfarin-induced hemorrhagic stroke occurs to anyone who takes Warfarin or another similar drug, not just people aged 75 or older.

Explanation?See Intracranial

Number 11 In Glossary:
Homograft ? A valve taken from a human body. See also Tissue Valve.

Correction: It should mention something about the human donor being no longer living or Cadaver.

Explanation: A homograft (or allograft) is any part taken from one human to be implanted in another human, including (but not limited to) heart parts. It doesn?t require the donor?s demise in all cases (such as kidney donors). In the case of a heart valve, it?s rather self-limiting. I see no harm in it, but have adjusted the wording to avoid confusion.

Number 12 In Glossary:
Insufficiency ? when blood leaving the heart fails to fully fill up either the aorta or the pulmonary artery. May be caused by stenosis or regurgitation. Sometimes used instead of the term regurgitation. See also Regurgitation.

Correction: You stated of the aorta when actually the insufficiency would occur by the aortic valve. The pulmonary artery insufficiency is actually usually referred to ask pulmonary valve insufficiency. All valves can be affected by insufficiency not just the aortic and pulmonary.

Explanation: Aortic Insufficiency means insufficient blood in the aorta to fill it properly. The source of the term is that the receptacle which the valve feeds has insufficiency, as it is not fully engorged with blood. Insufficiency is only the result of the valve?s or heart?s problem on the valve?s downstream neighbor, and doesn?t describe the valve itself.

Insufficiency is now used commonly as interchangeable with the term regurgitation, but is not precise in that usage, as the valve itself is not insufficient, and the insufficiency can be caused by other factors than valve regurgitation (stenosis, heart failure, myocardial damage). The common usage is acknowledged in the text. By way of correction, the ventricles have been added to the description.


Number 13 In Glossary:
Interventional Cardiologist ? a heart doctor whose specialty is the use of catheters in the arteries to perform angiograms, ablations, angioplasty, placement stents and transcatheter valves, and other non-surgical work on the heart. See Cardiac Catheterization, Angioplasty, Stent Cardiac Ablation, Transcatheter Valve.

Correction: It fails to state the diagnostic end of a interventional cardiologist?s job, which is an integral part of the catheterization lab?s abilities. Also, it should state: stent placement.

Explanation?an angiogram is a diagnostic test, and is the first item mentioned. There would be no room to mention all of the things that can be done in a cath lab. Nor would it ever be finished, as the applications keep piling up. The other sentence was intended to say, ?placement of stents and transcatheter valves.? This will be reworded, to try to include more.

Number 14 In Glossary:
Intracranial ? within the skull. Usually associated with the term intracranial bleed. This is an uncontrolled bleeding incident in the brain, caused by tauma or a brain aneurysm. Use of warfarin can increase the incidence of this problem in older patients. See also Aneurysm.

Correction: Trauma is spelled wrong. The risk of a bleed is increased in anyone taking anticoagulant drugs, not just the elderly.

Explanation?This is basically true, but the overall risk itself from intracranial (and intestinal) bleeds is increased moreso among the elderly, according to studies on anticoagulation. This is only because of the frequency (incidence) of this type of bleeds, which increases with age, not because the younger patient would clot more quickly. Older patients are more prone to these, due to the relative fragility of their vessels. The difference in numbers is sufficient to create a small, but significant negative issue when considering providing mechanical valves for older patients. For that reason, it?s of specific interest to valve patients. I?ll try to rephrase it. Trauma (tauma) was a typo.

Number 15 In Glossary:
mmHG - millimeters of mercury - a unit of measurement used to describe the pressure gradient through a valve (usually the aortic). Most often seen on an echocardiography report. See also Aortic Pressure Gradient, Echocardiogram.

Correction: The official symbol is mmHg instead of mmHG.

Explanation?This was correct in three places in the document, and incorrect twice. It?s an affectation of my typing, where I don?t always get my pinkie off the shift key fast enough.

Number 16 In Glossary:
Palpitations ? a generic name for premature atrial and ventricular contractions. Usually refers to common, non-threatening arrhythmias.

Correction: Palpitations is the abnormal feeling a rapid or irregular heartbeat: skipping, too fast, too slow, quivering, stopping suddenly and restarting, etc. The definition lacks the actual definition. It also implied that PAC/PVC?s are the only palpitations, which is far from the truth. Some are life-threatning.

Explanation?Agreed, excepting that the definition stated that it usually refers to common, non-threatening arrhythmias, which is correct. This has been redone.

Number 17 In Glossary:
Stent ? (1) in a tissue valve, usually a circular plastic or metal piece enclosed in a tissue sleeve that keeps the valve in the proper, round shape, so it opens and closes reliably. As the stent is inside the aorta, it makes the valve opening slightly smaller, unless the valve is placed supra-annularly. (2) In cardiac catheterization, a stent can be used to prop an artery open in a spot clogged by plaque, in place of performing angioplasty. The stent is placed in the artery by a catheter, then opened up to support the artery. Some stents leak small amounts of anticoagulants to avoid blood clot formation at the site. See also Xenograft, Supra-annular, Cardiac Catheterization, Angioplasty.

Correction: The definition states ?in place of performing angioplasty.? Angioplasty is performed when placing a stent to expand the stent into the compression of the artery wall.

Explanation?This was to differentiate between performing angioplasty with a stent, vs. without one, which used to be the norm. It didn?t really convey that message well, so it?s been reworded for clarity.

Number 18 In Glossary:
Tachycardia ? a rapid heartbeat. Note ? Things that stimulate the vagus nerve may help derail a tachycardia episode. They work better if they are attempted soon after the episode begins. These include: straining as if having a difficult bowel movement (do not try if you have an aneurysm or stenosis), rubbing the neck just below the angle of the jaw, and plunging the face into a bowl of ice-cold water. See also Arrhythmia.

Correction: The advice ?rubbing the neck just below the angle of the jaw? should be deleted from the text. This is more commonly known as a carotid artery massage which should only be performed by a physician as people could have undiagnosed Carotid Artery Stenosis, which could cause plaque to move and cause a stroke. Doctors can look for Carotid Artery Stenosis by listening to the artery and listening for a distinct bruit. Imaging is also done sometimes.

Explanation: The sources I used didn?t indicate it was a physician-only procedure. It has been reworded out of the item to avoid any risk it might create.

Number 19 In Glossary:
Transient Ischemic Attack ? a stroke-like attack that resolves itself completely and often leaves no evidence of its cause. Considered to be a precursor to a standard stroke.

Correction: ?Stroke-like? implies that it is of less severity than a stroke, which is far from the truth. ?Mini-stroke? is also a term that shouldn?t be used when relating to a TIA. It should also state that it has the exact same symptoms as stroke and is considered a medical emergency. Transient Ischemic Attack can cause brain damage, but does not always. Evidence can be found sometimes using imaging modalities.

Explanation?.The National Institute of Health takes a different tack, that a TIA is of less severity than an acute stroke, and is transient in nature as the name implies. To wit: ?Most symptoms of a TIA disappear within an hour, although they may persist for up to 24 hours.? More similar at: http://www.ninds.nih.gov/disorders/tia/tia.htm

It seems that when it leaves longer term damage behind, NIH no longer considers it a TIA, but an acute stroke. This logic is even more appealing when it's considered that the term TIA isn?t applied until after the effects of the event have been determined. However, I agree we should add that it should be approached as an acute stroke, as there is no way to tell which it will wind up being.


Number 20 In Glossary:
Ventricular Septal Defect ? a congential condition in which there is a hole between the ventricles of the heart, allowing oxygenated and deoxygenated blood to mix. This causes fatigue and usually requires surgery to patch the hole. See also Left Ventricle, Right Ventricle, Blue Baby Syndrome.

Correction: Actually, most VSD?s are closed in the catheterization lab now unless they are too complex to be done non-surgically. Congenital is spelled wrong. Fatigue should not be mentioned as many heart conditions cause fatigue unless you are going to list the full list of potential symptoms.

Explanation?This has been redone with the catheterization angle added. Congenital (congential) was just a typo here, and is spelled correctly in many other places. The symptoms for VSD are listed most often only as a nonspecific malaise with no other specific symptoms named at all, so fatigue seemed appropriate and reasonable. However, it will be removed to avoid confusion.

Best wishes,
 
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