What is Transesophageal echocardiogram (TEE)? Cardiology Basics
Echocardiogram is an image of the heart using ultrasound. An ultrasound beam is transmitted into the body using a device known as transducer. The echo received from the body is processed by the computer in the machine to give a moving image of the heart.
Transesophageal echocardiogram or TEE, is obtained by introducing a special type of transducer, also called a TEE probe, into the esophagus and stomach. Usual echocardiogram is obtained by placing the transducer or probe on the chest.
Lungs may overlap the heart intermittently while imaging the heart from the chest wall. This is because the lungs cover part of the heart d...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is dobutamine stress echocardiography? Cardiology Basics
Usual stress test for the heart is exercise ECG in which serial ECG recordings are done during a graded exercise protocol, usually on a treadmill. There are certain conditions like left bundle branch block in which an exercise ECG becomes uninterpretable. Some persons are unable to exercise on a treadmill due to illness or disability. In such situations dobutamine infusion is given instead of exercise, to increase heart rate and myocardial contractility, thereby increasing the workload of myocardium. Echocardiograms are taken then to assess the response of the myocardium to stress. This is known as dobutamine stress echoc...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important blood tests in relation to the heart – Cardiology Basics
Important blood tests in relation to the heart – Cardiology Basics
Here are some important blood tests in relation to the heart. Normal ranges of some of these tests may vary between labs.
Cholesterol is a type of fat found in the blood and has a role in the development of atherosclerosis in the coronary arteries as well as other arteries. Desirable value of total cholesterol in blood is less than 200 milligrams per decilitre.
Triglycerides is another type of fat found in the blood. Desirable value is less than 150 milligrams per decilitre. Very high levels of triglycerides carry a risk of pancreatitis. Calorie restr...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Ultrasound lung comets or B lines in pulmonary edema – Cardiology Basics
Ultrasound lung comets or B lines in pulmonary edema – Cardiology Basics
Usually air in the lungs does not permit transmission of ultrasound and that is the reason for poor echo window in those with chronic obstructive airways disease. But when the lung is waterlogged in pulmonary edema, certain broad lines extending from the transducer location to the end of the imaging field appear on lung ultrasound. These have been called as B lines or ultrasound lung comets. They move with the lung movement in respiration. B lines are easy to detect with any ultrasound device including pocket devices and conventional echocardiog...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is head up tilt test (HUTT) – Cardiology Basics
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What is head up tilt test (HUTT) – Cardiology Basics
Head up tilt test, known as HUTT or tilt table test is commonly done for the evaluation of recurrent episodes of syncope with no other evident cause. Change in heart rate and blood pressure on assuming the erect posture is monitored in this test. It is also useful in the evaluation of postural orthostatic tachycardia syndrome (POTS), a condition in which the heart rate increases on standing up. Various protocols are followed in different centres for HUTT.
One protocol is as follows: The subject is strapped to the tilt table and heart rate and blood pressure monit...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Single chamber or dual chamber pacemaker? Cardiology Basics
The decision between single chamber and dual chamber pacemaker though important based on cost, device longevity and complication wise, is not that easy to make. I am trying to summarize based on the 2018 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines on this aspect [1]. In underprivileged regions, given an option, there is always a potential bias towards single chamber devices as they are cheaper, tend to have more battery life, easier to implant and likely to have lesser procedure and lead related issues.
In symptomatic sinus node dysfunction, with correlation between symptoms a...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a myocardial bridge? Cardiology Basics
Normally the coronary arteries are located outside the myocardium. Occasionally a segment of the coronary artery passes through the myocardium. This causes a narrowing of that region in systole and is known as myocardial bridging. Myocardial bridging can be recognized as narrowing of a region of the coronary artery in systole which normalizes in diastole.
Usually myocardial bridges do not cause myocardial ischemia as normally the blood flow into the myocardium occur mostly during diastole. Still myocardial bridges can rarely cause myocardial ischemia and cause chest pain. Rarely this may need recurrent hospital admi...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What type of devices should a person with a pacemaker be cautious about? Cardiology Basics
Artificial pacemakers are cardiac implantable electronic devices (CIED) which give tiny electrical signals to the heart when the heart’s own pacemaker is not functioning well. Sinus node is the natural pacemaker of the heart, located in the upper part of right atrium near the orifice of superior vena cava.
Pacemakers may also be used when the impulses from the sinus node are not conducted well to the ventricles in complete atrioventricular block. Pacing for bradycardia can be with single chamber or dual chamber pacemakers, depending on the indication for pacing. Dual chamber pacemakers are AV sequential pacemakers which...
Source: Cardiophile MD - October 9, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is inappropriate sinus tachycardia? Cardiology Basics
Inappropriate sinus tachycardia (IST) is sinus tachycardia inappropriate to the situation. It is defined as sinus rates above 100 beats per minute at rest or average sinus rate above 90 beats per minute over 24 hours without an underlying cause. Important secondary causes of sinus tachycardia like the use of caffeine, alcohol, nicotine, drugs of abuse like cocaine, increased function of thyroid gland, fever, anxiety, pain, and other illnesses which can increase the heart rate have to be excluded before considering IST.
IST may be either asymptomatic or sometimes associated with palpitation, shortness of breath, near synco...
Source: Cardiophile MD - October 9, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a nuclear stress test? Cardiology Basics
Usual stress test for the evaluation of coronary artery disease is a treadmill exercise ECG. It is commonly part of general health check-up and is widely available. But there are certain situations when the exercise ECG is not interpretable as in a person with left bundle branch block. Then a nuclear stress test will be useful.
While exercise ECG tells you that there is a probability of obstructions in coronary arteries, it most often does not identify the region of myocardium supplied by the obstructed vessel.
Nuclear stress test will tell you which is the region of myocardium that is affected. If there is already signif...
Source: Cardiophile MD - October 9, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is pulmonary edema? Cardiology Basics
Pulmonary edema is collection of fluid within the lung alveoli.
The most important cause of pulmonary edema is heart failure, specifically, left ventricular failure. Pulmonary edema can also occur when there is fluid overload in the body as in renal failure.
Other causes of pulmonary edema are mitral stenosis, pulmonary venous obstruction and increased permeability of the pulmonary capillaries. Increased permeability of the pulmonary capillaries occurs in noncardiogenic pulmonary edema – e.g. adult respiratory distress syndrome or ARDS.
Sudden breathlessness is the most important symptom of pulmonary edema as the lungs ...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Bezold-Jarisch reflex – Cardiology Basics
Bezold-Jarisch reflex – Cardiology Basics
Bezold-Jarisch reflex was described as a cardiovascular response to injection of veratrum alkaloids in experimental animals. It consisted of apnea, bradycardia and hypotension. It was first described by von Bezold in 1867 [1] and later confirmed by Jarisch [2]. The reflex depends on intact vagal nerves and is mediated through medullary centres controlling respiration, heart rate and vasomotor tone [3].
The afferent limb of the Bezold-Jarisch reflex is from the cardiac sensory receptors through the non-myelinated vagal afferent pathways. The left ventricle, particularly the in...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Athlete ’s heart – Cardiology Basics
Athlete’s heart – Cardiology Basics
Athlete’s heart is thickening of the heart muscle due to constant training in response to increased circulatory demand. Athlete’s heart is not dangerous, it is a physiological adaptation of the heart to training and increased load. It is associated with a slow heart rate, called athlete’s bradycardia.
The slower resting heart rate is a protective mechanism to prevent undue rise with exercise as normally heart rate increases with intensity of exercise. There is an increase in the size of the chambers of the heart and increased efficacy of pumping to meet the high demand duri...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How does cervical rib mimic coronary artery disease? Cardiology Basics
Cervical rib is an accessory rib in addition to the 12 pairs of thoracic ribs, which can occur in some individuals. Cervical rib is an abnormal rib arising from the vertebra of the neck. It can press on nerve roots coming out of the neck from the spinal cord and cause symptoms in the dermatomal region.
If a nerve root from the same spinal segment which also supplies the heart gets compressed, the pain produced will be similar in location. But the pain due to nerve root compression will have different characteristics from that of pain originating from the heart. Pain due to myocardial ischemia is usually produced by ...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Why do they call LAD a widow maker? Cardiology Basics
LAD is short form for left anterior descending coronary artery. LAD is usually the largest branch of the left main coronary artery which supplies the major portion of the left ventricle. It supplies major portion of the interventricular septum which mostly constitutes the anterior wall of the left ventricle as seen on echocardiography. Coronary angiogram still picture shows a total occlusion of LAD. Coronary angiograms are obtained by injecting radiocontrast medication into the coronary artery and obtaining continuous X-ray imaging in the cardiac catheterization laboratory.
Occlusion of proximal LAD before its first septa...
Source: Cardiophile MD - October 7, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
