Ebstein ’ s Anomaly of Tricuspid Valve
Transcript of the video: Ebstein’s Anomaly is one of the cyanotic congenital heart disease in which survival to adult life is common. In Ebstein’s anomaly, there is downward or apical displacement of posterior and septal tricuspid leaflets. The anterior leaflet is not displaced, but is elongated to meet the other leaflets, so that when it closes, a loud sound, tricuspid sound, is produced, which is called as the sail sound. Ebstein’s anomaly may be associated with atrial septal defect or a patent foramen ovale, in about 50% of cases. The cyanosis in Ebstein’s anomaly, is usually not due to pulmonary...
Source: Cardiophile MD - March 30, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Determination of Electrical Axis in ECG
Transcript of the video: When we talk about the electrical axis in the ECG, we usually mean the mean QRS axis. Even though it is possible to calculate the axis of each component of the QRS like the initial activation and later activation, we usually mean the mean QRS electrical axis. And, electrical axis can be calculated for the P wave, PR segment, QRS complex, ST segment and T wave. All can be calculated separately. Modern ECG machines, with in-built computerized diagnostic algorithm, usually display a clock face in the print out, which will indicate the axis of P wave, QRS and T wave. Along with that, the measured axis ...
Source: Cardiophile MD - March 30, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Surgical Treatment of Tetralogy of Fallot and Sequelae
Transcript of video: Tetralogy of Fallot is one of the commonest cyanotic congenital heart diseases. As the name implies, there are four defects. One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. Overriding aorta with ventricular septal defect causes right to left shunt and cyanosis so that in infancy, cyanotic spells may also be there and squatting is one of the important symptoms of tetralogy of Fallot. There are several surgical options for tetralogy of Fallot and also some sequelae for...
Source: Cardiophile MD - March 29, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Brugada Syndrome
Transcript of the video: Brugada Syndrome was described by Brugada brothers in 1992 as right bundle branch block pattern in anterior leads with ST segment elevation and syncope or sudden cardiac death and it was later in 1998, that the genetic basis of the disease was identified, with mutations in sodium channel. Later on, several other mutations have been attributed to cause the ECG pattern in Brugada syndrome.
I am always happy to see this ECG of Brugada syndrome sent to me by Professor Josep Brugada, in 2001, for the inaugural issue of the Indian Pacing and Electrophysiology Journal, which I started in 2001. And, this r...
Source: Cardiophile MD - March 28, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important Complications of Eisenmenger Syndrome
Transcript of the video: Eisenmenger syndrome is an important complication of large left to right shunts which develop later due to development of pulmonary vascular obstructive disease and severe pulmonary hypertension. The first report of Eisenmenger was by Victor Eisenmenger in 1897 and that was in a thirty year old person who later succumbed to massive hemoptysis. This highlights one of the most important complications of Eisenmenger syndrome, that is airway hemorrhage. Airway hemorrhage can occur in those who ascend to high altitude and during air travel. But it commonly occurs at low level itself. It is one of the mo...
Source: Cardiophile MD - March 26, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important Normal Values for ECG
Transcript of the video: Normal values for ECG will depend on the age, body size, gender, as well as the population being assessed. So there is a wide variation. Still, in a normal adult population, some normal values are useful, while assessing an ECG.
These are the normal waves which you expect on the ECG and normal heart rate in an adult is 60 to 100 per minute. P wave, the atrial activation, PR segment, QRS complex – ventricular activation, ST segment, and T wave, ventricular repolarization. Atrial repolarization wave is usually not seen in a standard surface ECG. It will somewhere in the ST segment (error: PR se...
Source: Cardiophile MD - March 25, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Pediatric Exercise Testing
Discussion on pediatric exercise testing.
Pediatric exercise testing may be used for evaluation of various disorders of cardiac rhythm rather than for inducible ischemia as in adults.
In a child with suspected sinus node dysfunction, chronotropic incompetence from sinus node dysfunction can be assessed by exercise testing.
Evaluation of escape rates and ventricular ectopy with exercise in complete heart block is an important aspect in the evaluation of congenital complete heart block.
ECG showing congenital complete heart block with ventricular rate of 47/min and atrial rate of 63/min.
In stage I of Bruce protocol, the atr...
Source: Cardiophile MD - March 25, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Windkessel Effect In Aorta With Experimental Evidence!
Windkessel effect is applicable to large elastic arteries like aorta, which are situated close to the heart. They have more of elastic tissue than muscular tissue. The term Windkessel comes from German language and means air chamber.
Here is an illustration of the Windkessel, used in 18th century, by fire fighters. The additional pressure built up in the air chamber will ensure continuous delivery of water for fire fighting. A similar thing occurs in elastic arteries like aorta. During systole, more blood enters the aorta, than what leaves the aorta, because aorta expands. This additional blood received during systole, is ...
Source: Cardiophile MD - March 24, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Head Up Tilt Test (HUTT)
Transcript of the video: Head up tilt test, is usually done for the evaluation of recurrent syncope. Sometimes, head up tilt test, also known in short as HUTT, is also done for the evaluation of postural orthostatic tachycardia syndrome, POTS, a condition in which there is tachycardia on standing up, without a fall in blood pressure. In usual syncope, there could be a fall in blood pressure, bradycardia, and there are various types, which will be described.
There are various protocols for head up tilt test, which are followed in different institutions. Basically you need a tilt-table, in which the person is lying down fir...
Source: Cardiophile MD - March 24, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
M-Mode Echocardiogram in LV Dysfunction
Transcript of the video: This is a still image of M-Mode Echocardiogram. M-Mode is Time-Motion Mode. The horizontal axis is time. Vertical axis is distance from the transducer. That is M-Mode, one of the older modes, currently used mainly for taking left ventricular measurements. In the inset you can see the two dimensional image. Location of the transducer here, in the parasternal region. This is the parasternal long axis view. Right ventricular outflow tract, left ventricle, left atrium, aorta, aortic valve, mitral valve. These are the things you have seen in that inset image. This is movement of the anterior wall of the...
Source: Cardiophile MD - March 23, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Ret-He: Reticulocyte hemoglobin equivalent – Marker for iron deficiency in ADHF
It is well known that iron deficiency is associated with poor outcome in acute decompensated heart failure. Different criteria like serum ferritin less than 100 ng/mL or 100-299 ng/mL with transferrin saturation less than 20% have been used to define iron deficiency. Inflammation which is common in heart failure may hinder serum ferritin values [1]. Another marker which has been proposed is reticulocyte hemoglobin equivalent (Ret-He) which is thought to reflect the iron content in reticulocytes.
In a study of 225 patients with ADHF from Japan, median left ventricular ejection fraction was 37%. Median hemoglobin level was ...
Source: Cardiophile MD - March 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Mitral and Aortic Regurgitation on Colour Doppler Echo
Transcript of the video: This is a still image from a colour Doppler echocardiogram, obtained from the apical five chamber view. This is the region where the transducer is placed and the image looks inverted, because it is imaging from apex upwards. Left ventricle, right ventricle, left atrium and part of the aorta. That is why it is called as the five chamber view. This is the region of the right atrium. Here you can see an MR jet. That is, flow away from the transducer is depicted as blue. Flow towards the transducer is depicted as red. Here, this is the forward flow through the mitral valve in diastole in red. This is r...
Source: Cardiophile MD - March 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
M-Mode Echocardiogram in Left Ventricular Dysfunction
Transcript of the video: This is a still image from a colour Doppler echocardiogram, obtained from the apical five chamber view. This is the region where the transducer is placed and the image looks inverted, because it is imaging from apex upwards. Left ventricle, right ventricle, left atrium and part of the aorta. That is why it is called as the five chamber view. This is the region of the right atrium. Here you can see an MR jet. That is, flow away from the transducer is depicted as blue. Flow towards the transducer is depicted as red. Here, this is the forward flow through the mitral valve in diastole in red. This is r...
Source: Cardiophile MD - March 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Aprocitentan the first endothelin receptor antagonist approved for treatment of hypertension
Just now, I read online that aprocitentan has become the first endothelin receptor antagonist to be approved by the USFDA for treatment of hypertension. Edema and anemia are the most common adverse events as per the manufacturer’s prescribing information and aprocitentan is contraindicated in pregnancy. Edema could be managed by adding or uptitrating diuretics.
Macitentan used in the treatment of pulmonary arterial hypertension, metabolizes into the active compound, aprocitentan. Aprocitentan is an orally active, dual endothelin receptor antagonist which inhibits ET‐1 by binding to both ETA and ETB receptors. Aproc...
Source: Cardiophile MD - March 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Biatrial Enlargement on Chest X-Ray PA View
Transcript of the video: Chest X-ray PA view. You can see that there is straightening of left border. Normally, the main pulmonary artery segment will be concave and left atrial appendage region also will be not prominent. Here both have enlarged slightly, but not enough to produce gross bulges. So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. When there is gross pulmonary hypertension, instead of these being straight over here, it will form a bulge over here. And when there is gross enlargement of left atrial appendage, ...
Source: Cardiophile MD - March 21, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
