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

Important risk factors for aortic dissection
Most common risk factor for aortic dissection in the International Registry of Acute Aortic Dissection (IRAD) was hypertension. Hypertension was noted in 76.6% in the IRAD, while Marfan syndrome was noted only in 4.4% and diabetes mellitus in 7.8%. Twenty year data from IRAD has been published. It is a study involving over 7300 cases from over 51 sites in 12 countries. Two thirds were type A dissection and one third type B. Two thirds were men and the mean age was 63 years. In general type A cases underwent surgery and type B cases underwent endovascular repair. There has been a decrease in overall in hospital mortality i...
Source: Cardiophile MD - November 22, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

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

3 Reasons Why Patient Design Must Replace The Patient-Centricity Illusion
What is the difference between patient design and patient centricity? Why is the former a concept we need to embrace in the future of medicine, and why is it time to forget about the latter? These are the questions we examined in our latest paper published in the Journal of Medical Internet Research, authored by The Medical Futurist Dr Bertalan Mesko and patient scholar Dave deBronkart – widely known as ePatient Dave.  Patient centricity has been the buzzword of the past two decades, especially often used in the 2010s, from pharma companies to healthcare providers, it was loudly advertised everywhere. As nice...
Source: The Medical Futurist - September 27, 2022 Category: Information Technology Authors: Andrea Koncz Tags: TMF E-Patients Future of Medicine Healthcare Design study patient empowerment patient design Digital Health Trend Study Future of healthcare patient centricity Source Type: blogs

3-D printing of heart : Moving from the labs to bed side
3D printing technology is growing at a rapid pace. Both cardiologists and cardiac surgeons are expected to benefit a lot.It helps us in understanding deformed anatomy in complex congenital heart disease as well as planning for synthetic cardiac implants.  Currently, the technology is limited only by the chemical material used to print the heart and its components. The American chemical society is working at it to create more realistic heart models. Once we master this,  biological printing with synthetic tissue equivalents is the ultimate aim.  Major Indications Planning cardiac reconstructive surgeries in ...
Source: Dr.S.Venkatesan MD - June 3, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized 3D printing in cardiology 3d prototyping evolute r core valve future of cardiology sapien valve edwards tavr mavr Source Type: blogs

Management of aortic dissection
Aortic dissection is the most common aortic emergency. It is one of the three acute aortic syndromes, the others being aortic intramural hematoma and penetrating aortic ulcer. It has a grave prognosis with 20% pre hospital and 30% in hospital mortality. Aortic dissection is generally considered as acute when diagnosis is made within 14 days of onset and chronic after that. An intimal and medial tear in the aorta causes blood to seep into the media and the false lumen usually progresses along a variable extend of the aorta. Important risk factors for aortic dissection are hypertension, Marfan syndrome and bicuspid aortic ...
Source: Cardiophile MD - May 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Cardiac Surgery Source Type: blogs

Aortic and pulmonary vascular abnormalities on CXR
Aortic abnormalities on CXR Right aortic arch: Side of aortic arch is recognized by the indentation of tracheal air shadow. Normally it is on the left side as it is left aortic arch. In right aortic arch, the indentation is on the right side. Right aortic arch may be seen in tetralogy of Fallot and truncus arteriosus. Ascending aorta: Ascending aorta is seen well just above the right atrial contour on the right cardiac border when it is dilated. Dilated ascending aorta can occur in: Post stenotic dilatation in aortic stenosis Annuloaortic ectasia in Marfan syndrome Ascending aortic aneurysm Aortic knuckle: Intimal calci...
Source: Cardiophile MD - September 29, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC 3 sign in coarctation of aorta Antler sign Ascending aorta calcium sign cephalization cottage loaf sign E sign in coarctation of aorta Figure of 8 sign inverted moustache sign knuckle sign Palla’s sign Redistribution Revers Source Type: blogs

General examination – hands and feet
General examination – hands and feet Cyanosis and pallor can be noted in the tips of the digits in both central and peripheral cyanosis. Severe jaundice may be visible in the palms and soles, especially in small infants. Clubbing of digits may be noted in cyanotic heart diseases as well many other non cardiac conditions. In clubbing, initially there is fluctuation of nail bed (Grade 1) followed by obliteration of angle between nail and adjacent skin fold (Lovibond angle – Grade 2). Later there is curvature of the nails (parrot beaking – Grade 3). Grade 4 or hypertrophic osteoarthropathy is not common in cardiova...
Source: Cardiophile MD - September 22, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC Heberden’s nodes Janeway lesions Lovibond angle Osler’s nodes Pitting edema Polydactyly Source Type: blogs

General examination – eyes and facial dysmorphism
General examination – eyes and facial dysmorphism Clinically examination is guided by the symptoms. Unless the history is not correlated with findings, important diagnostic possibilities may be missed. Clinical examination starts off with a focused general examination followed by a detailed examination of the cardiovascular system. Relevant points in other systems like basal crepitations, hepatosplenomegaly and neurological deficits should be looked for. Examination strategy should be fitting to the clinical situation. When a patient presents to the emergency room, it should be a short but focused examination to perm...
Source: Cardiophile MD - September 21, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC Source Type: blogs

Funtabulously Frivolous Friday Five 284
Dr Neil Long Funtabulously Frivolous Friday Five 284 It's Friday. Boggle your brain with FFFF challenge and some old fashioned trivia. Funtabulously Frivolous Friday Five 284 (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - June 21, 2019 Category: Emergency Medicine Authors: Dr Neil Long Tags: FFFF Abraham Lincoln Basedow Basedow disease Consent Die Glotzaugen-cachexie Doc Martin Gone with the Wind syndrome Google-eyed cachexia House Karl Adolph von Basedow Marfan Syndrome MEN2B Nurse Jackie Pareto Principle pharma Source Type: blogs

Medicine MCQ Test Series 1
This Medicine MCQ Test Series contains 20 questions which can be attempted over 40 seconds each. After submission, answers and discussion will be displayed. Medicine MCQ Test Series 1 Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 ...
Source: Cardiophile MD - January 27, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Medicine MCQ - CVS Source Type: blogs

20 year old female with cardiac murmur – Medicine MCQ – CVS – Answer
20 year old female with cardiac murmur – Medicine MCQ – CVS – Answer 20 year old female is referred for evaluation of a cardiac murmur. On general examination she is very lean and has a high arched palate. She is likely to have – Correct answer: d) Both a or b are possible A person with a gracile habitus and high arched palate could be having Marfan syndrome. Mitral valve prolapse with mitral regurgitation and aortic dilatation with aortic regurgitation can be associated with Marfan syndrome. Females with aortic root dilatation have a risk of development of aortic dissection during pregnancy and labour...
Source: Cardiophile MD - September 26, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Medicine MCQ - CVS Source Type: blogs

M-mode echocardiogram of aorta and left atrium
M-mode echocardiogram of aorta and left atrium M-mode echocardiogram at aorta-left atrium level showing the movements of aortic walls (anterior and posterior) and aortic valve opening and closing movements. Measurement of left atrium is taken in systole while that of aorta is taken in diastole. The open position of the aortic valve has the shape of parallelogram while the close position appears as two parallel lines representing the movements of right coronary cusp (anterior) and the non coronary cusp (posterior). It can be seen that left atrial dimension is more in systole than in diastole due to the movement of the aort...
Source: Cardiophile MD - September 9, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Echocardiogram Library Echocardiography Systolic flutterin of the aorti valve Source Type: blogs

Impulse of left ventricular ejection
Impulse of left ventricular ejection is the rate of change of central arterial pressure with respect to time (dP/dt). In cases with aortic root dilatation like Marfan syndrome, an increase in the impulse of left ventricular ejection can increase the chance of dissection. Same is true while treating severe hypertension. If blood pressure is reduced with vasodilators which do not decrease the impulse, but rather risks an increase of the impulse, chance of dissection does not decrease. This is the rationale of combining a beta blocker with vasodilators while treating severe hypertension, especially with aortic dissection. Re...
Source: Cardiophile MD - June 14, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs