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Total 153 results found since Jan 2013.

Discordant grading of severity of aortic stenosis
Discordance between various measures of severity of aortic stenosis (AS) is considered as discordant grading of severity of aortic stenosis or simply discordant AS. Severe aortic stenosis has aortic Vmax ≥4.0 m/s, mean gradient ≥40 mm Hg and effective orifice area (EOA) ≤1.0 sq. cm. Peak aortic velocity and mean gradient are flow dependent measurements, while effective orifice area and Doppler velocity index are relatively flow independent. About 20-30% of patients may have discordant measures of severity of aortic stenosis on echocardiography [1]. Discordance is mostly between effective orifice area and Vmax/Doppl...
Source: Cardiophile MD - February 24, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Echocardiography discordant aortic stenosis discordant AS hybrid imaging hybrid imaging to assess LVOT measurement pseudo severe aortic stenosis pseudo severe AS Source Type: blogs

ST Depression Maximal in V1-V4 and Angio shows 3 Vessel Disease. Is it posterior? Which is the culprit?
A 70-something woman had acute chest pain.The ECG was texted to me with the words: " Acute chest pain. Could this be posterior MI? What do you make of the ST depression in V4-V6? "What do you think?My response: " The ST depression is maximal in V1-V4.  This is most consistent with a posterior MI.  If it sounds clinically like acute MI then this is good for activating the cath lab. "Her response: " Yeah, I did activate.  But the cardiology fellow told me he was sure it would not be a posterior MI because of diffuse ST depression.  He suggested that we should have consulted cardiology rather than activati...
Source: Dr. Smith's ECG Blog - December 23, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

RWMA – Echo
RWMA – Echo The term regional wall motion abnormality or RWMA can be used in any imaging which shows movements of the myocardial segments like echocardiography, cine cardiac magnetic resonance imaging, cine computed tomography and nuclear cardiology imaging. The left ventricular myocardium has been divided into 17 segments by the American Society of Echocardiography [1]. The true apex is a separate segment in this 17-segment nomenclature. In the previous 16 segment nomenclature, there is no separate true apical segment. True apical segment is beyond the left ventricular cavity towards the apex. More details at: Desc...
Source: Cardiophile MD - November 20, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Echocardiogram Library Echocardiography 17 myocardial segments echocardiographic myocardial segments Regional wall motion abnormality RWMA Source Type: blogs

Acute Aortic syndrome : Please mind the Length of “ Ascending Aorta ” as well !
 Aorta probably is the most critical structure in the entire circulatory system. (apart from the heart of course !) It is a 1.5 to 2.5 mm thick tube, with a diameter of 2.5 cm/length of 30 -35 cm from the aortic valve to the iliac bifurcation.(Eric Borsero 2011) It handles about 7500 liters of blood every day. Understanding the Aortic pathology has vastly improved at the molecular level with deep gene sequencing that defines fibrillin phenotypes.  Meanwhile, CT ,  4D MRI and 3D prototyping have landed us in a new era where we can feel the exact models of a patient’s virtual aAorta for monitoring and treatment purp...
Source: Dr.S.Venkatesan MD - November 1, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized marfan aortic dissection aorta size new coconcepts in aortic dimension normal aorta size normal aortic root size what is normal length of ascending aorta Source Type: blogs

Acute Aortic syndrome : Please mind the length of “ Ascending Aorta ” as well.
 Aorta probably is the most critical structure in the entire circulatory system. (apart from the heart of course !) It is a 1.5 to 2.5 mm thick tube, with a diameter of 2.5 cm/length of 30 -35 cm from the aortic valve to the iliac bifurcation.(Eric Borsero 2011) It handles about 7500 liters of blood every day. Understanding the Aortic pathology has vastly improved at the molecular level with deep gene sequencing that defines fibrillin phenotypes.  Meanwhile, CT ,  4D MRI and 3D prototyping have landed us in a new era where we can feel the exact models of a patient’s virtual aAorta for monitoring and treatment purp...
Source: Dr.S.Venkatesan MD - November 1, 2020 Category: Cardiology Authors: dr s venkatesan Tags: aortic aneurysm marfan aortic dissection aorta size new coconcepts in aortic dimension normal aorta size normal aortic root size what is normal length of ascending aorta Source Type: blogs

Exact Models of Aortic Heart Valves Help Prepare for Minimally Invasive Procedures
Complex transcatheter cardiac procedures, such as valve replacements, are often difficult to prepare for. Small anatomical differences can make big impacts on outcomes. Clinicians and researchers have been using models, both virtual and 3D printed, t...
Source: Medgadget - August 31, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Materials Radiology Source Type: blogs

Accordion sign – Cardiology MCQ – Answer
Accordion sign – Cardiology MCQ – Answer Accordion sign on magnetic resonance imaging (MRI) is seen in – Correct answer: 3. Arrhythmogenic right ventricular cardiomyopathy A focal crinkling of the right ventricular outflow tract and subtricuspid regions on MRI in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD/C) has been called “accordion sign” [1]. It was observed in 60% of the mutation carriers and none of those without the mutation (p < 0.001). {Another accordion sign (also called concertina sign) has been described in computed tomography (CT) after administration of or...
Source: Cardiophile MD - August 24, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Repost: 63 minutes of ventricular fibrillation, followed by shock. What is going on?
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely.  When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA.    ===================================MY Comment by KEN ...
Source: Dr. Smith's ECG Blog - June 27, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

What ’s a diagnosis about? COVID-19 and beyond
By MICHEL ACCAD Last month marked the 400th anniversary of the birth of John Graunt, commonly regarded as the father of epidemiology.  His major published work, Natural and Political Observations Made upon the Bills of Mortality, called attention to the death statistics published weekly in London beginning in the late 16th century.  Graunt was skeptical of how causes of death were ascribed, especially in times of plagues.  Evidently, 400 years of scientific advances have done little to lessen his doubts!  A few days ago, Fox News reported that Colorado governor Jared Polis had “pushed back against recen...
Source: The Health Care Blog - May 28, 2020 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Medical Practice Physicians Diagnosis MICHEL ACCAD Source Type: blogs

Issues in thrombolysis: There may not be anything called “ Absolute contraindication ”
This post was originally written in 2013. A middle-aged man with STEMI  came to our CCU.  It is just another case of STEMI and asked my fellow to lyse. But it was not the case . He, told me, Sir, the patient had a syncope following chest pain and he has injured his face and Jaw. He was actively bleeding. When I saw this face, it was indeed  frightening. What shall we do ? When a patient  with STEMI presents with bleeding facial Injury Rush for Immediate PCI (Which was  of course not possible in our place as it happened out of office hours! ) Take that ultimate risk and thrombolysis Give only heparin ( Many times it ...
Source: Dr.S.Venkatesan MD - May 16, 2020 Category: Cardiology Authors: dr s venkatesan Tags: bio ethics Cardiology -Therapeutic dilemma cardiology -Therapeutics Cardiology -unresolved questions Cardiology Risk assesment cardiology- coronary care Cardiology-Coronary artery disese Primary PCI Thrombolysis relative and absolute con Source Type: blogs

A curious CT scan in Cardiology
Presentation A 38-year-old women,with  episodic chest discomfort, mild dyspnea, and occasional non-productive cough. She was investigated in a non-emergent fashion.  After an abnormal X-ray chest, A CT scan was requested.  (*X-ray chest is Intentionally not posted here to add some curiosity factor) This is probably one of the most curious Images in cardiology I have stumbled upon. At the first look, it seemed a baseball has replaced a heart. Is it not? Posted with Creative Commons Attribution License CC-BY 3.0. Afzal et al. Dept of Internal Medicine, Florida Hospital, Orlando, USA.Cureus 10(11): e3566. When you see su...
Source: Dr.S.Venkatesan MD - March 23, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized aneurysm of coronary artery coronary artery aneurysm Images in cardiology Source Type: blogs

Burned out on Burnout?
Conclusion Learning how to pay attention to our attention (meta-attention) can be transformative. Using principles from cognitive science, we can create a comprehensive approach (attention capital theory in medicine) to reclaim the meaning and joy that has been depleted from our profession. Increasing the difficulty of our work to match our skill level, delegating low-level tasks to help us focus on critical steps in our physician zone, creating rules to eliminate distractions, and noticing both the wonder and suffering around us may be more important than resilience training or wellness modules. Although well-intention...
Source: The Health Care Blog - February 12, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Burnout physician burnout physician wellness Sanj Katyal Source Type: blogs

Canon Unveils Aquilion ONE / PRISM Edition Spectral CT Scanner
At the RSNA 2019 conference in Chicago, Canon Medical showed off its brand new Aquilion ONE / PRISM Edition spectral CT scanner, a system that takes advantage of artificial intelligence technologies. The device relies on Canon’s Advanced int...
Source: Medgadget - December 6, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Anesthesiology Cardiology Critical Care Diagnostics Emergency Medicine Neurology Ob/Gyn Oncology Radiology Source Type: blogs

60-something with 2 days of intermittent epigastric pain. Why does the cardiologist disagree?
Conclusion An invasive strategy based on coronary stenting with adjunctive use of abciximab reduces infarct size in patients with acute STEMI without persistent symptoms presenting 12 to 48 hours after symptom onset.===================================MY Comment by KEN GRAUER, MD (10/20/2019):===================================I find it difficult to believe that the Cardiologist Attending On Call did not allow for the possibility that the OMI in this case was either acute and/or ongoing.MY Question: Was this the opinion of the Attending Cardiologist  — or a Resid...
Source: Dr. Smith's ECG Blog - October 19, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs

Chest pain with NonDiagnostic ECG but Diagnostic CT Scan
An elderly woman presented with chest pain that radiated to the back for several hours.Here is here initial ECG:There is only a nonspecific flat T-wave in aVL.  It is essentially normal.The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI)Providers were concerned with aortic dissection, so they order a chest aorta CT.This showed no dissection but did show the following:Notice the area of the lateral wall (lower right) that has no contrast enhancement (It is dark, where areas of enhancement are light-colored). This transmural ischemia, but not necessarily completed infarction...
Source: Dr. Smith's ECG Blog - September 26, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs