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Total 153 results found since Jan 2013.

Evaluation of Prosthetic Aortic Valve Obstruction
This discussion will focus beyond the basic clinical evaluation, ECG, chest X-ray and hematological workup. Hematological workup is important in aortic valve obstruction because of likelihood of associated hemolytic anemia and acquired von Willebrand Syndrome. Former is due to destruction of red blood cells across the narrowed aortic valve, and latter due to loss of the largest multimers of von Willebrand factor. High shear stress across the narrowed aortic valve exposes a region of the von Willebrand factor which is susceptible to a specific von Willebrand protease. This can lead on to gastrointestinal angiodysplasia (He...
Source: Cardiophile MD - August 9, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Reviewing the all-in-pod heart health segment
BY ANISH KOKA The All-in podcast is a fairly popular show that features successful silicon valley investors commenting about everything worth commenting on from politics to health. The group has good chemistry and interesting insights that breaks the mold of the usual tribal politics that controls legacy media analysis of current events. Last week, the podcast touched on a topic I spend a fair amount of time on: Cardiology. Brad Gerstner, who is actually a guest host for this particular episode starts off by referencing something called Heartflow to evaluate the heart that has been recommended by one of the o...
Source: The Health Care Blog - July 20, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice All-in Podcast Anish Koka Brad Gerstner cardiology 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 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day
This was sent by a colleague.A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB.  She had one episode of pain the previous night and two additional episodes early on morning the morning she presented.  Deep breaths are painful and symptoms come and go.  She had one BP that was measured at 160/120, uncertain when and what the BP was at other moments.  Home meds were labetalol and nifedipine.  There are T-wave inversions in precordial leads.  The patient is pain free, so it is qu...
Source: Dr. Smith's ECG Blog - May 10, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Regional wall motion abnormalities in LAD territory on echocardiography.
Echocardiography is one of the simplest investigations to assess the myocardial regional wall motion abnormalities in coronary artery disease. Regional wall motion abnormalities can also be assessed by nuclear imaging and cine CT (computed tomography) scan / MRI (magnetic resonance imaging). The wall motion is scored from 1 to 4 depending on whether it is normal wall motion, hypokinesia, akinesia or dyskinesia. Hypokinesia means reduced contraction, akinesia means absence of contraction and dyskinesia means bulging out in systole. In order to standardize the reporting of wall motion abnormalities, American Society of Echo...
Source: Cardiophile MD - February 2, 2023 Category: Cardiology Authors: Johnson Francis Tags: Echocardiography General Cardiology Source Type: blogs

Return to McAllen: A Father-Son Interview
By IAN ROBERTSON KIBBE You are going to hear a little more about McAllen, TX on THCB Shortly. And before we dive into what’s happened there lately, I thought those of you who weren’t here back in the day might want to read an article on THCB from July 2009. Where then THCB editor Ian Kibbe interviewed his dad David Kibbe about what he was doing as a primary care doc in McAllen–Matthew Holt By now, Dr. Atul Gawande’s article on McAllen’s high cost of health care has been widely read.  The article spawned a number of responses and catalyzed a national discussion on cost controls and t...
Source: The Health Care Blog - January 27, 2023 Category: Consumer Health News Authors: matthew holt Tags: Uncategorized David Kibbe Ian Robertson Kibbe McAllen Physicians TX Source Type: blogs

Intraoperative Imaging for Porcelain Aorta
Diffuse calcification of ascending aorta which may extend down is known as “Porcelain aorta”. Intraoperative epiaortic  echocardiography along with manual palpation during surgery has been described as the most sensitive technique for detecting ascending aortic atheroma and calcification [1]. A prospective study evaluated this in hundred consecutive patients undergoing coronary bypass or valve surgery [2]. Ascending aorta was assessed by manual palpation by the operating surgeon, intraoperative transesophageal echocardiography and epiaortic ultrasound using linear and phased-array imaging. No difference was noted...
Source: Cardiophile MD - December 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

See OMI vs. STEMI philosophy in action
by Emre AslangerDr. Aslanger is our newest editorial member.  He is an interventional cardiologist in Turkey. Dr. Aslanger is also the author of the DIFFOCULT study:Emre K. Aslanger,a,⁎ Özlem Yıldırımtürk,b Bar ış Şimşek,c Emrah Bozbeyo ğlu,c Mustafa Aytek Şimşek,a Can Y ücel Karabay,b Stephen W. Smith,d and Muzaffer De ğertekina  DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction.  International Journal of Cardiology Heart& VasculatureCaseA 40-year-old man presents with...
Source: Dr. Smith's ECG Blog - December 22, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs

Thrombus, tumor or vegetation?
This question is often faced by the echocardiographer while evaluating a mass detected on the heart valves or cardiac chambers. Usual method is to take it in the clinical context. There could also be non-infective vegetations of marantic endocarditis which are almost impossible to differentiate from infective vegetations. Marantic vegetations can be suspected in the presence of small and multiple vegetations changing from one examination to another, without associated abscess or valve destruction [1]. It may be noted that echocardiography is neither 100% specific nor 100% sensitive for the diagnosis of infective endocardi...
Source: Cardiophile MD - December 15, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

A woman in her 20s with syncope
Written by Destiny Folk MD, with edits by Meyers, peer reviewed by Smith and GrauerA woman in her late 20s with a past medical history of cervical cancer status post chemotherapy and radiation therapy presented to the emergency department for shortness of breath, chest tightness, and two episodes of syncope.Her initial vital signs revealed a temp of 97.7F, HR 125, RR 20, BP 115/90, and an oxygen saturation of 95% on room air. Upon arrival, she did not appear in acute distress. She was noted to be tachycardic and her heart sounds were distant on physical exam. She had a normal respiratory effort, and her lungs were clear to...
Source: Dr. Smith's ECG Blog - November 28, 2022 Category: Cardiology Authors: Pendell Source Type: blogs

What is myocardial stunning and hibernation? Cardiology Basics
Just as you can get stunned for some time if hit on the head, part of the myocardium can also stop functioning following transient coronary obstruction. This usually occurs following a myocardial infarction after which the occluded coronary artery gets opened up spontaneously or by thrombolytic therapy or primary angioplasty. After a variable period of time, the stunned myocardium usually recovers full function. During the period of stunning, if a large part of myocardium is involved, the person may have features of heart failure due to decreased left ventricular systolic function. Myocardial stunning is the reason for he...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is myocardial viability assessment? Cardiology Basics
Myocardial viability means regions of myocardium which can recover its function if the blood supply is normalized. Viable myocardium will improve after restoring blood supply while non-viable myocardium will not. So myocardial viability assessment is important in deciding whether the person will benefit from revascularization procedures like coronary angioplasty and coronary bypass surgery. There are two types of viable myocardium, stunned myocardium and hibernating myocardium. Stunned myocardium needs only time to recover while hibernating myocardium needs restoration of blood supply. Stunned myocardium is transient dela...
Source: Cardiophile MD - October 12, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is a myocardial bridge? Cardiology Basics
Normally the coronary arteries are located outside the myocardium. Occasionally a segment of the coronary artery passes through the myocardium. This causes a narrowing of that region in systole and is known as myocardial bridging. Myocardial bridging can be recognized as narrowing of a region of the coronary artery in systole which normalizes in diastole. Usually myocardial bridges do not cause myocardial ischemia as normally the blood flow into the myocardium occur mostly during diastole. Still myocardial bridges can rarely cause  myocardial ischemia and cause chest pain. Rarely this may need recurrent hospital admi...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Athlete ’s heart – Cardiology Basics
Athlete’s heart – Cardiology Basics Athlete’s heart is thickening of the heart muscle due to constant training in response to increased circulatory demand. Athlete’s heart is not dangerous, it is a physiological adaptation of the heart to training and increased load. It is associated with a slow heart rate, called athlete’s bradycardia. The slower resting heart rate is a protective mechanism to prevent undue rise with exercise as normally heart rate increases with intensity of exercise. There is an increase in the size of the chambers of the heart and increased efficacy of pumping to meet the high demand duri...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is coronary calcium scoring? Cardiology Basics
Coronary calcium scoring is done from a plain multidetector computed tomography (CT) scan. MDCT produces images of coronary arteries in multiple thin slices. Calcium deposits in plaques within the coronary arteries can be found from these images. Calcium deposits occur within atherosclerotic lesions inside the coronary arteries. Some of these plaques can rupture later and lead to clot formation and total occlusion causing acute myocardial infarction. Coronary calcium scoring can be done as an outpatient test from the X-ray department. As no contrast medium is injected, there is no risk of allergic reactions unlike CT coro...
Source: Cardiophile MD - October 6, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs