Cardiology

Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. The field is commonly divided in the branches of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are called cardiologists.

The term cardiology is derived from the Greek word  (transliterated as kardia and meaning heart or inner self).

Basic anatomy (Structure of the heart)

* Epicardium
* Pericardium
* Myocardium
* Papillary muscle
* Endocardium
* Coronary circulation (Blood supply of the heart)
* Heart valves

Circulatory system (Blood supply of the body)

* Cardiac output
* Heart rate
* Vascular resistance
* Blood vessels

Pulmonary circulation (Oxygenation of the blood)

* Pulmonary artery
* Pulmonary vein

Cardiac pacemaker (Electrical system of the heart)

* Electrical conduction system of the heart
o Action potential
+ Ventricular action potential
* Sinoatrial node
* Atrioventricular node
* Bundle of His
* Purkinje fibers

Basic cardiac physiology

* Systole
* Diastole
* Heart sounds
* Preload
* Afterload
* Kussmaul’s sign

Disorders of the coronary circulation

* Atherosclerosis
* Restenosis
* Coronary heart disease (Ischaemic heart disease, Coronary artery disease)
* Acute coronary syndrome
o Angina
o Myocardial infarction (Heart attack)

Sudden cardiac death (The abrupt cessation of blood flow, leading to death)

* Cardiac arrest

Treatment of sudden cardiac death

* Cardiopulmonary resuscitation (CPR)

Disorders of the myocardium (muscle of the heart)

* Cardiomyopathy
o Ischemic cardiomyopathy
o Nonischemic cardiomyopathy
+ Amyloid cardiomyopathy
+ Hypertrophic cardiomyopathy (HCM)
# Hypertrophic obstructive cardiomyopathy (HOCM) (Idiopathic hypertrophic subaortic stenosis (IHSS))
# Apical hypertrophic cardiomyopathy
+ Dilated cardiomyopathy
# Alcoholic cardiomyopathy
# Tachycardia induced cardiomyopathy
# Takotsubo cardiomyopathy (Transient apical ballooning, stress-induced cardiomyopathy)
+ Arrhythmogenic right ventricular dysplasia (Arrhythmogenic right ventricular cardiomyopathy)
+ Restrictive cardiomyopathy
* Congestive heart failure
o Cor pulmonale
* Ventricular hypertrophy
o Left ventricular hypertrophy
* Primary tumors of the heart
o Myxoma

Disorders of the pericardium (outer lining of the heart)

* Pericarditis
* Pericardial tamponade
* Constrictive pericarditis

Disorders of the heart valves

* Aortic valve disorders
o Aortic insufficiency
o Aortic stenosis
o Aortic valve replacement
o Aortic valve repair
o Aortic valvuloplasty
* Mitral valve disorders
o Mitral valve prolapse
o Mitral regurgitation
o Mitral stenosis
o Mitral valve replacement
o Mitral valve repair
o Mitral valvuloplasty
* Pulmonary valve disorders
o Congenital pulmonic stenosis
* Tricuspid valve disorders

Disorders of the electrical system of the heart (Cardiac electrophysiology)

* Cardiac arrhythmias
o Supraventricular tachycardia (Fast rhythms that originate above the ventricles)
+ Atrial fibrillation
+ Atrial flutter
+ Atrial tachycardia
+ Sick sinus syndrome (Tachy-Brady syndrome)
+ AV nodal reentrant tachycardia (AVNRT)
+ AV reentrant tachycardia (AVRT)
* Bigeminy
* Premature ventricular contraction
* Ventricular tachycardia
o Monomorphic ventricular tachycardia
o Polymorphic ventricular tachycardia
+ Torsades de pointes
* Ventricular fibrillation
* Sick sinus syndrome
* Bundle branch block
o Left bundle branch block
o Right bundle branch block
* Heart block
o First degree heart block
o Second degree heart block
o Trifascicular heart block
o Third degree heart block
+ Lev’s disease
* Specific diseases of the electrical system of the heart
o Brugada syndrome
o Long QT syndrome
+ Andersen-Tawil syndrome
+ Romano-Ward syndrome
o Short QT syndrome
o Wolff-Parkinson-White syndrome (WPW syndrome)

Inflammation and infection of the heart

* Endocarditis
o Rheumatic heart disease
* Myocarditis
* Pericarditis

Congenital heart disease

* Atrial septal defect
* Ventricular septal defect
* Patent ductus arteriosus
* Bicuspid aortic valve
* Tetralogy of Fallot
* Transposition of the great vessels (TGV)

Diseases of blood vessels (Vascular diseases)

* Vasculitis
* Atherosclerosis
* Aneurysm
* Varicose veins
* Economy class syndrome
* Diseases of the aorta
o Coarctation of the aorta
o Aortic dissection
* Diseases of the carotid arteries
o Carotid artery disease
o Carotid artery dissection

Procedures done for coronary artery disease

* Atherectomy
* Angioplasty (PTCA)
o Stenting
* Coronary artery bypass surgery (CABG)
* Enhanced external counterpulsation (EECP)

Devices used in cardiology

* Stethoscope
* Devices used to maintain normal electrical rhythm
o Pacemaker
o Defibrillator
+ Automated external defibrillator
+ Implantable cardioverter-defibrillator
* Devices used to maintain blood pressure
o Artificial heart
o Heart-lung machine
o Intra-aortic balloon pump
o Ventricular assist device

Diagnostic tests and procedures

* Blood tests
* Echocardiogram
* Cardiac stress test
* Electrocardiogram (ECG or EKG)
o Ambulatory Holter monitor
* Electrophysiologic study
o Programmed electrical stimulation
* Sphygmomanometer (Blood pressure cuff)
* Cardiac enzymes
* Coronary catheterization
o Myocardial Fractional Flow Reserve (FFRmyo)
o IVUS (IntraVascular UltraSound)

Cardiac pharmaceutical agents

The followings are medications commonly prescribed in cardiology:

* Antiarrhythmic agents
o Type I (sodium channel blockers)
+ Type Ia
# Quinidine
+ Type Ib
# Lidocaine
# Phenytoin
+ Type Ic
# Propafenone
o Type II (beta blockers)
+ Metoprolol
o Type III (potassium channel blockers)
+ Amiodarone
+ Dofetilide
+ Sotalol
o Type IV (slow calcium channel blockers)
+ Diltiazem
+ Verapamil
o Type V
+ Adenosine
+ Digoxin
* ACE inhibitors
o Captopril
o Enalapril
o Perindopril
o Ramipril
* Angiotensin II receptor antagonists
o Candesartan
o Eprosartan
o Irbesartan
o Losartan
o Telmisartan
o Valsartan
* Beta blocker
* Calcium channel blocker

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