Dr. Usman's Cardiology Notes

  Rheumatic mitral stenosis is a serious heart condition that affects millions worldwide. It occurs when the mitral valve, which regulates blood flow between the left atrium and left ventricle, becomes narrowed due to rheumatic fever. This narrowing obstructs blood flow, causing the left atrium to dilate or enlarge. Above Video is showing Rheumatic Mitral Valve Stenosis with dilated LA. Symptoms People with rheumatic mitral stenosis and a dilated left atrium may experience: - Shortness of breath (dyspnea) during physical activity or at rest - Fatigue and weakness - Swelling in the legs, ankles, and feet (edema) - Palpitations or irregular heartbeats - Coughing up blood or pink, frothy mucus Diagnosis Diagnosing rheumatic mitral stenosis involves: - Physical examination and medical history - Echocardiogram (ultrasound of the heart) to visualize the mitral valve and left atrium - Electrocardiogram (ECG) to assess heart rhythm - Chest X-ray to evaluate lung congestion Treatment Treatm...

  ECG Showing Third Degree AV Block   Complete atrioventricular (AV) block, also known as third-degree AV block, is a rare but serious cardiac condition where the electrical signals between the atria and ventricles are completely blocked. This blockage prevents the ventricles from receiving the necessary electrical impulses to contract and pump blood effectively. Causes of Complete AV Block Complete AV block can occur due to various reasons, including: 1. Age-related wear and tear: The AV node can degenerate over time, leading to complete blockage. 2. Cardiac diseases: Conditions like coronary artery disease, cardiomyopathy, and myocarditis can damage the AV node. 3. Infections: Certain infections, such as Lyme disease, can cause inflammation and damage to the AV node. 4. Medications: Certain medications, such as beta-blockers and calcium channel blockers, can slow down or block electrical conduction. 5. Congenital heart defects: Some people are born with AV block due to conge...

This ECG is showing Atrial focus running around 240/min,  two or more ventricular foci competing , seems isorhythmic AV dissociation. So it's sinus tachycardia with Bifascicular block pattern Right Bundle with left axis and p occurs at constant Rate but with ventricular ectopics occurring in bigeminal and trigeminal pattern with no fixed PR interval related hence favoring ventricular ectopic beat with Left ventricular outflow origin. The Ventricular ectopics or ectopies creates lots of concerns , confusion and issue with labelling or terminologies and above all treatment / managment !!!!!  Mostly these are over concerns however sometimes the concern can be very genuine esp in case of them occurring as closely coupled !!! To better identify the Ectopies , the following needed to be known Shortly coupled Ventricular Ectopy (VE) that seems to be lodging onto the preceding T wave (the famous term R on T) May actually be indicative of electrical instability of the heart and de...

LA anatomy on Cardiac CT showing four Pulmonary Veins draining into LA Atrial Fibrillation Cryoablation: Indications 1. Symptomatic paroxysmal or persistent atrial fibrillation (AF) 2. Failed anti-arrhythmic drug therapy 3. Heart failure or reduced left ventricular function Procedure 1. Electrophysiology study (EPS) to identify left-sided pathway 2. Transeptal puncture and transseptal sheath placement 3. Cryoablation catheter (e.g., SL1) placement in left atrium 4. Cryoenergy application to pulmonary veins, posterior wall, and other targeted areas Key Ablation Targets 1. Pulmonary veins (PVs) 2. Posterior left atrial wall 3. Mitral isthmus 4. Left atrial appendage Benefits 1. High success rate for paroxysmal AF 2. Improved symptoms and quality of life 3. Reduced risk of stroke and heart failure hospitalization Risks and Complications 1. Cardiac tamponade 2. Stroke or transient ischemic attack (TIA) 3. Pulmonary vein stenosis 4. Atrio-esophageal fistula (rare) Post-Procedure Care 1. Mon...