Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy is a genetic disorder with a guarded prognosis which occurs in about 1:500 individuals.
It is an autosomal dominant disorder with variable penetrance with either a defect in sarcomeric protein genes which encode for myosin heavy chain, actin or tropomyosin or due to abnormal myocardial Ca++ kinetics which increase intracellular Ca++, causing hypertrophy and cellular disarray.
Echocardiography is the sheet anchor of diagnosis of HCM and other modalities are complementary.
MYH7 mutation in the gene which encodes for beta myosin heavy chain, located on chromosome 14 is found in about 15-25% of case...
Source: Cardiophile MD - May 1, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Assessment of LV Diastolic Function by Echo in SR and AF
Echocardiographic assessment of left ventricular diastolic function with special reference on diastolic function assessment in atrial fibrillation.
Though there are several parameters for evaluation of left ventricular diastolic function by echocardiography, the most commonly used are the pulsed Doppler mitral E/A ratio and tissue Doppler mitral E/e’ ratio.
Some of the other useful parameters are mitral E velocity deceleration time, changes in mitral inflow with Valsalva maneuver, mitral L velocity, isovolumic relaxation time, left atrial maximum volume index, pulmonary vein systolic/diastolic velocity ratio, color M-mod...
Source: Cardiophile MD - April 15, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
M-Mode Echocardiogram in LV Dysfunction
Transcript of the video: This is a still image of M-Mode Echocardiogram. M-Mode is Time-Motion Mode. The horizontal axis is time. Vertical axis is distance from the transducer. That is M-Mode, one of the older modes, currently used mainly for taking left ventricular measurements. In the inset you can see the two dimensional image. Location of the transducer here, in the parasternal region. This is the parasternal long axis view. Right ventricular outflow tract, left ventricle, left atrium, aorta, aortic valve, mitral valve. These are the things you have seen in that inset image. This is movement of the anterior wall of the...
Source: Cardiophile MD - March 23, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Two patients with chest pain, with QRS obscured: which was STEMI positive, and which had Occlusion MI?
Written by Jesse McLaren Two patients
presented with acute chest pain, and below are the precordial leads V1-6 for
each. Patient 1 (ECG on the left) was a 45 year-old male, and patient 2 (ECG is
on the right) was a 70 year-old male. The limb leads have been removed because
there was no ST elevation in those leads, the QRS complexes have been
obscured because this is irrelevant to STEMI criteria, and red lines have been added to measure ST segment elevation. Using the
current paradigm, can you tell which patient had an acute coronary occlusion? Using
T wave amplitude, can you tell which ECG has hyperacute T waves?...
Source: Dr. Smith's ECG Blog - January 17, 2024 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
An elderly patient with stuttering chest pain. Don't jump to conclusions.
I was reading ECGs on the system and saw this one, and instantly knew the probable ECG diagnosis:What do you think?I went to the patient ' s chart:Elderly woman with stuttering chest pain and SOB, and dizziness.What do you think now?This is a very typical ECG for Hypertrophic Cardiomyopathy. I sent it to our EKG Nerdz group and Jesse McLaren replied: " Apical HOCM "It reminded me of many other cases I have seen, such as this one: Left Bundle Branch Block with Less Than 1 mm of Concordant ST Elevation (in the Setting of Hypertrophic Cardiomyopathy)HOCM that mimicked LBBB with OMI (concordant STE in V5)Case continu...
Source: Dr. Smith's ECG Blog - December 26, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
A 90-something with acute stroke. She has no chest symptoms. What is the diagnosis?
A 90-something year old woman presented with an acute mild stroke.She had a routine ECG as part of her workup:What do you think?This was shown to me in real time.I thought it had to be an inferior-lateral-posterior OMI. But the patient had no symptoms. Later, she did admit to some vague chest discomfort, but that could be due to the power of suggestion.The one strange thing that I noted at the time is that there is no reciprocal ST depression in aVL. This is extremely unusual in inferior OMI, even if there is simultaneous STE in V5-6.We studied this: In this paper on the importance of lead aVL f...
Source: Dr. Smith's ECG Blog - November 11, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Continuous prolonged generalized weakness, lightheadedness, and presyncope. What might you suspect from the ECG?
A young man presented with continuous prolonged generalized weakness, lightheadedness, and presyncope. There was some dyspnea but no chest pain. Here is his ECG. This shows LVH, with high voltage.LVH can have very thick-walled ventricles and a correspondingly small LV cavity. LVH is a common etiology of heart failure with preserved ejection fraction, as it may results in a stiff ventricle with poor diastolic relaxation.See this articles: Heart Failure with Preserved Ejection Fraction (NEJM review)One etiology of LVH on the ECG is Hypertrophic Cardiolmyopathy (HOCM), and sometimes ECGs in pa...
Source: Dr. Smith's ECG Blog - October 28, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Does this T wave pattern mean anything?
Written by Michael Doyle DO and Timothy Palmieri MD. Edited by Bracey, Meyers, Grauer, and SmithA 50-something-year-old female with a history of an unknown
personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return
of spontaneous circulation. The described rhythm was an irregular, wide complex
rhythm. By EMS report, open pill bottles were found nearby at the scene, including quetiapine, fluoxetine, hydroxyzine, and gabapentin. She was successfully revived
after several rounds of ACLS including defibrillation and amiodarone.On arrival to the ED the patient was intubated with normal vi...
Source: Dr. Smith's ECG Blog - October 23, 2023 Category: Cardiology Authors: Bracey Source Type: blogs
Q & A With Dylan Burnette: Muscle Cells, Cell Movement, and Microscopy
Courtesy of Dr. Dylan Burnette.
“We scientists know very little of what can be known—I find that invigorating,” says Dylan Burnette, Ph.D., an associate professor of cell and developmental biology at Vanderbilt University School of Medicine in Nashville, Tennessee. “Most people find it exhausting, but I’m comfortable with not knowing all of biology’s secrets.” In an interview, Dr. Burnette shared his lab’s work on muscle cells, the knowledge he hopes readers take away from his research, and some advice to future scientists about being comfortable being wrong.
Q: How did you first become interested in s...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - September 6, 2023 Category: Research Authors: Chrissa Chverchko Tags: Being a Scientist Cellular Imaging Cellular Processes Profiles Source Type: blogs
New ESC 2023 Cardiomyopathy guidelines: Truths trail by 17 years!
It was 2006
Allow me to recount an unassuming piece of a PowerPoint presentation from my institute, Madras Medical College, at the annual Cardiological Society meeting in New Delhi. The paper was categorized under miscellaneous sessions. I vividly remember the day. I have to admit, It was a nearly empty hall E, located in the basement of Hotel Ashoka. After the talk, I looked up to find that neither the chairman nor the handful of kind academic souls had any questions or comments to make. Pausing for a few moments, I quietly walked down the podium with an inexplicable silent pain.
The title of the presentation was &#...
Source: Dr.S.Venkatesan MD - August 27, 2023 Category: Cardiology Authors: dr s venkatesan Tags: cardiomyopathy Dilated cardiomyopathy hypertrophic cardiomyopathy ischemic cardiomyopathy Uncategorized drsvenkatesan ESC 2023 new cardiomyopathy guideline ndlvc non dilated cardiomyopathy Source Type: blogs
Bonus Features – August 20, 2023 – Healthcare orgs only use 57% of their data to drive decision-making, digital health is well represented on the Inc. 5000 list, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.
News
The annual Inc. 5000 list is live. Digital health companies on the list include AngelEye Health, Authenticx, DAS Health, FarmboxRX, ixlayer, Mytonomy, Reveleer, TigerConnect, TimelyCare, Valenz Health, Veda, and Vytalize He...
Source: EMR and HIPAA - August 20, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Healthcare IT 1upHealth 4medica Accelecom AliveCor Anahi Santiago AngelEye Health Authenticx AVIA Azalea Health Boston Children's Hospital C3HIE Center for Virtual Care Value and Equity Cerner Cerner CommunityWorks Christiana Source Type: blogs
This was texted to me in real time. The patient has acute chest pain.
This was texted to me in real time. The patient has acute chest pain.What do you think?Here was my answer:" Not ischemia. Chronic. Maybe HOCM or another form of LVH. I would not activate cath lab. Get serial troponins "It is a scary ECG, with a lot of ST Elevation and what appear to be hyperacute T-waves in inferior leads, and profound reciprocal ST Depression in aVL. There are Q-waves in V4-V6, with what appear to be hyperacute T-waves. Any objective, rule-based analysis of this ECG would scream " STEMI " or " OMI " . But, alas, ECGs are like faces. No measurements can t...
Source: Dr. Smith's ECG Blog - July 5, 2023 Category: Cardiology Authors: Steve Smith 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
What is Mitochondrial Cardiomyopathy?
Mitochondria have two genomes – mitochondrial and nuclear. Mitochondrial disease could be due to mutations of nuclear or mitochondrial DNA. Mitochondrial DNA is inherited maternally while nuclear DNA has Mendelian inheritance, which could be dominant or recessive [1]. It may be noted in about one in 5000 live births. Cardiac involvement in mitochondrial disease seldom occurs in isolation and is often part of multiorgan dysfunction [2]. Mitochondria being part of the cellular respiratory chain, tissues with high energy requirements like heart, muscle, kidneys and endocrine system are often involved in mitochondrial d...
Source: Cardiophile MD - May 9, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A man in his 40s with epigastric pain and ST Elevation
Case submitted by Magnus Nossen MD, written by Pendell MeyersA previously healthy man in his 40s presented to the ED with epigastric abdominal pain off and on for several days. Vitals were within normal limits.It is unclear whether he had active pain at the time of the first ECG:What do you think?Here is PM Cardio ' s Queen of Hearts interpretation (AI ECG interpretation trained by Meyers, Smith, and PM Cardio team using thousands of cases and their outcomes):The output number ranges from 0 to 1, with numbers closer to zero meaning likely NOT OMI, and numbers closer to 1 meaning OMI. This result of 0.0002 is obviousl...
Source: Dr. Smith's ECG Blog - February 23, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
