Difference between pulsed wave and continuous wave Doppler
In pulsed wave Doppler, same piezoelectric crystal is used to transmit and receive the echo from the sample volume. Hence the signals are sent out in pulses and the intervals between the pulses are used to receive the echoes. In continuous wave Doppler, one piezoelectric crystal transmits continuously and another one receives continuously. As the transmission and reception are continuous, it is not possible to find out the depth from which the return signals are received. At the same time continuous wave Doppler can analyze higher velocities while pulsed wave Doppler can analyze only lower velocities.
In case of pulsed Dop...
Source: Cardiophile MD - April 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the Cyanotic Congenital Heart Diseases With Decreased Pulmonary Blood Flow?
Tetralogy of Fallot
TOF with pulmonary atresia
Pulmonary atresia with intact interventricular septum
Tricuspid atresia
Double outlet right ventricle
Transposition of great arteries with ventricular septal defect and pulmonary stenosis
Ebstein’s anomaly of tricuspid valve
In DORV and tricuspid atresia, there are also variants with increased pulmonary blood flow, in the absence of associated pulmonary stenosis. (Source: Cardiophile MD)
Source: Cardiophile MD - April 18, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the acyanotic congenital heart diseases with left to right shunt lesions?
Atrial septal defect – Ostium Primum, Ostium Secundum, Sinus Venosus
Partial anomalous pulmonary venous return
Atrioventricular septal defect
Ventricular septal defect – inlet, outlet, perimembranous, muscular
Patent ductus arteriosus
Aortopulmonary window
Coronary artery fistula draining to right heart
Ruptured sinus of Valsalva aneurysm to right heart (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 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
Ebstein ’ s Anomaly of Tricuspid Valve
Transcript of the video: Ebstein’s Anomaly is one of the cyanotic congenital heart disease in which survival to adult life is common. In Ebstein’s anomaly, there is downward or apical displacement of posterior and septal tricuspid leaflets. The anterior leaflet is not displaced, but is elongated to meet the other leaflets, so that when it closes, a loud sound, tricuspid sound, is produced, which is called as the sail sound. Ebstein’s anomaly may be associated with atrial septal defect or a patent foramen ovale, in about 50% of cases. The cyanosis in Ebstein’s anomaly, is usually not due to pulmonary...
Source: Cardiophile MD - March 30, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Surgical Treatment of Tetralogy of Fallot and Sequelae
Transcript of video: Tetralogy of Fallot is one of the commonest cyanotic congenital heart diseases. As the name implies, there are four defects. One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. Overriding aorta with ventricular septal defect causes right to left shunt and cyanosis so that in infancy, cyanotic spells may also be there and squatting is one of the important symptoms of tetralogy of Fallot. There are several surgical options for tetralogy of Fallot and also some sequelae for...
Source: Cardiophile MD - March 29, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important Complications of Eisenmenger Syndrome
Transcript of the video: Eisenmenger syndrome is an important complication of large left to right shunts which develop later due to development of pulmonary vascular obstructive disease and severe pulmonary hypertension. The first report of Eisenmenger was by Victor Eisenmenger in 1897 and that was in a thirty year old person who later succumbed to massive hemoptysis. This highlights one of the most important complications of Eisenmenger syndrome, that is airway hemorrhage. Airway hemorrhage can occur in those who ascend to high altitude and during air travel. But it commonly occurs at low level itself. It is one of the mo...
Source: Cardiophile MD - March 26, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Single Frame Echo Quiz
Transcript of the video:Â Interpreting an echo quiz just from a single frame has a lot of limitations. But, still for an academic exercise, we will try. Unlike the ECG, where a single image may be more informative, echo usually requires moving images. And moreover, even ECG requires a knowledge of the clinical background before interpretation, to avoid errors. Similarly, for echocardiogram, what we would do usually is, first we do a clinical history evaluation, then physical examination, and after that only we proceed with echocardiography in our routine work. But for an academic curiosity, we will just try to interpret an...
Source: Cardiophile MD - March 18, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
X-Ray Chest PA View in Severe PAH
Transcript of the video: Here is an X-ray chest PA view. The striking finding is the huge enlargement of the right pulmonary artery, almost aneurysmal dilatation of right pulmonary artery. Main pulmonary artery is also grossly dilated. And you can see left pulmonary artery shadow and rest of it is not seen here. It will be behind the main pulmonary artery shadow, because left pulmonary artery descends behind the main pulmonary artery and it will be a retrocardiac shadow. It is not visible here. This is the aortic knuckle. And you are seeing some end on views probably. This could be an end on view. This also could be, but y...
Source: Cardiophile MD - March 18, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Collection of a few ECGs in congenital heart diseases
Classical QRS pattern in ASD is the rSR’ in V1 suggestive incomplete RBBB. This pattern in ASD is due to RV volume overload. QRS axis is usually rightward, more so when there is severe PAH. Left axis deviation is feature of ostium primum ASD. First degree AV block may be noted in both primum and secundum ASD. Familial ASD with first degree AV block has been reported in secundum ASD. This type of familial ASD has an autosomal dominant inheritance pattern. There is also a higher incidence of SCD in this group.
IRBBB pattern in ASD
Crochetage sign in ASD, manifest as notching of R wave near the apex in inferior leads (a...
Source: Cardiophile MD - February 14, 2024 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology ECG Library 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
Clinical Examination of Cardiovascular System For Medical Students
Discussion on blood pressure is not included here as a separate topic is dedicated to it.
Though the most commonly examined pulse is the radial, to check some of the characteristics, a more proximal pulse like the brachial or carotid needs to be examined. Following parameters of the pulse are routinely documented: 1. The rate: Normal rate in adult is 60-100 per minute. It is higher in children. Younger the child, higher the pulse rate.
Rhythm: Regular and irregular rhythms are possible. Mild variation with respiration is called respiratory sinus arrhythmia, with higher rate in inspiration. Respiratory sinus arrhythmia may...
Source: Cardiophile MD - May 30, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A young patient with diminishing pain with a subtle but diagnostic ECG.
Written by Emre Aslanger(Emre is our newest editor. He is an interventionalist in Turkey and one of 3 originators of the OMI/NOMI paradigm, along with Pendell and Smith. Here are his publications.)CaseA 39-year-old male without prior medical history presents with chest pain that started 2 hours prior to presentation. He says that the pain intensity was 10/10 at home but now about 4/10. His medical exam is unremarkable. He has no cardiovascular risk factors except smoking for 10 pack-years. He denies any illicit drug use. His ECG is shown below. What do you think ?Although not striking, this is clearly a dia...
Source: Dr. Smith's ECG Blog - December 18, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs
ECG Quiz with Discussion
Discussion
What does this ECG show?
This ECG shows Katz-Wachtel phenomenon with large biphasic QRS complexes in mid precordial leads. It is typically seen in infants with large ventricular septal defect and biventricular hypertrophy. In addition, there is sinus tachycardia and right axis deviation which are common in an infant. (Source: Cardiophile MD)
Source: Cardiophile MD - December 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
ECG Quiz with Discussion Katz-Wachtel phenomenon
Discussion Katz-Wachtel phenomenon
What does this ECG show?
This ECG shows Katz-Wachtel phenomenon with large biphasic QRS complexes in mid precordial leads. It is typically seen in infants with large ventricular septal defect and biventricular hypertrophy. In addition, there is sinus tachycardia and right axis deviation which are common in an infant. (Source: Cardiophile MD)
Source: Cardiophile MD - December 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
