Filtered By:
Source: Dr.S.Venkatesan MD
This page shows you your search results in order of date. This is page number 11.
Order by Relevance | Date
Total 596 results found since Jan 2013.
Pulmonary valvotomy for Tetrology of Fallot : Will soon become a worthy option
Catheter based interventions in TOF has caught the imagination of Interventional cardiologists.decades ago. (Quereshi reported first in 1988 Royal Liverpool hospital ) .Somehow it could not develop into a full-fledged modality. The key issue in TOF is, RVOT obstruction is infundibular with some degree of valvular involvement. While the valvular component is amenable for easy correction by balloon, the infundibular stenosis requires some form of cutting or splitting. Embryologically, the malalignment of IVS is the primary mechanism of obstruction. The balloon catheter is will find it difficult to tackle the alignm...
Source: Dr.S.Venkatesan MD - December 24, 2019 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -congenital heart disease cardiology -Therapeutics Interventions -Structural heart disease Tetrology of Fallot balloon pulmonary valvotomy in tof camera tipped catheters cyanotic spell in tof tetrology management emergency balloon Source Type: blogs
Does elevated RVEDP cause dyspnea ?
Exertional dyspnea disproportional to the effort is the most common (cardinal)symptom of heart disease. Whenever we discuss the mechanism of cardiac dyspnea , we primarily attribute it to left heart disease, elevated LVEDP and the resultant pulmonary congestion.Conventional teaching in the past (may be in the present too !) doesn’t implicate raised RVEDP in the genesis of dyspnea.
It’s good to recall , the sensation of dyspnea is felt at the peri -Amygdala nuclear zone after complex processing with various cortical and sub-cortical level .It is subjected to as many afferent triggers other than J receptors in pu...
Source: Dr.S.Venkatesan MD - December 18, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical Clinical cardiology Uncategorized does raised rvedp cause dyspnea dyspnea in pulmonary hypertension mechanism of dyspnea Source Type: blogs
Why ventricular tachycardia has wide QRS complex ?
Why VTs have wide QRS complex?
Brief answer: VT usually presents with wide QRS tachycardia because it originates in ventricular myocardium, travels muscle to muscle instead of the normal conduction system. However, VTs need not be wide always, if it captures the conduction system early and more proximally it can be as narrow as SVT.
Further reading: Only for cardiology fellows
Two empirical statements are made here. (The scientific chances of both being reasonably correct are fair)
80 % of wide QRS tachycardia by default is VT. That means 20 % of wide QRS is not VT. We all accept that.
80 % of narrow QRS tachycardia i...
Source: Dr.S.Venkatesan MD - December 4, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
How common is the progression of non-culprit lesion after PTCA ? What is the significance?
Whenever a patient is getting discharged after a PCI, the treating cardiologist often faces this situation.
So, you fixed the block in my coronary artery doctor. Thank you so much. Now, I can have a peaceful life, free from future heart problems. “Am I right doctor”?
I wish I can answer “Yes” to your query but I can’t for the following reasons.
I have fixed only a lesion that caused maximum obstruction. Atherosclerosis is a diffuse disease and you have minor plaques scattered across your coronary artery. These can grow at its own will. So you carry a definite risk remote from the current ...
Source: Dr.S.Venkatesan MD - November 24, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized COURAGE ORBITA ISCHEMIA post ptca care progression of native vessel disease after ptca Source Type: blogs
CAD management in cross roads : Ischemia vs Ignorance driven PCI ?
*ISCHEMIA trial breaks not in NEJM or Lancet but in Washington Post and Wall street Journal
After three decades into cardiology profession, one thing is very clear. We work so hard to create pseudo-knowledge and struggle with it for so long and feel awkward and guilty to come out of the mess. But we have to . . . in the overall interest of mankind, isn’t?
We aptly call the whole process as continuing medical education, but in the melee, often we ditch some of the precious gems as obsolete. (This tempts me to suggest discontinuing false education is also an option for medical knowledge seekers !)
Confucius has som...
Source: Dr.S.Venkatesan MD - November 21, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coroanry syndrome cto management ISCHEMIA trial ischemia trial summary land mark trial in cardiology orbita courage bari 2d shid stbale cad take home message ischemia trial Source Type: blogs
Confabulation of a cardiologist – post ISCHEMIA trial !
I have never found it difficult to retrogradely cross a dangerous epicardial collateral in complex CTO. Delivering a twin stent in a partial culotte strategy for a bifurc lesion has never tested my talents. Stenting a left main across the LAD, jailing the LCX with OCT support is my favorite time pass. Crushing a calcium infested diffuse long lesion with diamond-tipped ablator appear as breezy as shopping in a mall.
But this one is really challenging
What is that?
Understanding these four studies (Ref 1-4 ). They dogmatically say medical management confers definitive protection in chronic coronary syndromes. It stretches...
Source: Dr.S.Venkatesan MD - November 17, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome acc esc guidelines scai pci ptca stable chd courage bari 2d orbita ischemia trials tips and tricks in ptca Source Type: blogs
Forbidden tips in PTCA : OMG , give me strength to leave this lesion alone !
Confabulation of a confused cardiologist
Yes, It has never bothered me to retrogradely cross a delicately dangerous epicardial collateral in complex CTO. Delivering a twin stent in a partial culotte strategy for a bifurc lesion has never tested my talents. Stenting a left main across the LAD, jailing the LCX with OCT support is my favorite time pass. Crushing a calcium infested diffuse long lesion with diamond-tipped ablator appear as breezy as shopping in a mall.
Oh …I am terribly upset with this damn thing.
What is that?
It requires 4 negative forces . . . to bring one big positive Impact!
These studies say medic...
Source: Dr.S.Venkatesan MD - November 17, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome acc esc guidelines scai pci ptca stable chd courage bari 2d orbita ischemia trials tips and tricks in ptca Source Type: blogs
Is LV dilatation (with normal EF) Indicate LV dysfunction?
LV dysfunction is one of the most commonly used terminology by cardiac professionals.It can be systolic, diastolic or global, regional etc. But, before dysfunction sets in, the heart fights. The Left ventricle can behave in many different ways when confronted with stress. It increases the force of contraction, elevates it’s Intra cavitary filling pressure and still accomplishes its task of pumping adequately. Further, It can build fresh muscle (LVH). It can double up with more heartbeats. (All these factors are referred to as cardiac reserve mechanisms)
These reserve mechanisms can be activated in the short or long ...
Source: Dr.S.Venkatesan MD - November 2, 2019 Category: Cardiology Authors: dr s venkatesan Tags: cardaic physiology cardiac physiology LV dilatation is diastolic dysfunction cardiac reserve cardiology research papers cardiology thesis topics dilated left ventricle lv dilatation is lv dysfunction Source Type: blogs
Is FFR heart rate dependent ? If yes, how significant it is?
FFR is the ultimate hemodynamic test that measures the physiological Impact of lesions. Just pass a manometer tipped wire across the lesion and note the pressure drop (with or without Adenosine) All you have to remember is two cut off values .8 for FFR and .9 for IFR. Abracadabra . . . yes you got the answer , whether to proceed with PCI or not? It’s as simple as that. We are no longer blind to physiology to which many coronary purists often criticize us.
Coronary physiology simplified
Now , answer this question.
Is FFR heart rate dependent? If yes, how significant it is?
This simple question on coronary physiology...
Source: Dr.S.Venkatesan MD - October 2, 2019 Category: Cardiology Authors: dr s venkatesan Tags: fame study ffr quantitative coronary angiogram fractional flow reserve ffr ifr IFR QFR instantaneous flow reserve Limitations of FFR pressure wire channel in gruentzig original ptca balloon zurich Source Type: blogs
Ischemic cardiomyopathy: Why is it, still searching for a definition?
The term Ischemic cardiomyopathy(ICM) was originally coined by Dr. Burch from Tulane University, New Orleans, USA in 1970. For many decades there was skepticism regarding the existence of such entity. WHO classification over the years never included this term. ESC working group of 2008 (Elliott P, European Heart 29(2):270–276) decided not to include CAD as a cause for cardiomyopathy. Even the current MOGES system doesn’t invoke CAD as a cause for cardiomyopathy. But, I am sure, most of practicing cardiologists would agree, there is a need for such an entity.
Why there is much reluctance to diagnose Ische...
Source: Dr.S.Venkatesan MD - September 21, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Criteria and Nomenclature ischemic cardiomyopathy Uncategorized defintion of ischemic cardiomyopathy MOGES classification what is ischemic cardiomyopathy who whf classification of cardiomyopathy Source Type: blogs
Digoxin in Heart failure: Foxglove blossoms again, please don ’ t crush it this time!
William Withering the British Botanist of 18th century now laid to rest in the St Barthomlew Churchyard ,Edgbaston is known for his astonishing isolation of the wonder moelcule Digoxin from Foxglove. (Of course, let us not forget original old lady Ms. Hutton from Shropshire who was treating epidemic dropsy with a concoction of herbal Tea ) He reported this in the seminal paper “An account of Foxglove’ in the year 1750 and subsequently became a fellow of Royal college of science.
(The story of Withering and Digoxin is extensively researched and written by Dr Dennis M, Krikler in a classic review article of 198...
Source: Dr.S.Venkatesan MD - September 14, 2019 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure history of cardiology dig trial radiance proved history of digoxin Source Type: blogs
Evidence based errors in cardiology . . . urgent need for special cognitive skills !
Preamble
Hey dudes, will you stent this 76 year old fragile man’s Aortic valve ? It looks shaggy and it seems to be leaking as well.Iam not sure its really tricuspid or not .It is so distorted . By the way , he also has a left main lesion with no protection.What shall we do ? Will the Jena valve do the trick ? My experienced collegue threw this question to a flock of freshly hatched senior residents of a upscale cardiac center.
After rapidly feeding the necessary risk predicting numericals, clinical and hybrid imagery data , they dug deep into the iOS-powered gadget, loaded with latest TAVR app fused with SYNTA...
Source: Dr.S.Venkatesan MD - September 13, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized cognitive skills in cardiology tavr for bicuspid aortic valve Source Type: blogs
DM cardiology course suffers from a 50% entry block … A NEET angioplasty done.
The most premier course in medicine, DM cardiology just got an entry makeover.
The qualifying mark was lowered to 20% from the current 50th percentile The reason is many private medical college seats went vacant after the Initial counselling in NEET superspeciality exams.
Becoming a cardiologist was a dream come true for those days for us. “You have to read the red covered 3rd edition Brunwald and all clinical chapters from Hurst for two full years” before even to think of writing DM entrance, my senior used to tell me in late 1980s.Yes, life may still be tough in post graduate entrance but, there is an exclus...
Source: Dr.S.Venkatesan MD - September 8, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
FAQs in STEMI : Why is the 3 hour gap recommended before pharmaco Invasive strategy?
Background STEMI knowledge check : Evidence-based Ignorance
I think , It was unfortunate, In the management of STEMI , the two popular strategies of myocardial reperfusion was made to fight with each other as if they are perennial enemies for over two decades. Suddenly, someone with a rare coronary insight thought, why fight each other , they can have a friendly hug and work together. That brought the concept of pharmco -Invasive approach or strategy(PIA) backed up by STREAM, FAST-MI, and TRANSFER AMI studies.Yes, it appears to work well and devoid of all the early adverse events of pPCI. (Much to the dismay of ardent fans...
Source: Dr.S.Venkatesan MD - August 14, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology - Animations Cardiology -Interventional -PCI Cardiology -unresolved questions cath lab tips and tricks Infrequently asked questions in cardiology (iFAQs) open artery hypothesis STEMI STEMI -Managment ST Source Type: blogs
Was the past perfect ? I don ’ t know, but the future looks tense … welcome on-board, to automated ACS management.
Charles river esplanade ,Boston* : A healthy middle-aged man who was jogging quietly, while his heart was under intense scrutiny by the bionic eyes of Apple i-watch’s smart patch electrode. Suddenly, it detected some bizarre ST segment fragmentation (Seems it can predict in advance , Ischemic signals 10 minutes prior to onset of ACS ) The built-in cosmos direct GPS instantly alerted & summoned a titanium powered Space X drone that pulled the patient from the riverside to the nearest human wellness port .
It dropped him through a remotely accessed split glass roof right inside the hybrid heart lab, to find , men ...
Source: Dr.S.Venkatesan MD - June 23, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coroanry syndrome Clinical cardiology Ethics in Medicine Hippocratic oath history of cardiology Histroy of medicine Left main disease Medical ethics Primary PCI Source Type: blogs
