CARDIOLOGY

The study of heart and it's functions

Friday, 17 February 2012

Black hole



Simulated view of a black hole (center) in front of theLarge Magellanic Cloud. Note the gravitational lensingeffect, which produces two enlarged but highly distorted views of the Cloud. Across the top, the Milky Way disk appears distorted into an arc.

Objects whose gravity field is too strong for light to escape were first considered in the 18th century byJohn Michell and Pierre-Simon Laplace. The first modern solution of general relativity that would characterize a black hole was found by Karl Schwarzschild in 1916, although its interpretation as a region of space from which nothing can escape was not fully appreciated for another four decades. Long considered a mathematical curiosity, it was during the 1960s that theoretical work showed black holes were a generic prediction of general relativity. The discovery ofneutron stars sparked interest in gravitationally collapsed compact objects as a possible astrophysical reality.A black hole is a region of spacetime from which nothing, not even light, can escape.[1] The theory of general relativity predicts that a sufficiently compactmass will deform spacetime to form a black hole. Around a black hole there is a mathematically defined surface called an event horizon that marks the point of no return. It is called "black" because it absorbs all the light that hits the horizon, reflecting nothing, just like a perfect black body inthermodynamics.[2] Quantum mechanics predicts that black holes emit radiation like a black body with a finite temperature. This temperature is inversely proportional to the mass of the black hole, making it difficult to observe this radiation for black holes of stellar mass or greater.
Black holes of stellar mass are expected to form when very massive stars collapse at the end of their life cycle. After a black hole has formed it can continue to grow by absorbing mass from its surroundings. By absorbing other stars and merging with other black holes, supermassive black holes of millions of solar masses may form. There is general consensus that supermassive black holes exist in the centers of most galaxies. In particular, there is strong evidence of a black hole of more than 4 million solar masses at the center of our galaxy, the Milky Way.
Despite its invisible interior, the presence of a black hole can be inferred through its interaction with other matter and with light and other electromagnetic radiation. From stellar movement, the mass and location of an invisible companion object can be calculated; in a number of cases the only known object capable of meeting these criteria is a black hole. Astronomers have identified numerous stellar black hole candidates in binary systems by studying the movement of their companion stars in this way

History

Schwarzschild black hole
Simulation of gravitational lensing by a black hole, which distorts the image of a galaxy in the background (larger animation)
The idea of a body so massive that even light could not escape was first put forward by geologist John Michell in a letter written to Henry Cavendish in 1783 of the Royal Society:
If the semi-diameter of a sphere of the same density as the Sun were to exceed that of the Sun in the proportion of 500 to 1, a body falling from an infinite height towards it would have acquired at its surface greater velocity than that of light, and consequently supposing light to be attracted by the same force in proportion to its vis inertiae, with other bodies, all light emitted from such a body would be made to return towards it by its own proper gravity.
—John Michell[3]
In 1796, mathematician Pierre-Simon Laplace promoted the same idea in the first and second editions of his book Exposition du système du Monde (it was removed from later editions).[4][5] Such "dark stars" were largely ignored in the nineteenth century, since it was not understood how a massless wave such as light could be influenced by gravity.[6]

General relativity

In 1915, Albert Einstein developed his theory of general relativity, having earlier shown that gravity does influence light's motion. Only a few months later, Karl Schwarzschild found a solution to Einstein field equations, which describes thegravitational field of a point mass and a spherical mass.[7] A few months after Schwarzschild, Johannes Droste, a student of Hendrik Lorentz, independently gave the same solution for the point mass and wrote more extensively about its properties.[8] This solution had a peculiar behaviour at what is now called theSchwarzschild radius, where it became singular, meaning that some of the terms in the Einstein equations became infinite. The nature of this surface was not quite understood at the time. In 1924, Arthur Eddington showed that the singularity disappeared after a change of coordinates (see Eddington–Finkelstein coordinates), although it took until 1933 for Georges Lemaître to realize that this meant the singularity at the Schwarzschild radius was an unphysical coordinate singularity.[9]
In 1931, Subrahmanyan Chandrasekhar calculated, using special relativity, that a non-rotating body of electron-degenerate matter above a certain limiting mass (now called the Chandrasekhar limit at 1.4 solar masses) has no stable solutions. [10] His arguments were opposed by many of his contemporaries like Eddington and Lev Landau, who argued that some yet unknown mechanism would stop the collapse.[11]They were partly correct: a white dwarf slightly more massive than the Chandrasekhar limit will collapse into a neutron star,[12] which is itself stable because of the Pauli exclusion principle. But in 1939, Robert Oppenheimer and others predicted that neutron stars above approximately three solar masses (the Tolman–Oppenheimer–Volkoff limit) would collapse into black holes for the reasons presented by Chandrasekhar, and concluded that no law of physics was likely to intervene and stop at least some stars from collapsing to black holes.[13]
Oppenheimer and his co-authors interpreted the singularity at the boundary of the Schwarzschild radius as indicating that this was the boundary of a bubble in which time stopped. This is a valid point of view for external observers, but not for infalling observers. Because of this property, the collapsed stars were called "frozen stars,"[14] because an outside observer would see the surface of the star frozen in time at the instant where its collapse takes it inside the Schwarzschild radius.

What is a Heart Murmur?


A heart murmur is a swishing or a whistling sound that the doctor hears when he listens to your child's heart with a stethoscope.
The heart beat normally makes two sounds: the first is Lub and the second is Dub, these two sounds follow each other (Lub Dub) and are not separated by any extra sounds.
A heart murmur will be heard as a swishing or a whistling sound in addition to the normal Lub-Dub sound. The moving blood sounds like the running water in your garden hose.
A heart murmur may indicate that there is a heart problem or may be due to normal blood flow. A heart murmur is not a diagnosis or disease, it is a sign to alert our attention to check if there is anything wrong.

Most of the time heart murmurs are normal and do not indicate that there is anything wrong with the heart. However, sometimes they may result from a hole in the heart or a narrowed valve. A hole in the hose allows water to squirt out producing a whistling sound.
Heart murmurs come in different sounds which may help indicate whether the murmur is normal or abnormal.
Click the sound icon to listen to the different heart murmur sounds on this page.
 Musical
 Harsh
 Machine-Like

Listen to the difference between a small hole in the heart and a large hole.





Small hole in the hose
 Small Hole

The fact that a heart murmur sounds softer may indicate that the hole is larger.





Large hole in the hose
 Large Hole
nnocent Causes:

Fever
FeverDuring fever the blood flows faster to meet the body's higher energy needs, this is similar to a fast flowing stream. This murmur could be heard in any child with fever and disappears when the fever is over.


Anemia
AnemiaWhen the concentration of red blood cells is low, as may happen with poor nutrition, the blood will flow faster, making a murmur. This murmur resolves after treating the anemia.
A thin chest wall and
a straight back
Thin chest wall and straight back
Simply because the heart is closer to the chest wall, the blood flow sound will be easily heard without indicating there is anything wrong with the heart.
Venous Hum
Venous hum is a common innocent murmur heard during childhood. This murmur is heard as a soft humming sound at the base of the neck just above the collarbone. It results from the normal blood flow in the large neck veins (jugular veins).

The doctor may lightly compress the neck vein to make the murmur transiently disappear, or he may turn your child's head to one side or another, so as to make the murmur sound louder. These simple maneuvers help the doctor to differentiate a Venous Hum from the murmurs resulting from heart disease.









Venous Hum
 Still's Murmur
This heart murmur is named after the doctor who described it. It is heard most frequently in active, healthy 3 to 7-year old children. The murmur represents the normal sound of blood gushing out into the aorta during heart contraction.

It has a musical tone to it and thus is frequently described as "musical murmur"; it usually sounds softer during sitting and may sound very loud during fever, anxiety, or exercise.
Not-Innocent Causes:
A narrow valveIf you press on your garden hose, the sound of the flowing water becomes louder, as the caliber of the garden hose becomes narrower.
Pinched Hose
As the blood encounters a narrowed valve it becomes turbulent, and faster to squeeze itself through, thus producing a heart murmur.

StenosisA narrow valve is called valve stenosis. The importance of the situation depends on what valve is involved and the degree of the narrowing.
A narrow arteryIf the arteries going to the lungs from the heart (Pulmonary Arteries) are narrow they may produce a heart murmur. This is a defect called Branch Pulmonary Artery Stenosis.

To learn more about Branch Pulmonary Artery Stenosis, 
A leaking valve
As the heart valve closes some blood leaks back making a blowing sound (murmur). A leaking valve is called insufficient or regurgitating. Its importance depends on how much blood is leaking, what valve is involved, and how long it has been going on.




Regurgitation
Regurgitation
A hole in the heart
Because the pressure in the heart chambers is not the same, the blood will flow from the high to the low-pressure chamber, producing a murmur sounding like a waterfall. If the hole is small, it will make a very loud sound. If the hole is large it may make a faint murmur that may go unnoticed for some time; therefore a faint murmur may sometimes indicate a serious problem.

A hole in the heart is called septal defect. If it is between the upper cardiac chambers, it is called Atrial Septal Defect (ASD), and is called Ventricular Septal Defect (VSD) if it is between the lower cardiac chambers. The importance of septal defects depends on their size and site.




Small Hole in the Heart
Small Hole





Large Hole in the Heart
Large Hole

   

Heart murmur


Murmurs are pathologic heart sounds that are produced as a result of turbulent blood flow that is sufficient to produce audible noise. Most murmurs can only be heard with the assistance of a stethoscope ("onauscultation").



A functional murmur or "physiologicmurmur" is a heart murmur that is primarily due to physiologic conditions outside the heart, as opposed to structural defects in the heart itself. Functional murmurs are benign (an "innocent murmur").
Murmurs may also be the result of various problems, such as narrowing or leaking of valves, or the presence of abnormal passages through which blood flows in or near the heart. Such murmurs, known as pathologic murmurs, should be evaluated by an expert.
Heart murmurs are most frequently categorized by timing, into systolic heart murmurs and diastolic heart murmurs. However, continuous murmurs cannot be directly placed into either category

Tuesday, 20 September 2011

Cardiovascular disease


Cardiovascular disease



Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels (arteries and veins).[1] While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH C14), it is usually used to refer to those related toatherosclerosis (arterial disease). These conditions usually have similar causes, mechanisms, and treatments.
Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer. In recent years, cardiovascular risk in women has been increasing and has killed more women than breast cancer.[2] A large histological study (PDAY) showed vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.[3][4]
By the time that heart problems are detected, the underlying cause (atherosclerosis) is usually quite advanced, having progressed for decades. There is therefore increased emphasis on preventing atherosclerosis by modifying risk factors, such as healthy eating, exercise, and avoidance of smoking.

Pathophysiology

Population based studies show that the precursors of heart disease start in adolescence. The process of atherosclerosis evolves over decades, and begins as early as childhood. The Pathobiological Determinants of Atherosclerosis in Youth Study demonstrated that intimal lesions appear in all the aortas and more than half of the right coronary arteries of youths aged 7–9 years. However, most adolescents are more concerned about other risks such as HIV, accidents, and cancer than cardiovascular disease.[5]
This is extremely important considering that 1 in 3 people will die from complications attributable to atherosclerosis. In order to stem the tide education and awareness that cardiovascular disease poses the greatest threat and measures to prevent or reverse this disease must be taken.
Obesity and diabetes mellitus are often linked to cardiovascular disease,[6] as are a history of chronic kidney disease and hypercholesterolaemia .[7] In fact, cardiovascular disease is the most life threatening of the diabetic complications and diabetics are two- to four-fold more likely to die of cardiovascular-related causes than nondiabetics