Dr. Usman's Cardiology Notes

Myocardial Performance Index (Tei Index) – An Interesting One  The Tei Index, introduced by Dr. Chuwa Tei, is a Doppler-derived, noninvasive parameter that evaluates global ventricular performance, integrating both systolic and diastolic functions into a single measure. How It’s Measured: ⬜ Acquired using pulsed and continuous wave Doppler from: • Mitral inflow (Apical 4-Chamber view) • Left ventricular outflow (Apical 5-Chamber view) ⬜ Key intervals measured: a. IVCT – Isovolumetric Contraction Time b. IVRT – Isovolumetric Relaxation Time c. ET – Ejection Time Formula: 👉 Tei Index = (IVCT + IVRT) / ET or 👉 Tei Index = (a - b) / b where: a = time from mitral valve closure to opening b = aortic ejection time Normal Values: LV Tei Index: ≤ 0.40 RV Tei Index: ≤ 0.43 Interpretation: 🔵 Higher Tei Index → Impaired ventricular function 🔵 Detects early ventricular dysfunction, even when LVEF appears normal Clinical Significance: Useful in assessing cardiomyopathies, heart failure, cong...

 Why You Should Avoid Processed Oils and Packaged Foods: The Hidden Truth About Additives and Their Effects In today’s fast-paced world, convenience often wins over caution. Packaged snacks, ready-to-eat meals, and refined cooking oils have become household staples. But behind the shiny labels and tempting flavors lies a complex web of chemical additives, industrial processing, and nutritional compromises that can harm our health in the long run. This article dives deep into why avoiding processed oils and packaged foods is one of the best choices you can make for your long-term well-being — and how the additives inside these products affect your body in ways you might not even realize. --- 1. The Rise of Processed Oils: From Natural Seeds to Industrial Liquids Once upon a time, oil was made by simply pressing olives, coconuts, or sesame seeds. Today, most cooking oils are the result of heavy industrial refining. Common processed oils include: Canola oil (rapeseed oil) Soybean oil ...

Left Ventricular Hypertrophy (LVH) is a common finding in patients with long-standing hypertension, aortic stenosis, or other conditions that increase left ventricular workload. Detecting LVH on an electrocardiogram (ECG) is crucial for identifying cardiac remodeling before structural heart disease becomes advanced. Although echocardiography remains the gold standard, ECG provides a fast and cost-effective screening tool. --- What is LVH? LVH refers to thickening of the left ventricular wall due to chronic pressure overload. On ECG, this manifests as increased QRS voltage and often secondary repolarization (strain) changes in the lateral leads. --- Main ECG Criteria for LVH 1. Sokolow–Lyon Criteria One of the oldest and simplest ECG criteria for LVH, mainly based on precordial lead voltages. Formula: S in V1 + R in V5 or V6 ≥ 35 mm (3.5 mV) (Use the larger R wave between V5 and V6) Optional additional criterion: R in aVL ≥ 11 mm Key Features: Easy and quick to apply. Best used in young...

Atrial Fibrillation Why AFib matters — beyond the heartbeat AFib is the most common sustained cardiac arrhythmia.  It is more than “just an irregular heartbeat”: it carries significant risks, including stroke, heart failure, reduced quality of life, and mortality.  Many people may not even know they have it — sometimes no symptoms, silent disease.  As the global population ages and cardiovascular risk factors (hypertension, diabetes, obesity) rise, AFib’s prevalence is increasing.  For clinicians: early detection, appropriate anticoagulation, rhythm/rate control, and lifestyle modification are critical. --- What happens in the heart (in plain language) Imagine your heart’s upper chambers (the atria) as concert halls where signals should arrive in perfect rhythm. In AFib: The atria don’t contract in a coordinated fashion; instead they “quiver” (fibrillate).  Many rapid, chaotic signals bombard the atrioventricular (AV) node and ventricles, so the heartbeat become...

Heart Failure: The Cardiology Topic Clinicians Search Most Heart failure (HF) emerges as the single most searched cardiology topic globally. It is a “rapidly growing public health issue” affecting an estimated 64 million people worldwide. In fact, heart failure is now a leading cause of hospitalization and mortality. Clinicians and researchers alike are focused on HF because its prevalence is rising (due to aging populations and better survival after heart attacks) even as outcomes remain poor. This immense burden – high mortality, frequent readmissions and poor quality of life – makes heart failure a central concern in cardiology. Online search trends reflect this intensity: Google query volumes for “heart failure” closely mirror the condition’s real-world prevalence. In short, heart failure is an ever-present topic in cardiology practice and research, and clinicians worldwide continually seek information on its diagnosis and management. Understanding Heart Failure Heart failure...

  C-peptide and antibody tests help distinguish between Type 1 diabetes, LADA, and MODY by assessing beta-cell function and autoimmune activity. Low C-peptide with positive antibodies indicates autoimmune Type 1 or LADA, while preserved C-peptide with negative antibodies suggests MODY or Type 2. This diagnostic approach guides appropriate therapy and avoids unnecessary lifelong insulin use. C-Peptide and Antibody Testing for Type 1 Diabetes, LADA, and MODY Understanding the role of C-peptide and antibody testing is essential for distinguishing between different types of diabetes, especially when clinical features overlap. These tests help confirm autoimmune diabetes, differentiate LADA (Latent Autoimmune Diabetes in Adults) from type 2, and identify patients who may have monogenic diabetes (MODY). --- What Is C-Peptide and Why It Matters C-peptide is produced in equal amounts with insulin when proinsulin splits into insulin and C-peptide. Measuring C-peptide tells us how much endog...

Resistant hypertension:   Resistant hypertension is defined as blood pressure that remains above target despite the use of three antihypertensive medications at optimal doses, including a diuretic, or when four or more drugs are needed to control it. 🧠 Key Criteria Confirmed diagnosis: Office BP ≥140/90 mmHg (or ≥130/80 mmHg in diabetics) despite ≥3 drugs, one of which is a diuretic. OR controlled BP but requiring ≥4 medications. True vs. pseudo-resistance: Rule out poor adherence, incorrect BP measurement, white coat effect, and suboptimal drug dosing. 🔍 Why it matters Resistant hypertension is a red flag for: Secondary causes (e.g., primary aldosteronism, renal artery stenosis, obstructive sleep apnea, pheochromocytoma). End-organ damage (e.g., LVH, CKD, retinopathy). Increased cardiovascular risk (stroke, MI, heart failure). It requires a structured evaluation to rule out secondary causes, optimize therapy, and assess end-organ damage. Labs should target renal, endocrine, and ...