Difference between pulsed wave and continuous wave Doppler
In pulsed wave Doppler, same piezoelectric crystal is used to transmit and receive the echo from the sample volume. Hence the signals are sent out in pulses and the intervals between the pulses are used to receive the echoes. In continuous wave Doppler, one piezoelectric crystal transmits continuously and another one receives continuously. As the transmission and reception are continuous, it is not possible to find out the depth from which the return signals are received. At the same time continuous wave Doppler can analyze higher velocities while pulsed wave Doppler can analyze only lower velocities.
In case of pulsed Dop...
Source: Cardiophile MD - April 22, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the Cyanotic Congenital Heart Diseases With Decreased Pulmonary Blood Flow?
Tetralogy of Fallot
TOF with pulmonary atresia
Pulmonary atresia with intact interventricular septum
Tricuspid atresia
Double outlet right ventricle
Transposition of great arteries with ventricular septal defect and pulmonary stenosis
Ebstein’s anomaly of tricuspid valve
In DORV and tricuspid atresia, there are also variants with increased pulmonary blood flow, in the absence of associated pulmonary stenosis. (Source: Cardiophile MD)
Source: Cardiophile MD - April 18, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the acyanotic congenital heart diseases with left to right shunt lesions?
Atrial septal defect – Ostium Primum, Ostium Secundum, Sinus Venosus
Partial anomalous pulmonary venous return
Atrioventricular septal defect
Ventricular septal defect – inlet, outlet, perimembranous, muscular
Patent ductus arteriosus
Aortopulmonary window
Coronary artery fistula draining to right heart
Ruptured sinus of Valsalva aneurysm to right heart (Source: Cardiophile MD)
Source: Cardiophile MD - April 17, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Surgical Treatment of Tetralogy of Fallot and Sequelae
Transcript of video: Tetralogy of Fallot is one of the commonest cyanotic congenital heart diseases. As the name implies, there are four defects. One is ventricular septal defect, second is overriding aorta, third is pulmonary stenosis, usually right ventricular outflow tract stenosis and associated right ventricular hypertrophy. Overriding aorta with ventricular septal defect causes right to left shunt and cyanosis so that in infancy, cyanotic spells may also be there and squatting is one of the important symptoms of tetralogy of Fallot. There are several surgical options for tetralogy of Fallot and also some sequelae for...
Source: Cardiophile MD - March 29, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important Complications of Eisenmenger Syndrome
Transcript of the video: Eisenmenger syndrome is an important complication of large left to right shunts which develop later due to development of pulmonary vascular obstructive disease and severe pulmonary hypertension. The first report of Eisenmenger was by Victor Eisenmenger in 1897 and that was in a thirty year old person who later succumbed to massive hemoptysis. This highlights one of the most important complications of Eisenmenger syndrome, that is airway hemorrhage. Airway hemorrhage can occur in those who ascend to high altitude and during air travel. But it commonly occurs at low level itself. It is one of the mo...
Source: Cardiophile MD - March 26, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Single Frame Echo Quiz
Transcript of the video: Interpreting an echo quiz just from a single frame has a lot of limitations. But, still for an academic exercise, we will try. Unlike the ECG, where a single image may be more informative, echo usually requires moving images. And moreover, even ECG requires a knowledge of the clinical background before interpretation, to avoid errors. Similarly, for echocardiogram, what we would do usually is, first we do a clinical history evaluation, then physical examination, and after that only we proceed with echocardiography in our routine work. But for an academic curiosity, we will just try to interpret an...
Source: Cardiophile MD - March 18, 2024 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Collection of a few ECGs in congenital heart diseases
Classical QRS pattern in ASD is the rSR’ in V1 suggestive incomplete RBBB. This pattern in ASD is due to RV volume overload. QRS axis is usually rightward, more so when there is severe PAH. Left axis deviation is feature of ostium primum ASD. First degree AV block may be noted in both primum and secundum ASD. Familial ASD with first degree AV block has been reported in secundum ASD. This type of familial ASD has an autosomal dominant inheritance pattern. There is also a higher incidence of SCD in this group.
IRBBB pattern in ASD
Crochetage sign in ASD, manifest as notching of R wave near the apex in inferior leads (a...
Source: Cardiophile MD - February 14, 2024 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology ECG Library 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
A young patient with diminishing pain with a subtle but diagnostic ECG.
Written by Emre Aslanger(Emre is our newest editor. He is an interventionalist in Turkey and one of 3 originators of the OMI/NOMI paradigm, along with Pendell and Smith. Here are his publications.)CaseA 39-year-old male without prior medical history presents with chest pain that started 2 hours prior to presentation. He says that the pain intensity was 10/10 at home but now about 4/10. His medical exam is unremarkable. He has no cardiovascular risk factors except smoking for 10 pack-years. He denies any illicit drug use. His ECG is shown below. What do you think ?Although not striking, this is clearly a dia...
Source: Dr. Smith's ECG Blog - December 18, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs
ECG Quiz with Discussion Katz-Wachtel phenomenon
Discussion Katz-Wachtel phenomenon
What does this ECG show?
This ECG shows Katz-Wachtel phenomenon with large biphasic QRS complexes in mid precordial leads. It is typically seen in infants with large ventricular septal defect and biventricular hypertrophy. In addition, there is sinus tachycardia and right axis deviation which are common in an infant. (Source: Cardiophile MD)
Source: Cardiophile MD - December 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
ECG Quiz with Discussion
Discussion
What does this ECG show?
This ECG shows Katz-Wachtel phenomenon with large biphasic QRS complexes in mid precordial leads. It is typically seen in infants with large ventricular septal defect and biventricular hypertrophy. In addition, there is sinus tachycardia and right axis deviation which are common in an infant. (Source: Cardiophile MD)
Source: Cardiophile MD - December 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
In which of the three Eisenmenger syndromes is cardiomegaly unlikely?
In ventricular septal defect with Eisenmenger syndrome, cardiomegaly is unlikely. Though there will be cardiomegaly initially when there is a large left to right shunt, cardiac size regresses when left to right shunt decreases as pulmonary hypertension develops. Pulmonary arteries become prominent. Aorta is not prominent in VSD Eisenmenger. In patent ductus arteriosus with Eisenmenger syndrome, ascending aorta is prominent. Cardiac size comes down in PDA with large left to right shunt when pulmonary hypertension develops.
In atrial septal defect, cardiomegaly is mainly due to the enlarged right atrium. Pulmonary arteries ...
Source: Cardiophile MD - December 1, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What causes a prominent a wave in jugular venous pulse?
Prominent a wave occurs when the right atrial contraction is more forceful due to increased resistance to right atrial emptying. This occurs in right ventricular hypertrophy, pulmonary hypertension, and tricuspid stenosis. In pulmonary stenosis with right ventricular hypertrophy, prominent a wave would suggest intact interventricular septum. Prominent a wave will be absent in the presence of associated unrestrictive ventricular septal defect. This is because an unrestrictive VSD prevents right ventricular pressure from rising to suprasystemic levels. Prominent a wave can be associated with a presystolic hepatic pulsation....
Source: Cardiophile MD - November 5, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the mechanical complications of acute myocardial infarction?
Typical mechanical complications of acute myocardial infarction are rupture of papillary muscle, rupture of interventricular septum and rupture of left ventricular free wall. Mechanical complications are more life threatening and seldom respond to medical management. They need early high risk surgery. Rupture of papillary muscle causes severe acute mitral regurgitation and pulmonary edema. Rupture of interventricular septum produces an acquired ventricular septal defect and leads to severe heart failure. Rupture of ventricular free wall causes hemopericardium and cardiac tamponade. (Source: Cardiophile MD)
Source: Cardiophile MD - November 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Heart disease in pregnancy? Cardiology Basics
Changes in blood circulation during pregnancy and labour can adversely affect many of the significant heart diseases. Increase in blood volume and heart rate are the important factors during pregnancy. Increase in blood volume is needed to give enough nutrients and oxygen to the growing baby. Nutrients and oxygen are transferred to the baby through the placenta during pregnancy, though there is no actual mixing of the blood of the baby and mother. In general, obstructive lesions and complex cyanotic congenital heart diseases have high risk in pregnancy.
Obstructive lesions like severe aortic stenosis and mitral stenosis a...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
