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What is a wearable cardioverter defibrillator (WCD)? Cardiology Basics
Wearable cardioverter defibrillator (WCD) is a device which is worn on a vest, monitors the heart rhythm continuously and delivers a defibrillator shock in case of life threatening ventricular arrhythmias. Implantable cardioverter defibrillator (ICD) is a similar device which is implanted subcutaneously for long term use. WCD is meant for temporary use for those who have a high risk of life threatening ventricular arrhythmias but are ineligible for an ICD implantation as per the guidelines. WCD has patch electrodes for giving the shocks and a monitoring system built-in into a vest while the defibrillator with battery is w...
Source: Cardiophile MD - October 20, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Is first degree heart block dangerous? Cardiology Basics
PR interval is measured from the onset of P wave to the onset of QRS complex. It includes the P wave and the PR segment. Normal PR interval is from 120 to 200 ms. If it is prolonged, it is called as first degree atrioventricular (AV) block. PR interval is the time taken for activation of the atria and conduction of the impulses down to the ventricles and initiate activation of the ventricles. This includes the physiological delay in conduction at the AV node. The delay allows complete emptying of the atria before the ventricles start contracting. The atrial help to ventricular filling acts like an atrial booster at the en...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Mural endocarditis
Vegetations in infective endocarditis are usually situated on the valves. If they are located on the walls of the cardiac chambers, it is known as mural endocarditis [1]. When mural endocarditis occurs without any cardiac structural abnormalities like ventricular septal defects, it is called primary mural endocarditis [2]. Primary mural endocarditis is extremely rare. Left atrial mural endocarditis usually occurs due to the jet lesion of mitral regurgitation [1,3]. Left atrial mural endocarditis is usually picked up by trans esophageal echocardiography. Vegetations are mostly located just distal to the mitral orifice betw...
Source: Cardiophile MD - October 31, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs

An Adolescent with dizziness and near syncope
Submitted by Maura Corbett, PA-C, written by Alex Bracey, with some comments by Smith and MeyersA teenage male presented to the emergency department with the complaint of dizziness with near-syncope. He was stable and able to provide a history and mentioned that he was asymptomatic while seated but dizzy and weak when attempting to stand. An ECG was recorded:What do you think? There iscomplete (third degree) heart block with wide complex bradycardicescape.  The morphology is that of LBBB and so the escape is originating from the right bundle.The possible etiologies of this ECG are:- Structural/congenital heart di...
Source: Dr. Smith's ECG Blog - August 7, 2021 Category: Cardiology Authors: Bracey Source Type: blogs

Treatment of infective endocarditis
Discussion of whole list of options of antimicrobials for different varieties of endocarditis is quite a large topic. This discussion is only a broad outline of the antimicrobial treatment of infective endocarditis, meant mainly for exam purpose rather than actual clinical treatment. References to more detailed guidelines have been provided for those who wish to learn more. Inoculum Effect High microbial density as in vegetations cause less antimicrobial activity of some antimicrobial agents. This is known as inoculum effect and has been documented with β-lactams and glycopeptides but not linezolid, in the treatment of St...
Source: Cardiophile MD - July 16, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

PET CT in endocarditis – Cardiology MCQ – Cardiology MCQ
PET CT in endocarditis – Cardiology MCQ – Cardiology MCQ MCQ Radioactive tracer used for detection of active foci of inflammation/metabolism in infective endocarditis is – Correct answer: 4. Fluorine-18 fluorodeoxyglucose Supplementing Dukes criteria with 18F-FDG PET CT increased the sensitivity from 52% to 91% with a slight fall in specificity from 95% to 89%. The authors further noted that reclassification from possible endocarditis to either definite or rejected category could be done in 95% which has great clinical significance [1]. This would permit early initiation of antibiotic therapy in definite...
Source: Cardiophile MD - August 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

PET CT in endocarditis – Cardiology MCQ – Answer
PET CT in endocarditis – Cardiology MCQ – Answer Radioactive tracer used for detection of active foci of inflammation/metabolism in infective endocarditis is – Correct answer: 4. Fluorine-18 fluorodeoxyglucose Supplementing Dukes criteria with 18F-FDG PET CT increased the sensitivity from 52% to 91% with a slight fall in specificity from 95% to 89%. The authors further noted that reclassification from possible endocarditis to either definite or rejected category could be done in 95% which has great clinical significance [1]. This would permit early initiation of antibiotic therapy in definite cases while...
Source: Cardiophile MD - August 17, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Pericardial effusion associated with Infective Endocarditis : Incidence , mechansim and clinical Implication.
Pericardial effusion is often detected in patients with Infective endocarditis. Incidence can be as high as 25% . Most often it is mild, can be moderate in few. Mechanism Sympathetic effusion in response to endocardial infection. It’s never more than minimal. (Evidence ? it’s only an assumption) IE related cardiac failure (Raised systemic venous pressure to which pericardial veins drain) Local sepsis, Abcess formation tracks to pericardial space through transmural lymphatics Fungal , granulomatous , Tuberculous IE (Rare) Here IE and PE  share the same pathology Part of systemic sepsis activated Immune mechan...
Source: Dr.S.Venkatesan MD - January 28, 2020 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Therapeutics Cardiology -unresolved questions Infrequently asked questions in cardiology (iFAQs) pericardial disease pericardial effusion Pericardium infective endocarditis pericardial effusion in infective endocarditis Source Type: blogs

Pricardial effusion associated with Infective Endocarditis : Incidence , mechansim and clinical Implication.
Pericardial effusion is often detected in patients with Infective endocarditis. Incidence can be as high as 25% . Most often it is mild, can be moderate in few. Mechanism Sympathetic effusion in response to endocardial infection. It’s never more than minimal. (Evidence ? it’s only an assumption) IE related cardiac failure (Raised systemic venous pressure to which pericardial veins drain) Local sepsis, Abcess formation tracks to pericardial space through transmural lymphatics Fungal , granulomatous , Tuberculous IE (Rare) Here IE and PE  share the same pathology Part of systemic sepsis activated Immune mechan...
Source: Dr.S.Venkatesan MD - January 28, 2020 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Therapeutics Cardiology -unresolved questions Infrequently asked questions in cardiology (iFAQs) pericardial disease pericardial effusion Pericardium infective endocarditis pericardial effusion in infective endocarditis Source Type: blogs

Our Visit to WIRED Health 2019 at London ’s Francis Crick Institute
WIRED Health, now in its sixth year, returned to London’s Francis Crick Institute. The event was opened by Crick Institute director Paul Nurse who introduced the institute and its mission to understand the fundamental biology of human health and d...
Source: Medgadget - April 2, 2019 Category: Medical Devices Authors: Tom Peach Tags: Exclusive Medicine Public Health Society Source Type: blogs

What Is The ‘Relative Value’ Of An Infectious Disease Physician?
Infectious diseases (ID) physicians may be disappearing. In the 2016 internal medicine fellowship match, in which residents were matched with sub-specialty training programs, 35 percent of available ID training positions nationwide were left unfilled. By comparison, just 0.9 percent of gastroenterology and cardiology positions were not filled that year (Figure 1). Although trainees’ career choices are influenced by many complex factors, the driving force behind residents’ aversion to ID is likely quite simple: money. ID specialists are among the lowest paid physicians in the United States. According to the 2016 Medscap...
Source: Health Affairs Blog - February 3, 2017 Category: Health Management Authors: Timothy Sullivan Tags: Costs and Spending Featured Health Professionals Payment Policy Quality Alternative Payment Models infectious disease Physicians RVU targets Source Type: blogs

FDG-PET CT increases the diagnostic yield in prosthetic valve and intracardiac device related endocarditis
Prosthetic valve endocarditis and intracardiac device related endocarditis are difficult to diagnose and treat. Because of dense acoustic shadowing related to the components of prosthetic valves and cardiac implantable devices, role of echocardiography is often limited in the diagnosis of endocarditis in these situations. Of late Positron Emission Tomography Computed Tomography (PET CT) have been used more often in detecting foci of active inflammation / metabolism in infective endocarditis. Study by María N. Pizzi et al[1] has provided us with documentary evidence for adding PET CT to our diagnostic armamentarium in susp...
Source: Cardiophile MD - September 23, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Research and Reviews in the Fastlane 035
This study suggests that antiemetics are not nearly as potent as widely believed. These drugs have been shown to be effective in preventing nausea (i.e. pretreatment for chemo) but it’s appears that the mechanism for halting nausea is different than that for preventing it. Recommended by: Anand Swaminathan Read More: Nausea? We’ve Got Placebo for That The Best of the Rest Emergency Medicine, Pulmonary 1. Kew KM, Kirtchuk L, Michell C. Intravenous magnesium sulfate for treating adults with acute asthma in the emergency department. Cochrane Database Syst Rev. 2014 May 28;5 PubMed ID: 24865567 This Cochr...
Source: Life in the Fast Lane - June 18, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Anaesthetics Cardiology Emergency Medicine Evidence Based Medicine General Surgery Intensive Care Palliative care Pediatrics Respiratory Resuscitation Trauma critical care literature R&R in the FASTLANE recommendations resear Source Type: blogs