Unusual ECG, ventricular extra systole following shortly after each sinus beat?
Hi
Stumpled upon this ECG yeasterday, has anyone seen something like it?
33 year old woman, no known diseases, now presenting with an extrauterine pregnancy (not sure for how long she had been pregnant, but she was in no way acute ill), no palpitations, no chest paid, no seizure or fainting. she tells that she had an ECG taken some years ago, with no abnormalitys.
St.c 1. and 2. heart sound with no abnormality =pp, followed by some murmur-like sound, not = any clear perifer puls.
Took several ecg's over a period of 15min, all the same pattern
To me it looks like each sinus beat is followed shortly after by ...
Source: Doc2Doc BMJ Cardiology - July 10, 2014 Category: Cardiology Authors: Munthen Source Type: forums
pericardial effusion in pregnancy
We repeated an echocardiogram yesterday on a lady who is 36 weeks pregnant . She had been scanned about 4 weeks ago as she was complaining of some palpitations and breathelssness and we found her to have a low normal efection fraction of around 50% . We weren't certain if this was peripartum cardiomyopathy and hence the rescan. To my surprise the rest of the echo hasn't changed but she now has a samll global pericardial effusion. Has anyone seen a case like this before?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - July 9, 2014 Category: Cardiology Authors: sadian Source Type: forums
has pci for stable angina finally reached the bar?
set by cabg where there is clear evidence of survival benefit. There is an editorial in the print edition covering the role of angioplasty in stable angina -which has fallen very much out of favour following the publication of the COURAGE trial. Questions - is this all due to improvements in stent technology and coatings , has the role of medical therapy been better understood or is this just we have got better at understanding which patients benefit?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - July 6, 2014 Category: Cardiology Authors: sadian Source Type: forums
Who is more at risk for alien abductions Males or Females?
The second law of thermodynamic and physicist Erwin Schrödinger should be given credit for the solution to this problem – ““How would we express in terms of the statistical theory the marvelous faculty of a living organism, by which it delays the decay into thermodynamic equilibrium (death)? We said before: 'It feeds upon negative entropy', attracting, as it were, a river of negative entropy upon itself.”10 Entropy has been expressed in a classical form ΔS=ʃ dQrev/T and in a statistical form -(entropy) = k log (l/D) where k is the Boltzmann constant = 3.2983 x 10-24 cal./C0 and D is ...
Source: Doc2Doc BMJ Cardiology - June 28, 2014 Category: Cardiology Authors: Houckster Source Type: forums
an amazing CT image
I have just been looking at this case report in the EHJ and I thought this image was amazing. The case describes a 3 year old with a continuous murmur. (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 27, 2014 Category: Cardiology Authors: sadian Source Type: forums
the whole truth about coronary stents?
I have just been reading this on the bbc website
http://www.bbc.co.uk/news/health-27983779
which covers this article
http://archinte.jamanetwork.com/article.aspx?articleid=1881927&utm_source=silverchair%20information%20systems&utm_medium=email&utm_campaign=archivesofinternalmedicine%3aonlinefirst06%2f23%2f2014
which to my mind makes valid points regarding ensuring everyone understands the risks and benefits of any treatment - angioplasty or otherwise!
Two thoughts struck me
1- truly how much do patients retain of the information we give - verbal or written
2- is it to easy to focus on the po...
Source: Doc2Doc BMJ Cardiology - June 24, 2014 Category: Cardiology Authors: sadian Source Type: forums
the lifetime risk of hypertension
this study has a cohort size of 1.25 million people - an impressive feat in itself
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60685-1/fulltext
this is one of the figures from the paper showing years of life lost per cardiac diagnosis - it seems that the blood pressure ranges to be in are 90-114mmhg ofr systolic and 60-74mmHg of the diastolic - is this surprising? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 22, 2014 Category: Cardiology Authors: sadian Source Type: forums
Why is there a young woman advantage? Why is it lost?
The answer to this question has been elusive. The Women’s Health Initiative was supposed to answer these questions but failed to find the advantage. During my stent as cardiology champion, the notion of fundamental laws of biology and a model of health and disease began to form. I used these principles to determine the difference between men and women. The results of this endeavor are now available on line in the article. Houck, PD. Why is there a young woman advantage? Why is it lost? Applying the laws of biology to men and women. JCvD 2014. In press.
The link is
https://urldef...
Source: Doc2Doc BMJ Cardiology - June 22, 2014 Category: Cardiology Authors: Houckster Source Type: forums
Why is there a young woman advantage? Why is it lost?
The answer to this question has been elusive. The Women’s Health Initiative was supposed to answer these questions but failed to find the advantage. During my stent as cardiology champion, the notion of fundamental laws of biology and a model of health and disease began to form. I used these principles to determine the difference between men and women. The results of this endeavor are now available on line in the article. Houck, PD. Why is there a young woman advantage? Why is it lost? Applying the laws of biology to men and women. JCvD 2014. In press.
The link is
https://urldef...
Source: Doc2Doc BMJ Cardiology - June 22, 2014 Category: Cardiology Authors: Houckster Source Type: forums
ca-125 in heart failure
I have seen a lady today who has heart failure with moderate/severe lv impairment on echo with normal rv size and estimated systolic pulmonary artery pressure. she also has ascites which appears to have increased in volume whislt her peripheral oedema hasn't changed (she's never had that much). The ca-125 is >500 (normal range for our lab<10) - do you think this could all be heart failure?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 16, 2014 Category: Cardiology Authors: sadian Source Type: forums
novel oral anticoagulants and dc cardioversion - what to do?
I saw a lady on friday who has presented with fast AF and has recently been anticoagulated with rivoroxaban. She is being considered for cardioversion and we have been discussing how long she should be anticoagulated for and whether she will need a transoesophageal echo prior to the cardioversion. I have jsut been reading this BCS editorial
http://www.bcs.com/pages/news_full.asp?NewsID=19792241
and it seems that we don't really know! Do you use NOAC's in this context and what do you do?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 15, 2014 Category: Cardiology Authors: sadian Source Type: forums
short term air pollutioin increases arrhythmia rates
but not apparently MI rates according to a study in Heart although PErates dd appear to increase
http://heart.bmj.com/content/early/2014/04/10/heartjnl-2013-304963.short?g=w_heart_ahead_tab
This seems contrary to other data which suggests that MI rates are increased.
can we explain this difference?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 7, 2014 Category: Cardiology Authors: sadian Source Type: forums
tetralogy of fallot / great arteries transportion Help!!!
Good Evening , we are facing in the family an case with a new born child , he was born with cardiac abnormality before 2 monthes associated with great arteries transposition involved with 3 more cardiac abnormalities. I am a medical student 1st year i have red a alot about the case , i have understood that in most cases an surgery should be done in the 1st 2 weeks of life . the baby is already 2 monthes old and he is facing some difficulties in several systems in his body such as the digestive system . the doctors who are treating our case inssist that he must become 7 kg to make the surgery , but in 2 monthes ...
Source: Doc2Doc BMJ Cardiology - June 5, 2014 Category: Cardiology Authors: shomar Source Type: forums
an incidental finding on CT...
There was a pciture report of an incidental finding on cardiac CT of an atrial myxoma recently in the Minerva page of the journal. I thought of that when I saw this image last week.
The case is a 54 year old smoker with known peripheral vascular disease who presents with chest pain. I have highlighted the area in question. Can you name the structure?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 3, 2014 Category: Cardiology Authors: sadian Source Type: forums
hypertension treatment saves 100000
the lance have just published a paper suggesting that improved treatment of blood pressure in England between 1994 and 2011 has saved 100 000 events (myocardial infarcts , strokes and deaths) with 37% of people having good blood pressure control versus 11% at the beginning of the study period. This period overlaps with the National Service framework for coronary disease . Do these changes result from better heart health generally or is this hypertension specific?
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60688-7/abstract (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 30, 2014 Category: Cardiology Authors: sadian Source Type: forums
