Heart disease in pregnancy: Risk stratification
It is needless to say that heart disease in pregnancy is a challenge for the obstetrician and the cardiologist. Hemodynamic changes in pregnancy and labour can adversely affect many of the significant cardiac lesions. Increase in blood volume and heart rate are the important factors during pregnancy. In general stenotic lesions and pulmonary hypertension are poorly tolerated, while regurgitant lesions are better tolerated. Specific risks like aortic dissection and rupture are there for coarctation of aorta. Several risk stratification schemes have been developed for assessing the risk of pregnancy with heart disease over ...
Source: Cardiophile MD - May 27, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology CARPREG II risk scoring CARPREG risk stratification mWHO classification ZAHARA risk score Source Type: blogs
Aortic dissection risk factor – Cardiology MCQ – Answer
Most common risk factor for aortic dissection in the International Registry of Acute Aortic Dissection (IRAD):
Correct answer: b) 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...
Source: Cardiophile MD - May 4, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Aortic dissection risk factor – Cardiology MCQ
Most common risk factor for aortic dissection in the International Registry of Acute Aortic Dissection (IRAD):
a) Diabetes mellitus
b) Hypertension
c) Marfan syndrome
d) Bicuspid aortic valve
Post your answer as a comment below. Correct answer will be published on: May 4, 2018 @ 15:13
The post Aortic dissection risk factor – Cardiology MCQ appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 2, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Interview with Tal Golesworthy, Inventor of the ExoVasc Aortic Root Support
Tal Golesworthy is the inventor of the ExoVasc, a bespoke implant that supports the aortic root when it has becomes weak and dilated. Tal’s invention was born out of his personal need for the device to support his aorta that was expanding dangerously due to Marfan syndrome. In 2004, Tal was the first patient to be implanted with the device that he invented, and many more patients have benefited from the ExoVasc Aortic Root Support since.
Medgadget editor Tom Peach spoke with Tal Golesworthy to hear about the inspiring journey that gave birth to the ExoVasc and to learn more about Exstent, the company that was formed as a...
Source: Medgadget - April 10, 2018 Category: Medical Devices Authors: Tom Peach Tags: Cardiac Surgery Cardiology Exclusive Source Type: blogs
Aortic Dissection Detection Risk Score
Acute aortic dissection may be present in only about one in ten thousand patients presenting to the emergency department. But missing an aortic dissection can be catastrophic. At the same time submitting all patients with suspected dissection to imaging studies may not be feasible in view of the cost and potential risks. Hence a good clinical bedside risk score may be useful, in addition to diligent clinical evaluation. Aortic Dissection Detection Risk Score (ADD Risk Score) was formulated by IRAD investigators using the International Registry of Acute aortic Dissection. Three groups of high risk features have been eval...
Source: Cardiophile MD - January 19, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 8
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease.
This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - January 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs
Aortic Regurgitation
Aortic regurgitation can occur due to damage to the aortic valve as well as due to dilatation of the aortic root so that aortic valve leaflets fail to coapt. The later condition occurs in annulo-aortic ectasia, often associated with Marfan syndrome. Aortic regurgitation due valvular damage can occur in rheumatic fever. A bicuspid aortic valve can also become regurgitant as age advances. In the yester years, tertiary syphilis was an important cause of aortic root dilatation and aortic regurgitation.
Aortic regurgitation is quantified in terms of regurgitant fraction,which is the fraction of left ventricular output that re...
Source: Cardiophile MD - April 22, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Echocardiogram Library Source Type: blogs
Cardiovascular contraindications to pregnancy
Short Notes
Abstract: In general, obstructive lesions and severe cyanotic lesions are poorly tolerated in pregnancy while regurgitant lesions and left to right shunts without pulmonary hypertension are well tolerated.
Pregnancy is associated with several hemodynamic changes. As term advances there is increase in heart rate and cardiac output while the peripheral resistance falls in pregnancy. Blood volume also increases in pregnancy and there is a sudden increase in blood volume after delivery when the placenta separates and pushes the blood from the maternal aspect back into circulation.
Some of the important cardiovas...
Source: Cardiophile MD - January 1, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Cardiovascular contraindications to pregnancy Marfan syndrome with dilated aorta Severe cyanotic congenital heart disease Severe obstructive valvular lesions severe pulmonary hypertension Source Type: blogs
Acute aortic syndromes
Brief Review
Acute aortic syndromes include aortic dissection, intramural hematoma of the aorta and penetrating ulcer of the aorta. The concept of acute aortic syndrome was introduced by Vilacosta I et al in an editorial which appeared in Heart in 2001.1 The nature and location of pain are important in the diagnosis of acute aortic syndrome. Usually it is an intense tearing type of pain and the location may change as the disease progresses as in aortic dissection. Pain in the front of the chest, neck or throat suggests ascending aortic involvement while pain in the back or over the abdomen suggests involvement of the des...
Source: Cardiophile MD - December 21, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Lost in Translation
Marfan syndrome is a rare genetic disease of connective tissue caused by a mutation in FBN1 (Source: NIMH Directors Blog)
Source: NIMH Directors Blog - December 5, 2014 Category: Psychiatry Authors: Thomas Insel Source Type: blogs
Cardiology MCQ: Cardiovascular contraindication to pregnancy
Cardiovascular contraindication to pregnancy:
a) Severe pulmonary hypertension
b) Severe obstructive valvular lesions
c) Marfan syndrome with dilated aorta
d) All of the above
Correct answer: d) All of the above
Marfan syndrome with dilated aorta carries a high risk of aortic dissection during labour. Severe cyanotic congenital heart disease is another cardiovascular contraindication to pregnancy.
In general obstructive lesions are poorly tolerated in pregnancy. Severe mitral stenosis can lead on to acute pulmonary edema during labour or in the immediate postpartum period. Pulmonary edema can occur earlier as well when th...
Source: Cardiophile MD - November 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ 363: Cardiovascular contraindications to pregnancy
Cardiovascular contraindication to pregnancy:
a) Severe pulmonary hypertension
b) Severe obstructive valvular lesions
c) Marfan syndrome with dilated aorta
d) All of the above
["Click here for the answer with explanation", "Correct Answer:"]
d) All of the above
Marfan syndrome with dilated aorta carries a high risk of aortic dissection during labour. Severe cyanotic congenital heart disease is another cardiovascular contraindication to pregnancy.
The post Cardiology MCQ 363: Cardiovascular contraindications to pregnancy appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - October 25, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
The Pains of Separation
When a patient arrives to your ED fresh from karate class still in her uniform, you get a feeling about where the case is heading. This patient was 49, and reported that she always had some aches after karate. This evening, though, her pain was very different — and much more concerning. The pain had started about an hour into her class and worsened over the next 30 minutes. It was a severe achy pain over her left chest that radiated to her neck and was associated with pronounced diaphoresis. This prompted an expedited cardiac workup.
The ECG showed a sinus tachycardia with ST-elevation in V2-V3, I, aVR, aVL, with de...
Source: Spontaneous Circulation - August 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Pains of Separation
When a patient arrives to your ED fresh from karate class still in her uniform, you get a feeling about where the case is heading. This patient was 49, and reported that she always had some aches after karate. This evening, though, her pain was very different — and much more concerning. The pain had started about an hour into her class and worsened over the next 30 minutes. It was a severe achy pain over her left chest that radiated to her neck and was associated with pronounced diaphoresis. This prompted an expedited cardiac workup.
The ECG showed a sinus tachycardia with ST-elevation in V2-V3, I, aVR, aVL, with depr...
Source: Spontaneous Circulation - August 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
How an Engineer Developed a Surgical Procedure That Saved His Own Heart
First there was the auto mechanic that developed a way to ease the difficulties of child birth. Now an engineer named Tal Golesworthy has developed a simple way to treat a heart condition called Marfan syndrome.Contributor: Mark WhittingtonPublished: Dec 08, 2013 (Source: Most Recent Health Wellness - Associated Content)
Source: Most Recent Health Wellness - Associated Content - December 8, 2013 Category: Other Conditions Source Type: blogs
