Source: http://circ.ahajournals.org/cgi/content-nw/full/111/23/e394/TBLIB Echocardiographic Features That Suggest Potential Need for Surgical Intervention Vegetation Persistent vegetation after systemic embolization Anterior mitral leaflet vegetation, particularly with size >10 mm* embolic events during first 2 wk of antimicrobial therapy* Increase in vegetation size despite appropriate antimicrobial http://circ.ahajournals.org/math/dagger.gif Valvular dysfunction Acute aortic or mitral insufficiency with signs of ventricular http://circ.ahajournals.org/math/dagger.gif Heart failure unresponsive to medical http://circ.ahajournals.org/math/dagger.gif Valve perforation or http://circ.ahajournals.org/math/dagger.gif Perivalvular extension Valvular dehiscence, rupture, or http://circ.ahajournals.org/math/dagger.gif New heart http://circ.ahajournals.org/math/dagger.gif Large abscess or extension of abscess despite appropriate

These defects or conditions are categorized according to the problems, which develop. One problem is when too much blood passes through the lungs. Another is when too little passes through the lungs. A third is when too little blood circulates in the body. And a fourth is a combination of several heart defects, presenting as a complex problem. Pediatric cardiologists are the specialists treating babies with congenital heart problems

Congestive Heart Failure It is a fact that Congestive Heart Failure is an extremely frightening word and an equally frightening concept to comprehend, and when a loved one, or oneself has been diagnosed with this condition, it is quite natural to relapse into a state of depression or panic. However, it is not an untreatable disease, and with the correct and appropriate treatment methods, and with the right physician attending, the

Advance Directives should include documented patient decisions about health care, which should be honored (Advanced practice in nursing: ethical and role issues in end-of-life care, 2004). As medical knowledge and technology increase, so do options for healthcare. When decisions arise concerning the treatment of dying patients, these options present complex ethical dilemmas. Many are faced with decisions about the best treatment to ease a patient's final suffering (End of Life Care:

Even though the heart works harder, blockages still shortchange the needed blood supply to all areas of the body. Kidney disorders, which leave extra fluids, sodium, and toxins in the body, obesity, diabetes, birth control pills, pregnancy, smoking, excess alcohol, stress, and thyroid and adrenal gland problems can also cause and exacerbate a high blood pressure condition. Proper ranges of cholesterol are also important in the prevention of heart attack

Psuedomonas Aeruginosa Pseudomonas aeruginosa Epidemiology The Gram-negative, motile, rod-shaped bacterium Pseudomonas aeruginosa is an opportunistic killer that takes advantage of people suffering from medical problems (Van Delden and Iglewski, 1998).For this reason, P. aeruginosa is one of the most common nosocomial infection that occurs in hospitals. P. aeruginosa is responsible for causing 16% of pneumonia cases, 12% of urinary tract infections, 10% of bloodstream infections, and 8% of surgical infections due to hospital