Download e-book for iPad: A Clinical Approach to Medicine by Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang

By Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng

ISBN-10: 9812389261

ISBN-13: 9789812389268

ISBN-10: 9812560734

ISBN-13: 9789812560735

During this re-creation of A scientific method of medication, the editor has assembled a panel of prime clinicians and researchers, and reorganized the cloth within the key components of drugs, cardiology, endocrinology, gastroenterology, hematology, neurology, oncology, rheumatology, renal drugs and respiration drugs. This booklet is exclusive -- it displays the adventure of major specialists on styles of disorder within the Asia-Pacific area. There are numerous different related books, yet these are by way of authors from the West and consequently supply a special viewpoint. The booklet additionally contains discussions on genetic illnesses, an infection and antimicrobial resistance to antibiotics, highlighting neighborhood incidences and data. each one bankruptcy starts off with the elemental ideas of a selected subject and steadily develops the subject to give the state-of-the-art within the subject. With its specialize in practices detailed to Asia-Pacific, this booklet is a needs to for the scholar, training clinician and learn scientist drawn to the newest advancements during this a part of the area.

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Usually appears within minutes after symptom onset. However, this is present on initial admission ECG in only ~30–40% of hospitalized patients with AMI. ST depression indicates ischemia, but has poor power to identify ongoing myocardial infarction (only ~50% of patients with ST depression develop MI). T-wave inversion is nonspecific. Multiple differential diagnoses. Only about one-third of patients with chest pain and T-wave inversion on admission ECG develops MI. About one-third of patients admitted to emergency department with acute chest pain have normal ECG.

Myocardial ischemia can also result from left ventricular (LV) hypertrophy or hypertrophic obstructive cardiomyopathy, when the myocardial oxygen demand exceeds normal supply. Obstructive Coronary Artery Disease Unlike skeletal muscles, the heart depends almost totally on aerobic metabolism. Dissimilar to other tissues, the amount of myocardial oxygen extraction from the blood is substantial, ranging from 70–80%, at resting state. These characteristics limit the capacity of the heart to provide for increased oxygen requirements during exercise or other forms of stress, and the major way to meet the increase in myocardial oxygen demand is to increase coronary blood flow.

With MI, there is accompanying cardiac enzyme (CK, troponin I and T, myoglobin) release. When the vessel is occluded and flow is absent, ST-segment elevation is indicative of STEMI. Clinical correlation of ECG changes, symptomatic functional angina classes and coronary blood flow through a progressively narrowing stenotic coronary artery is schemetically represented in Fig. 3. The progression from transmural ischemia to infarction is a function of time. Clinically, myocardial salvage by myocardial reperfusion after total flow cessation is still possible up to 12 hours from vessel occlusion.

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A Clinical Approach to Medicine by Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng

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