Chest pain in children – Cardiology Basics
Chest pain in children – Cardiology Basics
Even though chest pain in children is a common symptom, unlike in adults it is seldom due to heart disease. Most often the cause of chest pain in children is not a major life threatening disease. Still chest pain can cause restriction of activities, absence from school and cause of anxiety to children and their parents.
A good history and physical examination can give a lot of information to exclude any potentially serious condition causing chest pain, though it is rare. Costochondritis is a common cause of chest pain in adolescent and preadolescent girls. It can b...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a myocardial bridge? Cardiology Basics
Normally the coronary arteries are located outside the myocardium. Occasionally a segment of the coronary artery passes through the myocardium. This causes a narrowing of that region in systole and is known as myocardial bridging. Myocardial bridging can be recognized as narrowing of a region of the coronary artery in systole which normalizes in diastole.
Usually myocardial bridges do not cause myocardial ischemia as normally the blood flow into the myocardium occur mostly during diastole. Still myocardial bridges can rarely cause myocardial ischemia and cause chest pain. Rarely this may need recurrent hospital admi...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Athlete ’s heart – Cardiology Basics
Athlete’s heart – Cardiology Basics
Athlete’s heart is thickening of the heart muscle due to constant training in response to increased circulatory demand. Athlete’s heart is not dangerous, it is a physiological adaptation of the heart to training and increased load. It is associated with a slow heart rate, called athlete’s bradycardia.
The slower resting heart rate is a protective mechanism to prevent undue rise with exercise as normally heart rate increases with intensity of exercise. There is an increase in the size of the chambers of the heart and increased efficacy of pumping to meet the high demand duri...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Chest pain, shortness of breath, T wave inversion, and rising troponin in a young healthy runner.
In this study, 40 presumably healthy male marathon runners had their cardiac troponin and other findings measured before and after running a marathon. 39 pts (97.5%) had baseline cTnT values below the reference limit (less than 14 ng/L). 38 pts (95%) of participants had post-marathon cTnT concentration rise above this reference limit. The median post-marathon cTnT was 41 ng/L, and the 95th percentile concentration was 90 ng/L. None reported " cardiac symptoms " after the race.See this single post for many examples of BTWI:Understanding this pathognomonic ECG would have greatly benefitted the patient.More cases involving BT...
Source: Dr. Smith's ECG Blog - May 19, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Understanding this pathognomonic ECG would have greatly benefitted the patient.
Written by Pendell MeyersInterpret this ECG first without context. You don ' t need context yet because this ECG is nearly pathognomonic.After having learned about benign T wave inversion pattern years ago on this blog, and having seen many cases on this blog and in my practice since then, I instantly recognize this as BTWI, a fairly common normal variant. I see maybe one of these ECGs each month in my practice. There is no ischemia, certainly no concern at all for OMI. It meets basically all of the criteria that Dr. Smith has consistently described over the years, after reviewing a large cohort of patients by W...
Source: Dr. Smith's ECG Blog - March 22, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
A man in his 50s with abdominal pain and a computer read of ***Acute MI ***
Submitted by Dr. Arjun J V, Written by Pendell MeyersA man in his 50s with history of diabetes presented with acute onset abdominal pain and nausea.Here is his ECG at triage:What do you think?Sinus bradycardia. The QRS is narrow but very abnormal with significant LVH. There are widespread, dramatic, and discordant ST and T wave deviations which are due to the LVH. Look at leads III and aVF here for a particularly important lesson for your eyes. In these leads, the QRS does not actually have radically large QRS voltage, but yet there is substantial (easily meeting STEMI criteria) ST elevation which is due to LVH ...
Source: Dr. Smith's ECG Blog - January 8, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, November 8th 2021
In conclusion, in less common and visible cardiovascular diseases, it is crucial to recognize substantial progress and achievement, given that penetration of such information into clinical practice and the patient community can be inconsistent. Diseases such as hypertrophic cardiomyopathy, pulmonary arterial hypertension, and ATTR cardiac amyloidosis, once linked to a uniformly adverse prognosis, are now associated with the opportunity for patients to experience satisfactory quality of life and extended longevity.
VitaDAO, a Novel Approach to Crowdfunding Life Science Research
https://www.fightaging.org/archiv...
Source: Fight Aging! - November 7, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Cardiovascular Disease is Perhaps Less Well Understood than is Widely Perceived to be the Case
In conclusion, in less common and visible cardiovascular diseases, it is crucial to recognize substantial progress and achievement, given that penetration of such information into clinical practice and the patient community can be inconsistent. Diseases such as hypertrophic cardiomyopathy, pulmonary arterial hypertension, and ATTR cardiac amyloidosis, once linked to a uniformly adverse prognosis, are now associated with the opportunity for patients to experience satisfactory quality of life and extended longevity. (Source: Fight Aging!)
Source: Fight Aging! - November 4, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Hypertrophic cardiomyopathy : Two posters that summarise everything essential
Check out these two posters* for are a quick reference on HOCM with current updated evidence. The first one details about Echo evaluation. The second one illustrates the genetic screening flow chart of the HOCM families.
Some of the queries, you will find the answers from these posters are,
1. How to recognize Intrinsic mitral valve defect by MR jet morphology?
2. How to cross-check the true LVOT gradient from MR jet?
3. When to do a provocative test to document the LVOT gradient?
4. What are the standard pre-myectomy measurements by Echo?
5. How to screen a family member of HCM? Pros and cons of Phenotyp...
Source: Dr.S.Venkatesan MD - November 1, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology Illistrations Cardiology Illustrations Cardiology teaching websites Cardiology-Echocardiography cardiomyopathy hocm hcm hypertrophic cardiomyopathy Uncategorized Alcohol septal ablation ASE posters on hocm hcm best illistrat Source Type: blogs
Some ECG simply require pattern recognition, followed by a bit of investigation
Brooks Walsh @BrooksWalsh helped with this post One of my partners showed me this series of ECGs, without any info:I said: " It ' s a normal variant. Young black male, right? "He said, " Yes, but look at this one recorded 2 hours later. It is different " :There is T-wave inversion in V4 that was not there before.I said: " Yes, small changes can happen even with normal variants. " And there might be a slight difference in lead placement. On the 2nd ECG, V4 is farther to the right -- notice there is more S-wave than on the first and the R/S ratio is smaller. There was also a 3rd ECG at 3.5 h...
Source: Dr. Smith's ECG Blog - August 30, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Pregnancy in Hypertrophic cardiomyopathy : LSCS or vaginal delivery ?
Hypertrophic cardiomyopathy is a specific genetic disorder of myocyte (myosin and others) within the sarcomere. Though uncommon in pregnancy it raises considerable anxiety to the patient, family, and the obstetrician.
Hemodynamics
Though we tend to worry more about dynamic LVOT obstruction, it is actually the restrictive physiology of LV myocardium that might cause more concern. Three key variables operate in this entity namely preload, afterload, and contractility that determine the cardiac hemodynamics and possibly the symptoms. We know the classical consequence of pregnancy is a fall in systemic vascular resistance(...
Source: Dr.S.Venkatesan MD - August 27, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Pregnancy and heart pregnancy and heart disease Uncategorized esc ropac zahara pregnancy heart disease complicating pregnancy indication for lscs in hcm hocm lscs or normal delivery in hocm hcm pregnancy in hocm pregnancy in hypertrophic c Source Type: blogs
Pancreatitis with Bizarre T-wave inversions and a normal echo. Is it takotsubo?
I was shown this ECG and told that the patient is suffering from another bout of chronic pancreatitis. I was told there was no chest discomfort or SOB. What do you think?I said " this looks like takotsubo " .With this ECG and the presumptive diagnosis of pancreatitis, takotsubo stress cardiomyopathy is by far most likely. It is possible that it is due to ACS, but thebizarre diffuse T-wave inversions with a very long QT are nearly pathognomonic of takotsubo. (They can also be seen in apical hypertrophic cardiomyopathy, but this patient did not have any such history and previous ECGs were different)If ...
Source: Dr. Smith's ECG Blog - July 31, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Virtual native enhancement instead of late gadolinium enhancement
Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging is considered the gold standard for non-invasive myocardial tissue characterization [1]. Artificial intelligence was used to develop a CMR virtual native enhancement (VNE) imaging which does not need an intravenous contrast as in LGE. VNE uses a deep learning model with multiple streams of convolutional neural networks to enhance existing signals of native T1 maps and cine imaging of cardiac structure and function to produce LGE equivalent images. T1 maps are pixel wise maps of tissue T1 relaxation times.
The technology was developed in CMR ...
Source: Cardiophile MD - July 22, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Machine Learning and AI in Cardiology Source Type: blogs
Role of history in the evaluation of syncope
A detailed history is very useful in the evaluation of many cardiac disorders, more so in the assessment of syncope. In some of the causes for syncope, only diagnostic clue will be from the history. Associated symptoms like nausea, sweating, pallor, abdominal discomfort and yawning are usually considered features of neurally mediated syncope [1]. Evaluation of syncope can be difficult as one previous study has shown that the cause remained unknown in 97 of the 204 patients [2]. The situation might be better now because we have better diagnostic modalities including implantable loop recorders which are quite useful in eluc...
Source: Cardiophile MD - July 20, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Paradoxical splitting of second heart sound
Normal split of second heart sound is due to the delay in pulmonary valve closure compared to aortic valve. This is mostly contributed to by the pulmonary hang out interval. Hang out interval is the time taken for the actual valve closure after the pulmonary artery and right ventricular pressure tracings crossover. Normal split of second heart sound closes in expiration as the reduced venous return shortens right ventricular ejection. When the split closes in inspiration and becomes audible in expiration, it is called paradoxical splitting of second heart sound. Please note that a wide split of second heart sound as in ri...
Source: Cardiophile MD - June 20, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
