Dr. Usman's Cardiology Notes

  Bicuspid Aortic Valve (BAV) can cause severe aortic regurgitation (AR) through several mechanisms: Congenital Abnormalities 1. Abnormal valve morphology: BAVs often have an abnormal valve morphology, which can lead to incomplete closure of the valve leaflets, resulting in AR. 2. Fusion of valve leaflets: In BAV, the valve leaflets may be fused together, creating a single, abnormal leaflet that cannot close properly, leading to AR. Acquired Changes 1. Valve calcification: Over time, BAVs can become calcified, leading to stiffening of the valve leaflets and incomplete closure, resulting in AR. 2. Valve prolapse: BAVs can also prolapse, causing the valve leaflets to bulge backward into the left ventricle, leading to AR. Aortic Root Changes 1. Aortic root dilation: BAVs are often associated with aortic root dilation, which can lead to AR by causing the valve leaflets to become misaligned. 2. Aortic aneurysm formation: In some cases, BAVs can lead [3/4, 1:39 PM] Meta AI: Bicuspid Aort...

ECG artefacts!!! a relatively common happening in every day clinical life can have a wide range of presentations and can create varying clinical relevance !!!!!!  ECG artifacts are distortions/ changes in the ECG that are not caused by the heart electrically activity by itself !!!!!   Commonly used terms in this regard are  1. Motion artifacts! irregular ECG baseline changes caused by movement or shaking of body.  2. ECG artefacts! on the other hand “signals that are not related to cardiac electrical activity” A. Artefacts due to technical problems with recording sys  (nuisance artefact’s)  1. malfunctioning equipment  inc loose or fractured leads 2. accumulation of static energy 3. electromagnetic interference(EMI). caused by power lines and electrical equipment.  “It can be recognized as high frequency sharp signals at 60 Hz” 4. patient-related artifact such as body movement,  5. poor electrode contact because of hairy skin or w...

 ASD Rims to be assessed on Echocardiography These are usually assessed on Transesophageal Echocardiogram. 🚨 Watch TEE Protocol with labelled images >>

  Watch above video showing LVEF estimation by Simpson method. The Simpson method calculates left ventricular ejection fraction (LVEF) by tracing the endocardial border of the left ventricle in both apical four-chamber and two-chamber views. The volumes during diastole and systole are determined, and LVEF is calculated as the difference between these volumes divided by the end-diastolic volume. Steps to Calculate LVEF Using Simpson's Method Obtain Views : Acquire apical four-chamber and two-chamber views of the heart. Ensure optimal imaging quality to avoid foreshortening. Trace Endocardial Borders : In both views, trace the endocardial border of the left ventricle during end-diastole (maximum volume) and end-systole (minimum volume). Be careful to exclude structures like papillary muscles from the tracing. Calculate Volumes : Use the traced areas to calculate the left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). The vol...

Watch the above video for 16 most important views to get on TEE. Here is a comprehensive Transesophageal Echocardiography (TEE) protocol with tips and tricks: Pre-Procedure Preparation 1. *Patient preparation*: Ensure the patient is fasting for at least 4-6 hours before the procedure. 2. *Informed consent*: Obtain informed consent from the patient, explaining the procedure, risks, and benefits. 3. *Vital sign assessment*: Assess the patient's vital signs, including blood pressure, heart rate, and oxygen saturation. 4. *Medication review*: Review the patient's medications and consider withholding anticoagulants or adjusting sedation as needed. Equipment Preparation 1. *TEE probe*: Ensure the TEE probe is properly cleaned, disinfected, and ready for use. 2. *Ultrasound system*: Set up the ultrasound system, selecting the TEE probe and adjusting settings as needed. 3. *Monitoring equipment*: Ensure monitoring equipment, such as ECG, blood pressure, and oxygen saturation monitors, ...

Same Patient with Arm Pulled down towards Knee. If you have difficulty in getting Axillary Access, ask patient or someone to pull arm downward towards knee, as it's occluded in this position sometimes Between rib & Clavicle.

Here are simple estimates of pericardial effusion volume based on echo measurements: - Mild: < 100 mL (echo size < 1 cm) - Moderate: 100-500 mL (echo size 1-3 cm) - Severe: > 500 mL (echo size > 3 cm) To estimate the volume of pericardial effusion (in mL) based on the size measured on echocardiography, you can use the following formula: Volume (mL) = [ (D1 x D2 x D3) / 3 ] x 4 Where: D1, D2, and D3 are the diameters of the effusion (in cm) measured in three different views: - D1: Anteroposterior diameter (measured in the parasternal long-axis view) - D2: Transverse diameter (measured in the parasternal short-axis view) - D3: Inferosuperior diameter (measured in the apical four-chamber view) Note: This formula is an estimate and may not always accurately reflect the actual volume of the effusion. Here are the key points for signs of cardiac tamponade: *Clinical Signs:* 1. *Beck's Triad*:     - Hypotension (low blood pressure)     - Muffled heart sounds ...