Internal Medicine: Cardiology Lecture Notes

Comprehensive vocabulary practice covering clinical examination, diagnostics, hypertension, atherosclerosis, myocardial infarction, and heart failure.

"Pet prstiju" principle

A principle for cardiovascular clinical examination developed by Dr. $W.\,Proctor\,Harvey$, encompassing physical examination, anamnesis, $EKG$, X-ray, and special methods.

Orthopnea

Forced sitting position or the need for a raised headrest due to breathlessness, indicating left heart failure, pericardial effusion, or pleural effusion.

Paroxysmal nocturnal dyspnea

Sudden nighttime gasping that wakes a patient from sleep, caused by an increased blood flow to the heart and lungs in a lying position.

Oslerovi čvorići (Osler's nodes)

Painful nodes on the legs and arms resulting from immune complex deposition in skin blood vessels, typically associated with bacterial endocarditis.

Džejnvejeve (Janeway) lezije

Painless nodules on the palms and soles associated with infectious endocarditis.

Kusmaulov znak (Kussmaul's sign)

Increased venous filling during inspiration, indicating elevated pressure in the right atrium; seen in heart failure, constrictive pericarditis, and cardiac tamponade.

Levinova (Lewin) skala

A scale from $1$ to $6$ used to grade the intensity of heart murmurs.

Ajnthovenov trougao (Einthoven's triangle)

An equilateral triangle whose vertices represent the placement of active $EKG$ electrodes on the right arm ($DR$), left arm ($LR$), and left leg ($LN$).

Bazetova formula (Bazett's formula)

A formula used to determine the corrected $QT$ interval ($QTc$), expressed as $QTc = \frac{QT}{\sqrt{R-R}}$, adjusted for heart rate.

Pardeov talas (Pardee wave)

A fusion of the elevated $ST$ segment and the $T$ wave into a single wave, serving as a sign of myocardial lesion in acute infarction.

Kardiotorakalni indeks

A ratio determined by teleradiography comparing the maximum transverse diameter of the heart shadow to the maximum transverse diameter of the thorax; normal values are less than $50\%$.

Kerley B linije

Fluid collections between lung lobes visible on an X-ray when pulmonary capillary pressure reaches $21-30\,mm\,Hg$, indicating interstitial edema.

Ejekciona frakcija (Ejection fraction)

The most significant parameter of global systolic function, calculated as the difference between end-diastolic and end-systolic volume divided by end-diastolic volume ($EF = \frac{EDV - ESV}{EDV}$).

Normokinezija

Normal regional mobility and thickening of the left ventricular walls during systole.

Pojednostavljena Bernulijeva (Bernoulli) jednačina

An equation used to determine the transvalvular pressure gradient to assess stenosis severity, expressed as $Gradijent\,(mm\,Hg) = 4V^2$, where $V$ is the maximum measured velocity in $m/s$.

Brusov (Bruce) protokol

A standard exercise treadmill protocol where treadmill speed and incline are increased at intervals of $3$ minutes.

MET (Metabolički ekvivalent)

A measure of energy consumption during exercise, where $1\,MET = 3.5\,ml\,O_2/kg/min$ at rest.

Ishemijska kaskada

The chronological order of ishemia signs during physical stress: starting with regional wall motion abnormalities, followed by $EKG$ changes ($ST$ depression), and finally anginal pain.

Fra kciona rezerva protoka (FFR)

The ratio between blood pressure distal to a coronary stenosis and aortic pressure ($Pd/Pa$); values below $0.80$ indicate myocardial ischemia.

SCORE sistem

Systemic Coronary Risk Evaluation used to estimate the $10$-year risk of a fatal atherosclerotic event based on sex, age, smoking status, systolic blood pressure, and total holesterol.

Penaste ćelije (Foam cells)

Macrophages in the subintima that accumulate oxidized $LDL$ holesterol in the form of droplets, typical for the early phase of atherosclerotic plaque formation.

Glagov efekat

Positive arterial remodeling involving compensatory local increases in vessel volume when atherosclerotic plaque does not exceed $40\%$ of the lumen.

Diper (Dipper)

A person who exhibits the expected nocturnal blood pressure drop of more than $10\%$ during ambulant $24$-hour monitoring.

Princmetalova (Prinzmetal) angina

A rare form of unstable angina caused by coronary artery spasm, characterized by transient $ST$ elevation without biomarker increase.

MINOCA

Myocardial infarction with non-obstructive coronary arteries, diagnosed when clinical signs of $AIM$ are present but coronary angiography reveals stenosis less than $50\%$.

Kilipova (Killip) skala

A scale used to classify heart failure in $STEMI$ patients from Class $I$ (no congestion) to Class $IV$ (cardiogenic shock).

NYHA klasifikacija

A functional classification system by the New York Heart Association used to assess the severity of heart failure based on activity tolerance from Class $I$ (no limitations) to Class $IV$ (symptoms at rest).

Sistolni anteriorni pokret (SAM)

The systolic movement of the anterior mitral valve leaflet toward the interventricular septum, causing dynamic obstruction in hypertrophic kardiomyopathy.

Takocubo (Takotsubo) kardiomiopatija

Transient regional systolic dysfunction of the left ventricular apex or mid-segments, typically following physical or emotional stress, in the absence of significant coronary disease.