When does streptokinase beat primary PCI most dramatically !

STEMIis numero uno of any medical emergency . The risk of death is maximum in the first  hour. Here is a patient who presented within 30 minutes  of  chest pain.Enzyme sample was  just sent and a bed side echo  revealed a severe wall motion defect in LAD region. What would have been  the response from a  current generation cardiologist ? [...]

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Drug eluting stents fail in crucial board EXAMINATION in STEMI !

Interventional cardiologist are excessively  talented  guys .They always  lead ahead in innovations  .The only issue is , their  enthusiasm  (   many times  overtake  the pace of science .  In the name of off label indications  they indulge   in drug and device extravaganza   in uncharted territory . Even as we boast of practicing evidence  based cardiology   [...]

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What is the function of moderator band of right ventricle ?

Moderator band is a ubiquitous structure  found inside right ventricular   cavity , often overl0oked by cardiologists. God has created no structure  without any purpose ! Moderator band too has important role to play  both in physiology and pathology . Image credit and courtesey : Whoever has created The table attempts to summarise what is [...]

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What is the function of pectinate muscles of heart ?

Pectinate muscles are specialized Intracardiac  muscle Pectinate muscles are located mainly in the right atrium  , more  in right atrial  appendage , sparse in left atrium Has muscle fibers arranged in a  comb like fashion. Has less mechanical activity, no significant contribution to atrial contractility. Can stretch and improve the voluminous nature of right atrium [...]

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Silly questions in live cardiac work shops !

This  happened  in one  of the cardiology  work shops  I  recently attended ,  which  beamed  live cath lab procedures from across the  country. An   interventional   cardiology  team  in a  bright sky  blue  suit was preparing a  patient for   graft angioplasty  in  a degenerated  SVG graft to left circumflex  . The patient had apparently [...]

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Can you do PTMC in the presence of LA clot ?

Left atrial clot is a  traditional contraindication for performing PTMC.  This rule was formed in the early days of PTMC. PTMC  recently celebrated  its 25th birth day .  In India  it was  first  done by   GB Pant hospital by  Kallilulah in early 1980s. Now most  centers  do it  routinely   like a diagnostic angiogram.  Even [...]

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What is geographic miss during PCI ? How do you classify it ?

A stent missing a  lesion after a PCI  is referred to as geographical miss. It can be metal missing a lesion ( in BMS )or a drug missing a lesion  with DES. Geographical miss is  obviously  more important with DES ,   as both metal and drug can miss a lesion ! (A double miss [...]

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Nesiritide : Death of wonder drug and a concept ?

Medical science is  nothing ,  but trying hard all possibilities. Most innovations die .Only a fraction will survive . That does not mean we should not try ! The greatness is in accepting the failure.  The wonder drug which was an analogue of human atrial  naturetic peptide    (BNP)  Nesiritide   , died a peacful death on [...]

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How to become a good cardiologist in 7 minutes !

Here is a  video recipe  ! Please click here to  see more videos from my you tube site

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What is the best intervention for critical in-stent restenosis (ISR) ? Do we have an universal recipe ? !

How do you tackle  In-stent restenosis  (ISR) ? Deploy another BMS Use a third generation  DES No . . . first  generation DES(Paclitaxel ) Consider Plain balloon angioplasty.(POBA) Refer for CABG. Fall back on medical management.(Ingloriously  referred to  as  “No option” patient !) Answer:  Please  note , there is no single response answer for this [...]

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