Cardiology Scheme and Heart Failure

Cardiology Dr . Ahmad Mowafy

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branch

liver

80 %

rheumatology liver


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Heart failure

cardiology

cardiology

branch


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Liver

written

Liver

Liver

Liver


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Liver

Jaundice

Liver

Liver

Liver

Liver rheumatology

15


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Cardiology Neuro

cardiology

cardiology

rheumatology

rheumatology cardiology

cardiology

cardiology

cardiology

cardiology

60 % cardiology

cardiology

cardiology


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Neuro endocrine GIT rheumatology Infection blood chest

cardiology

cardiology

2007

In capsule series

In Capsule Series

arrhythmia

rheumatology

attitude

cardiology

cardiology

clinical picture investigations

clinical pictures

clinical pictures

clinical picture cardiology


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Manifestations of low cardic output

Low cardic output

low cardic output

Low cardic output

headache blurred of vision

Syncope

syncope

ischemic heart disease

Oliguria

S

S

skin

skeletal muscle

skin pale and cold skeletal muscle fatigue claudication

cardiology

fatigue and intermittent claudication

pulse

blood pressure pulse

blood pressure


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low cardic output

symptoms and signs

signs

signs

symptoms symptoms

signs of low cardic output

9: 10

9: 10

signs

Syncope Ischemic heart disease Oliguria Pallor

fatigue and intermittent claudication Pulse Blood pressure

signs



signs

cold

pulse

cyanosis



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Low cardic output

Manifestation of

Pulmonary congestionLung congestion

Pulmonary Lung

Lung congestion

Lung

Left side

Lung left

lung congestion

lung congestion

cardiology dyspnea

dyspnea dyspnea

specific left sided heart failure

specific left sided heart failure

Left sided heart failure

specific

dyspnea

dyspnea

Paroxysmal nocturnal dyspnea

Lung congestion

dyspnea


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Coughhemoptysis

Recurrent chest infection

congestion pleura pleural effusion

congestion acute

alveoli pulmonary edema

alveoli

apparatus

mechanism of

alveoli

crepitation

systemic congestion

systemic congestion

congestion


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Insomnia

congested neck vein

Edema lower limb

edema lower limb

Low cardic output

fatigue

Lung congestion ischemia

systemic congestion edema lower limb

then ascites

edema pitting Non pitting

Pittingbilateral Unilateral

bilateral

Unilateral

heart failure

P

Pittingbilateral

insomnia congested neck vein

edema lower limb then ascites


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sweating on slight activity

systemic congestion

systemic congestion

sweating on slight activity

Liver

Enlargedsoft smooth round edge tender

Liver

GIT

dyspepsia

Dyspepsia Heart burn

diarrhea

dyspepsia

related dyspepsia

Heart failure

systemic congestion

Pleural effusion

Pleural effusion systemic congestion

pleura

visceral Pulmonary circulation

Parietal systemic circulation


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Left right

Left right

Pleural effusion

systemic congestion

Low cardic output

cardiology

Manifestation of low cardic output

Lung congestion

systemic congestion

Pericardial effusion



Low cardic output

systemic congestion

Lung congestion

chest pain chest pain

angina


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Palpitation

arrhythmia Palpitation

Palpitation

bigger not better

Mediastinum

mediastinum

pressure manifestation

trachea Lung

dyspnea cough

esophagus

dysphagia

Nerve

left recurrent laryngeal nerve

Hoarsness of voice

Left recurrent laryngeal nerve

right

right


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Low cardic output

Lung congestion

systemic congestion

Chest pain Palpitation Pressure manifestation

stagnation of blood thrombo embolism

cardiology

clinical picture of cardic tamponade

cardiology

cardiology


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clinical picture

rheumatology

rheumatology

cardiology

Investigation

Investigation

Investigation cardiology

Investigation

ECG

ECHO

angio

cardiology

Investigations

Investigations

Investigations

cardiology


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X-ray ECG ECHO Catheterization

To detect the cause and to detect chamber enlargement

Detect the cause detect the chamber enlargement

ECHO

detect paradoxical movement of the myocardium

paradoxical movement of the myocardium

ECG

ECG To detect the cause and detect chamber enlargement

ECG

ECG

Angina ECG angina

Myocardial infarction

dry pericarditis


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arrhythmia arrhythmia ECG

ECG

ECG

detect the cause and detect chamber enlargement

investigations

myocardium infarction

cardic enzymes

Myocardial infarction

cardic enzymes

ECG

Infective endocarditis

infective endocarditis

culture

pulmonary

20 :40


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pulmonary embolism

myocardial infarction

infective endocarditis

Pulmonary embolism

Pulmonary embolism

Pulmonary embolism

dissecting aorta

CT

angio CT

CT

CT dissecting aorta


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dissecting aorta

dissecting aorta

CT

constrictive pericarditis

CT

Investigations

Investigations

Investigations

Investigations

Investigations

treatment

Investigations

etiology

Investigations

Heart failure


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investigations

cardiology

definition

etiology

clinical pictures

differential diagnosis

treatment

cardiology

Liver

cardiology

Liver

Liver

heart failure angina


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cardiology

endocrine

endocrine

Infection

cardiology

cardiology

cardiology branch

heart failure

Heart failure heart failure

definition

definition etiology etiology Heart failure

etiology

heart failure

etiology Hyper tension


etiology

etiology

etiology


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Pathophysiology

cardic reserve

etiology

clinical pictures

investigation cardiology

Investigations Investigations break

Investigations

treatment

definition of heart failure

Definition

definition heart failure


syndrome in which the heart can't maintain adequate cardic output

clinical syndrome in which

can't maintain adequate cardic output

adequate

Normal cardic output

high cardic output heart failure

High cardic output heart failure

cardic output Heart failure


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heart failure

High cardic output

normal

adequate cardic output

adequate

syndrome in which the heart can't maintain adequate

adequate

cardic output


In spite of normal ventricular filling

ventricle

shock

Heart failure

In spite of normal venous return

In spite of normal


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ventricular filling

etiology

Etiology

etiology

etiology

Heart failure

right left sided heart failure


Left

etiology

the most common causes are

Coronary heart disease Hyper tension

etiology

etiology

clinical pictures

Item clinical picture of the cause

clinical picture of the cause

cause

coronary heart disease


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hyper tension

Heart failure

Left side of the heart

left atriumleft ventricle

Left atrium

atrium

left sided heart failure 70 % pressure gradient

left atrium

failure

left atrium Essential for life

left atrium

left atrium failure

left atrium failure

Left atrium failure

Mitral stenosis

left atrium

bigger not better


Mitral stenosis

Mitral stenosis valvular heart disease

related

left sided heart failure


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Mitral stenosis left ventricle Left ventricle

left ventricle mitral stenosis

female female

Femalefemale

female

Femalefemale

female

female

Mitral stenosis

left atrium

Myxoma

benign tumor Left atrium

left atrium

atrium

left ventricle


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Left ventricle

Left ventricular failure

Myocardial disease

myo Myocardial infarction

Myocarditis

myopathy cardiomyopathy

after load

after load

pre load

Load

Load

Load after load

pre load

after load

after load

systemic hyper tension


the most common causes are coronary and systemic hyper tension


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most common causes

Systemic hyper tension

Aortic stenosis

Coarctation of the aorta

Pre load Pre load

pre load

Pre load venous return

venous return

after load

Pre load

Hyper dynamic circulation


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Valvular heart disease

Mitral stenosis

Mitral regurge aortic regurge

Mitral regurge aortic regurge pre load

valvular heart disease

mitral aortic regurge



congenital heart disease

VSD

VSD

VSD




PDA in left and ASD in right

PDA ASD




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coronary heart disease

hyper tension

acute heart failure

diastolic heart failure

acute

diastolic

causes of diastolic heart failure


systolic heart failure


etiology

acute heart failure


acute heart failure diastolic heart failure

precipitating factor

Precipitating factors



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A

Anemia Arrhythmia

Heart failure

Precipitating factor

Heart failure

P pregnancy

Physical effort

i

infection

iatrogenic

infection Infection Infective endocarditis

iatrogenic calcium channel blocker

heart failure

endocrine

Load

endocrine


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diastolic acute

cardic reserve

cardic reserve

Heart failure

cardic reserve

heart failure

cardic output


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cardic output Stroke volume heart rate

stroke volume

stroke volume

heart rate

Heart rate

sympathetic

sympathetic

heart rate

cardic reserve

cardic reserve

heart rate

150

150

tachycardia


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tachycardia

Heart rate

heart rate

120 70

physiological

Physiological

Heart rate

heart rate

Beta blocker

cardic output

stroke volume heart rate


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Tachycardia

cardic reserve

Left ventricle

left ventricle

dilatation

fibers Starling law

within limit

ventricular dilatation

fibers

after load

against resistance

Hypertrophyhypertrophy

without blood supply

ischemia


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cardic reserve

adverse effect

side effects

ANP PNP Atrial naturtic peptide

ANP

ANP

failure

ANPANP

shock

dyspnea

dyspnea chest

MCQ

chest X-ray

ECG

ECHO

ANP

chest dyspnea

ANP


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ANP

ANP lasix

heart failure heart failure

: : - : :

heart failure

Heart failure

lasix

lasix

Lasix

ANP lasix

heart failure

heart failure

lasix

sympathetic

renin renin

RBCs

Low cardic output

Renin ANP

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cardic reserve

cardic reserve heart failure

cardic reserve

Heart failure

symptoms

etiology heart failure

definition

Heart failure

clinical pictures treatment differential diagnosis

Investigations

clinical pictures

clinical pictures

Clinical pictures

clinical picturescardiology


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clinical pictures cardiology

clinical pictures of cardiology



Left ventricle

Manifestation of low cardic output

manifestations Low cardic output

dizziness

tinnitus blurring of vision

syncope


manifestions of lung congestion


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left ventricle

left atrium

left atrium

Lung

Pulmonary veins

pulmonary veins

Left atrium

left atrium

Pulmonary veins

pulmonary congestion pulmonary veins

Manifestions of lung congestion

Lung congestion

clinical pictures of left sided heart failure

Low cardic outputcardiology


Left Lung congestion

lung congestion

clinical pictures of the cause


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coronary disease

systemic hypertension

Pressure manifestations

dilatation hypertrophy

even source

thrombo embolism

stagnation of blood

Manifestations of thrombo embolism

clinical pictures

Cardic signs


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clinical pictures

cardic signs

cardic signs

Manifestations of low cardic output

symptoms signs

symptoms signs

lung congestion systemic congestion


symptoms signs


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cardic signs

IQ IQ

left

left ventricular enlargement

Left ventricular

Left ventricle

MCQ



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MCQ

right ventricular enlargement

bilventricular enlargement

right ventricle

Left ventricle

clinical

left ventricle right ventricle


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Most anterior

right ventricle

most posterior

left

right ventricle

most anterior

Left ventricle

apex

clinical

clinical

apex of the heart

Left ventricle

right ventricle

spleen

Left ventricle


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right ventricle

spleen

left ventricle

left ventricle

apex

Localized Localized

diffused

diffused

right ventricle

right ventricle

normal

cardiology

chamber

According


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longitudinal axis

Longitudinal axis left ventricle

right ventricle

longitudinal axis

Left ventricle

longitudinal axis

apex

outward and downward

apex

According the longitudinal axis

Longitudinal axis

Palpation

right ventricle

longitudinal axis

Outward

According


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During systole

apex

bulge

systolic bulge

contraction

rotation

IQ

systolic bulge


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systolic bulge

systolic bulge

due to rotation of the heart


rheumatology

rheumatology

rheumatology


Localized

outward and downward

systolic bulge

Left ventricular enlargement

tachycardia

tachycardia


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tachycardia pulse

Pulse

pulsus alterns

Pulsus alternas

Pulse

pulse

heart failure

Pulse

pulsus alterns

heart


left ventricle

left ventricle

left ventricle


left ventricle

fibers healthy

fibers diseased

healthy diseased

diseased


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healthy fibers

diseased fibers

healthy

diseased

fibers healthy


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healthy

healthy diseased

Healthy

Healthy

stress

Pulsus alterns

Normal heart sound

S1 and S2

systole distole

first heart sound second heart sound

S1S2S2 S1

S1 S2 systole

S2 S1diastole (

clinical first heart sound second heart sound

first second


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timing carotid

systole diastole

tachycardia

first second

diastole

atrium ventricle

left ventricle

left ventricle

Left ventricle


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ventricle

Vibration

Heart failure ventricle

ventricle

S3

S3Heart sound

tachycardia

gallop

Gallop

Left ventricle

left ventricle

cuspus valve


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regurge

apex

Pan systolic murmur of mitral regurge


murmur Mitral regurge

left ventricle

signs

clinical pictures

Low cardic output

Lung congestion

cardic signs

cardic signs


pulse


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clinical pictures

right

Right

right Left

Lung congestion systemic congestion

right ventricular

Investigations

Investigations

Investigations

Pulsus alterns right

Pulsus alterns

Pulse

Pulse Left ventricle

right ventricle

right pulsus alterns


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Investigations

Investigations

Investigations

Investigations

Investigations

X-ray ECG ECHO cath

key investigations

heart failure

X-ray

ECG

ECHO

ECHO

ECHO

ECHO

ECG

X- ray

to detect the cause, to detect the chamber enlargement

ECHO


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Ejection fraction

EF

EF Ejection fraction

ejection fraction

100

50

ejection fraction

50/100 50 %

heart failure

ejection fraction

stroke volume

diastole systole diastole

end diastolic volume

stroke volume 70

end diastolic volume physiology 140

Ejection fraction 10 %


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ejection fraction

Investigations

ANPANP

acute dyspnea ICU

9092

92

92

Investigations treatment


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treatment of heart failure

Treatment

treatment of the cause

precipitating factors

failure

failure

Logic

Liver


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Liver

hypo kalemia

hypokalemia Liver

D D D

diuretic

diuretic

diuretics

heart failure digitalis

Heart failure

digitalis

diuretics

diuretics

Load

vaso dilator

after load

preload

diuretics

lasix thiazide


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spironolactone

spironolactone

Lasix thiazide

Mechanism of action

Kidney

kidney

lasix loop of Henle

thiazide

Distal tubules DD

loop

thiazide

distal

95 % absorption

mechanism of action

re absorption of

H ions

side effects

side effects

Hypo

Hypokalemia Hypokalemia

Hyperglucose

hyper glycemia


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hyper glycemia Hyperlipidemia Hyperurecemia Hypercalcemia

side effects

Hyperglycemialipidemia urecemia calcemia

calcemia

thiazide Hyper calcemia

Lasix Hyper calcemia

hyper calcemia

thiazide hypercalcemia

lasix Hypocalcemia

lasix

Ototoxicity

lasix

4080

160

lasix


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lasix

lasix symptomatic treatment

load

symptomatic treatment

congestion

Heart failure congestion

Digitalis digitalis

action

action

cardiology

cardiology

digitalis

digitalis action

contractility

heart failure

conductivity

conductivity

A.V. node

atrial arrhythmia

conductivity

arrhythmia atrium ventricle

ventricle

conductivity

Atrial arrhythmias

contractility Heart failure


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conductivity

atrial arrhythmias

para sympathetic effect

para sympathetic

contractility

para sympathetic contractility

parasympathetic

ventricle

digitalis

digitalis

digitalis

excitability

digitalis

Para sympathetic tachycardia

excitability

arrhythmia of digitalis

digitalis

digitalis

magic product

digitalis

digitalis arrhythmia


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heart failure

arrhythmia

digitalis toxicity

arrhythmia digitalis

type two second degree heart block

digitalis

arrhythmia

sinus tachycardia

bradycardia

sinus tachycardia

arrhythmia

arrhythmia

heart block

digitalis heart block

digitalis type two second degree heart block

arrhythmia

MCQ

digitalis

contra indication of digitalis

digitalis toxicity

paroxysmal

ventricular tachyarrhythmia

arrhythmia


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V Tac

ventricular tachycardia

digitalis

digitalis

arrhythmia ventricle

arrhythmia atrium

ventricle

excitability

digitalis ventricular tachycardia

excitability

absolute contraindication

digitalis

digitalis toxicity


Heart rate

A.S. node

ectopic focus

excitability




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arrhythmia

atrium

atrium

ventricular

no absolute contra indication digitalis

absolute contraindication in very severe heart failure

absolute contraindication


severe heart failure

absolute contra indication


Absolute contraindication

severe heart failure

Severe contraindication

relative contraindication

Relativearrhythmia

atrial arrhythmia


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Relativepeptic ulcer

Peptic ulcerpara sympathetic effect

peptic ulcer

digitalis

digitalis

digitalis toxicity

Partial

Peptic ulcer partial

Partial

complete

complete heart block

Complete heart block

partial heart block

partial

impulse Impulses

digitalis Partial complete


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partial p

heart block

Partial P

digitalis toxicity

digitalis toxicity

400

400Metabolism

digitalis toxicity

digitalis toxicity

renal failure

digitalis digoxin

digoxin Digitoxin digitoxin

Digitoxin

Digitoxin digoxin

kidney digoxin

Liver Digitoxin

digoxin

digoxin


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Digoxin ( lanoxin ) : excreted mainly by the kidney ( tab = 0.25 mg , amp = 0.5 mg ) Digitoxin : metabolised mainly in the liver ( Digitoxin hepatic )

digoxin

renal failure

hypo thyroidism

Metabolism

Hyper thyroidism

Hyper thyroidism tachy arrhythmia

arrhythmia


hyper thyroidism

digitalis

toxicity

Hypokalemia

hypercalcemia

digitalis toxicity MCQ

arrhythmia

digitalis toxicity Hypokalemia

HypocalcemiaHypercalcemia

Hypo phosphatemia

Hypo kalemia Hyper calcemia

digitalis toxicity

non cardic

cardic

Non cardic

Anorexianasuea vomiting


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first symptom

digitalis

anorexia

digitalis toxicity

Yellow vision

gynecomastia

psychosis

cardic

cardic manifestations of digitalis toxicity

paroxysmal supra ventricular tachycardia

Ventricular tachycardiaHeart block

arrhythmia

arrhythmia

extrasystole

arrhythmia


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type two second degree heart block

Nephrology

rheumatology


Type two second degree heart block

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Cardiology Scheme and Heart Failure