VT? Or Supraventricular tachycardic rhythm with aberrancy?
A 70 something male presented in severe respiratory distress.The patient had altered mental status and so he was prepared for intubation. Before intubation, he became hypotensive.On the monitor patient had wide-complex tachycardia. The following 12-lead was obtained:What do you think?Differential is ventricular tachycardia versus supraventricular tachycardia with aberrancy versus sinus tachycardia with a aberrancy. There are possible P waves in lead II. But these could be an extension of the QRS, so sinus tach is not certain. Certainty could come with the use of Lewis leads. Much easi...
Source: Dr. Smith's ECG Blog - October 21, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
“ Low quality ” Interventions in “ high quality ” cath labs
Recently, I visited a seven-star cardiology center. It had a fascinating lab with a near-360-degree roaming arm and floor (even the roof, I think!). The lab also had provision for optional thoracotomy support by surgeons and a CT scan. What’s more, I was told that an adorable robot will soon be added to the cath lab workforce to assist in delivering and maneuvering catheters. It’s truly amazing to see the advancements in science!
I asked the chief staff nurse how many procedures are being performed per day. She pulled out an Excel chart from a gesture-controlled touch panel. It was clocking about 20 to 25 ca...
Source: Dr.S.Venkatesan MD - October 20, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized comparative efficacy trials cost effectiveness in medicine ethics in medicine EVO;LUTE PRO SAPIENS XT health economics HYBRID CATH LAB TAVR TAVI VALVE IN VALVE Source Type: blogs
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
Fight Aging! Newsletter, January 16th 2023
Conclusions
Implanted Hair Follicle Cells Produce Remodeling of Scar Tissue
Assessment of Somatic Mosaicism as a Biomarker of Aging
The Gut Microbiome of Centenarians
https://www.fightaging.org/archives/2023/01/the-gut-microbiome-of-centenarians/
The state of the gut microbiome is arguably as influential on health as exercise. Various microbial species present in the gut produce beneficial metabolites, such as butyrate, or harmful metabolites, such as isoamylamine, or can provoke chronic inflammation in a variety of ways. An individual can have a better or worse microbiome, assessing these and other...
Source: Fight Aging! - January 15, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Commentary on More Drastic Scenarios of Partial Brain and Full Body Replacement
Is outright replacement of tissues a viable option for the treatment of aging? There are factions within the longevity-interested community who think that the paths to either (a) engineering replacement brain tissue for parts of the brain not involved in memory, or (b) transplantation of an old head onto a young body or brain into a young body, are short enough to be worth pursuing, where "short enough" means a few decades of work given sufficient funding. To my mind, major surgery of the sort implied by replacement of large sections of tissue or entire organs is something to be avoided in later life, given the risks and c...
Source: Fight Aging! - January 10, 2023 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
December 2022: Something's Missing
"Can I get a turkey sandwich?"I heard this exchange between a patient and a nurse. It's not an unusual request for patients experiencing homelessness. But this patient's chief symptom was that he couldn't eat. Something must be missing here.The patient confirmed to me that he wanted a turkey sandwich and that he had been losing weight because he couldn't eat. His loose pants requiring a new hole for his belt supported his words. Looking closer, I could see a left thoracotomy scar. He told me he had gotten it on his last hospitalization, but he had no idea why. Something was definitely missing here.Reviewing hi...
Source: Lions and Tigers and Bears - November 30, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
What is TAVI? Cardiology Basics
TAVI is short form for transcatheter aortic valve implantation. It is also called TAVR (transcatheter aortic valve replacement). Surgical aortic valve replacement (SAVR) was the only option in symptomatic severe aortic stenosis earlier. Now we have the option of implanting a valve without surgery, using artificial valves mounted on balloon catheters. Approaches to TAVI can be transapical, through the left ventricular apex, transfemoral, through the femoral artery or transcarotid, through the carotid artery.
Transcatheter aortic valve implantation (TAVI)
When TAVI was initially introduced, it was done only for those at ver...
Source: Cardiophile MD - October 22, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Transcatheter Edge-to-Edge Repair (TEER) of Mitral Valve
Transcatheter Edge-to-Edge Repair (TEER) of the mitral valve is done for treatment of mitral regurgitation [1]. Anterior and posterior leaflets of mitral valve are approximated using a clipping device and is similar to the corresponding surgical procedure known as Alfieri stitch [2].
Earlier porcine study had used left thoracotomy for placing the flexible delivery catheter with a clip in the left atrium. The clip grasped and approximated the mid portion of the anterior and posterior mitral leaflets with echocardiographic and fluoroscopic guidance. Clip was detached from the system and the catheter withdrawn after confirma...
Source: Cardiophile MD - September 27, 2022 Category: Cardiology Authors: Johnson Francis Tags: Angiography and Interventions Structural Heart Disease Interventions Source Type: blogs
Inspection of precordium
Precordial examination starts with inspection, though inspection and palpation are often combined in regular practice. Some of the features to look for are:
Sternal deformities: Pectus excavatum is concavity of the sternum, and is the commonest congenital malformation of the chest wall which may be associated with congenital heart diseases like ventricular septal defect. Pectus carinatum is sternal prominence, also known as pigeon chest, which can occur in congenital heart disease with large left to right shunts in infancy.
Visible pulsations: Suprasternal pulsations can be seen in aortic aneurysm and aortic regurgitatio...
Source: Cardiophile MD - September 23, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: HBC Source Type: blogs
Cardiovalve Wins FDA Breakthrough Device Designation for Transcatheter Tricuspid Valve Replacement System
Cardiovalve announced that it received FDA Breakthrough Device Designation for its Transcatheter Tricuspid Valve Replacement System. The company also received approval for an Early Feasibility Study of the device for tricuspid and mitral valve regurgitation indications.
The Cardiovalve transcatheter system is designed for treatment
of mitral and tricuspid regurgitation by replacement of the native valves via a
transfemoral approach. Using a transfemoral procedure allows surgeons to offer a
minimally-invasive alternative to open heart surgery or transapical delivery
with mini-thoracotomy access.
The Cardiovalve ...
Source: Medgadget - March 4, 2020 Category: Medical Devices Authors: Cici Zhou Tags: Anesthesiology Cardiac Surgery Cardiology Radiology Source Type: blogs
Nanocomposite Heart Valve to Replace Animal-Derived Devices
Researchers at the University of British Columbia (UBC) have developed a nanocomposite biomaterial heart valve that could provide an alternative to the animal valves that are currently used as heart valve replacements. Moreover, the nanocomposite valves can be delivered to the heart through a transcatheter, allowing for minimally invasive placement. The new valve is aimed at high-risk patients.
“Existing transcatheter heart valves are made of animal tissues, most often the pericardium membrane from a cow’s heart, and have had only moderate success to date,” explains Hadi Mohammadi, a researcher involved in the study....
Source: Medgadget - March 27, 2019 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Materials Nanomedicine Source Type: blogs
An image that reminds us what life versus death looks like
This is what life versus death looks like. This is what medicine verses mortality looks like. This is what science verses humanity looks like. After a thoracotomy, a fellow ER doctor Dr. Mitch Li snapped this picture of the spilled blood and Propofol on the trauma bay floor. Blood courses through every on e of our veins to sustain life. Propofol courses through […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - March 24, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/amy-ho" rel="tag" > Amy Faith Ho, MD < /a > < /span > Tags: Physician Emergency Medicine Source Type: blogs
Medtronic ’s HVAD Heart Pump FDA Approved for Less Invasive Implantation
Medtronic’s HVAD System, a left ventricular assist device, can now be implanted via a thoracotomy, a less invasive procedure than a median sternotomy. Moreover, a thoracotomy means that future procedures that may require access through the chest can still be performed in what are already risky patients.
The HVAD System is indicated for those with advanced, refractory heart failure, both as a bridge to a heart transplant and as a final therapy if a transplant is not an option.
Some details about what led to this news:
FDA approval for HVAD implantation via thoracotomy is based on data from the LATERAL prospective ...
Source: Medgadget - July 12, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Source Type: blogs
Retiring early from medicine: Is it ethical?
Eight weeks after I delivered my third child, I was diagnosed with a four-centimeter lung mass. Yes, you heard that right. For those in medicine, this is terrifying to hear as the first thing that comes to mind is lung cancer. Lung cancer is notoriously hard to treat, typically fatal with a short life expectancy after diagnosis and extremely unfair to a lifelong nonsmoker who has spent 12 years in the prime of her life dedicated to training to become a physician.
Luckily, I soon found out my situation was not as grave as first expected. A PET scan leaned toward benign diagnosis (or at least consolidated disease). I could t...
Source: Kevin, M.D. - Medical Weblog - January 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/valerie-a-jones" rel="tag" > Valerie A. Jones, MD < /a > Tags: Physician Oncology/Hematology Pulmonology Source Type: blogs
The AAJT: Simplicity in the Face of Adversity
There is a saying, "Complexity in the face of adversity breeds chaos." I'm not sure where this maxim originated, but it is definitely true in resuscitation settings. That's the crux of this post: Is the abdominal tourniquet simplicity in the face of adversity compared with the resuscitative endovascular balloon occlusion of the aorta (REBOA)?We all know how futile it feels to do CPR on a traumatic cardiac arrest patient with suspected massive blood loss. Just what are we pumping, and if there is any remaining intravascular blood, where are we pumping it?I will never forget the pain of trying to resuscit...
Source: M2E Too! Mellick's Multimedia EduBlog - December 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
