Inferolateral myocardial infarction P
ST segment elevation is seen in inferolateral leads (II, III, aVF, V5, V6) indicating inferolateral ST elevation myocardial infarction (STEMI). There is a discordance between the ST segment in aVL and V6 – there is ST segment depression in aVL while the ST segment is minimally elevated in V6. STEMI is an indication immediate angiography and percutaneous coronary intervention (PCI). If that is not feasible, either the patient can be transferred to a PCI capable center or thrombolytic therapy administered if there are no contraindications. Differential diagnosis of this pattern is of course an early repolarization (ERP...
Source: Cardiophile MD - November 5, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology ECG / Electrophysiology ECG Library Source Type: blogs
Corindus Unveils CorPath GRX, a New Robotic PCI System
Corindus Vascular Robotics, a company based in Waltham, MA, won FDA clearance to introduce its CorPath GRX robotic angiography system. The new generation of the CorPath system is intended to make robotically-assisted angioplasties even more precise, make operation faster for shorter procedure times, and allow for more patients to be treated with it.
The firm’s Active Guide Management technology controls the guide catheter and accompanying stent or balloon within a millimeter accuracy. An intuitive interface and comfortable seating help the physician speed up delivery and placement of the instruments. The actual robot...
Source: Medgadget - November 3, 2016 Category: Medical Equipment Authors: Editors Tags: Cardiology Radiology Source Type: blogs
Predictors of contrast induced AKI – Cardiology MCQ
Predictors of contrast induced acute kidney injury:
a) Estimated glomerular filtration rate (eGFR)
b) ST elevation myocardial infarction (STEMI)
c) Cardiogenic shock
d) All of the above
e) None of the above
Correct answer: d) All of the above
These are also the strongest predictors of AKI requiring dialysis. Roxana Mehran and associates developed a comprehensive risk prediction score which included age, hemoglobin level, pre-existing chronic kidney disease, volume of contrast administered during the percutaneous intervention, need for IABP (intra aortic balloon counterpulsation) and a few other variables. Presen...
Source: Cardiophile MD - October 31, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Underuse is Rampant, But Overuse is All We Talk About
By KIP SUILLIVAN, JD
This is my fourth in a series of imaginary lectures on remedial health policy for President Obama. My goal is to convince Obama that he relied on the wrong people for health policy advice. I am focusing on three people in particular: Elliott Fisher and his colleagues at the Dartmouth Institute, Peter Orszag, and Atul Gawande.
In my first comment , I criticized Obama for clinging to the belief that the Affordable Care Act has already reduced health care inflation and will continue to do so in the future. I devoted my second comment to explaining how influential the Dartmouth Institute has been. In my ...
Source: The Health Care Blog - October 6, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Shockwave Lithoplasty for Peripheral Vascular Disease FDA Cleared
A unique system that uses a balloon and sound waves to break up plaque in patients with peripheral artery disease has just been cleared by the FDA. The Lithoplasty system from Shockwave, a firm out of Fremont, California, is basically a traditional angioplasty balloon catheter with added capability that resembles lithotripsy that’s used to break up kidney stones.
The transducers along the length of the balloon section are tuned to generate sound at frequencies that resonate hardened calcium. Being all shook up, the calcium deposits are motivated to crack and to allow the balloon to push them closer to the vessel ...
Source: Medgadget - September 19, 2016 Category: Medical Equipment Authors: Editors Tags: Radiology Vascular Surgery Source Type: blogs
Percutaneous transluminal coronary angioplasty (PTCA)
Here is an illustrated review of steps in percutaneous transluminal coronary angioplasty (PTCA) of left anterior descending (LAD) coronary artery:
Still frame from the angio shows total occlusion of left anterior descending coronary artery after a major diagonal branch. LMCA: Left main coronary artery; LAD: Left anterior descending coronary artery; LCX: Left circumflex coronary artery. The marked portion of the catheter is in the descending aorta.
Balloon inflation in LAD
Guide wire is cautiously passed across the total occlusion taking care that it does not produce a false lumen. If the wire is able to pass back and for...
Source: Cardiophile MD - September 18, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Coronary Interventions Source Type: blogs
AngioSculptX, a New Drug-Coated PTCA Catheter Now Available in Europe
Spectranetics out of Colorado Springs, Colorado won the CE Mark in Europe to bring to market its AngioSculptX Drug-coated PTCA (percutaneous transluminal coronary angioplasty) Scoring Balloon Catheter. Originally developed by AngioScore, a company purchased by Spectranetics, the device is a drug coated version of the company’s proven AngioSculpt PTCA scoring balloon catheter and is indicated for treatment of coronary artery stenosis, which includes in-stent restenosis.
“AngiosculptX represents a unique coronary scoring technology that incorporates a drug coating. Given its clinical results, it is a signific...
Source: Medgadget - August 12, 2016 Category: Medical Equipment Authors: Editors Tags: Cardiology Source Type: blogs
Kokeshi phenomenon: stuck rotablator burr
Kokeshi phenomenon is a stuck rotablator burr in a heavily calcified coronary artery during attempted rotablation. Though it is a rare complication, it is a potentially serious one as it can cause coronary occlusion and necessitate emergency surgery. Different methods have been described for retrieval of the stuck burr. Mechery A and associates noted that deep engagement of the guiding catheter and manual traction is a safe method for retrieval of the burr [1].
Tanaka Y et al used a modified STAR (subintimal tracking and re-entry) technique using a 3 g tapered tip hydrophilic wire to remove the burr [2]. Successful removal...
Source: Cardiophile MD - July 19, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology Coronary Interventions Source Type: blogs
Chocolate Heart, a New Drug Coated PTCA Balloon Cleared in Europe
TriReme Medical (Pleasanton, California), part of QT Vascular, a company based in Singapore, received European regulatory approval for its new Chocolate Heart drug-coated percutaneous transluminal coronary angioplasty (PTCA) balloon for pushing apart stenoses in the coronary arteries. It’s a paclitaxel coated version of the Chocolate PTCA balloon, a device cleared in the U.S. a couple years ago.
The company believes the drug coating will provide some patients the ability to receive treatment without leaving a stent behind.
From QT Vascular:
The FIH study of Chocolate Heart™ was conducted at CECANOT Hospital in S...
Source: Medgadget - July 14, 2016 Category: Medical Equipment Authors: Editors Tags: Cardiology Radiology Source Type: blogs
Research and Reviews in the Fastlane 142
This study demonstrated that very early administration (pre-hospital) did not change outcomes in terms of infarct size. There was also no reduction in ventricular dysrhythmias. Once again we see that earlier is not always better.
Recommended by Anand Swaminathan
The R&R iconoclastic sneak peek icon key
The list of contributors
The R&R ARCHIVE
R&R Hall of famer You simply MUST READ this!
R&R Hot stuff! Everyone’s going to be talking about this
R&R Landmark paper A paper that made a difference
R&R Game Changer? Might change your clinical practice
R&R Eureka! Revolut...
Source: Life in the Fast Lane - July 13, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Clinical Research Education Emergency Medicine Pediatrics R&R in the FASTLANE critical care EBM literature recommendations research and reviews Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 2
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Quiz-summary
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Questions:
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Source: Cardiophile MD - July 2, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Don’t hunt for non-existing culprits in STEMI crime scene !
Scientific cardiology has forced us to believe ACS management must be catheter based and all others are inferior and those who pursue the later , carry a risk of being labelled as unethical in near future. However ,experienced cardiologists will know where the truth lies.
Now,in the interventional cardiology board rooms there is a big debate going on regarding the value of early total revascualrisation in STEMI with multivessel CAD.Suddenly , every lesion looks suspect ( Ex,current or future culprit ! ) and all stentable lesion are stented either in an emergency or semi emergency fashion (The new age post PC...
Source: Dr.S.Venkatesan MD - June 22, 2016 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology -unresolved questions Primary PCI diferred pci for non ira ira non ira culprit vessels multivessel pci in stemi Source Type: blogs
Don ’ t hunt for non-existing culprits in STEMI crime scene !
Scientific cardiology has forced us to believe ACS management must be catheter based and all others are inferior and those who pursue the later , carry a risk of being labelled as unethical in near future. However ,experienced cardiologists will know where the truth lies.
Now,in the interventional cardiology board rooms there is a big debate going on regarding the value of early total revascualrisation in STEMI with multivessel CAD.Suddenly , every lesion looks suspect ( Ex,current or future culprit ! ) and all stentable lesion are stented either in an emergency or semi emergency fashion (The new age post PC...
Source: Dr.S.Venkatesan MD - June 22, 2016 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology -unresolved questions Primary PCI diferred pci for non ira ira non ira culprit vessels multivessel pci in stemi Source Type: blogs
Tribute to Charles Dotter
Happy Birthday Charles Dotter **********************Charles Theodore Dotter (14 June 1920 – 15 February 1985) was a pioneering US vascular radiologist who is credited with developing interventional radiology. Dotter, together with his trainee Dr Melvin P. Judkins, described angioplasty in 1964. Dotter invented angioplasty and the catheter-delivered stent, which were first used to treat peripheral arterial disease. Charles Dotter is commonly known as the "Father of Interventional Radiology." Famous Radiology Blog http://www.sumerdoc.blogspot.com
TeleRad Providers at www.teler...
Source: Sumer's Radiology Site - June 14, 2016 Category: Radiology Authors: Sumer Sethi Source Type: blogs
An American Cardiologist in Paris
Next week more than 12,000 cardiologists will stream into the Palais des Congrès in Paris to make presentations and learn about stents, angioplasty, fractional flow reserve, intravascular ultrasound, dual antiplatelet therapy, etc. It’s the annual EuroPCR meeting, “the world-leading course in interventional cardiovascular medicine.” Just be careful in the shower and don’t answer the phone. Especially if you’re traveling with your wife! (Source: Burts Stent Blog : The Voice in the Ear)
Source: Burts Stent Blog : The Voice in the Ear - May 11, 2016 Category: Medical Equipment Source Type: blogs
