Cardiology

Emboligenic heart diseases

Emboligenic heart diseases often come with disturbance of the heart rhythm or a mechanical disturbance of the intracardiac blood flow.

Emboligenic heart diseases are responsible for the formation of blood clots in the heart chamber. When this clot is ejected into the general circulation, it can cause embolism and stroke in the most severe cases.(1)

Emboligenic heart disease is the second most common cause of stroke ⁽¹⁾.
Some of the most common etiologies include:
- Rhythm disorders (essentially complete arrhythmia by atrial fibrillation, more rarely atrial disease, flutter)
- Mitral stenosis, especially narrowing, even in the absence of associated atrial fibrillation, and mitral valve prolapse
- Myocardial infarction with left ventricular thrombus formation in contact with a recent or old infarction, with extensive ventricular hypokinesia or akinesia, or on left ventricular aneurysm (at a distance from the acute phase)
- Congenital heart diseases⁽¹⁾ …
Emboligenic heart diseases can be effectively prevented by rapid diagnosis of the heart defect⁽¹⁾.

(1)JFR 2010 – Accidents ischémiques cérébraux d’origine cardiaque et aortique : des diagnostics à ne pas méconnaître (consulté le 02/03/2020)

Deep vein thrombosis (DVT) and pulmonary embolism (PE), two clinical manifestations of the same entity, venous thromboembolism (VTE).⁽¹⁾

Thrombophlebitis, or deep vein thrombosis, is a circulation disorder caused by the formation of a blood clot in a deep vein of a limb. Thrombophlebitis is the leading cause of pulmonary embolism.⁽¹⁾

Venous thromboembolism (VTE) is a frequent disease: its annual incidence in France is estimated at 110 000 cases per year (70 000 deep vein thromboses and 40 000 pulmonary embolisms) ⁽¹⁾.
The annual incidence of venous thromboembolism increases with age ⁽¹⁾.

Deep vein thrombosis (DVT)

Venous thrombosis is the formation of a blood clot (thrombus) within the venous network. It usually occurs in the lower limbs, totally or partially blocking the blood circulation ⁽²⁾.
DVT often causes no symptoms, but it must be treated because it can sometimes lead to serious complications, such as pulmonary embolism, which causes 10 to 20,000 deaths each year in France ⁽²⁾.

Pulmonary Embolism (PE)

Pulmonary embolism is the obstruction of a pulmonary artery or one of its branches (usually by a blood clot) ⁽³⁾.

When a blood clot, formed during venous phlebitis or thrombosis (usually in the legs), detaches from the vein wall and moves with the blood into the venous circulation towards the heart, it can then be propelled towards the lungs. As the pulmonary arteries become thinner and thinner, the blood clot eventually remains blocked, causing pulmonary embolism ⁽³⁾
The severity of pulmonary embolism depends on the extent of the part of the lung damaged by the blocked artery ⁽³⁾ and the person’s cardiac or respiratory condition before it occurred.
When severe, pulmonary embolism is responsible for severe hypoxemia (decrease in the amount of oxygen in the blood) and has an impact on the right ventricle of the heart (heart failure) ⁽³⁾.

(1) Collège des Enseignants de Pneumologie (2017) (consulté le 02/03/2020)
(2) INSERM: Thrombose veineuse (consulté le 02/03/2020)
(3) AMELI: Embolie pulmonaire (consulté le 02/03/2020)

High blood pressure (hypertension)

High blood pressure (also called essential adult hypertension or hypertension) is one of the major risk factors for heart disease, kidney failure and stroke. With few symptoms, it usually appears with age, often accompanied by excess weight.(1-2)

High blood pressure (hypertension), is a typical disease of developed countries. High blood pressure corresponds to an abnormal increase in the pressure exerted by blood on the walls of the arteries, an increase that persists over time ⁽¹⁾.
To talk about high blood pressure, you need ⁽²⁾:
High blood pressure affects about 20% of the adult population and its incidence increases with age ⁽²⁾.
High blood pressure is the primary reason for consultation in general practice. If high blood pressure cannot be cured, it can be treated very well if diagnosed ⁽¹⁾. Indeed, hypertension being most often “silent”, many people are unaware that they are affected ⁽²⁾.

High blood pressure increases the risk of stroke, ischemic heart disease (angina pectoris, myocardial infarction), lower limb arterial disease (narrowing of the arteries that supply blood to the legs) and chronic renal failure that may eventually require dialysis ⁽²⁾.
In addition, blood pressure indirectly increases the activity of the heart to maintain constant blood flow that can eventually develop into heart failure ⁽²⁾.
Healthy diet measures, combined with drug treatment, are most often used to control blood pressure ⁽²⁾.

(1)Fédération Française de Cardiologie : l’hypertension artérielle (consulté le 02/03/2020)

(2)INSERM: l’hypertension artérielle (consulté le 02/03/2020)

Edema of cardiac, renal or hepatic origin

Edema is the swelling of an organ or tissue due to the accumulation or excess intratisular fluid in the interstitial medium. Edema can be caused by many primitive causes.

Edema is the swelling of an organ or tissue due to fluid accumulation or excess ⁽¹⁾.
Edema may be due to many primitive causes, but its general mechanism is the intratisular accumulation of fluids ⁽¹⁾.
Some possible causes of edema:
- Congestive heart failure, right or overall
- Cirrhosis
- Nephrotic syndrome (loss of proteins in the kidneys), or acute glomerulonephritis ⁽¹⁾…*

(1) INFORMATION HOSPITALIERE : Œdème (consulté le 02/03/2020)

Heart failure

Heart failure is the inability of the heart muscle to normally propel blood through the body. It can occur in the evolution of myocardial infarction, angina, high blood pressure… Its frequency increases with age.⁽¹⁾

The heart of a patient with heart failure has lost muscle strength and normal contraction capacity; it no longer pumps enough blood to allow the organs to receive enough oxygen and nutrients, essential to their proper functioning ⁽¹⁾.
In France, in 2008-2009, heart failure affected 2.3% of the French adult population, or approximately 1,130,000 people ⁽¹⁾.
Heart failure is a major cause of death in France regardless of age. In 2010, it was directly or indirectly responsible for more than 95,000 deaths ⁽¹⁾.
There are several possible causes for heart failure:
- Ischemic heart diseases (myocardial infarction, angina…), which create irreversible damage to part of the heart muscle
- High blood pressure, which causes the heart muscle to thicken to fight against high blood pressure
- Heart rhythm disorders, atrial fibrillation, heart valve diseases ⁽¹⁾ …

(1)AMELI: l’insuffisance cardiaque (consulté le 02/03/2020)

Emboligenic heart diseases

Emboligenic heart diseases often come with disturbance of the heart rhythm or a mechanical disturbance of the intracardiac blood flow.

Emboligenic heart disease is the second most common cause of stroke (1).
Some of the most common etiologies include:
- Rhythm disorders (essentially complete arrhythmia by atrial fibrillation, more rarely atrial disease, flutter)
- Mitral stenosis, especially narrowing, even in the absence of associated atrial fibrillation, and mitral valve prolapse
- Myocardial infarction with left ventricular thrombus formation in contact with a recent or old infarction, with extensive ventricular hypokinesia or akinesia, or on left ventricular aneurysm (at a distance from the acute phase)
- Congenital heart diseases (1) …
Emboligenic heart diseases can be effectively prevented by rapid diagnosis of the heart defect (1).

(1)JFR 2010 – Accidents ischémiques cérébraux d’origine cardiaque et aortique : des diagnostics à ne pas méconnaître http://www.sfrnet.org/formation/mediatheque/Textes/02%20-%20Cardiovasculaire%20diagnostique%20et%20interventionnel/article.phtml?id=rc%2Forg%2Fsfrnet%2Fhtm%2FArticle%2F2011%2F20110623-154140-812 (consulté le 01/08/2018)

Deep vein thrombosis (DVT) and pulmonary embolism (PE), two clinical manifestations of the same entity, venous thromboembolism (VTE).⁽¹⁾

Thrombophlebitis, or deep vein thrombosis, is a circulation disorder caused by the formation of a blood clot in a deep vein of a limb. Thrombophlebitis is the leading cause of pulmonary embolism.

Venous thromboembolism (VTE) is a frequent disease: its annual incidence in France is estimated at 110 000 cases per year (70 000 deep vein thromboses and 40 000 pulmonary embolisms) (1).
The annual incidence of venous thromboembolism increases with age (1).