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Condition: Cardiomyopathy

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Total 333 results found since Jan 2013.

Dip and plateau pattern of ventricular pressure tracing in constrictive pericarditis
Thickened and stiff pericardium in chronic constrictive pericarditis has poor compliance reducing the distension of cardiac chambers to a limited fixed total volume. Transmission of intrathoracic pressure to the pericardial cavity is also prevented by thickening of the pericardium [1]. Manifestation of compression occurs when the total cardiac volume reaches the pericardial volume in diastole. The severe restriction causes elevation of pulmonary and systemic venous pressure which becomes equal to diastolic pressures in all cardiac chambers. Relative change is more on the right sided chambers. Inspiratory fall in intratho...
Source: Cardiophile MD - August 31, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

New ESC 2023 Cardiomyopathy guidelines: Truths trail by 17 years!
It was 2006 Allow me to recount an unassuming piece of a PowerPoint presentation from my institute, Madras Medical College, at the annual Cardiological Society meeting in New Delhi. The paper was categorized under miscellaneous sessions. I vividly remember the day. I have to admit, It was a nearly empty hall E, located in the basement of Hotel Ashoka. After the talk, I looked up to find that neither the chairman nor the handful of kind academic souls had any questions or comments to make. Pausing for a few moments, I quietly walked down the podium with an inexplicable silent pain. The title of the presentation was &#...
Source: Dr.S.Venkatesan MD - August 27, 2023 Category: Cardiology Authors: dr s venkatesan Tags: cardiomyopathy Dilated cardiomyopathy hypertrophic cardiomyopathy ischemic cardiomyopathy Uncategorized drsvenkatesan ESC 2023 new cardiomyopathy guideline ndlvc non dilated cardiomyopathy Source Type: blogs

Poor Long Term Outcome With Subsequent Pregnancies After Peripartum Cardiomyopathy
This study was from a single centre where mortality in women with peripartum cardiomyopathy was higher than in other studies from the United Studies. Most of the patients were African American and of low socioeconomic status. Earlier studies have clearly demonstrated a different phenotypic presentation and outcome in African American women with peripartum cardiomyopathy compared to non-African American women. African American women had been shown to be diagnosed later, present lower LVEF, larger LV volume and more severe heart failure symptoms. The rate of recovery was lower and time for recovery markedly longer in that pa...
Source: Cardiophile MD - June 28, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Young Man with Very Fast Regular Wide Complex Tachycardia
EMS was dispatched for a 30-something male who feels his heart is racing.  Sudden onset.The patient had no previous medical history.Vitals were normal except for a heart rate of 226.A prehospital 12-lead was recorded:There is a regular wide complex tachycardia.  The computer diagnosed this as Ventricular Tachycardia.Is it definitely VT??The patient was given 6mg, then 12 mg, of adenosine, without a change in the rhythm.He arrived in the ED and had an immediate bedside cardiac ultrasound while this ECG was being recorded.The bedside ultrasound (video not available) reportedly showed only a slightly reduced LV func...
Source: Dr. Smith's ECG Blog - June 28, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Wide complex tachycardia and hypotension in a 50-something with h/o cardiomyopathy -- what is it?
A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension.Bedside echo showed " mildly reduced " LV EF.Here is the ED ECG:What do you think?Analysis: there is a wide complex tachycardia. It is regular.  There are no P-waves.  The morphology is of RBBB and LAFB.  The initial part of the QRS is very fast, suggesting that it starts in conducting fibers and not in myocardium.  Thus, it is probably SVT with aberrancy (RBBB + LAFB) or it is posterior fascicular VT (which starts in the pos...
Source: Dr. Smith's ECG Blog - June 23, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

COAPT Trial of Transcatheter Mitral Valve Repair in Patients with Heart Failure
Patients with heart failure and left ventricular dilatation may have secondary or functional mitral regurgitation. This is due to alteration of the left ventricular geometry producing changes in the functioning of papillary muscles and chordae tendineae and poor coaptation of the mitral leaflets. Secondary mitral regurgitation causes volume overloading of the left ventricle and is associated with reduced survival, increased hospitalization rates and decreased quality of life [1, 2]. Secondary mitral regurgitation can be reduced by guideline directed medical therapy and cardiac resynchronization therapy. This will also pro...
Source: Cardiophile MD - June 5, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Structural Heart Disease Interventions Source Type: blogs

Myocardial Insulin Resistance
Myocardial insulin resistance is said to occur in about 60% of patients with type 2 diabestes mellitus and is associated with higher cardiovascular risk compared to those with insulin sensitive myocardium [1]. It is  known that systemic insulin resistance is an independent risk factor for heart failure and cardiovascular death [2]. Myocardial insulin resistance occuring along with systemic insulin resistance is characterized by ineffecient energy metabolism and contributes to post ischemic heart failure. Myocardial insulin resistance can also be caused by myocardial hypertrophy, independent of systemic insulin resist...
Source: Cardiophile MD - June 3, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!
 Written by Pendell MeyersA woman in her 30s with minimal past medical history presented simply stating she was " feeling unwell. " Her symptoms started suddenly about 48 hours ago, but had continued to worsen, including epigastric discomfort, nausea, cough, and dyspnea and lightheadedness on exertion. She denied chest pain and denied feeling any palpitations, even during her triage ECG:What do you think?Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED.She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for ...
Source: Dr. Smith's ECG Blog - June 3, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Clinical Examination of Cardiovascular System For Medical Students
Discussion on blood pressure is not included here as a separate topic is dedicated to it. Though the most commonly examined pulse is the radial, to check some of the characteristics, a more proximal pulse like the brachial or carotid needs to be examined. Following parameters of the pulse are routinely documented: 1. The rate: Normal rate in adult is 60-100 per minute. It is higher in children. Younger the child, higher the pulse rate. Rhythm: Regular and irregular rhythms are possible. Mild variation with respiration is called respiratory sinus arrhythmia, with higher rate in inspiration. Respiratory sinus arrhythmia may...
Source: Cardiophile MD - May 30, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is Mitochondrial Cardiomyopathy?
Mitochondria have two genomes – mitochondrial and nuclear. Mitochondrial disease could be due to mutations of nuclear or mitochondrial DNA. Mitochondrial DNA is inherited maternally while nuclear DNA has Mendelian inheritance, which could be dominant or recessive [1]. It may be noted in about one in 5000 live births. Cardiac involvement in mitochondrial disease seldom occurs in isolation and is often part of multiorgan dysfunction [2]. Mitochondria being part of the cellular respiratory chain, tissues with high energy requirements like heart, muscle, kidneys and endocrine system are often involved in mitochondrial d...
Source: Cardiophile MD - May 9, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Localisation of Ventricular Tachycardia by Surface ECG
Surface ECG can be used to identify the site of origin of ventricular tachycardia. QRS morphologic patterns and vectors are helpful in discerning the activation pattern of the myocardium. Chest wall deformity as well as metabolic and drug effects can cause limitations in analysis sometimes [1]. Identification of site of origin of VT is useful while planning catheter ablation. It is also useful in correlating with the clinical situation as in post myocardial infarction scar related VT. Another instance is for correlation with findings on imaging modalities like echocardiography and cardiac magnetic resonance imaging [2]. F...
Source: Cardiophile MD - April 23, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Learning new lessons from a stressful “ ST segment ”
This is the Incidental ECG of an apparently healthy 50-year-old businessman, recorded while  applying for health insurance How will you describe this ECG? Let me magnify it for you    Why this big fuss about this ECG?  Such ECGs are so common. Looking at the ST segment, we are supposed to think of significant CAD,, LVH, Aortic stenosis or variants of cardiomyopathy, and sometimes electrolytic shifts. The fact that it is recorded at rest, and the patient is absolutely asymptomatic, it is very unlikely there is ongoing ischemia.It could be a myocardial origin or an unk...
Source: Dr.S.Venkatesan MD - April 22, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized non specific st segment Source Type: blogs

Compare these two ECGs. Do either, neither, or both show anything important?
One case sent by Dr. Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve SmithTake a look at these two ECGs below from two patients in the ED, first without any clinical context. Full case details and outcomes are below.Case 1:Case 2: Case 1:What do you think?This was sent to Dr. Smith by SamGhali (@EM_RESUS) with zero other info.  Smith ' s response was: " OMI Mimic. "Later, this info was supplied by Sam:This ECG was recorded in a 23-year-old African American man with a history of psychiatric illness, acute alcohol/drug intoxication, brought in by police officers status post being ...
Source: Dr. Smith's ECG Blog - April 17, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Off and on chest pain for 24 hours in a 50s year old man
Submitted by Ali Khan MD and James Mantas MD, MS, written by Pendell MeyersA man in his 50s with history of diabetes, hypertension, and tobacco use presented to the ED with 24 hours of worsening left sided chest pain radiating to the back, characterized as squeezing and pinching, associated with shortness of breath. His pain was initially mild, then became severely worse several hours prior to presentation, but then eased off again and was minimal on arrival. There was no associated diaphoresis, nausea, vomiting, arm pain, jaw pain, syncope, lightheadedness or other acute symptoms.Initial vitals: Temp 36.7 C, BP 161/79, RR...
Source: Dr. Smith's ECG Blog - April 9, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Cardiology update: Should mRNA vaccine myocarditis be a contraindication to future COVID-19 vaccinations ?
BY ANISH KOKA Myopericarditis is a now a well reported complication associated with Sars-Cov-2 (COVID-19) vaccinations. This has been particularly common with the messenger RNA (mRNA) vaccines (BNT162b2 and mrna-1273), with a particular predilection for young males. Current guidance by the Australian government “technical advisory groups” as well as the Australian Cardiology Society suggest patients who have experienced myocarditis after an mRNA vaccine may consider a non-mRNA vaccine once “symptom free for at least 6 weeks”. A just published report of 2 cases from Australia that document myopericarditi...
Source: The Health Care Blog - January 26, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Anish Koka mRNA vaccine myocarditis Source Type: blogs