Mesocardia with L-TGA
X-ray chest PA showing mesocardia and L-posed aorta in levo transposition of great arteries (L-TGA)
The cardiac shadow is seen in the midline, with almost equal spread to either side, suggesting mesocardia. In levocardia the heart is predominantly in the left hemithorax and the apex points to the left. In dextrocardia, the heart is predominantly in the right hemithorax and the apex points to the right.
Normally the aorta is dextro-posed and the ascending aorta is seen along the right cardiac border. In levo-posed (L-posed) aorta, the ascending aorta is on the left border, as in this case. In dextro-transposition of great a...
Source: Cardiophile MD - September 15, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology X-ray Featured Source Type: blogs
A Hole in the Heart, Part II
This study looked at patients between 18 and 60 years of age who had a prior stroke or a transient ischemic attack within the prior 6 months. This was a resoundingly negative study. At two years, the 12/447 patients in the closure group suffered a recurrent stroke, while 13/462 patients in the medical therapy suffered a recurrent stroke. The trial, however, reveals one of the important chinks in the armor of the randomized control trial (RCT). Randomized control trials are only as good as the patients they enroll. Enroll the wrong patients, and the results don’t tell you much. CLOSURE-1 didn’t provide closure...
Source: The Health Care Blog - September 11, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
A Hole In the Heart, Part I
By ANISH KOKA, MD
Strokes are the third leading cause of death in the United States. 800,000 people suffer a stroke every year, and the consequences are frequently devastating. Lives are not just lost, but changed forever – speech permanently silenced, arms and legs turned into useless appendages. The brain is very expensive real estate and it is little surprise that a clot the size of a pinhead lodged in a blood vessel feeding the brain is all that is needed to wreak a devastation most fear worse than death.
Most of the time the source of the debris that results in a stroke can be readily identified, but at least one-th...
Source: The Health Care Blog - September 6, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 5
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Source: Cardiophile MD - August 6, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
The Spectacular Incompetence of 3rd Party Payers
By SAURABH JHA, MD
To paraphrase Tolstoy, all competence is alike, but every incompetence is incompetence in its own way. Every time I think I’ve seen the horizon of incompetence, I’m dealt a surprise. The sun never sets on incompetence. In healthcare, incompetence can be found in odd places, such as three recent examples I encountered with third party payers.
Case 1: Downgrading Caviar to Boiled Salmon
A patient was referred for a CT angiogram run off – which is a CT scan of the arteries of the belly, pelvis, both legs and feet – a very detailed and costly study. The cardiologist suspected a pseudoaneurysm of the ...
Source: The Health Care Blog - July 31, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 4
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Source: Cardiophile MD - July 16, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 2
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Source: Cardiophile MD - July 2, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance New Test Series 1
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Source: Cardiophile MD - June 28, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Splintered QRS – Cardiology MCQ
Splintered QRS is a term used in the description of ECG in:
a) Ebstein’s anomaly
b) Acute myocardial infarction
c) Ventricular septal defect
d) Pericardial effusion
Correct answer: a) Ebstein’s anomaly
Read more on ECG in Ebstein’s anomaly…
(Source: Cardiophile MD)
Source: Cardiophile MD - May 11, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 26
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Source: Cardiophile MD - May 10, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Echo Quiz – Cardiology MCQ
Type of ASD seen in this echo:
a) Sinus venosus
b) Secundum
c) Primum
d) None of these
Correct answer: b) Secundum
There is good rim of septal tissue between the atrial septal defect and the atrioventricular valves, suggesting secundum ASD. In sinus venosus ASD, the superior rim will not be there. (Source: Cardiophile MD)
Source: Cardiophile MD - May 10, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology X-ray DM / DNB Cardiology Entrance Echocardiography Source Type: blogs
Cardiology X-ray Quiz – Cardiology MCQ
This chest X-ray is suggestive of:
a) Primary pulmonary hypertension
b) Atrial septal defect with pulmonary hypertension
c) Ventricular septal defect with pulmonary hypertension
d) Idiopathic dilatation of pulmonary artery
Correct answer: b) Atrial septal defect with pulmonary hypertension
End on view of dilated pulmonary artery branches suggest increased pulmonary blood flow as the cause of pulmonary hypertension. Right atrial enlargement is not seen in ventricular septal defect with pulmonary hypertension. Read more on multi-modality imaging in atrial septal defect… (Source: Cardiophile MD)
Source: Cardiophile MD - May 10, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray DM / DNB Cardiology Entrance Source Type: blogs
Swiss cheese VSD – Cardiology MCQ
Swiss cheese VSD is:
a) Sub-pulmonic VSD
b) Peri-membraneous VSD
c) Multiple muscular VSD
d) None of the above
Correct answer: c) Multiple muscular VSD
Multiple muscular ventricular septal defects (VSD) are also called swiss cheese VSD. Swiss cheese VSDs are associated with left axis deviation on ECG. Swiss cheese VSDs are difficult to close surgically. It is difficult to locate the openings of the VSD from the right ventricular side. Some may have multiple right ventricular openings for a single left ventricular orifice. Read more… (Source: Cardiophile MD)
Source: Cardiophile MD - May 8, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Deficiency of aortic rim an important risk factor for cardiac erosion with ASD device
Cardiac erosion is a potential nightmare of device closure of atrial septal defect (ASD) device closure, though exceedingly rare. Recent study published in Circulation [1] documented 125 erosions over a period of 12 years from a database. Erosions were diagnosed over a median of 14 days after the device closure. Deficiency of aortic rim was found to be almost universal while deficiency of any of the aortic, superior vena caval or inferior vena caval rims were the most important risk factor for cardiac erosion. The study was a case control study with age and sex matched controls. Device oversizing also contributed to the c...
Source: Cardiophile MD - May 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Structural Heart Disease Interventions Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 25
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Source: Cardiophile MD - April 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
