It is a well known fact , CABG and PCI provides immediate relief for patients with angina , which is refractory to medical therapy. Of course , this happens only if a critical occlusion of at least one epicardial coronary artery is opened . It need to be realised , angina due to microvascular [...]
Archive for December, 2009
Why revascularisation promptly relieves angina but rarely relieves dyspnea ?
Posted in Cardiology - Clinical, Cardiology -Interventional -PCI, cardiology -Therapeutics, cardiology- coronary care, Infrequently asked questions in cardiology (iFAQs), tagged angina relief, cabg, canadian cardiovascualr, cardiomyopathy, courage study, diastolic dysfunction, dilated cardiomyopathy, dyspnea, functional class, ischemic dcm, lv dysfunction, lv fucntion, nyha class 3, nyha class 4, oat study, pci, ptca, stable angina, toat study, unstable angina on December 30, 2009 | Leave a Comment »
Less discussed issues in coronary care : Preinfarction angina vs Acute MI – problems in estimating Time window in STEMI
Posted in Cardiology - Clinical, cardiology -ECG, Cardiology-Arrhythmias, Cardiology-Coronary artery disese, Infrequently asked questions in cardiology (iFAQs), tagged pre infarction angina, preinfarction angina vs acute MI, stemi, time window in stemi on December 30, 2009 | Leave a Comment »
Acute MI is a major medical emergency encountered in ER . Prompt adminstration of thrombolytic agents or rapid triaging for a primary PCI may be required . The whole concept of management of STEMI revolves around time as a therapeutic target .Every minute counts . The beneficial effects of reperfusion and the resultant myocardial salvage rapidly declines over time . Hence , [...]
Why we rarely diagnose junctional ectopic beats ?
Posted in Cardiology - Clinical, Cardiology - Electrophysiology -Pacemaker, Infrequently asked questions in cardiology (iFAQs), Uncategorized, tagged apd, av junction, av node, avnrt, congenital junctional tachycardia, digoxin, his bundle, his bundle ectopic, incessant jt, jpd, junctional escape beats, junctional tachycardia, mahim vt, narrow qrs ectopic, post operative tachycardia, purkinke fibre ectopic on December 26, 2009 | Leave a Comment »
Ectopic beats , other wise called premature depolarisaton are one of the common ECG abnormalities diagnosed by physicians. Atrial premature beats (APDs) Ventricular premature beats(VPDs) APDs and VPDs form the bulk of all clinically important ectopic beats. Heart has a specialised electrical conducting system , every cell in this system is capable of firing on it’s own. [...]
When knowledge becomes a disease !
Posted in bio ethics, Cardiology - Clinical, tagged african children, bmj, cardiology, climate summit, evidence based medicine, green house effect, health outcome analysis, hunger, knowledge disease, lancet, logic in medicine, malnourished, nejm, obesity, poverty, rich vs poor, unequal world, unlearning in medicine on December 26, 2009 | Leave a Comment »
When we get contaminated with excess knowledge , we lose our ability to think ! & Common sense is the casuality . . . Human beings differ from other forms of life by their sixth sense . Our planet is few billion years old . Life came into existence over a million years ago .Our [...]
Pericarditis can be regional just like STEMI !
Posted in Uncategorized, tagged pericarditis on December 25, 2009 | 1 Comment »
The commonest cause of ST elevation is STEMI . The non infarct causes of ST elevation include Pericarditis Early repolarisation syndrome Hyperkalemia Brugada syndrome CNS injury What is the mechanism of ST eelvation in pericarditis ? The mechanism of ST elevation in STEMI is injury current coming towards the recording lead. In pericarditis we are [...]
Pulmonary artery pulse pressure : A simple parameter to predict reversible PAH In Eisenmenger syndrome
Posted in cardiac surgery, Cardiology -Interventional -PCI, Hemodynamics, Uncategorized, tagged 100% oxygen, asd, bi directional shunt, bosentan, cyantoic heart disease, eisenmenger syndrome, heath edwards, irreversible pulmonary hypertension, left to right shunt, mean pulmonary arterial pressure, mean pulmonary artery pressure, oximetry, pah, papp, pda, pht, prostocyclin, pulmonary artery diastolic pressure, pulmonary artery pulse pressure, pulmonary hypertension, pvr vs svr, reversible pulmonary, right to left shunt, sildanefil, tolazoline, vsd on December 20, 2009 | Leave a Comment »
PAH is the major determinant of surgical outcome of left to right shunts. In this modern era of cardiac care allowing a child with left to right shunt to progress to a stage of Eisenmenger syndrome is considered as a huge medical failure . But , this is still rampant in many of the [...]
The advanced gadget for reviving the dead . . .
Posted in Cardiology -Interventional -PCI, cardiology -Therapeutics, Cardiology-Coronary artery disese, Great websites in cardiology, Hemodynamics, tagged acls, artifitial heart, bls, cardiac arrest, cpr, femor femoral bypass, heart lung machine, lifebridge, portable heart lung on December 20, 2009 | Leave a Comment »
Can modern technology bring back the life from a dead person ? Yes it is possible , not in the near future ! but in the present era . . . This revolutionary new portable heart lung machine may just do that . Imagine this scenerio : A cardiac arrest victim – failed resuscitation [...]
Adventures in Cardiology : A great story , must read by all interventional cardiologist & electrophysiologists !
Posted in cardiology-ethics, tagged atrial fibrillation, ep study, evidence based cardiology, pulmonary vein ablation, rate control vs rhythm control, RF ablation on December 19, 2009 | 1 Comment »
This is a real life experience of a patient who underwent a electrophysiology study and ablation procedure for atrial fibrillation .The blog describes how the procedure became a nightmare .Written in a most readable fashion . Interventional cardiologists need not get hurt by this narration instead they should do a reality check on [...]
Who is a pessimist in medical science ?
Posted in cardiology -Therapeutics, Cardiology -unresolved questions, cardiology-ethics, Uncategorized, tagged auditing health, bmj, cleansing medical literature, commerce in medicine, comparative effectiveness, cost effectiveness, drsvenkatesan, ethics in medicine, evidence based medicne, futile medicine, futility in medicine, health outcome analysis, hippocrates, inappropriate therapy, jama, medical greenhouse effectl, nejm, null hypothesis, optimisim, pessimissm, pessimissm vs optimissm, positive thinking, power of negative thinking, power of positive thinking, world climate summit on December 18, 2009 | Leave a Comment »
Pessimism, from the Latin pessimus (worst), is a state of mind which negatively colors the perception of life, especially with regard to future events. Understanding pessimism is not that simple . Some people argue optimism represents a strong mind while a pessimism is the domain of the weak . But it is not necessarily [...]
Some of the best illustrations in basic cardiac electrophysiology
Posted in Uncategorized, tagged absolute refractory period, action pontential, cardiac action potential, ECG, phase 4, pottasium channel, qt interval, refractory period, sodium channel on December 17, 2009 | Leave a Comment »
Here is the link to one of the best illustration for cardiac action potential which I have stumbled upon ! Spend some time on the following illustration depicting the normal cardiac action potential that explain the ionic movements . Understand why a cardiac muscle has two refractory periods , why there is a sustained dome [...]
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