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l******i
发帖数: 73 | 2 你好。我是写这个贴子的LZ的朋友，也同样在为这个孩子奔忙。我手上译了一份英文的
病历。麻烦你问一下医生。人工二尖瓣叫mitral valve。病历如下：
English Medical Record:
Name: Qianrui Su Gender: female Birthday 2009-6-9
1. Congenital heart disease was found 35 days after the birth (CAVC,
complete atrioventricular canal), and she was treated by radical surgery of
CAVC at Shanghai Children’s Medical Centre on 2009-9-21. Echocardiography
after the surgery shows that ventricular septum and atrical septum are both
well repaired without shunt. Mitral valve is a li... 阅读全帖 |
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c**i
发帖数: 6973 | 3 (1) You are confused.
Your title says 可怜的姐姐. Then you say, "姐姐1987年刚满十岁的时候进行了第
一次心脏手术：房室缺陨。当时手术后伤口化脓感染，几天后又开胸做了清理，并且当
时在医院输血感染上了乙肝。"
You are confused with cause and effect.
The problems were with China's poor medicine, not with your sister. If a
patient in US got/gets hepatitis B after transfution, the patient will sue
the hospital, the blood bank.
In 1980s, one of the best hospitals in Taiwan, owned by central government,
had EVERY open-heart patients infected. The hospital shut down the operat... 阅读全帖 |
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l******i
发帖数: 73 | 4 您好。我是LZ的朋友，也同样为这个孩子在奔忙。我手上有翻译的病历如下：
English Medical Record:
Name: Qianrui Su Gender: female Birthday 2009-6-9
1. Congenital heart disease was found 35 days after the birth (CAVC,
complete atrioventricular canal), and she was treated by radical surgery of
CAVC at Shanghai Children’s Medical Centre on 2009-9-21. Echocardiography
after the surgery shows that ventricular septum and atrical septum are both
well repaired without shunt. Mitral valve is a little narrow and mitral and
tricuspid valv... 阅读全帖 |
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m********4
发帖数: 607 | 5 We currently have these 2 patients. As a Doctor, how do you feel if they are
your patients?
Life is unfair, isn't it?
---------------------------------------------------
A: 46 yo patient multiple times hospital admissions.
-PAST MEDICAL HISTORY INCLUDES:
1. Hypertension.
2. Hyperlipidemia.
3. Diabetes type 2.
4. Hypothyroidism.
5. Obesity.
6. Congestive heart failure secondary to mitral stenosis status
post mitral and tricuspid annuloplasty in 2003 with known
physiology compl... 阅读全帖 |
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E******r
发帖数: 40 | 6 你可以查询：
rheumatic heart disease (风湿心脏病)
mitral valve stenosis
mitral valve regurgitation
heart valvular replacement
第二，第三个是风湿心脏病最常见的现象，第四个是瓣膜更换。如果你妈妈年纪较高，可
以看看仿生瓣膜(bioprosthesis)有关的信息。
四
多
很
我
加 |
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d**j
发帖数: 240 | 7 这还需要吐脏字啊？呵呵。
你看最新一期的nejm Article，共5篇
Stenting and Medical Therapy for Atherosclerotic Renal-Artery Stenosis
第1作者兼Christopher J. Cooper, M.D.,.*********************[email protected].
Mitral-Valve Repair versus Replacement for Severe Ischemic Mitral
Regurgitation
共20个作者，第5作者兼 Annetine C. Gelijns, Ph.D. a**************[email protected].
Unexpected Abrupt Increase in Left Ventricular Assist Device Thrombosis
第1作者兼Randall C. Starling, M.D., M.P.H.,............. s*****[email protected].
A Randomized Trial of Prolonged C... 阅读全帖 |
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y**********7
发帖数: 52 | 8 考版都不需要这些..
只要知道在哪个瓣膜区, 在收缩期或舒张期的就可以了..
没有这种要鉴别 mitral regurgitation vs mitral valve prolapse 的题..
真考版答案选项是只有其中之一. |
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n***j
发帖数: 184 | 9 Re: MVP, less preload, less tense the chordae tendieae (CT), longer distance
the mitral valve needs to travel from the relaxed position to closed
position. So louder murmur. You may take a look at the anatomy from google
image and see the position of the mitral valve.
Valsava is all about increasing intraabdominal pressure so we usually pay
attention to the change during the strain part. But you are right, strain
and release have opposite effects on the murmur. |
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s******w
发帖数: 80 | 10 请教各位大神，国内心脏彩超的描述，我自己结合google翻译，是否准确？
右房右室增大，左房左室大小范围正常；各瓣膜回声及开放尚好；房间隔与左室后壁厚
度正常，略成通向运动，搏动好；房间隔中部连续性中断，可见回声失落约9mm. 主肺
动脉内径未见异常。PDE, CDFI可见房间隔水平左向右分流，二尖瓣瓣口血流E峰大于A
峰及二尖瓣、三尖瓣反流征象。CW估测肺动脉收缩压约为30mm Hg.
Right atrium and right ventricle enlargement, left atrium left ventricle
size within normal range; the echo and opening of valves are still OK;
interatrial septum and posterior left ventricle thickness normal, slightly
into the movement, good pulse; interrupted central continuity of the
interatrial sept... 阅读全帖 |
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发帖数: 1 | 11 11 月13日 终于找到另一股在我家害我的势力
昨天，这些人折腾了一天，白天，晚上皮啦啦，也不知道谁把谁杀了，谁把谁带走了。
反正我先生和孩子被绑架了，就不知道是不是已经遇害了。我本来是打算睡觉的，但他
们头上，地下装电磁波攻击器，让我几乎窒息。虽然我没倒下，但其实他们在我身上扎
的毒针已经蔓延，我能感觉到我的呼吸有窒息的感觉。我想我对他们已经非常仁慈了，
但他们不依不饶地攻击我，欲置我于死地，让我非常生气，特别是肆意伤害我家里的人
，绑架我先生和孩子，而且有许许多多无辜的生命毁于他们之手，有必要把他们曝光。
当然我还没分析这里边是那几个人具体攻击我，伤害我的，但他们显然都是一伙的。鉴
于他们伤害我的头部，胸部 和胃部，我就把这几部分的医生都曝光，受害者慢慢去调
查，追查他们吧。
Cleveland Clinic, Website: my.clevelandclinic.org
Call 855. REFER. 123 or 855.733.3712
Lung Cancer
Results: 57 Doctors
PREV123NEXT
Results per page:
Dav... 阅读全帖 |
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W*****B
发帖数: 4796 | 12 trivial to mild的二尖瓣或三尖瓣regurgitation有意义吗？ |
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t**x
发帖数: 20965 | 13 Here's a (partial) list of all the pre-existing conditions the GOP bill may
not cover
感觉常见病都包了
Acne
Acromegaly
AIDS or ARC
Alzheimer's Disease
Amyotrophic Lateral Sclerosis
Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)
Anxiety
Aortic or Mitral Valve Stenosis
Arteriosclerosis
Arteritis
Asbestosis
Asthma
Bipolar disease
Cancer
Cardiomyopathy
Cerebral Palsy (infantile)
Chronic Obstructive Pulmonary Disease
Cirrhosis of the Liver
Coagulation Defects
Congestive Heart Failure
Cy... 阅读全帖 |
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y***u
发帖数: 64 | 14 风湿性心脏病, rheumatic heart disease
二间瓣, mitral valve
there are two types of artificial heart valves: mechanical and bioprosthetics
(from animals such as pigs).
Do a google search and you will find a lot of information. Good luck. |
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f******I
发帖数: 769 | 15
rheumatic heart disease, mitral valve insufficiency? |
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f******I
发帖数: 769 | 16
based on the echocardiogram, it's quite unremarkable, i wouldn't worry too
much about the trace mitral regurg,
i'm not sure about the ECG though, depends on your age,
many healthy young adults have a very slight ST elevation, which is normal
and occurs mostly in pre-cordial leads from V1 to V6,
to my poorly trained eyes you have some very subtle ST changes and maybe
elevations but not significant enough,
and i don't know what happened at lead V3, if that's poor repolarization or
what;
the other |
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f******I
发帖数: 769 | 17
24 hr holter is a good screening test to look for any type of arrythmia such
as PACs or PVCs,
most of PACs and even PVCs are benign unless there is known structural
defect, valvular disease, such as mitral valve, or underlying coronary
artery disease,
coffee and alcohol and smoking also tend to increase atrial premature beats
often perceived as "skipped beats", |
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f******I
发帖数: 769 | 18
she could still have paroxysmal afib that 24 hrs holter failed to capture,
what is her ejection fraction? does she also have any significant valvular
disease, such as mitral valve? what are her atrial sizes? what medications
does she take? |
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h***f
发帖数: 162 | 19 Are you sure this is a heart attack? 35 is very young to have a heart attack
. Chances are your husband had an arrhythmia. Given his age, unless he has a
history of mitral stenosis or regurgitation secondary to rheumatic fever, I
don't think he has atrial fibrillation. He probably has supraventricular
tachycardia, although without an EKG I can't tell you what kind (AVNRT, AVRT
, MAT, atrial flutter, etc). If your husband's arrhythmia cannot be
controlled, he may undergo an ablation procedure and... 阅读全帖 |
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D*****r
发帖数: 6791 | 21 Thank you, Lord, for cancer, flu,
For athlete’s foot and typhus too.
Your wondrous world with birth defects,
And ticks and strokes is so complex.
I marvel at your pedophiles,
And mumps sure does elicit smiles.
Your greatest feat -- the tornadoes
Are right up there with lava flows.
I simply love my varicose veins,
And thank you for the hurricanes.
The miracle of gum disease
Goes hand-in-hand with cavities.
My urinary incontinence
Compliments my flatulence.
Chickenpox is a grand thing,
As is, I f-... 阅读全帖 |
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s******n
发帖数: 2279 | 22 ME NOT A CARIAC DOC,BUT 伟大的GOLJAN在他的大作RAPID REIEW PATHOLOGY 中提到
As blood exits the left ventricle, the anterior leaflet of the mitral valve
is drawn against the hypertrophied Interventricular Septum
Harsh systolic ejection murmur is intensified by the worsening of the
obstruction, which can be caused by a decreased preload, including Valsalva
maneuver( increased positive intrathoracic presseure)
回心血量少了，收缩期射血二尖瓣前叶更容易梗阻流出道 |
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h**s
发帖数: 1757 | 23 The notes said that VSD and Mitral regurgitation murmur would
"no change" when squatting, why?
I thought the murmur should be increased because when squatting,the
afterload is increased.
Thanks!!! |
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c**i
发帖数: 6973 | 24 I assume CMG stands for Chinese medical graduate.
I am not familiar with China. But I know Taiwan's medicine inside and out.
(a) A former colony of Japan, Taiwan follows Japan's medical tradition.
Older doctors were Japanese-trained (they died out); later generations are
American-trained. Commoners highly respect doctors/teachers. But when
doctors did bad things or made mistakes, we clammed up. Patients knew nothing;
doctors covered up for one another; lawyers did not sue; everything was
kosher.... 阅读全帖 |
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M****a
发帖数: 577 | 25 1. A 60-YO female said:" I have a loving boyfriend called arthritis."
2. Another 60 YO female said:" I am Ms.Piggy at heart." She has a porcine
prosthetic mitral valve placed 2 years ago.
have |
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H*****1
发帖数: 41 | 26 来自主题: MedicalCareer版 - uw题请教 restricted motion of aortic or mitral valve cusps倒底产生什么样的后果和心音
，狭窄／返流？为什么？
谢谢 |
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发帖数: 1 | 27 去参加了纽约GOLD 辅导班，听到些新信息，和大家分享一下。
1. Pain rating: 0-10, not 1-10 (FA) 专门问了在做临床的，的确如此。FA 过时
了。
2. During hx taking, if your height is above 5’3’’, you should sit
down. “Do you mind if I sit down and take some notes?” 这样就不会有高高在
上的感觉。但我感觉不能绝对，如果病人很高， 坐在病床上也很高，你一坐下离老远
，你就站着，只要两个人视线平齐就好。
3. Questions about sexual partners. FA : “men, women, or both?” Some
patients will feel offended. To be safe, ask: “can you describe your sexual
partners for me?”
4. If you use hand sanitizer, say “Are you a... 阅读全帖 |
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l******0
发帖数: 1362 | 32 谢谢斑竹。能否把所有的这类学习资料合集放精华啊？ |
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y*****g
发帖数: 193 | 34 murmur is whooshing sound, s3,s4 is galloping sound. S1,s2,s3 sometimes like
"kentucky",s3 is -chy ; s4,s1,s2 is "tennesse",s4 is "tenn--".
to differentiate murmur, first identify it's systolic murmur or diastolic
murmur. When you ausculate heart, also press carotid pulse. If murmur after
pulsation, it is systolic. if murmur before pulsation, it is diastolic. then
you need identify it is aortic murmur or mitral valve murmur. Move your
stethscope, find the area where you heard murmur sound loudes |
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d***n
发帖数: 43 | 35 经常看见有通过考试来报喜的童鞋，替她们高兴之余想到自己的失败经历，写出来和大
家分享一下吧。
2010年6月中旬，既蠢又懒的我呕心沥血的终于熬到毕业。和别人share Kaplan, 把考
试日子定在了8月6日。 毕业的兴奋冲晕了头脑，做了件相当蠢的事：把所有书和资料
都卖了，认为1个多月应该把重点放在做题而不是看书。可悲的是每天做不到50题，成
绩是40%-50%。居然毫无危机感。（自大啊，太高估自己了。导致最后悲剧的发生。）
8月6日，12：30pm开考。边做心就边沉，似乎都不难，但没多少是确定的。 于是安慰
自己慢慢做，每个选项都仔仔细细的想完又想（又一致命错）。结果是越想越不确定。
做到75题没出现期望中的黑屏，一阵失望。很快到了第一个休息时间，当时想100题就
完了吧。 可是没有。 110，120，130。。。真希望下一题就黑屏。可是没有！ 等来的
是第二个休息。开始烦躁，怎么那么没完没了？！ 160，170，180。。。如坐针垫。
做到200题， 我已经崩溃了。眼睛越来越模糊，肚子越来越饿，心越来越凉，凉得身子
开始发抖， 大腿坐得早就发麻了。
由于开始做得太慢了，我意识到... 阅读全帖 |
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p**i
发帖数: 66 | 36 That's hard to compare because they are two different career paths and it
really depends on at which stage you are in your life. Overall, I think it
all boils down to the timing in your life--whether you are willing to go
through extra years of school and put your spouse and children through some
extra sacrifices.
For a 20 year old or someone who doesn’t mind going through med school and
residency for 7, 8 years later in their lives, I'd say go for the MD if you
want a doctor’s title and a hig... 阅读全帖 |
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f****o
发帖数: 2770 | 37 我讲话难听由于家庭遗传，真不好意思。
我吧书本上的东西全部贴出来，你能看懂多少算多少吧。
Heart Failure
DEFINITION
Heart failure (HF) is a clinical syndrome caused by the inability of the
heart to pump sufficient blood to meet the metabolic needs of the body.
Heart failure can result from any disorder that reduces ventricular filling
(diastolic dysfunction) and/or myocardial contractility (systolic
dysfunction).
PATHOPHYSIOLOGY
Causes of systolic dysfunction (decreased contractility) are reduction in
muscle mass (e.g., myocardial infarctio... 阅读全帖 |
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g*2
发帖数: 658 | 38 刚刚把堆积了几个星期的nejm翻看了一下，居然在11月底的那期case discussion就是
讲得这个病
http://www.nejm.org/doi/full/10.1056/NEJMcpc1103565
Case 36-2011 — A 93-Year-Old Woman with Shortness of Breath and Chest Pain
Presentation of Case
Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the
emergency department at this hospital because of chest pain and shortness of
breath.
The patient had been in her usual state of health, with hypertension and
chronic renal insufficiency, until the morning of admission, wh... 阅读全帖 |
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g*****d
发帖数: 991 | 39 4. A healthy 78-year-old man, who is still working, comes for a
consultation because he is "just not feeling well." He has "weakness"
associated with dyspnea occuring unpredictable. Episodes last from a few
seconds to several minutes. He has never had syncope. During the last 2-3
years, he has had 8-10 episodes of typical angina on very severe effort. He
weighs 235 pounds, has been treated for hypertension for many years with "
good control," and has troublesome arthritis in his right shoulde... 阅读全帖 |
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w*****s
发帖数: 230 | 40 5. Indirect markers for impaired relaxation of the left ventricle include
abnormal annular and septal tissue doppler patterns, 'a' wave reversal in
pulmonary venous Doppler.
6 There is mild increase in velocity across aortic, pulmonary and mitral
valves, indicating hyperdymanic or fluid over overloaded status.
谢谢南山无言的回复，现在的问题是5是否说明一种危险呢？
因为我家宝宝肝硬化，当初医生说心脏没有问题，肝硬化查不出病因。
目前我们已经基本确定病因，而这个病很新，很多人都表现为心脏有问题，心脏没有问
题的还比较少见。当初我们医生说他心脏没有问题，可问题是可能5就是一个问题。
具体病因就是fatty acid oxidation disorders, 再具体就是acad9，介于... 阅读全帖 |
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