Forgotten concepts and drugs in cardiology : Lignocaine for Ventricular tachycardia and fibrillation !

Lignocaine , probably has saved more lifes  world over  than any other cardiac drug .
It was the only choice for ventricular tachycardia  till 1990s, both in pre and post  thrombolytic era.Every coornary care unit has reverted tens of thousands of  unstable VTs with this simple and cheap intravenous drug.the utility value of lignocaine is not limited to [...]

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Can cannon waves occur within pulmonary veins during VPDs ? What is the significance of it ?

Cannon waves occur classically, during  ventricular ectopic beats .(Commonly irregular) regular cannon waves occur during Junctional tachycardias with 1:1 VA conduction
Cannon like wave may appear  in the jugular vein if the VPDs is timed in a such a fashion ,the atrial systole occurs with a closed AV ( Tricuspid and mitral valve ) so the [...]

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Why , stable angina is stable ?

Angina is classified in many ways .The most useful , clinical classification is stable and unstable angina . While  ,the former generally is considered   innocuous  the  later conveys a sinister  signal to the patient as well as  the physician. 
Why stable angina is  stable ?
In stable angina

The patient knows how the pain is going to behave by his past [...]

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Can mitral valve act as a safety valve in patients with dilated cardiomyopathy ?

                                    Competence of mitral valve is vital  for proper hemodynamics of  heart .A trivial mitral regurgitation ,is observed in nearly 10-20% of normal population detected by doppler echocardiograpgy .This is other wise clinically insignificant. In fact , it is expected  , the sonographers do not report this,  as it might increase the patient anxiety.
Can a mildly [...]

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Land mark papers in cardiology : What is the hidden link between esophagus and coronary artery ?

Gastric pain is a great mimicker of cardiac pain.
It may have , almost all the typical characters of angina . . . in some cases ECG changes too.
The confusion is complete ,  as esophageal pain can also  be relieved by sublingual nitrates !
The issue is further complicated, when  esophagus and coronary artery share  the same neural [...]

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Is septal branches of left anterior descending coronary artery immune to atherosclerosis ?

                                         Coronary arteries are the major site for human atherosclerosis .CAD is considered the ultimate determinant of  cardio vascualr health of our global population.Coronary atherosclerosis has a predilection for proximal sites and branching points.Typically it occurs in leftmain, LAD ostium, LCX ostium, proximal LAD, diagonal origins, OMs RCA  and its branches .

Septal branches , even [...]

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Land mark concepts in cardiology : Biochemical diagnosis of aortic dissection

                                       Aortic dissection is a complex cardiac problem and a  killer disease .Even though it is a fancier to make a  diagnosis  of aortic dissection in any intractable chest (or back )pain   the  most common error  committed by physicians is failure to recognise it  .
Is it possible to diagnose or atleast suspect aortic dissection  by [...]

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Critical cardiology : And now , drug abuse inside human coronary arteries !

                                                    Drugs are poisons , whenever it is administered without valid purpose. it can enter human body  in many ways (Oral, intravenous, percutaneous etc ) And now we have another route namely intracoronary !
                                                   In quest for prevention of restenosis, many of the anti cancer drugs are now delivered directly inside the coronary arteries .These drugs [...]

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The art of unlearning cardiology : ACC/AHA 2009 revascularisation guidelines -It is 135 pages of simple commonsense !

Contrary to popular belief ,great things happen only rarely in medicine . It takes  only  few  months of  training  or  workshops ,  for a  wrong or inappropriate concept  to  percolate  our  brains !  But , it  would require,   decades  of  time , energy  and  efforts  ,  for  correcting  that  wrongly  assimilated concept  in medicine !
Interventional cardiologists are  among the  rare breed of physicians,   who always believe [...]

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Drug eluting stents : A slap on the face of Evidence based cardiology . . .

Drug eluting stents : A slap on the face of Evidence based cardiology . . .
Click the BMJ link or read below
 

It is often said science is sacred and unfortunately we forget ,  science is not a heavenly creation and it is the creation of scientist of varying grades of integrity fueled by the vested [...]

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