What are BNP and NT-proBNP tests? Cardiology Basics
BNP and NT-proBNP tests are used for detection of heart failure. When the heart fails, there is stretching of the ventricles which leads to release of BNP from the myocardium. Pro BNP is the precursor of BNP, which is cleaved by enzymes to NT-proBNP and BNP. BNP stands for brain natriuretic peptide or B-type natriuretic peptide. BNP is biologically active while NT-proBNP is not. NT stands for amino terminal of the protein.
NT-proBNP has a longer plasma half life than BNP. Hence levels of NT-proBNP are more stable. Thus, it can reflect the stretching of the left ventricle, over the previous 12 hours. This is the reas...
Source: Cardiophile MD - October 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are ventricular ectopic beats (VPC)? Cardiology Basics
Ventricular ectopic beats are premature heart beats originating from the ventricles. Normal heart beats originate from the sinus node, situated in the upper part of right atrium. Sinus node is the natural pacemaker of the heart which gives out regular impulses to induce sequential contractions of atria and ventricles.
Ventricular ectopic beats (VEB) are also known by other names like ventricular premature beat (VPB), ventricular premature complex (VPC) and premature ventricular complex (PVC). Ventricular ectopic is the commonest form of cardiac arrhythmia.
In a ventricular ectopic beat, the sequence of activation is diffe...
Source: Cardiophile MD - October 25, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is an implantable cardioverter defibrillator (ICD)? Cardiology Basics
Implantable cardioverter defibrillator or ICD is a cardiac implantable electronic device or CIED. The device is implanted subcutaneously under local anaesthesia, usually below the left clavicle. The electrodes from the device are introduced into the right sided cardiac chambers through a subclavian vein puncture. The ICD senses and analyzes heart rhythm continuously. It can detect life threatening ventricular arrhythmias and treat them electrically.
If a ventricular tachycardia is detected, the ICD tries to overdrive it by fast pacing. If it does not suppress the ventricular tachycardia, the ICD delivers a shock through i...
Source: Cardiophile MD - October 23, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Rheumatic heart disease – Cardiology Basics
Rheumatic heart disease – Cardiology Basics
Rheumatic heart disease is a group diseases which occur secondary to heart valve damage from rheumatic fever. Rheumatic fever is a disease in which antibodies produced by the body against streptococci cross react with different tissues in the body, especially the heart.
Group A beta hemolytic streptococci causing sore throat are involved in the pathogenesis of rheumatic fever. Most of the long term damage following rheumatic fever is caused by damage to heart valves . Initial manifestation of rheumatic fever is with polyarthritis, usually of the large joints.
But it does no...
Source: Cardiophile MD - October 22, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Heart failure in chronic kidney disease – Cardiology Basics
Heart failure in chronic kidney disease – Cardiology Basics
Prevalence of both heart failure and chronic kidney disease (CKD) are increasing as the population is aging globally. Hence heart failure in chronic kidney disease is seen more often. Presence of CKD in heart failure increases morbidity and mortality. Though there is increasing use of effective medications and special devices like cardiac resynchronization therapy in heart failure patients in general, those with CKD have not been benefited well.
CKD is defined as abnormalities of kidney structure or function, present for >3 months, with implications for h...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is Eisenmenger syndrome? Cardiology Basics
Eisenmenger syndrome is a late complication of congenital heart diseases with large left to right shunts. Fortunately, it is rare now-a-days because most conditions which can cause Eisenmenger syndrome later, are detected by neonatal screening and treated early so that this complication does not develop later. Eisenmenger syndrome is a condition in which long standing high pulmonary blood flow leads to irreversible pulmonary hypertension with reversal of shunt. Right to left shunt causes reduced systemic oxygen saturation with cyanosis.
This is an echocardiogram showing a left to right shunt from the left ventricle to the...
Source: Cardiophile MD - October 20, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a wearable cardioverter defibrillator (WCD)? Cardiology Basics
Wearable cardioverter defibrillator (WCD) is a device which is worn on a vest, monitors the heart rhythm continuously and delivers a defibrillator shock in case of life threatening ventricular arrhythmias. Implantable cardioverter defibrillator (ICD) is a similar device which is implanted subcutaneously for long term use. WCD is meant for temporary use for those who have a high risk of life threatening ventricular arrhythmias but are ineligible for an ICD implantation as per the guidelines.
WCD has patch electrodes for giving the shocks and a monitoring system built-in into a vest while the defibrillator with battery is w...
Source: Cardiophile MD - October 20, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Pulmonary stenosis – Cardiology Basics
Pulmonary stenosis – Cardiology Basics
Pulmonary stenosis is most often congenital, though occasionally it can occur in carcinoid syndrome and related disorders. Dysplastic pulmonary valve occurs in Noonan’s syndrome. Pulmonary stenosis increases the workload of the right ventricle, which gets hypertrophied in an attempt to overcome the obstruction. Hypertrophied right ventricle becomes less compliant, increasing its filling pressure.
Decrease in right ventricular compliance increases right atrial pressure. This will be more when the right ventricle fails ultimately. Forceful right atrial contraction produces a...
Source: Cardiophile MD - October 18, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Fight Aging! Newsletter, October 17th 2022
This study investigated whether multimorbidity is associated with incident dementia and whether associations vary by different clusters of disease and genetic risk for dementia. The study used data from the UK Biobank cohort, with baseline data collected between 2006 and 2010 and with up to 15 years of follow-up. Participants included women and men without dementia and aged at least 60 years at baseline. The presence of at least 2 long-term conditions from a preselected list of 42 conditions was used to define multimorbidity.
A total of 206,960 participants (mean age 64.1 years) were included in the final sample, of...
Source: Fight Aging! - October 16, 2022 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
How can exercise prevent cardiovascular disease? Cardiology Basics
Dr. Paul Dudley White, the famous physician who has taught many a luminary in the field of cardiology once wrote that heart disease before eighty is our fault and not God’s will or nature’s will.
This means that he recognized long back, the role of life-style modification in preventing heart disease. Exercise in a regular pattern is one of the important life style modifications which everyone can adopt to prevent or delay cardiovascular disease. Exercise helps in various ways for prevention of cardiovascular disease. In those with established cardiovascular disease, graded exercise programs can promote the formation o...
Source: Cardiophile MD - October 15, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a perimembranous VSD? Cardiology Basics
Perimembranous VSD is the commonest type of ventricular septal defect. When there is a ventricular septal defect, blood shunts from the left ventricle to the right ventricle as the pressure in the left ventricle is higher. This leads to increased pulmonary blood flow. VSD usually occurs as a congenital defect, though it can rarely occur in the adult after a myocardial infarction due to rupture of the ventricular septum. If the VSD is large, high pulmonary blood flow increases the amount of blood returning to the left atrium and left ventricle through the pulmonary veins. This volume overloading of the left ventricle can l...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is myocardial stunning and hibernation? Cardiology Basics
Just as you can get stunned for some time if hit on the head, part of the myocardium can also stop functioning following transient coronary obstruction. This usually occurs following a myocardial infarction after which the occluded coronary artery gets opened up spontaneously or by thrombolytic therapy or primary angioplasty.
After a variable period of time, the stunned myocardium usually recovers full function. During the period of stunning, if a large part of myocardium is involved, the person may have features of heart failure due to decreased left ventricular systolic function. Myocardial stunning is the reason for he...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is the difference between CRT-P and CRT-D? Cardiology Basics
In cardiology, CRT stands for cardiac resynchronization therapy. CRT is used in heart failure with reduced ejection fraction. According to the Universal Definition and Classification of Heart Failure, heart failure with reduced ejection fraction has left ventricular ejection fraction of 40% or less. CRT is a type of pacemaker in which three chambers of the heart are paced, right atrium, right ventricle and left ventricle.
This picture illustrates what reduced ejection fraction means. Ejection fraction is the fraction of end diastolic volume which is pumped out from the left ventricle during systole. Normal ejection fracti...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Definition of HFpEF needs a tweak : Time to make pulmonary hypertension an essential criteria !
Though all of us are aware, the incidence of heart failure is increasing exponentially and is the leading cause of global disease mortality, what we fail to understand is, we still lack a good definition cardiac failure.
Defining HF based on EF% is convenient but adds more complexity, and is less scientific too. Still, as of now, we have adopted this. I think, one of the important factors that apparently increased the incidence of HF is the creation of an entity called HFpEF. (Formerly diastolic heart failure)
Thanks to ESC, we have a consensus document, which has defined HFpEF based on functional, morphological, and b...
Source: Dr.S.Venkatesan MD - October 12, 2022 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized criteria for hfpef esc guidelines on hfpef Source Type: blogs
What is myocardial viability assessment? Cardiology Basics
Myocardial viability means regions of myocardium which can recover its function if the blood supply is normalized. Viable myocardium will improve after restoring blood supply while non-viable myocardium will not.
So myocardial viability assessment is important in deciding whether the person will benefit from revascularization procedures like coronary angioplasty and coronary bypass surgery.
There are two types of viable myocardium, stunned myocardium and hibernating myocardium. Stunned myocardium needs only time to recover while hibernating myocardium needs restoration of blood supply. Stunned myocardium is transient dela...
Source: Cardiophile MD - October 12, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
