Syncope by definition is a transient loss of consciousness due to cerebral hypo perfusion and loss of muscular tone, and the patient falls but recovers fully and gets up either assisted or spontaneous.The cardiac and vascular counter response to syncope is most often intact .This makes syncope characteristically transient . If a patient does not recover [...]
Archive for September, 2008
Why syncope is rarely fatal ?
Posted in Cardiology - Clinical, Infrequently asked questions in cardiology (iFAQs), Uncategorized, tagged bmj, cardiac arrest, cardiology, cardiology lancet, drsvenkatesan, epilepsy, head up tilt test, holter, hut, hypoglycemia, jama, loop recorder, loss of consiouness, nejm, neuro cardiogenic syncope, stroke, sudden cardiac death, syncope, vaso vagal syncope, ventricular tachycardia on September 30, 2008 | Leave a Comment »
Dr.S.Venkatesan.MD.DM(Cardiology)
Posted in dr s venkatesan -Personal, tagged Add new tag, madras medical college, mayo clinic, cardiologist, india, chennai, escorts, interventional, assistant professor, tamil nadu, anna nagar, sangareddi, ucla, cleaveland clinic, TAS Narmada enclave, shanthi colony, aiims, indian on September 28, 2008 | Leave a Comment »
Dr. Venkatesan Sangareddi
AK 53/1, # 9
Narmada enclave
7th main road
Anna nagar
Chennai -600 040
Tel:044 26209009
Age & Date of birth
42 , 25-5 -1964
Experience
1998–2007 Madras medical college Madras
Asst. Professor Of Cardiology
Work involves intensive coronary care, invasive and non invasive cardiology. Has special interest in clinical research in Acute Coronary Syndromes
Has publications in various Journals.
1997-1998 Madras [...]
Is there an antomical continuity between pleural space and pericardial space ?
Posted in Cardiology - Clinical, Infrequently asked questions in cardiology (iFAQs), tagged anatomy of pleura, cardiology, chest, drsvenkatesan, pericardial effusion, pleural effusion, pleuro pericardial rub, pleuropericardial effusion, polyserositis, sle, thorax on September 28, 2008 | 1 Comment »
The pleura and pericardium are very close anatomical companions within the thorax. Both contain minimal levels of physiological fluid. It is quiet common to find combined pleural and pericardial effusion. While the commonest explanation for combination of pleural and pericardial effusion is inflammation of both in systemic disorders like polyserositis or malignancy . In [...]
What is the mechanism of pericardial rub ?
Posted in Cardiology - Clinical, Tutorial in clinical cardiology, tagged auscultation, bmj, clinical cardiology, drsvenkatesan, epicardium, lancet, parietal pericardium, pericardial effusion, pericardial rub, pericarditis, spodick, to and fro murmur, venkatesan sangareddi, visceral pericardium on September 28, 2008 | 2 Comments »
Heart is externally covered by two layers of pericardium . Pericardial space is formed between parietal and visceral layers of pericardium . It is a narrow space which is normally lubricated with pericardial fluid up to 25ml. When these two tissue surfaces come into contact , pathological rub takes place.It is heard whenever the pericardium is [...]
What is no reflow ? What is the mechanism of no reflow ?
Posted in Cardiology -Interventional -PCI, Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged acs, cath lab, ccu, complications in cath lab, distal protection device, drsvenkatesan. cardiology, epicardial myocardial dissciation, europcr, export catheter, failed primary pci, failed thrombolysis, jacc, lancet, medtronic export, micro vascular plugging, myocardial edema, nicorandil, no reflow, nstemi, pci, primary angioplasty, primary pci, scai, slow flow, stemi, tct md, thrombus aspiration, timi 3 flow on September 24, 2008 | Leave a Comment »
No reflow is the terminology used primarily in cath labs where, even after a successful opening and stenting of a coronary artery the coronary blood flow is not restored to myocardium . The point to be emphazised here is blood do cross successfully the site of the obstruction but fails to enter the muscle segment to [...]
Why thrombolysis rarely fails in right coronary artery ?
Posted in Cardiology -Interventional -PCI, Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged acs, acute myocardial infarction, angiogram, bmj, cardiology, ccu, circulation, coronary, coronary circulation, failed thrombolysis, lancet, left anterior descending, nejm, nstemi, persistent st elevation, stemi, streptokinase, successful thrombolysis, thrombolysis, tissue plasminogen activator, tpa on September 22, 2008 | Leave a Comment »
Differential response of thrombolysis between left and right coronary system
Thrombolysis is the specific treatment for acute myocardial infarction. ( Privileged few , get primary PCI))
Failed thrombolysis occurs in significant number of patients ( 30-40%).
Persistent ST elevation 120 minutes after thrombolysis is best indicator of failed thrombolysis.
It has been a consistent observation failed thromolysis almost always [...]
What is myocardial ventricular tachycardia ? and non myocardial ventricular tachycardia?
Posted in Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged acs, amiodarone, bundle branch reentry, jacc. drsvenkatesan, journal of electrophysiology, myocardial ventricualr tacycardia, nejm. lancet, stemi, ventricualr tachycardia, wellens, zipes on September 21, 2008 | Leave a Comment »
The cell of origin of ventricular tachycardia is rarely discussed at bedside. It is still in research labs !
Ventricles are not made up off entirely myocytes. Apart from myocytes it contains specialised purkinje cells , fibrocytes, interstitial cells and some times primitive mesenchymal cells. Ventricular tachycardia can arise either in purkinje cells, the myocytes or even the [...]
In which tachycardias electrical cardioversion is ineffective or rather contraindicated ?
Posted in Cardiology - Clinical, Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged atrial fibrillation, binphasic shocks, bmj, cardiology, cardioversion, ccu, coronary, dc shock, digoxin, heart rhythm, jama, lancet, nejm, pace, svt, ventricular arrhythmias, ventricular tachycardia on September 20, 2008 | 1 Comment »
Cardioversion with DC shock offers immediate cure in many of the dangerous ventricular and atrial tachycardias. It is often taught , any hemodynamically unstable tachycardia refractory to medical therapy respond to electrical cardioversion. One should also remember electricity is in fact be called as a drug ! and it should be delivered in proper form and dose. [...]
What will happen if you accidentally thromobolyse early repolarisation syndrome ?
Posted in Infrequently asked questions in cardiology (iFAQs), cardiology- coronary care, tagged drsvenkatesan, stemi, cardiology, thrombolysis, chest pain, nejm, bmj, streptokinase, emergency room, jama, early repolarisation syndrome, ers, coronary care, ccu, medical error, legal medicine, acc.aha, american college of cardioogy, acc stemi guidelines, brugada syndrome on September 19, 2008 | Leave a Comment »
Indication for thrombolysis in ST elevation MI is mainly determined by clinical and ECG features. ST elevation of more than 1mm in two consecutive leads with a clinical suspicion of acute coronary event demands immediate thrombolysis.
Early repolarisation syndrome(ERS) is a is typical mimicker of STEMI . In ERS , ST segment elevation occurs in many leads [...]
What is the difference between left ventricular pressure curve and right ventricular pressure curve ?
Posted in Hemodynamics, Tutorial in clinical cardiology, tagged aortic pressure, cardiology, cath lab, drsvenkatesan, hang out interval, Hemodynamics, left ventricle, pressure curve, pressure tracing, pulmonary artery, right ventricle on September 18, 2008 | Leave a Comment »
The pressure tracing between two chambers of the heart are distinctly different .
Apart from the magnitude of the pressure ,(LV at systemic pressure ) The morphology also changes.
RV pressure curve is triangular in shape,
Upstroke is not rapid , (Low dp/dt)
There is no sustained peak ,
There is an early fall and
The pressure falls to zero which [...]
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