Posted in cardiology -Therapeutics, tagged ACE INHIBITORS, Add new tag, ARBS, cardiology, drsvenkatesan, drug trials, drugs, ebm, emprical medicine, ethics, evidence based cariology, futile medicine, jama, lancet, medical auditing, nejm, ONTARGET, pharma industry, TELMISARTAN on July 27, 2008 | 2 Comments »
Peer review of an article even in major journals never scrutinise the “Aim of a study ” . However big is the journal, they seem to bother only about the authors, materials, methods, and statistical analysis. If only they peer review an article , right from the “Aim of the study” like ,
Who asks the research [...]
Posted in Infrequently asked questions in cardiology (iFAQs), Uncategorized, tagged drsvenkatesan, cardiology, pulmonary atherosclerosis, pulmonary hypertension, statins, atherosclerosis on July 26, 2008 | 1 Comment »
Atherosclerosis is the number one killer of mankind .It involves all medium and large sized blood vessels.Any intima and media can be invaded by the disese process.Most common to involve are cerebral, carotid, coronary, aortic and it’s branches, renal, and peripheral arteries. But how pulmonary artery is missing in this list ? Is it really [...]
Posted in Cardiology - Clinical, cardiology -Therapeutics, cardiology- coronary care, tagged acs, cardiogenic shock, cardiology, drsvenkatesan, heart, myocardial infarction, stemi, ventricle on July 19, 2008 | Leave a Comment »
CCU’S can also save patients with cardiogenic shock
Many of us would say ” never” or some may say “rarely” but in reality the answer is “yes it can ” slightly lower than Primary PCI . One could save atleast few lives every month by intensive medical management alone (Inotrope, vasodilator,pacing if needed ) in any coronary care unit.
So the message [...]
Posted in Cardiology - Clinical, Infrequently asked questions in cardiology (iFAQs), tagged angina equivalent, atypical chest pain, cardiac neuralgia, cardiac plexus, chest pain, drsvenkatesa, neuralgia, post cabg, syndrome x on July 19, 2008 | Leave a Comment »
Are we missing an entity called Primary cardiac neuralgia ?
Unexplained chestpain even after elaborate investigation is a very common clinical cardiac problem. Cardiac neural plexus has a complex network with mainly autonomic network ,with somatic projections. Neural dysfunction could occur in any organ which has rich neural network.Diabetes is the classical example of cardiac autonomic [...]
Posted in Cardiology -Interventional -PCI, tagged acs, aorta, cardiology, cath lab, chest pain, coronary, dissection, drsvenkatesan, heart, madras medical college, nstemi, pci, stemi on July 19, 2008 | Leave a Comment »
Thousands of dissections happen in cath labs all over the world every day very rarely it is painful . the answer is not clear. Both have rich vasa nervorum. Aortic dissection involves media and smooth muscle . Coronary dissection may also be a equally painful , probably we are not recognising it ! or we [...]
Posted in cardiology- coronary care, tagged acs, chest pain, coronary plaque, dissection, drsvenkatesan, interventional cardiology, nstemi, stemi on July 19, 2008 | Leave a Comment »
Plaque fissure ,rupture and subsequent thrombois is the hallmark of acute coronary syndrome . Are these events painful ? We always attribute any chest pain in an ACS patient to ischemia of myocardium.Is that always true? Coronary artery also has a rich vasa nervorum that could be activated by plaque disruption.
Why we need an answer [...]
Posted in cardiology -Therapeutics, tagged acute pulmonary embolism, drsvenkatesan, pulmonary infarction, stemi, thrombolysis, time window on July 15, 2008 | Leave a Comment »
Salvaging lung tissue is not the aim in pulmonary embolism , Hence Time window is a myth !
There is a time window for thrombolysis in myocardial infarction ( STEMI). This time window is to salvage myocardium before it dies.The average time window in STEMI is 12 hours. When does the lung start dying [...]
Posted in cardiology -congenital heart disease, tagged asd, drsvenkatesan, left to right shunt on July 15, 2008 | Leave a Comment »
Atrial septal defect is one of the common congenital heart disese. Surgical correction or device closure is indicated in all patients with significant shunts. Statistically for every ASD diagnosed with more than 2:1 shunt there must be is atleast three pateints with ASD with less than 2:1 shunt in general population. Do we diagnose it ? . [...]
Posted in cardiology-Anatomy, tagged anatomy, cardiac failure, cardiology, collage, drsvenkatesan, fibroblasts, heart, LV mass, myocardium on July 2, 2008 | Leave a Comment »
Heart is a muscular pump .But it contains more of non muscular cells than contractile cells.
The average human heart which weighs 300 -400 grams . Contrary to the popular perception heart is not purely a muscular organ. In fact myocytes constitutes only 30% of heart mass. Rest formed by
1.Fibroblasts
2.Endothelial cells
3.Purkinje cells
4.Interstitial cells
5.Collagen
6.Fibrous skeleton
7.Extracellualr matrix.
Why is this [...]
Posted in Cardiology - Clinical, Infrequently asked questions in cardiology (iFAQs), Tutorial in clinical cardiology, tagged angina, angiogram, cardiology, coronary, drsvenkatesan, Heberdens, LAD, nstemi, RCA, STMI on July 2, 2008 | Leave a Comment »
How is LAD angina differnt from RCA angina ?
Can we localise the “Angina related artery “ from the the type of chest pain ?
Patients with stable angia many times have multivessel CAD. There has been some correlation with radiation of anginal pain and the culprit artery.If the angina spreads to jaw or neck it is [...]
