What is the difference between “Electrical wall motion defect” and “Mechanical wall motion defect” following myocardial infarction ?

Regional wall motion defect( WMD) is the hall-mark of myocardial infarction.It can vary between complete akinseia to mild hypokinesia. The wall motion defect is a gross terminology which is used  to describe any abnormal motion of the ventricular   segments.Technically,  hypo,   hyper , dyskinetic , akinetic  ,  even any vigorous  movement of LV segments will [...]

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Tough hearts never die ! Surviving with a heart rate of 6 / mt

Bradycardia is a common cardiac arhythmia. Sinus bradycardia  is  often considered an arrhythmia from a disciplined heart. It denotes high vagal tone .  A  heart rate  of  40 , some times even 35 is well tolerated . But bradycardia due to heart blocks are dangerous. Sinus bradycardia can not get lower than 30/mt or so [...]

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How common is “Junk articles” in mainstream medical journals

There are about 5000 medical journals ,  churning out tens of thousands of articles every month .Most of these  papers  come from developed world where publication is made mandatory to get a medical  degree . So it is not surprising  to find   proliferation of medical journals . Publishing a paper is strictly monitored by [...]

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Intriguing concepts in cardiology :Anemic heart ! Is it cardiac failure or cardiac success ?

Anemia is one  of the earliest human diseases  that was identified. Traditionally  heart disease and anemia have a  close relationship.(Is it a true relation ?)  .Most of  us  are made  to  believe so, by meager speculation ! In what way anemia is linked to heart failure? The answer is explicit  in the definition of cardiac [...]

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Should post prandial angina be classified as unstable angina?

Stable angina is graded by Canadian cardiovascular society classification ( CCSC ) by 4 grades. Angina at rest  usually  denotes unstable angina. But,  patients with stable angina  may also experience rest angina according to CCSC ,  still this is   not considered as  unstable angina by many . Post prandial angina is one such  example. Few [...]

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If you think you are an expert in “ECG diagnosis” of acute coronary syndrome : Please read this !

Once in a while the ACC/AHA comes with knock out articles. Here is a  must read  topic for every cardiologist. How to diagnose MI in ECG ? Sounds , insulting ? After reading this you should change the way 12 lead  ECG is looked at . . . Experts from the article How to make [...]

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Why patients with dilated cardiomyopathy show high voltage qrs in precardium and low voltage in limb leads ?

A combination of  low voltage  qrs  and high voltage  qrs is a well known marker of dilated cardiomyopathy . classically patients with  severe forms  of  dilated cardiomyopathy show high voltage qrs complex in V1 to V6 and significantly low voltage in limb leads. Why this happens ? This happens due to two reasons. 1 .We know , chest leads are unipolar [...]

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How to lose the golden hour in the management of acute myocardial infarction ?

“Time is muscle” is  the often quoted “sermon”  in emergency cardiology , implying ,  every patient with STEMI should be taken up for   thrombolysis or primary PCI at the earliest  after the onset of symptoms. While thrombolysis is the proven method of reperfusion for over 25 years , Primary PCI , a costly , risky but [...]

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Bermuda triangle of the left ventricle

Human heart is a vital bundle of muscle  weighing  about 300-400 grams. The blood  supply of this muscle  mass  is highly variable . Some areas are abundantly  vascularised ( eg -IVS.) Some areas have a balanced blood supply  or   twin blood supply (Often the  LCX and RCA in the  crux of the heart ). [...]

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Great Indian cardiologists

When the concept of acute  coronary syndrome was at infancy, when there was no echocardiography , when there was no coronary angiogram   when there was no coronary care units either , this man was able to identify a group of patients who are high risk to develop acute MI These pateints are now refered to [...]

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