Pulmonary Artery Catheterization Blogs This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Opening narrowed heart valves without surgery
Opening narrowed heart valves without surgery is by dilating them with balloons introduced into the heart through blood vessels. The procedure is known as balloon dilatation or balloon valvotomy. Four Valves in the Heart There are four valves for a normal heart. The mitral valve or bicuspid valve separates the left atrium (upper chamber) from the left ventricle (lower chamber). The aortic valve separates the left ventricle from the aorta, the largest artery of the body carrying oxygenated blood. The tricuspid valve separates the right atrium from the right ventricle and the pulmonary valve separates the right ventricle fr...
Source: Cardiophile MD - August 2, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Source Type: blogs

Closed loop catheter position in patent ductus arteriosus (PDA) with video
PA view of fluroscopic image showing closed loop catheter position in patent ductus arteriosus (PDA). The catheter is seen emerging from the inferior vena cava into the right atrium (RA) above the right hemidiaphragm and crossing the mid line across the tricupsid valve into the right ventricle. In the right ventricle, it does not go into the apical region, but goes straight to the right ventricular outflow (RVOT) region. From the RVOT it crosses the pulmonary valve into the main pulmonary artery (MPA). From the MPA, it enters the descending aorta through the PDA which is situated at the junction of the left pulmonary arter...
Source: Cardiophile MD - July 29, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Source Type: blogs

If a catheter passes from the right ventricle into the descending aorta, what are the possibilities?
It could be passing through a ventricular septal defect (VSD), patent ductus arteriosus (PDA) or aortopulmonary window (AP window) into the descending aorta. In VSD and AP window, the catheter will form an open loop while in PDA the catheter will form a closed loop (closed loop catheter course in PDA) as it crosses from the pulmonary artery into the descending aorta. Read more on closed loop catheter pattern with illustrative images and video… (Source: Cardiophile MD)
Source: Cardiophile MD - July 29, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology closed loop catheter course in PDA Source Type: blogs

Research and Reviews in the Fastlane 040
In this study the role of a “1/2 dose” thrombolysis was evaluated for the reduction of pulmonary artery pressure in moderate PE. A total of 121 patients with moderate PE received either tissue plasminogen activator plus anticoagulation or anticoagulation alone with the primary end points of pulmonary hypertension and the composite end point of pulmonary hypertension and recurrent PE at 28 months. The results suggested that the ½ dose or “safe dose” thrombolysis was safe and effective in the treatment of moderate PE, with a significant immediate reduction in the pulmonary artery pressure that was ma...
Source: Life in the Fast Lane - July 21, 2014 Category: Emergency Medicine Authors: Soren Rudolph Tags: Anaesthetics Emergency Medicine Evidence Based Medicine Featured Gastroenterology Haematology Health Infectious Disease Intensive Care Neurology Pre-hospital / Retrieval Respiratory critical care literature R&R in the FASTLANE Source Type: blogs

FDA Approves Novel Implanted Sensor To Monitor Heart Failure
The FDA announced today that it had approved the CardioMEMS Champion HF System. The small implantable device provides daily pulmonary artery pressure measurements to guide physicians in their treatment of NYHA Class III heart failure patients who have been hospitalized for heart failure in the previous year. The system consists of three parts: a small permanent sensor implanted in the pulmonary artery, a catheter-based delivery system, and a system that acquires and processes PA pressure measurements from the implanted monitor and transfers the data to a secure database. … Click here to read the entire post on ...
Source: CardioBrief - May 28, 2014 Category: Cardiology Authors: Larry Husten Tags: Heart Failure People, Places & Events Policy & Ethics CardioMems FDA remote monitoring st jude medical Source Type: blogs

Upstream Problems
He had been through this before. The patient, a 57-year-old man, had come through the doors of this emergency department many times. He had a favorite seat in triage. He knew what questions the nurse would ask him once he was in a room, and that the doctor would repeat those same questions. Then tests and labs, then moved upstairs for a couple of days before going home, hopefully feeling better. He knew all of this. Today, though, everything he thought he knew was wrong. He had once considered himself lucky. He even survived a gunshot to the chest as a young man. But that notion had faded long ago. His health had been gett...
Source: Spontaneous Circulation - May 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Upstream Problems
He had been through this before. The patient, a 57-year-old man, had come through the doors of this emergency department many times. He had a favorite seat in triage. He knew what questions the nurse would ask him once he was in a room, and that the doctor would repeat those same questions. Then tests and labs, then moved upstairs for a couple of days before going home, hopefully feeling better. He knew all of this. Today, though, everything he thought he knew was wrong. He had once considered himself lucky. He even survived a gunshot to the chest as a young man. But that notion had faded long ago. His health had been get...
Source: Spontaneous Circulation - May 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A 16 year old girl has syncope while playing basketball.....
A 16 yo Female with no previous medical history had a syncopal event while playing basketball. She arrived to the ED in severe respiratory distress, awake but agitated. She was tachypneic in the 40s-50s. She was intubated shortly after arrival, and had an ECG recorded: Sinus tachycardia with massive ST elevation in I, aVL, V5 and V6, with extreme ST depression in V3 and V4, and reciprocal ST depression in II, III, aVF. This is diagnostic of a very acute posterolateral STEMI.The ECG was briefly inspected by a pediatric emergency physician unaccustomed to diagnosing acute MI. He did not ...
Source: Dr. Smith's ECG Blog - May 6, 2014 Category: Cardiology Authors: Steve Smith Source Type: blogs

A Constricting Diagnosis
The heart, vasculature, and blood (pump, pipes, and fluid) work together to meet the metabolic demands of the body. End organs and tissue are not adequately perfused when the system fails, leading to injury and deranged physiology. Understanding the hemodynamic relations in normal cardiovascular physiology and how it changes in pathologic conditions helps us make the correct diagnosis and implement the right treatment. Physical examination can provide indirect clues to hemodynamics, though invasive evaluation has been the traditional gold standard. This can include arterial and central venous pressure measurements, ca...
Source: Spontaneous Circulation - December 12, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A Constricting Diagnosis
The heart, vasculature, and blood (pump, pipes, and fluid) work together to meet the metabolic demands of the body. End organs and tissue are not adequately perfused when the system fails, leading to injury and deranged physiology. Understanding the hemodynamic relations in normal cardiovascular physiology and how it changes in pathologic conditions helps us make the correct diagnosis and implement the right treatment. Physical examination can provide indirect clues to hemodynamics, though invasive evaluation has been the traditional gold standard. This can include arterial and central venous pressure measurements, card...
Source: Spontaneous Circulation - December 12, 2013 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care. Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!). These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs

Bedside pulmonary artery pressure monitoring
Catheter used for bedside pulmonary artery pressure monitoring is: a) Foley’s catheter b) Swan-Ganz catheter c) Pigtail catheter d) Cournand catheter Correct answer: b) Swan-Ganz catheter Swan-Ganz catheter is a balloon floatation catheter with an inflatable balloon near the tip. It can be introduced without fluroscopy, through a central venous puncture. Once the catheter is in the right atrium (as assessed by atrial pattern of the pressure tracing from the catheter tip), the balloon is inflated. It is directed by the flow of blood into the right ventricle and to the pulmonary artery. (Source: Cardiophile MD)
Source: Cardiophile MD - September 1, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Common sense as an Interventional Tool : A case of CTO of Left Pulmonary artery !
A 25 year man , hotel manager who had a documented DVT , since 2011 was on tablet warfarin . He discontinued the drug by sheer miscommunication as he was told he should stop the drug beyond INR 3 by his general practitioner.He stopped it permanently instead of titrating the dose of warfain .Six months later he landed in August 2013 with an episode of minor hemoptysis . Clincally he was normal .His lower limbs were fine. He was investigated and his image file showed . Living with one lung He is comfortable with one lung function (Akin to Pneumonectomy ) His saturation was 100 % at room air Pulse -80/...
Source: Dr.S.Venkatesan MD - August 30, 2013 Category: Cardiology Authors: dr s venkatesan Tags: acute pulmonary embolism chronic pulmoanry embolism cto of pulmonary artery deep vein thrombosis ivc filter pulmonary angiogram Source Type: blogs

Changing the culture of American Medicine — Start by removing hubris
This may be the most important post I have ever published. I’m going to tell you about a study that should change the entire way doctors approach patients, and how patients should think of prescribed treatments. These findings should begin a culture change in American medicine. Background: I used to think Medicine would get easier over time. It makes sense, right? You see patterns, you learn how treatments work, and you just get to know stuff. Experience should make it easier to diagnose and treat. That’s not been the case for me. In fact, it’s closer to the opposite. In the exam room, as I look up to the patient fro...
Source: Dr John M - July 28, 2013 Category: Cardiology Authors: Dr John Source Type: blogs