Dr. Usman's Cardiology Notes

Above video demonstrate the10 Basic Views to master in Intracardiac Echocardiography also known as ICE, presented in simple form with real time images labeled with important structures. Home view is usually the first view when we insert intra-cardiac echo catheter or ICE catheter into right atrium.  Types of Intracardiac Echocardiography:   There are two types of ICE - phased array and radial. ○ Phased array: more common as it creates a view that is easier to interpret as it resembles a TTE or TEE. ○ Radial ICE: greater resolution, but is more difficult to interpret and is best for discriminating near-field structures and therefore requires transseptal puncture to visualize left heart structures. Process: ● Insert catheter through the femoral vein up through the IVC to the right atrium (most commonly), “the home base” for the ICE catheter. The catheter can also be inserted via the right IJ or left subclavian and then through the SVC however this will give “upsidedown” image...

Types of Ventricular Septal Defects and their Echocardiogram Features:   BROWSE FREE ECHO LIBRARY HERE >>  Ventricular septal defects are the most common congenital heart defects, accounting for approximately 25% of all congenital heart defects. A ventricular septal defect is a hole in the septum, the wall of tissue that separates the right and left ventricles of the heart. There are several types of ventricular septal defects, each with distinct echocardiogram features. Membranous ventricular septal defects are the most common type, accounting for approximately 75% of all ventricular septal defects. They occur in the membranous portion of the septum, near the aortic valve. On echocardiogram, a membranous ventricular septal defect appears as a hole in the membranous septum, typically located near the aortic valve. Turbulent flow through the defect is visible on color Doppler, and left-to-right shunting of blood is visible on spectral Doppler. Muscular ventricular septal ...

A 65-year-old man with a history of complete heart block underwent pacemaker implantation. A few months later, he presented with symptoms of fatigue and shortness of breath. An echocardiogram was performed, which showed significant tricuspid regurgitation. The video below shows the echocardiogram images, which clearly demonstrate the pacing lead interfering with the tricuspid valve and causing regurgitation. Browse FREE ECHO LIBRARY>> As shown in the video, the pacing lead is seen to be interfering with the normal coaptation of the tricuspid valve leaflets, leading to significant regurgitation. This is a classic example of pacing lead-induced tricuspid regurgitation. The patient's symptoms were attributed to the regurgitation, and he underwent lead repositioning, which resolved the issue. Pacing lead-induced tricuspid regurgitation is a complication that can arise in patients with permanent pacemakers. It occurs when the pacing lead, which is inserted through a vein and guide...

How to measure Pulmonary regurgitation Jet Width in PSAX view of Echocardiography, Here is how you take measurements:     As we know PR jet covering more than 50% of RVOT width suggests severe PR     Measuring the PR jet in the parasternal short-axis (PSAX) view of an echocardiogram: Step-by-Step Guide: 1. Obtain a PSAX view: Position the ultrasound probe to obtain a PSAX view of the aortic valve and left ventricular outflow tract. 2. Identify the PR jet: Look for the PR jet, which appears as a turbulent, high-velocity flow signal originating from the pulmonary valve and directed towards the septum. 3. Measure the PR jet: Measure the PR jet using the following methods: Diameter Measurement 1. Place the cursor: Place the cursor at the point of maximum jet diameter, usually at the pulmonary valve annulus. 2. Measure the diameter: Measure the diameter of the PR jet at this point. Other methods to assess PR:  VTI Measurement 1. Place the cursor: Place the cursor at ...

  Acute pericarditis is a condition characterized by inflammation of the pericardium, the sac surrounding the heart. This inflammation can lead to a range of symptoms, including chest pain, fever, and fatigue. One of the key diagnostic tools for acute pericarditis is the electrocardiogram (ECG), which can reveal a number of characteristic changes. In the early stages of acute pericarditis, the ECG may show a pattern of widespread ST-segment elevation. This is often accompanied by a slight elevation of the PR segment, and a decrease in the amplitude of the QRS complex. The ST-segment elevation is typically concave upwards, and may be seen in all leads except aVR. This pattern of ST-segment elevation is often referred to as a "saddle-shaped" or "dome-shaped" appearance. As the condition progresses, the ECG may show a number of additional changes. One of the most characteristic features of acute pericarditis is the development of PR-segment depression. This is often se...

Health is more than a state of physical fitness—it’s about the harmony of mind, body, and spirit. In our fast-paced world, maintaining balance can feel challenging. However, without health, everything else takes a backseat. Good health isn’t just about avoiding illness; it’s about thriving. Let’s explore how physical, mental, and preventative practices can improve your overall well-being. ---------------------------------------- The Foundations of Physical Health Physical health forms the backbone of overall wellness. By focusing on nutrition, exercise, and sleep, you can create a strong base for a healthy life. Nutrition: Building a Balanced Diet Food is your body’s fuel. If you give it the right nutrients, it runs smoothly; if not, things break down over time. A balanced diet includes proteins, carbohydrates, fats, vitamins, and minerals. Proteins help build muscles and repair tissues. You can find them in lean meats, fish, eggs, beans, and tofu. Carbs supply energy, and healthy opti...

  Watch above video to understand diastolic Dysfunction  Diastolic Dysfunction on Echo: Diastolic dysfunction refers to the heart's inability to relax and fill properly during diastole. Echo findings: Grading of Diastolic Dysfunction: 1. *Grade 1 (Mild)*: Abnormal relaxation, E/A ratio < 0.8 2. *Grade 2 (Moderate)*: Pseudonormal filling, E/A ratio 0.8-1.5 3. *Grade 3 (Severe)*: Restrictive filling, E/A ratio > 2 Echo Parameters: 1. *E/A Ratio*: Early diastolic filling velocity (E) to late diastolic filling velocity (A) ratio 2. *E-wave Deceleration Time (DT)*: Time for E-wave to decrease from peak to baseline 3. *Isovolumic Relaxation Time (IVRT)*: Time from aortic valve closure to mitral valve opening 4. *Tissue Doppler Imaging (TDI)*: Measures myocardial velocities, helping to assess diastolic function Clinical Significance: Diastolic dysfunction can lead to: 1. Heart failure with preserved ejection fraction (HFpEF) 2. Increased risk of cardiovascular events 3. Decreas...