Glossary Of Terms - B
Bacterial endocarditis. See Endocarditis.
Balanced diet. See Balanced diet under Diet.
Balanced scorecard is a report for top management of a company or hospital showing performance and outcomes. Over the years since about 1990, it has evolved from its early simple performance measurement framework to a full strategic planning and management system.
In December 2009 the Chief Executive of the Care & Quality Commission CQC, suggested balanced scorecards should be scrapped to avoid duplicating NHS bureaucracy.
Balloon angioplasty. This is a procedure where an angioplasty catheter is used to place a tiny balloon at a blocked or partially blocked place in an artery. This is then inflated to about 3 mm diameter and it flattens the fatty tissue that was blocking the artery against the artery wall. Usually, a stent is inserted to keep the artery open. The balloon is deflated, and the catheter is withdrawn.
Bare-metal stent. See under Stent.
Baroreceptor See baroreceptor under Collapse.
Basal metabolic rate. See basal metabolic rate under Metabolism.
Base See base under Organic chemistry.
BCPA J means BCPA Journal. See there for an index to the issues since mid 2005.
bd = twice per day. Also see od = once a day, tds = three times, qds = four times, om = every morning, on = every night/bedtime. See under Prescription terms.
Beating heart transplant. On 22nd May 2006 a team at Papworth Hospital performed the first ‘beating’ heart transplant in the UK. The recipient - a 58-year old man - was two weeks later doing extremely well and had already left hospital.
A donor heart will deteriorate without a blood supply outside the body and the current method of preserving its function is a high dose of potassium to stop it beating, and then cooling to maintain it during transport. Unfortunately despite the above measures the heart slowly deteriorates and there is a safe time limit of about 5 hours between removal from the donor and implantation to the recipient.
In the new system, developed by TransMedics in the USA, the heart is transported in an Organ Care System with conditions as close as possible to the human body; it has warm oxygenated, nutrient-rich blood flowing through it and thus continues to beat. The new technique should mean that the heart is in better condition at the time of the transplant. The organ care system may also allow the time interval before transplantation to be extended and possibly allow drug treatment to be used to improve hearts prior to transplantation. The latter will increase the number of donor hearts that can be used for transplantation, which would be a major benefit.
Beats per minute = Heart rate.
Benign in pathology or tumour contexts means not threatening to health or life, not malignant.
Benzine and benzene ring See benzine ring under Phenol.
Betablocker = beta-adrenergic blocker. Betablockers slow the heartbeat, and are used to: relieve angina, reduce high blood pressure, reduce the risk of a further heart attack, and/or regulate the heart rhythm. Some betablockers also relax the blood vessels.
They interrupt the transmission of stimuli through the body's beta receptors. Thus they nullify the stimulating action of norepinephrine (= noradrenaline), which is the main fight-or-flight hormone. The beta receptors in different parts of the body produce a variety of benefits and/or side effects – the benefits or otherwise depend on what conditions and/or diseases the patient has. The main effects of beta blockers follow.
● Heart rate is slowed and the force / pressure in the outflowing blood at each heartbeat is reduced – the reduced heart workload helps prevent angina and/or abnormal heart rhythms. Unfortunately this may increase the risk of heart failure.
● Blood pressure is lowered since the heart rate and the heart's force / pressure is reduced.
● Blood vessels are narrowed, which may cause the hands or feet to feel cold from reduced blood flow.
● Overactivity of the thyroid gland is reduced – so muscles may tremor from that or from anxiety.
● Narrowing of airways to the lungs may cause breathlessness.
● Dilating blood vessels surrounding the brain is inhibited (= prevented).
In summary they are effective because they slow the heart rate, reduce the workload of the heart, and lower the blood pressure.
Betablockers are prescribed for a number of conditions.
● Relieve angina chest pain, as they reduce the frequency and/or severity of angina.
● Reduce high blood pressure
● Reduce the risk of a further heart attack
● Regulate the heart rhythm.
Many different betablockers are available. Some mainly affect the heart; others are not aimed at the heart.
Brand names of Betablockers. The following betablockers mainly aim at the heart, eg to stop the heart from beating too fast. Acebutolol; Atenolol - brand names Antipressan, Atenix, Tenormin; Betaxolol; Bisoprolol - brand names Bipranix, Cardicor, Emcor, Monocor, Soloc, Vivacor; Celiprolol; Metoprolol - brand names Betaloc, Lopresor; Nebrivolol.
The following betablockers are mainly not aimed at the heart. Carvediol; Labetalol; Nadolol; Oxprenolol; Pindolol; Propranolol - brand name Inderal; Sotalol - brand names Beta-Cardone, Sotacor; Timolol - brand names Betim, Glau-opt, Nyogel, Timoptol.
If you, the patient, are taking the dose once a day it is best to take it in the morning. If you are taking more than one dose a day, then space them out evenly through the day. The tablets, particularly the slow-release SR variety, should be swallowed whole with a glass of water and never crushed or chewed.
It is important never to stop taking betablockers suddenly without consulting your doctor.
Betablockers side effects are relatively rare. Occasionally people suffer with cold hands and feet. Make sure you keep warm in the cold. You may feel tired when you first start taking betablockers. This usually passes within a few days, as your body adjusts to a slower pulse rate. A minority of people may suffer wheeziness or breathlessness when taking betablockers. People with asthma should not normally take Betablockers. Very rarely, men may suffer from impotence whilst taking betablockers. If you notice any of the above side effects, you should contact your doctor.
BHFNC See British Heart Foundation National Centre.
Bile is a greenish to golden brown liquid produced by the liver and stored in the gall bladder. During digestion of food it is released into small intestine via the bile duct to aid digestion. It is also discharged into the duodenum where it helps the emulsifying of and absorption of fats. See Cholesterol, lipid-lowering drugs.
Bilirubin. See under Jaundice.
The Biotechnology and Biological Sciences Research Council, BBSRC, is the UK funding agency for research in the life sciences. Sponsored by the government, with a budget of £370 million in 2007, it supports industrial stakeholders in the agricultural, food, chemical, healthcare, and pharmaceutical sectors. See also Institute of Food Research.
Biventricular heart failure. For biventricular heart failure see under heart failure terms.
Blackout See blackout under collapse.
Blocker. See antagonist.
Blood contains red cells, white cells, plasma, and platelets and other agents that are active in the clotting of blood. Plasma is the clear or yellowish fluid in which corpuscles and cells are suspended; including water, dissolved proteins, salts, sugars, fats, minerals, and vitamins. Red cells have haemoglobin for carrying oxygen. Antibodies for various diseases are proteins in the blood that render the toxins harmless.
Plasma is the clear or yellowish fluid in which corpuscles and cells are suspended; including water, dissolved proteins, salts, sugars, fats, minerals, and vitamins.
Red cells have haemoglobin for carrying oxygen. Antibodies for various diseases are proteins in the blood that render the toxins harmless.
Blood analysis measures the amounts of particular substances in a blood sample in a blood test.
The equipment is called a blood analyser. In 2004 the BCPA bought seven for Papworth Hospital, costing over £15,000. Each could measure the clotting properties, INR, and other variables in a few minutes from a drop on a slide. The previous equipment needed a tube full of blood and took hours.
Blood cholesterol test. A blood cholesterol test measures the amount of cholesterol and other fatty substances in a blood sample.
Blood clot. A blood clot is an unwanted lump of blood platelets creating a blockage in an artery or vein. A part of such a clot may break away – called an embolus, and if it flows to some other place it may cause further problems there. Deep vein thrombosis means a blood clot in a leg.
Blood oxygen A gadget can be clipped to a finger to measure the oxygen content of the blood, called the saturation of peripheral oxygen, SpO2. It transmits red and infrared light of various wavelengths through the finger. It detects the pulse, finds the minimum and maximum absorption, and distinguishes arterial from venous blood flows. From the differences it calculates the SpO2.
Blood pressure, BP, measures the systolic (highest) and diastolic (lowest) pressure during each heartbeat. For high blood pressure see hypertension. It is normal for blood pressure to rise with exercise, stress, and exertion. Low BP is when the systolic is less than 110mg - the diastolic is not relevant here. But there can be reasons for high BP or low BP so whether such should be treated in any way may depend on the patient's other conditions, which a doctor may decide.
Systolic is the maximum blood pressure during each heartbeat, eg the 130 of 130/80, measured in mm of mercury (mmHg).
Diastolic is the minimum blood pressure during each heartbeat, ie the 80 of 130/80.
Blood test. A blood test is an analysis of a small sample of blood to measure the amounts of various chemicals and/or trace elements (under Minerals) in the blood. Eg patients with unknown cholesterol, or with deep vein thrombosis, or taking warfarin, are tested to determine the amounts of particular chemicals so that appropriate treatment may be given. See also blood analysis, troponin.
Blood tests include the following. This list is not complete.
- Blood gas indicates the levels of oxygen and carbon dioxide in the blood.
- Blood cholesterol, which measures lipids.
- Blood glucose, to check for diabetes.
- Creatine kinase (CK) is a muscle enzyme released when the muscle is damaged; eg this test may be done after a patient has had MI to measure heart muscle damage. It can also indicate inflammation of the muscles.
- CRP = C-reactive protein. The test helps evaluate the severity of an inflammation. See also under polymyalgia.
- ELISA = enzyme-linked immunosorbent assay, which may indicate an infection or an allergy, checking whether the blood has the relevant antibodies.
- ESR = Erythrocyte sedimentation rate, the rate at which red cells settle; a high value may indicate inflammation. See also under polymyalgia.
- FBC = Full blood count. Used to assess general health, including some of the other tests listed here and the following.
- Haemoglobin - low may indicate anaemia or poor diet; high haemoglobin may indicate lung disease or bone marrow problem.
- White blood cell count (=white cell count) - low may indicate bone marrow problem; high white blood cell count may indicate an infection; and also it may be high when patients are on or have had steroids.
- Platelet count - low may indicate an infection or fault with the immune system; high platelet count may indicate infection or bone marrow problem; platelets help blood to clot.
- Electrolyte test, which measures chlorine, potassium (which can be raised by ACE inhibitors and may indicate kidney problems), and sodium (possibly indicating dehydration, diabetes).
- Liver function tests.
BMJ The British Medical Journal is a journal for UK doctors.
Body mass index, BMI, is the weight in kilograms divided by the square of the person's height in metres. Eg weight 75 kg and height 1.73 m gives 75/(1.73*1.73) equals 25.
To get your BMI, divide your weight in kilograms by the square of your height in metres.
Excluding people training for sports or ill the following are the relevant ranges. But for all these terms in detail it also depends on whether the person has a small, medium or large frame, and whether they are training for a sport.
For most adults a BMI between 20 and 25 is normal BMI - ie healthy and good.
● Under either 18.5 or 20 is normally regarded as underweight
● 25 to under 30 is overweight
● Over 30 is obese. See Obesity eg for risks.
Some people think Waist-to-hip ratio is a better measure.
Body salts are minerals present in body fluids such as blood, urine, sweat, or within cells.
Bones. The human body has 208 bones. The arms, wrists, & hands have 60. The legs, ankles, & feet have 60. The backbone has 26 vertebrae; there are 12 vertebral ribs each side, (a few people have 11 and are missing the lowest rib on each side). The skull has 22 bones. The ears have three each, and the throat has one. The collar & shoulder blades have four, the sternum (breastbone) has three, & the pelvic girdle has two.
The bones give rigidity, support, and shape to the body – including the ability of joints to move with muscles attached at appropriate places. They also give protection to certain parts – eg the skull & ribs protect. The inside of a bone is hollow and holds the systems that make blood cells and also make calcium. Bones are 33% water.
When they start growing they are solid, developing the hollow centres later. They also have the ability to repair themselves eg after a fracture – even a complete fracture broken right through. At a fracture the blood vessels also are damaged, so blood escapes as internal bleeding, and this blood clots into a hard mass to help the healing processes.
Bones can have various diseases. Congenital = hereditary diseases are rare and usually not curable, eg dwarfism, deformities. Biochemically caused bone diseases are where the body's functions have not worked properly to control the bones, eg rickets, weak bones. Bones can be infected by bacteria, eg osteomyelitis. They can also have tumours, eg a lump on the skull; and malignant growth such as cancer spreading from somewhere else. Osteoarthritis and rheumatoid arthritis first affect the lining of joints and the cartilage space between bones, and then affect the bones themselves.
BP stands for blood pressure.
Brachial means of the arm. Brachium means the arm, brachia being the plural.
Bradycardia is an abnormally slow heart rate, usually below 60 beats per minute. Compare Tachycardia.
Brain. The brain uses about 25% of the energy available when a person is resting. The blood flows from the ascending aorta through arteries – the carotid arteries can be felt on each side at the front of the neck.
Brand name = trade name = name for a particular product manufactured and marketed by a commercial company – a name chosen by the manufacturer. Contrast with generic name.
The different brands each contain the same generic substance. The differences between the brands may be slight – eg rate of absorption, convenience, and digestibility.
A particular drug may be available in generic form, in one or more brand forms, or both.
Some brand named products contain more than one, ie several, generic drugs.
Generic names are normally not spelt with an initial capital; but brand names normally have an initial capital.
Finding brand name drugs. Here are some links to either the generic name or the brand name of brand names occurring elsewhere in this Glossary.
Links to many generic names of drugs are given together under Drugs – finding in this Glossary.
Brand names of Alphablockers
Alfuzosin
Doxazosin - Brand names Cardura, Doxadura
Indoramin
Prazosin
Tamsulosin - Brand names Flomaxtra XL, Omnic MR, Stronazon MR.
Terazosin
Brand and generic names of Analgesics that are opioids include Buipreorpine, Co-codamol, Codeine, Co-dydramol, Diamorphione (= heroin), Dihydrocodeine, Dipipanone, Fentanel, Meptazinol, Methadone, Morphine, Oxycodone, Pethidine, Tramadol.
Brand and generic names of analgesics that are NSAIDs include Aspirin, Diclofenac, Etodolac, Fenbufen, Fenoprofen, Ibuprofen, Indometacin, Ketoprofen, Meloxicam, Mefenamic acid, Piroxicam.
Brand and generic names of analgesics that are non-opioids include Nefopam, Paracetamol.
Brand names of Antidepressant There are many. Mirtazapine.
Brand names of ACE inhibitors
Captopril - Brand name Capoten
Cilazapril
Enalapril - Brand name Innovace
Fosinopril
Lisinopril - Brand names Carace, Zestril
Perindopril
Quinapril
Ramipril - Brand name Titrace
Trandolapril.
Angiotensin-II blockers. Valsartan, brand name Diovan.
Antihistamine brand name Anthisan. See also under histamine.
Bumetanide is a fast-acting diuretic - possibly slightly-stronger or faster-acting alternative to Furosemide. Brand name Burinex.
Brand names of betablockers. The following betablockers mainly aim at the heart, eg to stop the heart from beating too fast.
Acebutolol
Atenolol - brand names Antipressan, Atenix, Tenormin
Betaxolol
Bisoprolol - brand names Bipranix, Cardicor, Emcor, Monocor, Soloc, Vivacor
Celiprolol
Metoprolol - brand names Betaloc, Lopresor
Nebrivolol.
The following betablockers are mainly not aimed at the heart.
Carvediol
Labetalol
Nadolol
Oxprenolol
Pindolol
Propranolol - brand name Inderal
Sotalol - brand names Beta-Cardone, Sotacor
Timolol - brand names Betim, Glau-opt, Nyogel, Timoptol.
Brand names of calcium channel blockers
Amlodipine - brand name Istin
Diltiazem - brand names Adizem, Tildiem
Felodipine - brand names Cardioplen, Felotens, Keloc, Neloc, Plendil, Vascalpha
Nicardipine - brand name Cardene
Nifedipine - brand names Adalat, Coracten, Nifensar
Verapamil - brand names Cordilox, Securon, Univer.
Brand names of Clopidogrel, brand name Plavix.
Co-proxamol withdrawn - brand names affected were Cosalgesic and Distalgesic.
Brand names of diuretics. Loop diuretics are fast acting to increase the output of urine for just a few hours. Loop diuretics generic and brand names include:
Bumetanide - brand name Burinex.
Furosemide - brand names Froop, Lasuix, Frusol
Torasemide.
See also brand names of Thiazides below.
Brand name for clopidogrel is Plavix.
Brand names of diclofenac include: Diclomax SR, Motifene, Rhumalagan, Volraman, Vlotarol, Voltarol Pain-Eze.
Dipyridamole brand name Persantin.
Brand names of Epinephrine: Ana-Guard, Ana-Kit, Anapen, EpiPen, and Minijet.
Brand names of ibuprofen, which is a generic name: Arthrofen, Brufen, Calprofen, Ebufac, Ibugel, Ibumousse, Ibuleve, Nurofen, and many others. Also junior brands for children. Ibuprofen is also used in the following drugs that are combinations: Codafen, Cuprofen Plus, Nurofen Plus, Solpaflex.
Brand names of ISMN or ISMO (brand names Monit or Elantan), Isosorbide dinitrate (Cedocard, Isordil), and Isosorbide mononitrate slow release (IMDUR) tablets.
Brand names of methadone drugs include: Methadose, Metharose, Physeptone, Synastone.
Brand names of morphine drugs: Morphgesic SR, MST Continus, MXL, Oramorph, Oramorph SR, Sevredol, Zomorph. Also in Cyclimorph, which is a combination.
Names of NSAIDs include:
Aceclofenac - brand name Hiffenac to relieve arthritis
Acemetacin - brand name Emflex and others - a COX2 inhibitor and anti-inflammatory
Aspirin
Diclofenac
Diflunisal - several generic versions available for inhibiting the production of prostaglandins, which regulate the contraction and relaxation of smooth muscles
Felbinac - for muscle inflammation and arthritis
Flurbiprofen - for arthritis pain - brand names Urbifen, Ansaid, Flurwood, Froben. Also an active ingredient is some throat lozenges eg Strepsils
Ibuprofen
Indometacin - to reduce fever, pain, stiffness and swelling
Nabumetone - to treat arthritis pain - brand names Relafen, Relifex and Gambaran
Sulindac - brand name Clinoril - for acute inflammations
Tenoxicam - brand name Mobiflex - to relieve inflammation, stiffness, swelling and arthritis pains
Tiaprofenic acid - of the profen class of chemicals - to relieve arthritic pain - brand names Surgam, Surgamyl and Tiaprofen.
Brand names of NSAIDs include: Etodolac; Fenbufen; Fenoprofen; Indometacin; Ketoprufen; Meloxicam; Mefenamic acid; Naproxen; and Piroxicam.
Names of COX2 inhibitors include: Celecoxib; Etodolac; Etoricoxib; Lumiracoxib.
Generic and brand names of opioids include:
Buprenorphine
Co-codamol
Codeine - many brand names for codeine with other drugs in combinations, eg: Codafen, Codis, Cuprofen, Feminax, Migraleve, Panadol, Solpadeine, Solpadol, Veganin, and others
Co-dydramol
Diamorphine = heroin
Dihydrocodeine
Dipipanone
Fentanyl
Meptazinol
Methadone - brand names: Methadose, Metharose, Physeptone, Synastone
Morphine
Oxycodone
Pethidine
Tramadol - brand names: Dromadol, Larap0am, Mabron, Tramake, Zamadol, Zydol
Brand names of paracetamol include: Alvedon, Calpol, Disprol, Hedex, Panadol, Panaleve, and many others; including some junior brands for children. They are also in the following brand combination drugs: Anadin extra, Migraleve, Panadeine, Paradote, Tylex and others.
Brand name of potassium channel blocker Nicorandil - brand name Ikorel.
Brand names of prednisolone include: Deltacortril, Deltastab, Minims prednisolone, Predenema, Predfoam, Pred Forte, Predsol.
Obesity drug sibutramine brand name Reductil suspended.
Brand names of statins
Atorvastatin - brand name Lipitor, which came off patent protection in 2012 and hence much cheaper
Fluvastatin - brand name Lescol
Simvastatin - brand name Zocor
Pravastatin - brand name Lipostat
Cerivastatin - brand name Lipobay
Rosuvastatin - brand name Crestor.
Brand names of thiazides, which are the commonest diuretics, and which can cause potassium deficiency so a potassium supplement is often prescribed as well. Genetic and brand names:
Bendroflumethiazide - brand names: Aprinox, Neo-NaClex
Chlortalidone
Cyclopenthiazide
Hydrochlorothiazide - no brand names as such, but used in various combined drugs
Hydroflumethiazide
Indapamide brand names: Natrilix SR, Nindaxa
Metolazone
Xipamide.
Breastbone means the same as sternum.
Breathing. Being breathless, short of breath, may indicate a heart-related condition as below – eg angina; or perhaps anaemia. There are other possibilities. See ambulance for when to call an ambulance.
Breathlessness can be caused by some heart-related condition that affects the flows of blood round the body and/or to and/or from the lungs. SOBOE = Shortness of breath on exertion / exercise. See also SOBOE.
British Heart Foundation, BHF, is a registered charity that plays a leading role in the fight against heart and circulatory diseases. It sponsors research and has produced many booklets. The BCPA and the BHF co-operate. Tel 020 7935 0185, Website www.bhf.org.uk
British Heart Foundation National Centre for Physical Activity and Health, BHFNC, is at Loughborough. They found that 37% of CHD deaths are related to inactivity; as compared to only 19% of CHD deaths being related to smoking. See BHFNC under Exercise.
Bronchial tube See bronchial tube under Lung.
Bruce cycle. See Bruce Treadmill Test under Exercise stress test.
Bumetanide is a generic name fast-acting diuretic to treat the accumulation of fluid in body tissues. It is a possibly slightly-stronger or faster-acting alternative to Furosemide. Brand name Burinex®.
Copyright
This information was created and edited by Richard Maddison for the BCPA.
Copyright © 1997-2013 The British Cardiac Patients Association, and/or Richard Maddison.
BCPA Head Office: 15 Abbey Road, Bingham, Nottingham NG13 8EE
Reg Charity 289190. Email: Admin@BCPA.co.uk
First published in this form 2002, and updated 2005, 2007, 2008, 2011, 2012, 2013.
All rights reserved. No part of this work may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, without written permission from the BCPA Head Office.
We give permission for copies to be stored and made within the BCPA and any UK hospital; and these hospitals may give printed but not electronic copies to patients provided the source and copyright is acknowledged on the copies – eg include the page footer.
Authors, sources and acknowledgements
The main sources are BCPA Journal published articles, other information from authors, and publicly available documents and websites. In many cases the journal articles give sources and further information than the Glossary entries.
Parts of the wordings under ECG and Echocardiogram are adapted with permission from BUPA's health information resources, available at www.bupa.co.uk/health-information.
We hope we have thanked everyone.
Richard Maddison