Intravascular Ultrasound (IVUS) for Coronary Intervention
Coronary Intravascular Ultrasound (IVUS) equipment consists of an IVUS catheter, pullback device and the imaging console. If lesion lengths have to be assessed, motorized pullback is required. For assessing lesion morphology a manual pullback can also be done. While manual pullback allows concentration on specific lesions, it may miss some lesions in between if the pullback is not steady. Catheter has to be disengaged while evaluating coronary ostial lesions. Heparin and intracoronary nitroglycerine are given before the guide wire is inserted after the coronary cannulation with a guide catheter. The IVUS catheter is then i...
Source: Cardiophile MD - April 11, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Differentiating Between Cardiac and Non-Cardiac Chest Pain
It is not always possible to be certain about the origin of chest pain just by its characteristics as the variation between individuals is quite a bit. A medical opinion should be sought in case of any significant chest pain so that important ailment is not missed. There can be a lot of overlap between symptoms due to heart disease and disease of other nearby organs. Still some general observations are possible regarding chest pain originating from the heart. The typical pain of cardiac origin is a central chest pain which occurs on walking or other forms of exercise, known as effort angina. This pain is caused by insuffic...
Source: Cardiophile MD - April 10, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Echocardiographic evaluation in aortic regurgitation
Echocardiographic evaluation of aortic regurgitation, demonstrated through multiple images. Echocardiogram in parasternal long axis view shows dilated left ventricle, left atrium, aorta and a small portion of the right ventricle, which is usually the outflow region. Mitral valve leaflets seen in open position between the left ventricle and left atrium are thickened. The large aortic regurgitation jet can be seen as a mosaic jet in the left ventricular outflow tract anterior to the anterior mitral leaflet. A portion of the thickened aortic valve can be seen between the aorta and left ventricle. The AR jet is almost filling ...
Source: Cardiophile MD - April 10, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Know About Cardiogenic Shock
When the heart is not able to pump enough blood for the needs of the body and the blood pressure falls, it is known as cardiogenic shock. Most important cause of cardiogenic shock is a heart attack. It is more likely to occur in those who are older, having blocks in multiple blood vessels of the heart, and in those with a previous heart attack. Cardiogenic shock is a potentially life threatening condition and needs urgent treatment. Even with treatment about half of those with cardiogenic shock might die. Those with cardiogenic shock may have severe shortness of breath, weak pulse, rapid heart-beats, low blood pressure, un...
Source: Cardiophile MD - April 10, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is the reason for sudden breathlessness at night in those with heart disease?
Sudden breathlessness at night in those with known heart disease is usually due to collection of fluid in the lungs (pulmonary edema). During day time, when one is walking about, any extra fluid in the body tends to collect in the legs, due to the effect of gravity. Extra fluid in the body can occur due to failure of heart, kidneys, liver and rarely due to other causes. In heart failure, the extra fluid is due to inability of the heart to pump out blood well. This can occur if the heart muscle is weak or there is obstruction to a valve regulating the flow of blood inside the heart. At night, when one is lying down, extra f...
Source: Cardiophile MD - April 8, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Antler Sign in Pulmonary Venous Hypertension
Transcript of the video: Now we will discuss a chest X-ray showing antler sign in pulmonary venous hypertension. For a change, first we will see the picture of a stag, with antlers. You can see the antlers here. So, the shape of the upper lobe vessels in venous hypertension, pulmonary venous hypertension, will be resembling the antlers of the stag. That is why, the name antler sign has been given. These are the dilated upper lobe vessels, in  a person with pulmonary venous hypertension and this is known as the antler sign. Other names are inverted moustache sign, cephalization, and redistribution. Redistribution because, ...
Source: Cardiophile MD - April 8, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Ashman Phenomenon in A F and Fish Criteria
Transcript of the video: Now I am going to describe Ashman Phenomenon in atrial fibrillation, which is responsible for a long and short sequence followed by a wide QRS, in atrial fibrillation noted on ECG, which may resemble a ventricular ectopic beat. This is the diagrammatic representation of Ashman phenomenon. You have sequences of AF beats, and a long cycle occurs, followed by a short cycle. So this QRS is aberrant, having rSR’ pattern, resembling right bundle branch block pattern. This was described by Richard Ashman, from Lousiana State University School of Medicine in New Orleans. This is the long cycle. Durin...
Source: Cardiophile MD - April 7, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

How to control high blood pressure without medications
Just because you have been told that your blood pressure is above normal need not mean that you are tied up to medications lifelong. Changes in lifestyle can definitely bring down your blood pressure even without medications. In those already taking medications, the dose of medications can be brought down by important lifestyle changes. Some lucky ones may be able to stop medications as well. But you have to continue monitoring your blood pressure regularly so that any recurrence can be picked up. One of the important ways in which to reduce elevated blood pressure is by reducing extra weight. Roughly the blood pressure mi...
Source: Cardiophile MD - April 6, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Echocardiogram in Mitral Valve Prolapse with Mitral Regurgitation (MVP, MR)
Transcript of the video: Now we will discuss echocardiogram in mitral valve prolapse. It is a fairly common condition. But, even though mitral valve prolapse can be detected echocardiographically in many cases, there may not be significant regurgitation and symptoms in many of them. Many of them may have just echo diagnosis without other relevances. So we will see some of the features of mitral regurgitation. This is an echocardiogram from the apical four chamber view, you can see all the cardiac chambers, interventricular septum, and you can very well see the bowing of the anterior mitral leaflet and posterior mitral leaf...
Source: Cardiophile MD - April 6, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Basics of Echocardiography
Transcript of the video: Echocardiography is now not restricted to the echocardiographic laboratory. It is used in the emergency department, at bedside, in the intensive care unit as well as in the operating room. Hence a basic knowledge is needed for all physicians and paramedics. During echocardiography, a transducer transmits the ultrasound beam towards the heart. Echoes received by the transducer from various structures of the heart are analysed by the echocardiograph and a graphical representation displayed on the monitor. Location of the transducer is at the top of the image sector. Structures nearer to the tr...
Source: Cardiophile MD - April 4, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Eccentricity Index in Bicuspid Aortic Valve
Transcript of the video: Closure line of aortic valve on M-Mode echocardiogram, is seen as central line, while in bicuspid aortic valve, it is an eccentric closure, nearer to one of the walls of the aorta. This eccentricity of closure of the aortic valve leaflets, can be calculated using what is known as eccentricity index. That is an important feature of bicuspid aortic valve on M-Mode echocardiogram. This is an M-Mode echocardiogram at the aorta-left atrium level. You can see the cursor on the 2-D echo, and this is the closure line. This is normal aortic valve, central closure as a single line. During systole, one openin...
Source: Cardiophile MD - April 2, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Hemodynamic Vise
Transcript of the video: Hemodynamic vise is the term given to compression of a vertical vein, which ascends to the brachiocephalic vein, between a bronchus and pulmonary artery. This produces a vicious cycle and that is why it is known as hemodynamic vise in certain types of congenital heart diseases which have a vertical vein. This is the typical location of the hemodynamic vise, between the pulmonary artery and left bronchus. When the vertical vein ascends, it is compressed by these two. When it is compressed, pulmonary venous drainage is obstructed partially, which leads to increase in the pulmonary venous pressure. Pu...
Source: Cardiophile MD - April 1, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Arterial Switch Operation
Transcript of the video: Arterial switch operation is the ideal corrective surgery for D-Transposition or dextro transposition of great arteries, if it can be detected early in life. As the left ventricle is facing the pulmonary artery in dextro transposition of great arteries, if there is a delay beyond two to three weeks of life, there is possibility that the muscle mass of the left ventricle can regress, so that, later if arterial switch operation is done, it will not be able to face the systemic vascular resistance and it will fail. That is why, arterial switch operation has to be done very early in life. For the same ...
Source: Cardiophile MD - April 1, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Norwood Procedure for Hypoplastic Left Heart Syndrome
Transcript of video: Hypoplastic Left Heart Syndrome is a very severe form of congenital heart disease, in which, the left ventricle, aorta and mitral and aortic valves are hypoplastic and valves may be atretic as well. It has a very poor survival. Norwood procedure is the first stage palliation for hypoplastic left heart syndrome, and a second stage palliaton, bidirectional Glenn procedure is done, to separate the pulmonary and systemic circulations, and finally, a Fontan procedure, Fontan type of procedure, connecting inferior vena cava also to the pulmonary circulation, is done at a still later, as a third stage. This i...
Source: Cardiophile MD - March 31, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Mild Tricuspid Regurgitation
Transcipt of video: Mild tricuspid regurgitation is often noted on echocadiogram reports and sometimes causes a little bit of worry and a lot of questions are asked on mild tricuspid regurgitation. What is this mild tricuspid regurgitation? This is the schematic diagram of the heart in which you can see right atrium, right ventricle, left atrium, left ventricle, aorta and pulmonary artery. And mild tricuspid regurgitation is just a small leak from the tricuspid valve. Normally, the tricuspid valve is expected to close fully and prevent backleak of blood from the right ventricle to right atrium, when the right ventricle co...
Source: Cardiophile MD - March 30, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs