Forgotten concepts in cardiology : Over drive pacing

It is one of the greatest innovation in medicine  . . . that is . . . electric current being  used as  a  drug to  treat disorders of heart . Of course ,  it is not a surprising finding  when we know heart is an  electro mechanical organ ,  and electricity can be used  to [...]

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The impact factor of diabetes , hypertension , smoking and dyslipidemia on human vasculature : Aren’t they different ?

We know diabetes, smoking, hyperlidemia, hypertension are major risk factors for progressive vascular disease. They damage the vascular endothelium either directly or indirectly ,   by aggravating the atheroscelortic process .  Diabetes apart from affecting the medium sized arteries , also affect the microvasculature.  Smoking  has a direct effect on endothelial function .It depletes vascular nitric [...]

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How common is ischemic SVT ?

Ischemic ventricular tachycardia is a  too well recognised clinical  entity  . But , ischemia triggered atrial arrhythmias are less often encountered .
Does that mean , atria are relatively protected from the effects of ischemia ?
Not really  . . .  It  is possible  it may not be  that rare ,  as we think .
And then ,  [...]

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What is the difference between isoelectric P waves and absent p waves ?

P waves represent atrial depolarisation. The p wave height  and width depends not only the size of the RA and LA but also the site of  origin of atrial  impulse .A normal SA nodal origin of P wave produce the normal shaped p waves.
We know  ectopic  p waves can have a wide variation of morphology.(Fully [...]

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Does the esophageal spasm get relieved by sublingual nitroglycerine ?

Esophagus and the heart are closely related structures. Both can generate chest pain that can mimic each other. The squeezing substernal pain  is very characteristic of esophageal spasm  .The smooth muscle of esophagus can exactly mimic a vascular smooth  muscle  .The relief of chest pain following nitrates  though very classical of angina it can very [...]

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What is being rescued in rescue angioplasty ?

Rescue angioplasty as a concept in PCI is advocated for the past  two decades. Rescue angioplasty  continues to enjoy the  controversy over the years. A procedure which fails to shrug off the controversy for so long   inspite of multiple studies ,  would indicate there is something seriously wrong in the  procedure  or in the [...]

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Can medical mangement convert a patient with positive stress test into negative ?

Exercise stress test is the most commonly used non invasive  diagnostic test for CAD.
It is also useful in the functional capacity evaluation.Even though medical management of CAD is a proven and accepted  method of therapy in CAD . There  is always a   perception  even   among the  cardiologists  medical management  is an inferior form of [...]

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How to humiliate medical therapy for CAD ! Learn how COURAGE and OAT trials were disgraced by the mainstream cardiology community !

Medical profession has  evolved over centuries with humble discoveries by genuine researchers in the past . As we  pursued  science vigorously  , we  looked  for innovations , when innovation  work ( or many times shown to work !) we jump to sky , even as  some of these  innovations fail and crash down  to earth [...]

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Great medical web sites : How to innovate medical education ?

Internet has revolutionised  in sharing our knowledge . But  , the  freedom it gives  has a trade off .Identifying   genuine  knowledge  in the  vast cyberspace is like searching for lost treasure in the ocean bed.
Have a look at this site which innovates medical teaching

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Why P wave becomes “tall” in RA enlargement and “wide” with LA enlargement ?

Normal P waves

What are the components of Pwave ?
RA component : The SA node depolarises the RA first  , so the initial part of  P wave represents  RA  after about 40msec  the wave front reaches LA and it begins it’s depolarisation .LA component :By the time LA is maximally depolarised the RA  already starts its [...]

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