Health Excel

Chronic Diseases Dataset – Long-Term Health Conditions Database

Chronic Diseases Dataset

The Chronic Diseases Dataset is a structured medical database containing a comprehensive list of long-term health conditions that require ongoing management.

Chronic diseases such as diabetes, cardiovascular conditions, respiratory disorders, and autoimmune diseases affect millions of people worldwide and are a major focus of public health and healthcare research.

This dataset provides organised information about chronic conditions, helping researchers, developers, and healthcare professionals analyse disease patterns, risk factors, and treatment approaches.

Each record includes detailed information such as disease descriptions, affected body systems, symptoms, severity levels, and management strategies.

The dataset has been cleaned and structured for easy integration into spreadsheets, databases, and analytics tools.

It is ideal for medical researchers, healthcare developers, educators, and data scientists working on long-term health conditions and disease management.

Dataset Contents

The dataset includes fields such as:

  • Disease / Condition Name
  • Description
  • Affected System
  • Common Symptoms
  • Severity Level
  • Disease Category
  • Risk Factors
  • Management / Treatment Approach

Example Conditions Included

  • Diabetes Mellitus
  • Hypertension
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Arthritis
  • Chronic Kidney Disease
  • Alzheimer’s Disease
  • Parkinson’s Disease
  • Multiple Sclerosis
  • Chronic Liver Disease

...and many more long-term health conditions.

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  ID Disease Name Disease Category Primary System Affected Global Prevalence Etiology / Risk Factors Pathophysiology Key Symptoms / Clinical Features Diagnostic Criteria / Methods First-Line Treatment Key Medications Lifestyle Modifications Major Complications Prognosis / Life Expectancy Impact Global Burden (DALYs/Deaths) ICD-10 Code WHO NCD Priority Typical Age of Onset
1 1 Coronary Artery Disease Cardiovascular Cardiovascular System ~200 million globally; leading cause of death worldwide Atherosclerosis, smoking, hypertension, diabetes, dyslipidemia, family history, obesity, sedentary lifestyle Atherosclerotic plaque buildup in coronary arteries causing reduced myocardial blood flow and oxygen delivery Angina pectoris (chest pain), dyspnea on exertion, fatigue, may be asymptomatic until MI Cardiac stress test, coronary angiography, ECG changes, elevated troponins if acute MI, coronary CT angiography Antiplatelet therapy (aspirin, P2Y12 inhibitors), statins, beta-blockers, ACE inhibitors, lifestyle modification, revascularization if indicated Aspirin, clopidogrel, atorvastatin, metoprolol, lisinopril, nitroglycerin, ranolazine Smoking cessation, Mediterranean diet, regular aerobic exercise, weight management, stress reduction Myocardial infarction, heart failure, arrhythmias, sudden cardiac death, cardiogenic shock Variable; well-controlled CAD can have near-normal life expectancy; post-MI 5-year mortality ~50% if untreated 9.44 million deaths annually; leading global cause of mortality I25 Yes Typically >45 years; earlier with risk factors
2 2 Heart Failure Cardiovascular Cardiovascular System 64 million globally; prevalence 1-2% in adults, >10% in those >70 CAD, hypertension, valve disease, cardiomyopathy, diabetes, alcohol abuse, viral myocarditis, congenital heart disease Impaired ventricular filling (diastolic dysfunction) or ejection (systolic dysfunction) causing inadequate cardiac output and fluid retention Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, peripheral edema, fatigue, exercise intolerance Clinical symptoms + BNP/NT-proBNP elevation, echocardiography showing reduced EF (<40% HFrEF) or preserved EF with diastolic dysfunction (HFpEF) Diuretics for congestion, ACE inhibitors/ARBs/ARNI, beta-blockers, MRAs, SGLT2 inhibitors, device therapy if indicated Furosemide, sacubitril/valsartan, carvedilol, spironolactone, empagliflozin, digoxin Sodium restriction (<2g/day), fluid restriction, daily weights, exercise as tolerated, vaccination Acute decompensation, arrhythmias, renal dysfunction, thromboembolism, sudden death Chronic progressive condition; 5-year mortality ~50%; significantly reduced life expectancy especially with advanced HF 3.5 million deaths annually; major cause of hospitalization in elderly I50 Yes Typically >65 years; can occur earlier with CAD
3 3 Hypertension Cardiovascular Cardiovascular System 1.39 billion adults worldwide; ~46% of adults have hypertension Primary (idiopathic 90-95%); secondary causes include renal disease, endocrine disorders, medications, OSA; risk factors: age, obesity, salt intake, alcohol, stress, family history Increased peripheral vascular resistance and/or cardiac output; chronic elevation damages arterial walls and end organs Often asymptomatic ('silent killer'); severe HTN may cause headache, vision changes, chest pain, dyspnea BP ≥130/80 mmHg (ACC/AHA) or ≥140/90 mmHg (ESC/WHO) on multiple occasions; ambulatory BP monitoring for confirmation Lifestyle modification first; pharmacotherapy: thiazide diuretics, ACE inhibitors, ARBs, CCBs, beta-blockers Hydrochlorothiazide, lisinopril, amlodipine, losartan, metoprolol, chlorthalidone DASH diet, sodium restriction (<2.3g/day), weight loss, regular exercise, alcohol moderation, stress management Stroke, MI, heart failure, chronic kidney disease, retinopathy, aortic dissection, dementia Good prognosis with treatment; well-controlled hypertension can have normal life expectancy; untreated significantly increases CV mortality 10.8 million deaths annually; leading risk factor for global disease burden I10 Yes Typically >40 years; increasing prevalence with age
4 4 Atrial Fibrillation Cardiovascular Cardiovascular System 60 million globally; ~3% of adults >20 years; 9% in those >65 Hypertension, heart failure, valve disease, CAD, hyperthyroidism, alcohol, obesity, sleep apnea, age, genetic factors Chaotic atrial electrical activity causing irregular ventricular response; atrial remodeling and fibrosis perpetuate arrhythmia Palpitations, dyspnea, fatigue, dizziness, chest discomfort; may be asymptomatic in paroxysmal AF ECG showing irregularly irregular rhythm without P waves, fibrillatory waves; echocardiography to assess structural disease and thrombus risk Rate control (beta-blockers, CCBs) vs rhythm control (antiarrhythmics, cardioversion); anticoagulation based on CHA2DS2-VASc score Metoprolol, diltiazem, amiodarone, flecainide, apixaban, warfarin, rivaroxaban Alcohol abstinence, weight loss, treatment of OSA, regular exercise, BP control Stroke (5x risk), heart failure, cardiomyopathy, dementia, bleeding from anticoagulation Variable; well-controlled AF with anticoagulation has near-normal life expectancy; increased stroke and mortality risk if untreated 287,000 deaths annually; major cause of stroke and disability I48 Yes Typically >65 years; incidence increases with age
5 5 Peripheral Arterial Disease Cardiovascular Cardiovascular System Over 200 million globally; 12-14% of general population; higher in elderly Atherosclerosis, smoking (strongest risk), diabetes, hypertension, dyslipidemia, age >65, family history Atherosclerotic narrowing of peripheral arteries (especially lower extremities) causing reduced blood flow and ischemia Intermittent claudication (leg pain with walking), rest pain, non-healing ulcers, cold extremities; 50% asymptomatic Ankle-brachial index (ABI <0.90), arterial duplex ultrasound, CT/MR angiography, physical exam findings Antiplatelet therapy (aspirin/clopidogrel), statin therapy, cilostazol for claudication, exercise therapy, revascularization if severe Aspirin, clopidogrel, atorvastatin, cilostazol, rivaroxaban (high-risk patients) Smoking cessation (critical), supervised exercise program, foot care, wound care if ulcers present Critical limb ischemia, amputation, MI, stroke, cardiovascular death Reduced life expectancy; 5-year mortality 10-15%; high CV event risk; critical limb ischemia has poor prognosis Significant CV morbidity; marker of systemic atherosclerosis; increases overall mortality risk I73.9 Yes Typically >50 years; earlier with diabetes/smoking
6 6 Aortic Aneurysm Cardiovascular Cardiovascular System Abdominal aortic aneurysm (AAA): 5-10% of men >65; thoracic aortic aneurysm: less common Atherosclerosis, hypertension, smoking, genetic factors (Marfan, Ehlers-Danlos), age, male sex, family history, bicuspid aortic valve Weakening and dilation of aortic wall due to medial degeneration, inflammation, and proteolytic enzyme activity Usually asymptomatic until rupture; large aneurysms may cause back/abdominal pain, pulsatile mass; rupture causes sudden severe pain, hypotension, shock Ultrasound screening (AAA), CT/MR angiography for sizing and surveillance; aneurysm defined as aortic diameter >3cm (abdominal) or >5cm (thoracic) Small aneurysms: surveillance imaging; BP control; large aneurysms (≥5.5cm AAA, ≥6cm thoracic): surgical or endovascular repair Beta-blockers, ACE inhibitors, statins for medical management pre-surgery Smoking cessation (critical), BP control, lipid management, avoid heavy lifting Rupture (90% mortality), dissection, thromboembolism, compression of adjacent structures Variable; small stable aneurysms with surveillance have good prognosis; rupture is often fatal; 5-year rupture risk increases with size 154,000 deaths annually from aortic aneurysm/dissection worldwide I71 Yes Typically >60 years; earlier with genetic syndromes
7 7 Rheumatic Heart Disease Cardiovascular Cardiovascular System ~40 million cases globally; endemic in developing countries; rare in developed nations Sequela of acute rheumatic fever following untreated Group A Streptococcal pharyngitis; poverty, overcrowding, inadequate healthcare access Autoimmune response to strep antigens causing valvular inflammation, scarring, and deformity; mitral stenosis most common lesion Dyspnea, fatigue, palpitations, chest pain, syncope; heart murmur on exam; symptoms of valvular disease History of rheumatic fever, echocardiography showing valvular thickening/stenosis/regurgitation, Doppler assessment of severity Penicillin prophylaxis to prevent recurrent RF, heart failure management, anticoagulation for AF, valve repair/replacement for severe disease Benzathine penicillin G (monthly IM), warfarin, diuretics, ACE inhibitors, surgical valve intervention Secondary antibiotic prophylaxis continuation, good dental hygiene, endocarditis prophylaxis for dental procedures Progressive valvular disease, heart failure, atrial fibrillation, stroke, endocarditis, pulmonary hypertension Variable; depends on severity and access to surgery; untreated severe disease has shortened life expectancy; good outcomes with timely valve surgery 319,000 deaths annually; major cause of CV death in young people in endemic regions I09 Yes Initial RF typically 5-15 years; chronic RHD develops over decades
8 8 Dilated Cardiomyopathy Cardiovascular Cardiovascular System 1 in 2,500 adults; leading indication for heart transplantation Idiopathic (50%), genetic mutations (30-40%), alcohol, viral myocarditis, chemotherapy, peripartum, chronic tachycardia, nutritional deficiencies Progressive ventricular dilation and systolic dysfunction due to myocyte loss, fibrosis, and impaired contractility Heart failure symptoms: dyspnea, fatigue, edema, orthopnea; arrhythmias, thromboembolism Echocardiography showing LV dilation and reduced EF (<40%); MRI for tissue characterization; genetic testing if familial; exclude secondary causes Standard heart failure therapy: ACE-I/ARBs/ARNI, beta-blockers, MRAs, SGLT2-i, diuretics; ICD/CRT device therapy; transplant for refractory cases Sacubitril/valsartan, carvedilol, spironolactone, empagliflozin, furosemide, digoxin Alcohol abstinence, sodium restriction, family screening if genetic, avoid cardiotoxic substances Progressive heart failure, ventricular arrhythmias, sudden cardiac death, stroke, transplant need Variable prognosis; 5-year mortality 20-50% depending on severity; progressive disease with significantly reduced life expectancy without transplant Major cause of heart failure and transplant need; significant mortality burden I42.0 Yes Typically 20-60 years; can occur at any age
9 9 Hypertrophic Cardiomyopathy Cardiovascular Cardiovascular System 1 in 500 adults; most common genetic cardiovascular disease Autosomal dominant mutations in sarcomeric protein genes (MYH7, MYBPC3); 50% familial; de novo mutations Asymmetric LV hypertrophy (especially septum) with possible LV outflow obstruction, diastolic dysfunction, myocardial disarray, and fibrosis Many asymptomatic; dyspnea, chest pain, palpitations, syncope, sudden cardiac death (especially in young athletes) Echocardiography showing LV wall thickness ≥15mm (≥13mm with family history); cardiac MRI; genetic testing; exclude other causes of LVH Beta-blockers or CCBs for symptoms; disopyramide for obstruction; ICD for high-risk SCD; septal reduction therapy (myectomy or alcohol ablation) if refractory obstruction Metoprolol, verapamil, disopyramide, ICD placement for primary prevention Avoid strenuous competitive sports, maintain hydration, family screening, genetic counseling Sudden cardiac death (especially young patients), heart failure, atrial fibrillation, stroke, endocarditis Variable; many have normal life expectancy with treatment; annual SCD risk 1%; risk stratification critical Leading cause of sudden cardiac death in young athletes; significant genetic burden I42.1 Yes Any age; often diagnosed in adolescence/young adulthood
10 10 Pulmonary Hypertension Cardiovascular Cardiovascular/Respiratory System ~1% of global population; higher in elderly; varies by subtype (idiopathic PAH rare ~5-10/million) Group 1 (PAH): idiopathic, genetic, drugs/toxins, CTD; Group 2: left heart disease (most common); Group 3: lung disease/hypoxia; Group 4: CTEPH; Group 5: multifactorial Elevated pulmonary artery pressure (mean PAP ≥20mmHg) due to pulmonary vascular remodeling, vasoconstriction, thrombosis; leads to RV failure Dyspnea on exertion, fatigue, chest pain, syncope, edema; progressive exercise intolerance Echocardiography with elevated RVSP; right heart catheterization (gold standard) showing mean PAP ≥20mmHg with PVR ≥2 WU; workup to determine subtype Treat underlying cause; Group 1 PAH: pulmonary vasodilators (ERAs, PDE5-i, prostacyclins, sGC stimulators); oxygen; diuretics; anticoagulation in selected cases Ambrisentan, sildenafil, treprostinil, riociguat, epoprostenol, furosemide, warfarin Oxygen therapy if hypoxic, graded exercise rehabilitation, avoid pregnancy (high risk), altitude avoidance Right heart failure, arrhythmias, sudden death, hemoptysis, complications of therapy Variable by etiology; idiopathic PAH median survival 7 years untreated, improved with modern therapies; secondary PH prognosis depends on underlying disease Significant mortality especially in PAH and CTEPH groups; major cause of RV failure I27 Yes Group 1 PAH: typically 30-60 years; Group 2/3: older adults
11 11 Chronic Venous Insufficiency Cardiovascular Cardiovascular System ~25 million adults in US; prevalence 5-30% in adults, increases with age Venous valve incompetence, previous DVT (post-thrombotic syndrome), obesity, pregnancy, prolonged standing, age, family history Venous valve dysfunction causes retrograde flow, venous hypertension, inflammation, and tissue changes leading to edema and skin damage Leg swelling, aching, heaviness, varicose veins, skin changes (hyperpigmentation, lipodermatosclerosis), venous ulcers Clinical presentation, duplex ultrasound showing venous reflux >0.5 seconds, venous plethysmography Compression therapy (20-30mmHg stockings), leg elevation, exercise, weight loss; wound care for ulcers; ablation/sclerotherapy for varicose veins Compression stockings (primary therapy), pentoxifylline, topical wound care agents, antibiotics for infected ulcers Compression stockings daily, leg elevation, walking exercise, weight management, avoid prolonged standing Venous ulceration (most significant), skin infection/cellulitis, bleeding from varices, rarely DVT Chronic condition; good prognosis with compression therapy; venous ulcers can be recurrent and challenging to heal but rarely life-threatening Major cause of morbidity and healthcare costs; ulcers affect quality of life I87.2 No Typically >50 years; increases with age and risk factors
12 12 Calcific Aortic Valve Disease Cardiovascular Cardiovascular System ~25% of adults >65 have aortic sclerosis; 2-3% have aortic stenosis; prevalence increases with age Age-related calcification, bicuspid aortic valve (congenital), rheumatic heart disease, chronic kidney disease, similar risk factors to atherosclerosis Progressive calcium deposition on aortic valve leaflets causing thickening, reduced mobility, and stenosis; hemodynamic obstruction to LV outflow Early: asymptomatic; symptomatic severe AS: dyspnea, angina, syncope (classic triad); heart failure Echocardiography showing aortic valve thickening/calcification, reduced valve area (<1cm² severe AS), elevated gradient; systolic ejection murmur on exam Asymptomatic mild-moderate AS: surveillance; symptomatic severe AS: aortic valve replacement (surgical AVR or transcatheter TAVR); manage risk factors No medical therapy delays progression; diuretics/ACE-I for HF symptoms; surgical AVR or TAVR for severe symptomatic disease Heart-healthy lifestyle, BP control, lipid management (though statins don't slow AS progression) Heart failure, syncope, sudden death, endocarditis; once symptomatic, poor prognosis without valve replacement Asymptomatic mild-moderate AS: normal life expectancy with surveillance; symptomatic severe AS: median survival <2-3 years without intervention; excellent outcomes with valve replacement Significant cause of morbidity in elderly; major indication for valve replacement I35.0 No Typically >65 years; earlier with bicuspid valve (40-50s)
13 13 Mitral Valve Prolapse Cardiovascular Cardiovascular System 2-3% of general population; more common in women; most common valvular abnormality Primary (myxomatous degeneration, genetic connective tissue disorders like Marfan/Ehlers-Danlos); secondary (rheumatic, ischemic, cardiomyopathy) Abnormal mitral valve leaflet tissue causing leaflet displacement into left atrium during systole; may progress to mitral regurgitation Most asymptomatic; palpitations, chest pain (atypical), anxiety, fatigue; severe MR causes HF symptoms; midsystolic click on exam Echocardiography showing >2mm systolic displacement of mitral leaflets into LA; assess degree of mitral regurgitation and LV function Asymptomatic/mild: observation; beta-blockers for palpitations; severe MR with symptoms: mitral valve repair or replacement Beta-blockers for symptom management, antibiotic prophylaxis no longer recommended except high-risk, surgical repair/replacement for severe MR Usually none required; avoid dehydration, manage anxiety/stress Progressive mitral regurgitation, heart failure, atrial fibrillation, endocarditis (rare), arrhythmias, rarely sudden death Excellent prognosis; most have normal life expectancy; <2-4% develop significant MR requiring surgery; very low risk of complications in classic MVP Generally benign condition; rarely progresses to severe disease I34.1 No Often diagnosed in young adulthood; can be any age
14 14 Varicose Veins Cardiovascular Cardiovascular System ~23% of US adults; up to 40% of women and 20% of men; prevalence increases with age Venous valve incompetence, family history, pregnancy, obesity, prolonged standing, age, female sex, prior DVT Venous valve failure causes blood pooling and increased pressure, leading to vein dilation, tortuosity, and visible varicosities Visible dilated, tortuous superficial veins; aching, heaviness, cramping in legs; worsens with standing; skin changes in chronic cases Clinical examination; duplex ultrasound to assess saphenous vein reflux and rule out DVT Conservative: compression stockings, leg elevation, exercise; interventional: endovenous ablation (laser/RF), sclerotherapy, phlebectomy for symptomatic or cosmetically bothersome veins Compression stockings (first-line), sclerosants for sclerotherapy, endovenous ablation procedures Compression stockings, regular exercise, leg elevation, weight management, avoid prolonged standing/sitting Chronic venous insufficiency, venous ulcers (rare), superficial thrombophlebitis, bleeding, rarely DVT Excellent prognosis; primarily cosmetic and quality-of-life concern; rarely causes serious complications; recurrence common after treatment Major cause of healthcare visits and cosmetic procedures; minimal mortality risk I83 No Typically >30 years; increases with age and pregnancies
15 15 Raynaud's Phenomenon Cardiovascular Cardiovascular System 3-5% of general population; primary Raynaud's ~90% of cases; more common in women Primary (idiopathic); secondary to connective tissue diseases (scleroderma, lupus), medications (beta-blockers), occupational vibration, smoking Exaggerated vasospastic response to cold or stress causing triphasic color changes (white→blue→red) due to vasospasm and reperfusion Episodic color changes of digits (white/blue/red), numbness, pain with cold exposure or stress; symmetric in primary, asymmetric in secondary Clinical diagnosis based on history and exam; nailfold capillaroscopy and autoantibody testing to distinguish primary from secondary Avoid triggers (cold, stress), keep warm; CCBs (nifedipine) for severe cases; treat underlying condition if secondary; rarely prostacyclin analogs Nifedipine, amlodipine, topical nitroglycerin, sildenafil (severe cases), iloprost infusions (critical ischemia) Avoid cold exposure, wear gloves/warm clothing, smoking cessation, stress management, avoid vasoconstricting medications Primary: rarely serious; secondary: digital ulceration, gangrene, amputation (especially in scleroderma) Primary Raynaud's: excellent prognosis, normal life expectancy, rarely progresses; secondary: depends on underlying disease, risk of tissue loss Minimal mortality; quality of life impact; secondary Raynaud's in scleroderma has risk of digital loss I73.0 No Primary: typically 15-30 years; secondary: any age with onset of underlying disease
16 16 Deep Vein Thrombosis (Chronic/Post-Thrombotic Syndrome) Cardiovascular Cardiovascular System Post-thrombotic syndrome develops in 20-50% of DVT patients within 2 years Prior DVT (main cause), venous valve damage, recurrent thrombosis, inadequate anticoagulation, delayed treatment, extensive initial clot burden Chronic venous obstruction and valve incompetence following DVT causes venous hypertension, inflammation, and chronic tissue changes Chronic leg pain, swelling, heaviness, cramping, skin changes (hyperpigmentation, induration), venous ulcers; worse with standing History of documented DVT, clinical symptoms, duplex ultrasound showing venous obstruction/reflux, Villalta scale score for severity assessment Compression therapy (30-40mmHg stockings), leg elevation, exercise, weight management; treat venous ulcers; rarely venous stenting for severe obstruction Compression stockings (mainstay), anticoagulation continuation if recurrent VTE risk, wound care for ulcers, pain management Daily compression stockings (proven to reduce PTS risk), regular walking, leg elevation, weight management Chronic venous insufficiency, recurrent venous ulceration, chronic pain, reduced quality of life, rarely recurrent DVT Chronic condition but not life-threatening; quality of life significantly impacted; venous ulcers can be recurrent and difficult to heal Major cause of chronic morbidity post-DVT; healthcare burden from ulcer management I87.0 No Develops months to years after initial DVT; typically adults >40
17 17 Myocarditis (Chronic) Cardiovascular Cardiovascular System Acute myocarditis incidence ~10-20/100,000; chronic/persistent myocarditis less common (exact prevalence unknown) Viral infections (most common: coxsackie, adenovirus, parvovirus B19), autoimmune diseases, drug hypersensitivity, toxins, giant cell myocarditis, sarcoidosis Persistent myocardial inflammation leading to myocyte damage, fibrosis, and ventricular dysfunction; may evolve into dilated cardiomyopathy Chest pain, dyspnea, fatigue, palpitations, heart failure symptoms; may have arrhythmias; fulminant cases have cardiogenic shock Elevated troponin, ECG changes, echocardiography showing wall motion abnormalities/reduced EF, cardiac MRI (gold standard), endomyocardial biopsy in selected cases Supportive care for HF, treat underlying cause if identified, immunosuppression for giant cell/autoimmune cases, standard HF therapy, manage arrhythmias, mechanical support/transplant for refractory cases Standard HF medications (ACE-I, beta-blockers, diuretics), immunosuppression (prednisone, azathioprine) for specific etiologies, antiarrhythmics if needed Rest during acute phase, avoid competitive sports during active inflammation, gradual return to activity after recovery Dilated cardiomyopathy, heart failure, ventricular arrhythmias, sudden cardiac death, heart block, transplant need Variable; many recover fully; fulminant myocarditis has high mortality (25-40%) acutely but better long-term survival if survive acute phase; chronic cases may progress to DCM Rare but significant cause of sudden death in young adults and athletes; can lead to transplant I51.4 No Any age; acute often in young adults 20-40; chronic develops over time
18 18 Pericarditis (Chronic/Constrictive) Cardiovascular Cardiovascular System Acute pericarditis ~5% of chest pain ER visits; chronic/constrictive pericarditis rare; recurrent pericarditis in 15-30% of acute cases Acute: viral (most common), post-MI, uremia, autoimmune; chronic/constrictive: prior cardiac surgery, radiation, TB, recurrent pericarditis, idiopathic Pericardial inflammation (acute) or fibrosis/calcification (constrictive) causing impaired diastolic filling and reduced cardiac output Acute: chest pain (sharp, positional, relieved by leaning forward), pericardial friction rub; constrictive: dyspnea, fatigue, edema, ascites, elevated JVP Acute: clinical criteria (chest pain + friction rub/ECG changes/pericardial effusion); constrictive: echo/MRI showing thickened pericardium, catheterization showing equalization of pressures Acute: NSAIDs + colchicine; constrictive: pericardiectomy (definitive); treat underlying cause; avoid NSAIDs in chronic cases Ibuprofen, aspirin, colchicine, corticosteroids (refractory cases), surgical pericardiectomy for constrictive Rest during acute phase, gradual activity resumption, continue colchicine for recurrence prevention Recurrent pericarditis, progression to constrictive pericarditis, cardiac tamponade (acute), chronic heart failure Acute pericarditis: excellent prognosis with treatment; constrictive pericarditis: significantly reduced life expectancy without surgery; pericardiectomy mortality 5-10% but improves long-term survival Rare condition; constrictive form has significant morbidity and surgical risk I31.1 No Acute: any age, often young adults; constrictive: typically develops years after initial insult
19 19 Type 2 Diabetes Metabolic/Endocrine Endocrine/Metabolic System 537 million adults globally (10.5%); projected 643 million by 2030; 90% of all diabetes Insulin resistance and beta-cell dysfunction; risk factors: obesity, sedentary lifestyle, age, family history, ethnicity (higher in South Asian, African descent), gestational diabetes history Progressive insulin resistance in peripheral tissues combined with inadequate compensatory insulin secretion by pancreatic beta cells, leading to hyperglycemia Often asymptomatic initially; polyuria, polydipsia, polyphagia, weight loss, fatigue, blurred vision, slow wound healing, recurrent infections Fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or random glucose ≥200 mg/dL with symptoms; OGTT ≥200 mg/dL at 2 hours Lifestyle modification (diet, exercise, weight loss); metformin first-line; add SGLT2-i, GLP-1 RA, DPP-4i, insulin as needed; target HbA1c <7% Metformin, empagliflozin, semaglutide, sitagliptin, insulin glargine, pioglitazone, sulfonylureas Weight loss (5-10%), Mediterranean/low-carb diet, 150 min/week exercise, smoking cessation, BP/lipid control Microvascular: retinopathy, nephropathy, neuropathy; macrovascular: CAD, stroke, PAD; hypoglycemia, infections, diabetic foot ulcers/amputation Chronic progressive disease; well-controlled diabetes can have near-normal life expectancy; poorly controlled reduces life expectancy by 10-20 years; CV disease major cause of death 6.7 million deaths annually; leading cause of blindness, kidney failure, lower limb amputation; massive global health burden E11 Yes Typically >40 years; increasing incidence in younger adults/children with obesity epidemic
20 20 Type 1 Diabetes Metabolic/Endocrine Endocrine/Metabolic System 8.4 million people globally; ~5-10% of all diabetes; incidence highest in Northern Europe Autoimmune destruction of pancreatic beta cells; genetic susceptibility (HLA-DR3/DR4) + environmental triggers (viral infections, diet); islet autoantibodies present T-cell mediated autoimmune destruction of insulin-producing beta cells leading to absolute insulin deficiency Polyuria, polydipsia, polyphagia, weight loss, fatigue; may present with diabetic ketoacidosis (DKA); requires insulin for survival Hyperglycemia + presence of islet autoantibodies (GAD, IA-2, ZnT8); C-peptide low/absent; DKA at presentation common Lifelong insulin therapy (multiple daily injections or insulin pump); continuous glucose monitoring; target HbA1c <7%; carbohydrate counting Insulin (rapid-acting: lispro, aspart; long-acting: glargine, degludec), adjunct therapies (pramlintide), SGLT2-i and GLP-1 RA emerging Carbohydrate counting, regular glucose monitoring, physical activity with glucose adjustment, avoid alcohol excess, sick-day management Microvascular: retinopathy, nephropathy, neuropathy; macrovascular: CAD; DKA, severe hypoglycemia, increased infection risk With modern insulin therapy and glucose monitoring, near-normal life expectancy possible; intensive control reduces complications; DKA and severe hypoglycemia remain risks; reduced life expectancy by ~10 years if poorly controlled Significant cause of morbidity; DKA mortality risk; long-term complications burden; earlier onset than T2DM increases lifetime complication risk E10 Yes Peak onset childhood/adolescence; can occur at any age (LADA in adults)
21 21 Obesity Metabolic/Endocrine Metabolic System Over 1 billion people globally (650M adults, 340M adolescents, 39M children); 13% of global adult population Energy imbalance (caloric intake > expenditure); genetic factors, sedentary lifestyle, high-calorie diet, environmental factors, medications, endocrine disorders (rare) Chronic positive energy balance leading to excess adipose tissue accumulation; adipose dysfunction causes inflammation, insulin resistance, metabolic dysregulation BMI ≥30 kg/m²; associated symptoms: dyspnea, joint pain, fatigue, sleep disturbance; stigma and psychosocial impact BMI ≥30 kg/m² (Class I: 30-34.9, Class II: 35-39.9, Class III: ≥40); waist circumference; assess for comorbidities (metabolic syndrome, diabetes, OSA) Lifestyle modification (diet, exercise, behavioral therapy); pharmacotherapy (GLP-1 RA, orlistat) for BMI ≥30 or ≥27 with comorbidities; bariatric surgery for BMI ≥40 or ≥35 with comorbidities Semaglutide, tirzepatide, orlistat, phentermine-topiramate, naltrexone-bupropion; bariatric surgery (Roux-en-Y, sleeve gastrectomy) Caloric restriction (500-750 kcal/day deficit), Mediterranean or low-carb diet, 150-300 min/week exercise, behavioral therapy, sleep hygiene Type 2 diabetes, hypertension, dyslipidemia, CAD, stroke, OSA, NAFLD, certain cancers, osteoarthritis, GERD, reproductive issues, psychosocial impact Chronic condition; Class III obesity reduces life expectancy by 8-10 years; weight loss of 5-10% significantly improves metabolic health; bariatric surgery can add years to life 5 million deaths annually; major risk factor for diabetes, CVD, cancer; enormous global health and economic burden E66 Yes Increasing prevalence in all age groups; childhood obesity epidemic; adult onset typically 30-50 years
22 22 Metabolic Syndrome Metabolic/Endocrine Metabolic System ~25-35% of US adults; varies by country; prevalence increases with age and obesity Insulin resistance (central mechanism), obesity (especially visceral), sedentary lifestyle, genetics, age, PCOS, NAFLD Cluster of metabolic abnormalities driven by insulin resistance and visceral adiposity, causing inflammation, dyslipidemia, hypertension, and dysglycemia Often asymptomatic; symptoms of individual components (fatigue, abdominal obesity); increased CV and diabetes risk ≥3 of 5 criteria: waist circumference >102cm (M) or >88cm (F), triglycerides ≥150 mg/dL, HDL <40 (M) or <50 (F) mg/dL, BP ≥130/85 mmHg, fasting glucose ≥100 mg/dL Lifestyle modification (weight loss, exercise, diet); treat individual components (statins for dyslipidemia, antihypertensives, metformin for prediabetes) Metformin, statins (atorvastatin), antihypertensives (ACE-I, ARBs), weight loss medications if indicated Weight loss (7-10% target), Mediterranean diet, DASH diet, 150 min/week moderate exercise, smoking cessation Type 2 diabetes (5x risk), cardiovascular disease (2x risk), NAFLD, PCOS, sleep apnea, chronic kidney disease Reversible with lifestyle changes; significantly increases CV mortality and diabetes risk; life expectancy reduced if progresses to diabetes/CVD Major predictor of diabetes and CVD; present in ~40% of adults >60; huge preventive health target E88.81 Yes Typically >40 years; increasing in younger adults and adolescents with obesity
23 23 Graves' Disease Metabolic/Endocrine Endocrine System ~1% of population; most common cause of hyperthyroidism; female:male ratio 7-10:1 Autoimmune disorder with TSH receptor antibodies (TRAb); genetic predisposition, smoking, stress, pregnancy, high iodine intake TSH receptor-stimulating antibodies cause unregulated thyroid hormone production and gland enlargement; orbital inflammation in Graves' ophthalmopathy Hyperthyroidism: weight loss, heat intolerance, palpitations, tremor, anxiety, diarrhea, menstrual changes; specific: exophthalmos, pretibial myxedema, diffuse goiter Suppressed TSH, elevated free T4/T3, positive TRAb or thyroid-stimulating immunoglobulin (TSI), increased radioactive iodine uptake, clinical features Antithyroid drugs (methimazole, PTU), beta-blockers for symptoms; definitive: radioactive iodine ablation or thyroidectomy Methimazole, propylthiouracil (PTU), propranolol, radioactive iodine-131, surgical thyroidectomy Smoking cessation (worsens eye disease), stress management, adequate iodine (not excessive), selenium for mild ophthalmopathy Thyroid storm (rare, life-threatening), atrial fibrillation, osteoporosis, Graves' ophthalmopathy (can threaten vision), heart failure Good prognosis with treatment; remission possible with ATD (30-50%); most eventually become hypothyroid after RAI/surgery requiring lifelong levothyroxine; normal life expectancy with treatment Rare cause of mortality; ophthalmopathy can impact quality of life; well-managed disease has excellent outcomes E05.0 No Typically 30-50 years; can occur at any age; more common in women
24 24 Hashimoto's Thyroiditis Metabolic/Endocrine Endocrine System ~5% of population; most common cause of hypothyroidism in iodine-sufficient areas; female:male ratio ~10:1 Autoimmune destruction of thyroid gland; genetic factors, environmental triggers, associated with other autoimmune diseases, higher iodine intake Chronic lymphocytic infiltration and antibody-mediated (anti-TPO, anti-thyroglobulin) destruction of thyroid tissue leading to progressive hypothyroidism Early: may have transient hyperthyroidism; later: hypothyroidism symptoms (fatigue, weight gain, cold intolerance, constipation, dry skin, bradycardia, depression); goiter may be present Elevated TSH, low free T4, positive anti-thyroid peroxidase (anti-TPO) antibodies in 90%, anti-thyroglobulin antibodies; thyroid ultrasound shows heterogeneous echotexture Levothyroxine replacement therapy titrated to normalize TSH (typically 0.5-5 mIU/L); lifelong treatment required once hypothyroid Levothyroxine (T4 replacement); liothyronine (T3) rarely added; target TSH normalization No specific dietary changes needed; ensure adequate iodine (but not excessive); regular TSH monitoring Untreated: myxedema coma (rare, life-threatening), heart disease, infertility, pregnancy complications; small increased risk of thyroid lymphoma Excellent prognosis with levothyroxine replacement; normal life expectancy; lifelong treatment required; dose adjustments needed with aging/pregnancy Very common condition; minimal mortality with treatment; major cause of hypothyroidism globally E06.3 No Typically 30-60 years; can occur at any age; often diagnosed in middle-aged women
25 25 Cushing's Syndrome Metabolic/Endocrine Endocrine System Rare: ~1-2 per million/year (endogenous); more common from exogenous glucocorticoid use Exogenous: chronic corticosteroid therapy (most common); endogenous: pituitary adenoma (Cushing's disease 70%), adrenal tumors, ectopic ACTH (lung cancer, carcinoid) Chronic excess cortisol causing protein catabolism, altered fat distribution, insulin resistance, immune suppression, and mineralocorticoid effects Central obesity, moon facies, buffalo hump, purple striae, easy bruising, muscle weakness, hypertension, glucose intolerance, osteoporosis, mood changes, hirsutism Elevated 24-hour urinary free cortisol, elevated late-night salivary cortisol, lack of cortisol suppression on low-dose dexamethasone test; imaging and ACTH levels to localize source Exogenous: taper corticosteroids; endogenous: transsphenoidal surgery for pituitary adenoma, adrenalectomy for adrenal tumors, medical therapy (ketoconazole, metyrapone) if surgery not possible Ketoconazole, metyrapone, pasireotide, mifepristone (for hyperglycemia); surgical resection when possible Manage complications: diabetes control, BP management, bone health (calcium, vitamin D, bisphosphonates), gradual steroid taper for exogenous cases Hypertension, diabetes, osteoporosis with fractures, infections, cardiovascular disease, psychiatric disturbances, adrenal insufficiency post-treatment Variable; depends on cause and treatment; untreated endogenous Cushing's has significantly reduced life expectancy (5-year mortality ~50%); surgical cure improves prognosis but residual morbidity common Rare condition; significant morbidity from complications; untreated has high mortality from CV disease and infections E24 No Pituitary Cushing's: typically 20-40 years; adrenal/ectopic: any age
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