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Don’t hunt for non-existing culprits in STEMI crime scene !
Scientific cardiology has forced us to believe ACS management must be catheter based and all others are inferior and those who pursue the later , carry a risk of being labelled as unethical in near future. However ,experienced cardiologists will know where the truth lies. Now,in the interventional cardiology board rooms there is a big debate going on regarding the value of early total revascualrisation in STEMI with multivessel CAD.Suddenly , every lesion looks suspect ( Ex,current or future culprit ! ) and all stentable lesion are stented either in an emergency or semi emergency fashion (The new age post PC...
Source: Dr.S.Venkatesan MD - June 22, 2016 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology -unresolved questions Primary PCI diferred pci for non ira ira non ira culprit vessels multivessel pci in stemi Source Type: blogs

IABP in action
IABP – monitor screenshot Green tracing: ECG. White tracing: Respiration. Red tracing: Intra arterial blood pressure. Yellow tracing: Pulse oximetry. Displays on right side, from top to bottom: Heart rate, respiratory rate, blood pressure, oxygen saturation (SPO2). Intra aortic balloon pump (IABP) or intra aortic balloon counterpulsation is used to augment the cardiac output and reduce the afterload to the heart. Classic indication for IABP is cardiogenic shock. It can be either in the setting of acute myocardial infarction, cardiac surgery or in a person undergoing high risk percutaneous coronary intervention. The I...
Source: Cardiophile MD - April 28, 2016 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 23
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Source: Cardiophile MD - March 25, 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

A Pathognomonic ECG
This was sent to me by Mauro Cassazza from Italy:What do you see?AnalysisIt is tempting to think that the waves before the QRS are large P-waves, but in fact one can discern P-waves within these large waves (see V2 in particular). Thus, these are very late T-waves. Thus the QT interval is very long. I measure the QT interval at about 520 ms. Since the RR interval is about 560 ms, then the Bazett-corrected QTc is about 690 ms (very long). What part of the QT interval is long? Is the T-wave itself very wide? Is the time from T-wave peak to T-wave end (T-peak to T-end, or TpTe, long)?...
Source: Dr. Smith's ECG Blog - March 23, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 21
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Source: Cardiophile MD - March 8, 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 Mock Test 10
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Source: Cardiophile MD - February 1, 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 Mock Test 9
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Source: Cardiophile MD - January 27, 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 Mock Test 7
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Source: Cardiophile MD - January 23, 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 Mock Test 3
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Source: Cardiophile MD - January 17, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Should Fluoro be Your New Go-To?
Part Three in a Three-Part Series This is the third and final part of our series on foreign bodies and fluoroscopy. Click here for part one and here for part two. This month, we walk you through a step-by-step guide with bonus video footage to aid in your technique. This progressive procedure is absolutely significant to your practice, and we hope you all get a chance to try it. The Approach n Identification of foreign body on plain film or ultrasound n Saphenous or posterior tibial nerve block n Enlargement of the wound or entrance site using incision...
Source: The Procedural Pause - January 4, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Is there hemodynamic advantage for co-dominant coronary circulation ?
Co-dominant coronary circulation is defined as , when posterior crux of the heart receives twigs from both right and left system making this water shed area with advantage of twin innervation.They essentially supply inferior and posterior aspect of both left and right ventricle including the posterior aspect of interventricular septum. Image courtesy modified from :http://www.meddean.luc.edu/lumen/meded/mech/cases/case1/image4.JPG Traditionally inferior and basal aspects of heart are perceived (wrong tough !) as less important than anterior surface of heart.Infero posterior MI can be extensive and cause significa...
Source: Dr.S.Venkatesan MD - December 20, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

An episode of low-value care delivered to my father
My father recently visited his internist with complaints of vague chest symptoms and was referred to a cardiologist who recommended coronary CT, ultrasonography, and angiography. A cardiac workup would seem to be a reasonable course of action given that he has a history of coronary artery disease (CAD) with prior angioplasty. However, upon further exploration, I felt that his chest symptoms were due to stress and were not of cardiac origin. He exercises regularly without symptom provocation. A few months ago our family went on a cruise, and my father would walk on the treadmill for hour-long sessions to pass time whi...
Source: Kevin, M.D. - Medical Weblog - October 30, 2015 Category: Journals (General) Authors: Victor Lee, MD Tags: Physician Heart Source Type: blogs

Anterorlateral STEMI? Old Anterior MI? But cath shows RCA thrombotic stenosis.
This case is from a frequent contributor, Brooks Walsh. With additions and edits by me.A 68 year-old man had been having chest discomforts intermittently for the past 2 weeks. About 18 hours prior to presentation, his pain began to worsen. He developed nausea, and 911 was called after he vomited once. EMS obtained an ECG:There is subtle ST depression in II, III, and aVF. There is ST elevation in V2 – V5, with Q waves in V2 – V4. This is all but diagnostic of anterior MI.Is it acute? subacute? Old MI with persistent ST elevation?EMS requested cath lab activation. The patient was given nitroglycerin 3 times, ...
Source: Dr. Smith's ECG Blog - October 25, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Factors predicting stroke after CABG – Cardiology MCQ
Factors predicting stroke after CABG: a) Presence of intracerebral and extracerebral atherosclerotic disease b) Demonstration of previous stroke by imaging c) Atheromatous disease of the aorta d) All of the above Correct answer: d) All of the above Aortic plaques have a high chance of embolization while cannulating the aorta for cardiopulmonary bypass. Avoiding cardiopulmonary bypass with off pump CABG (OPCAB) may have an edge over conventional on pump CABG in this situation. Previous history of stroke or transient ischemic attacks (TIA) within the previous six months is an important risk factor for perioperative stroke. ...
Source: Cardiophile MD - October 15, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs