Rheumatic heart disease – Cardiology Basics
Rheumatic heart disease – Cardiology Basics
Rheumatic heart disease is a group diseases which occur secondary to heart valve damage from rheumatic fever. Rheumatic fever is a disease in which antibodies produced by the body against streptococci cross react with different tissues in the body, especially the heart.
Group A beta hemolytic streptococci causing sore throat are involved in the pathogenesis of rheumatic fever. Most of the long term damage following rheumatic fever is caused by damage to heart valves . Initial manifestation of rheumatic fever is with polyarthritis, usually of the large joints.
But it does no...
Source: Cardiophile MD - October 22, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How are stroke and heart disease related? Cardiology Basics
Ischemic stroke is often due to sudden obstruction to a cerebral artery which usually results in paralysis. Hemorrhage stroke is due a bleed from a cerebral vessel and deemed to be more dangerous than ischemic stroke.
Stroke and heart disease are linked together in various ways. In general, risk factors for stroke and ischemic heart disease are similar. Ischemic strokes can sometimes occur simultaneously with an acute myocardial infarction.
Stroke can occur after a myocardial infarction as well. Myocardial infarction can cause damage to a region of endocardium over the infarct. This region can be a nidus for the formation...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How is pulmonary embolism treated? Cardiology Basics
Pulmonary embolism is obstruction of pulmonary arteries due to emboli migrating from other parts of the body. It is a potentially life threatening condition if a major branch or multiple branches are obstructed. More emboli can travel to the lungs from the original source and hence pulmonary embolism may worsen later even if the initial episode involves only a small portion of the lungs. So, it is important to treat pulmonary embolism even if it is mild. Treatment options will depend on the severity of the situation.
Initial treatment will be with parenteral anticoagulants like heparin or low molecular weight heparin. Aft...
Source: Cardiophile MD - October 18, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How does stress cause heart disease? Cardiology Basics
Stress and heart disease have various aspects. Stress can lead to increase in risk factors for cardiovascular disease as well as precipitate symptoms in a hitherto silent cardiovascular disease. There is also a condition known as stress cardiomyopathy or broken heart syndrome, typically precipitated by an acute stressful event like loss of spouse in an elderly female.
Most older persons have build-up of atherosclerotic plaques in the coronary arteries. When there is a sudden severe stress, heart rate and blood pressure can shoot up due to sympathetic overactivity. There is also the release of stress hormones like adrenali...
Source: Cardiophile MD - October 16, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is thrombolytic therapy for myocardial infarction? Cardiology Basics
Thrombolytic therapy used to be an important mode of early treatment of acute myocardial infarction. Though it has been largely superseded by primary angioplasty, thrombolytic therapy may still be useful in certain situations. It is still an important form of treatment in resource limited locations.
Myocardial infarction is usually due to sudden occlusion of a coronary artery by thrombus formation on a pre-existing partial obstruction by an atherosclerotic plaque. Plaque rupture with local thrombus formation is the usual mechanism. Dissolving the thrombus soon after the occurrence of a myocardial infarction can salv...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is myocardial stunning and hibernation? Cardiology Basics
Just as you can get stunned for some time if hit on the head, part of the myocardium can also stop functioning following transient coronary obstruction. This usually occurs following a myocardial infarction after which the occluded coronary artery gets opened up spontaneously or by thrombolytic therapy or primary angioplasty.
After a variable period of time, the stunned myocardium usually recovers full function. During the period of stunning, if a large part of myocardium is involved, the person may have features of heart failure due to decreased left ventricular systolic function. Myocardial stunning is the reason for he...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the types of myocardial infarction? Cardiology Basics
World Heart Federation along with major European and North American Heart Societies have brought forth the universal definition of myocardial infarction. It has been revised the fourth time in 2018. In the latest revision myocardial infarction has been classified into 5 types, of which type 4 has three subtypes as well.
Type 1 is the type of myocardial infarction which all of us are familiar with. It occurs due to sudden occlusion of a coronary artery. This leads to chest pain and ECG changes. Myocardial damage can be noted on echocardiography as well as other imaging modalities like cardiac magnetic resonance imaging (CM...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A man in his 30s with cardiac arrest and STE on the post-ROSC ECG
Conclusions: outpatients with witnessed cardiac arrest and primary PEA carry a high probability of Massive Pulmonary Embolism________________Case Continued:" Initial ROSC EKG showed what appeared to be in atrial fibrillation with inferior ST elevations, depressions in aVL, concerning for STEMI. "He had multiple cardiac arrests with ROSC regained each time. " Endotracheal tube re-intubation was confirmed multiple times, bilateral breath sounds, yet O2 saturation remained in the 50s and 60s. I was able to visualize the ETT on initial intubation pass through the cords however given his continued hypoxemia, I felt it...
Source: Dr. Smith's ECG Blog - October 10, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Why do they call LAD a widow maker? Cardiology Basics
LAD is short form for left anterior descending coronary artery. LAD is usually the largest branch of the left main coronary artery which supplies the major portion of the left ventricle. It supplies major portion of the interventricular septum which mostly constitutes the anterior wall of the left ventricle as seen on echocardiography. Coronary angiogram still picture shows a total occlusion of LAD. Coronary angiograms are obtained by injecting radiocontrast medication into the coronary artery and obtaining continuous X-ray imaging in the cardiac catheterization laboratory.
Occlusion of proximal LAD before its first septa...
Source: Cardiophile MD - October 7, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is coronary calcium scoring? Cardiology Basics
Coronary calcium scoring is done from a plain multidetector computed tomography (CT) scan. MDCT produces images of coronary arteries in multiple thin slices. Calcium deposits in plaques within the coronary arteries can be found from these images. Calcium deposits occur within atherosclerotic lesions inside the coronary arteries. Some of these plaques can rupture later and lead to clot formation and total occlusion causing acute myocardial infarction.
Coronary calcium scoring can be done as an outpatient test from the X-ray department. As no contrast medium is injected, there is no risk of allergic reactions unlike CT coro...
Source: Cardiophile MD - October 6, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Interatrial septal device therapy in HFpEF
Interatrial septal device therapy in HFpEF
Effective therapeutic modalities for heart failure with preserved ejection fraction (HFpEF) are lesser than those available for heart failure with reduced ejection fraction (HFrEF). All the same, prevalence, morbidity and mortality for HFpEF are not lower than that of HFrEF. Ongoing search for therapeutic options has led to the development of interatrial septal devices to decompress the left atrium, which are still in investigational phase [1].
A unidirectional left-to-right interatrial shunting device was initially tested in patients with HFrEF as a safety and proof-of-principle...
Source: Cardiophile MD - October 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Chest pain one day after a negative stress test
Discussion Points:The patient ’s ECG transmitted to ED providers by EMS showed T waves that are easily confused with the peaked T waves of hyperkalemia. Sometimes hyperacute T waves have this slimmer, taller appearance, and it can be difficult to distinguish them in these cases. The new STE in anterior leads helps to understan d these as hyperacute. Also, other signs of hyperkalemia were absent, as there was no P wave flattening or QRS broadening, bradycardia, new AV blocks or NSIVCD, bizarre QRS morphology, or Brugada patterning. Additionally the clinical context was clearly ACS in this case, and if there were remaining...
Source: Dr. Smith's ECG Blog - October 3, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
hs-CRP as a risk assessment tool for cardiovascular disease
It is often mentioned that almost half of first cardiovascular events occur in individuals with no known risk factors. C-reactive protein (CRP) which is usually considered as an inflammatory marker, has emerged as an important cardiovascular risk marker as well. CRP is equivalent to LDL cholesterol (low density lipoprotein cholesterol) as a risk marker. Being an inflammatory marker, high CRP levels also indicate the possibility of plaque rupture leading to coronary thrombosis and myocardial infarction [1].
The current high sensitivity assays of CRP known in short as hs-CRP can also predict recurrent coronary events in tho...
Source: Cardiophile MD - September 25, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Implantable cardioverter defibrillator (ICD)
Implantable cardioverter defibrillator, known in short as ICD, is a device which monitors the heart rhythm continuously and treats it electrically when needed. As it functions automatically without the need for a bystander intervention as in automated external defibrillator or AED, it is also known as automatic implantable cardioverter defibrillator or AICD. When Michel Mirowski reported on a standby automatic defibrillator in 1970, it was met with a lot of skepticism [1]. But now ICD is a time tested life-saving equipment.
The most commonly implanted ICD is also called transvenous ICD because the leads are introduced thr...
Source: Cardiophile MD - September 19, 2022 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs
Weekly Overseas Health IT Links –17th September, 2022.
This study adds to the evidence showing that expanded access to these services could have a longer-term positive impact if continued.”Roughly 1 in 8 beneficiaries in the pandemic group received OUD-related telehealth services compared with 1 in 800 in the prepandemic group, the research revealed. Access to telehealth services was associated with better treatment retention and lower risk of medically treated overdose in the pandemic group compared to those not receiving telehealth services.-----https://healthimaging.com/topics/management/education-training/ai-deterring-students-pursuing-radiologyConcerns about the future ...
Source: Australian Health Information Technology - September 17, 2022 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
