Rules of myocardial revascularisation REVIVEed : Quantify ” non-viable tissue ” first.
”It looks like, science oftentimes struggles at the hands of scientists“
The weakest link in medical research is framing the right research question. How will you explain the drama of research on myocardial viability studies that have been going on full steam for more than 3 decades,? Which has become junk now.
This truth came out from a secondary analysis of the famous REVIVED-BCIS2 trial. For the busy guys, the conclusion is given in the box below.
JAMA Cardiol. 2023;8(12):1154-1161.
Final message
We realize, in the game of myocardial revascularisation t...
Source: Dr.S.Venkatesan MD - December 20, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized accc aha esc guid;ines on myocardial revascularisation cabg cabg patch study ischemic dcm myocardail viablity pet scan for myocardial viablity REVIVED BCIS2 viablity study myocardial Source Type: blogs
What is conservative management ?
Conservative management conveys two tangentially opposite meaning.
For the superior “physicians & Interventional cardiologists” it would mean
For the “Inferior genre of physicians” it will sound like this
Reference
This is a partial repost from a 2008 article . https://drsvenkatesan.com/2008/11/30/what-do-we-mean-by-conservative-management-why-it-is-often-considered-as-an-inferior-form-of-treatment-in-medicine/ (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - December 16, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized accc aha guidlines ethics in medicine GDMT OPTIMAL MEDICAL THERAPY principles of practice of medicine WHAT IS CONSERVATIVE MEDICAL MANAGEMENT Source Type: blogs
A basic query in LV function measurement
Which point in ECG is taken as reference for End systolic dimension for LV function assessment?
Marking the end diastolic point in ECG is quiet straight forward. Peak of R wave.(or Q)*
But, what about the reference point for end systole.
Descending slope of T wave
Peak of T wave
End of T wave
If T is absent or not clear , I will be confused
To be realistic, ECG has no reliable reference point for end systole.
Answer: If I say the answer is 5, no one is going to agree. Please note, the relationship between the T wave and the peak systolic phase in echocardiography is weak. Is there any relat...
Source: Dr.S.Venkatesan MD - December 16, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ase criteria for lv function measurement ecg gating in ct scan ecg gating volume correlation ecg vs echo gating end diastole in ecg end systole in eco vs ecg end systolic point in ecg peak r and peak t systole and diastole Source Type: blogs
An extract of “ Illustrative echocardiography ” in Twenty pages.
Learning resources in the web, has made the traditional methods of learning & teaching almost redundant.
American society of Echocardiography (ASE) has produced this 20 page PDF document, which covers the entire field of echocardiography , in an Illustrative format.
Take a print out, of this and stick in your lab (If you have space) for an Immersive experience. Hope, sharing this document here doesn’t violate any copyright issues.
ASE POSTER MIND MAPDownload (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - December 15, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ase-posters best-echocardiography-book echo-manual illustrative-echocardiography Source Type: blogs
Is coronary dissection painful ?
Answer : Is the coronary dissection really painful ? As in most situations of scientific medicine, the answer to the question is, It “may or may not”. But, for some strange reason, it is more often painless . Mind you, even if it occurs, it is atypical, continuous, non-anginal if flow is unaffected, and not relieved by nitro-glycerine. This has important clinical significance , as many successfully lysed STEMI patient might have minimal segments of dissection/deep plaque fissures. , may be misdiagnosed as post infarct angina.
Spontaneous coronary dissection vs Iatrogenic dissection
SCAD is a rare , diffe...
Source: Dr.S.Venkatesan MD - December 3, 2023 Category: Cardiology Authors: dr s venkatesan Tags: acute aortic dissection acute coroanry syndrome Source Type: blogs
Can you try these two questions on Amyloid ?
Is it a physiological molecule ?
1.Yes, It is a physiological molecule.
2.No, Amyloid is always pathological.
Where does it gets deposited ?
A .Extracellular*
B. Intracellular
C. Both
Answer : Q 1: A / Q 2: C. It is indeed a physiological molecule in small amounts that help carry hormones across the blood. In pathology, it accumulates in huge amounts. It is a disorder of protein folding, making them thick, stiff , sheets of peptide, hence mis-behaving with adjacent cells, injuring them in the process. This is responsible for the systemic nature of disorder right from the brain to peripheral nerves, H...
Source: Dr.S.Venkatesan MD - December 1, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Alzheimer disease amyloidosis ttr amyloid what is amyloid Source Type: blogs
What happens to blood pressure when we stand up ?
Many times , an Innocuous question poses a real challenge, to our life time understanding of circulatory physiology.
Submit a form.
This question is very important , if we want to understand the true mechanism of postural hypotension, a commonest autonomic disorder in elderly (& also the newly recognised entity orthostatic hypertension)
Orthostatic hypotension is defined as a sustained drop of at least 20 mm Hg in systolic blood pressure (SBP) or 10 mm Hg in diastolic blood pressure (DBP) within 3-5 minutes of going from a supine to a standing position. In patients with associ...
Source: Dr.S.Venkatesan MD - November 29, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized bp response on standing hemodynamics of standing hypertesnion orthostatic hypertension orthostatic hypotension pots syndreome Source Type: blogs
STEMI Breakthrough: Looking beyond Primary PCI with “ Intra-coronary liquid oxygen ”
This study was sponsored by ZOLL® TherOx® .
A possible deterrent is the problematic and complex concept of reperfusion Injury. The term Oxygen radicals always sounds sinister .Really I can’t understand how a cell which get injured by the lack of a a particuar gas, get damaged by the same gas .(Oxygen in liquid from might behave differently as in this study ?) I think,its all in timing of delivery of oxygen, and if we start thinking like Einstein, then ,there is nothing called time.
cit0923_ft_zoll-1Download
Final message
Innovation and experimentation is must be allowed as liberally as possible....
Source: Dr.S.Venkatesan MD - November 25, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Live view of yourself on the globe : Find, which dot are you ?
Really thrilled to see who all are reading this site live on a rotating globe. It makes much more happier to know that all those grateful and honourable dots (i.e., you) are literally drawing the world map . Six million reads from 190 countries, right from the Solomon Islands in Micronesian Pacific, abutting the International date line, to the extreme west, reaching Chile and Hawaii has happened so far.
Please click here, to see your live location , zoom on the dot and check, it is indeed true.https://www.revolvermaps.com/livestats/globe/53mvtnd7p2d/ (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - November 24, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Live view on the globe : Find which dot is you ?
Really thrilled to see who all are reading this site live on a rotating globe. It makes much more happier to know that all those grateful and honourable dots (i.e., you) are literally drawing the world map . Six million reads from 190 countries, right from the Solomon Islands in Micronesian Pacific, abutting the International date line, to the extreme west, reaching Chile and Hawaii has happened so far.
Please click here, to see your live location , zoom on the dot and check, it is indeed true.https://www.revolvermaps.com/livestats/globe/53mvtnd7p2d/ (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - November 24, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Live view on the globe as you read : Find which dot is you ?
Really thrilled to see who all are reading this site live on a rotating globe. It makes much more happier to know that all the grateful and honourable dots (i.e., you) literally draw the world map . Six million reads from 190 countries, right from the Solomon Islands in Micronesian Pacific, from the International date line to the extreme west right reaching Chile and Hawaii has happened so far.
Please click here, to see your live location , zoom on the dot and check, it is indeed true.https://www.revolvermaps.com/livestats/globe/53mvtnd7p2d/ (Source: Dr.S.Venkatesan MD)
Source: Dr.S.Venkatesan MD - November 24, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
ICMR study on sudden unexplained deaths in Covid times : An atypical observation
Conclusion is fair
It is traditional (and acceptable ) to blame the heart for all unexplained sudden deaths. The study suggests that heavy drinking, along with with intense physical activity in the background of positive family history, is behind many of the deaths. It is a fair assumption that they are all cardiac. Sudden neurological and pulmonary deaths are under reported. In fact many of the SCD is an arrhythmic event originating from CNS or electro-ionic triggers in blood with the healthy heart
Is this not a major limitation*
When you want to know whether COVID vaccination is related to sudden death in any ...
Source: Dr.S.Venkatesan MD - November 22, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized covid and sudden cardaic deaths scd in covid Source Type: blogs
A query in the ICMR study on sudden deaths in Covid times : Why there is no unvaccinated cohort and follow up ?
Conclusion is fair
It is traditional (and acceptable ) to blame the heart for all unexplained sudden deaths. The study suggests that heavy drinking, along with with intense physical activity in the background of positive family history, is behind many of the deaths. It is a fair assumption that they are all cardiac. Sudden neurological and pulmonary deaths are under reported. In fact many of the SCD is an arrhythmic event originating from CNS or electro-ionic triggers in blood with the healthy heart
Is this not a major limitation*
When you want to know whether COVID vaccination is related to sudden death in any ...
Source: Dr.S.Venkatesan MD - November 22, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized covid and sudden cardaic deaths scd in covid Source Type: blogs
A query in the ICMR study on sudden deaths in Covid times : How can the control group is also vaccinated ?
Conclusion is fair
It is traditional (and acceptable ) to blame the heart for all unexplained sudden deaths. The study suggests that heavy drinking, along with with intense physical activity in the background of positive family history, is behind many of the deaths. It is a fair assumption that they are all cardiac. Sudden neurological and pulmonary deaths are under reported. In fact many of the SCD is an arrhythmic event originating from CNS or electro-ionic triggers in blood with the healthy heart
Is this not a major limitation*
When you want to know whether COVID vaccination is related to sudden death in any ...
Source: Dr.S.Venkatesan MD - November 22, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized covid and sudden cardaic deaths scd in covid Source Type: blogs
Why Oval shaped ASD device are not popular ?
This study , though addressed a vital query ,is never meant to find the truth we want, as it has no oval vs circular device to compare the outcome.
Final message
It is strange ,cardiologists look for perfection and precision in every cardiac intervention, … while in case of ASD device closure, size is sacrosanct, but shapes, we are allowed to shrug off. May be things will change.
Reference
1.Song J, Lee SY, Baek JS, Shim WS, Choi EY. Outcome of transcatheter closure of oval shaped atrial septal defect with amplatzer septal occluder. Yonsei Med J. 2013 Sep;54(5):1104-9.
2.Roberson DA, Cui W, Patel D, ...
Source: Dr.S.Venkatesan MD - November 21, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized amplatzer asd device ASD device closure asd device erosion asd ostium secundum size ivc rim vs aortic rim oval asd oval vs circular defects ovoid asd device size vs shape of asd Source Type: blogs
