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Atrial septal defect and Pregnancy - Patient Information

Atrial septal defect and Pregnancy – Patient Information

What is atrial septal defect (ASD)

Atrial Septal defect is an abnormal communication between the upper two chambers of the heart namely left atrium and right atrium. Normally the left and right atrium are separated by the interatrial septum. So in atrial septal defect (ASD)  a part of the interatrial septum is missing. See the image below

(Source : http://www.wikipedia.org)

In patients with ASD…

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Eggshell calcification of the heart in constrictive pericarditis

Eggshell calcification of the heart in constrictive pericarditis

 Eggshell calcification of the heart in constrictive pericarditis

Rajesh Vijayvergiya, Ramalingam Vadivelu, Sachin Mahajan, Sandeep S Rana, Manphool Singhal

World J Cardiol 2015 September 26; 7(9): 579-582

43/M presented with dyspnoea on exertion NYHA class III since 6 months. No other positive history.

On Examination:

HR-100/min  BP- 100/64   JVP- elevated, 18 cm; prominent X and Y descent

CVS:…

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Interesting image- Post BT shunt seroma- a rare complication

Interesting image- Post BT shunt seroma- a rare complication

Indian Heart J. 2014 Mar-Apr;66(2):227-30.

Post Blalock-Taussig shunt mediastinal mass – a single shadow with two different destinies

Rohit MK1, Vadivelu R2, Khandelwal N3, Krishna S3.

One of the rare complications following BT shunt surgery is seroma formation. It usually is benign and  x ray chest will reveal a mediatinal mass (left upper). CT scan usually confirms the diagnosis. Usually…

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When to intervene in patients with bicuspid aortic valve and dilated aortic root or ascending aorta

When to intervene in patients with bicuspid aortic valve and dilated aortic root or ascending aorta

Circulation – December 4, 2015

Surgery for Aortic Dilatation in Patients with Bicuspid Aortic Valves:

 A Statement of Clarification from the American College of Cardiology/ American Heart Association Task Force on Clinical Practice Guidelines

Intervention in Patients with BAV and Dilatation of the Aortic Root (Sinuses) or Ascending Aorta:

Operative intervention to repair or replace the aortic…

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New Drug : Andexanet Alfa- Reversal agent for Factor X a inhibitors

New Drug : Andexanet Alfa- Reversal agent for Factor X a inhibitors

NEJM- Nov 2015 – ANNEXA-A and ANNEXA-R ClinicalTrials

As of now the major limiting factor with the use of novel anticoagulants is the absence of  reversal agents in case of bleeding complications.

To find a solution to this problem, a new drug has been recently tested in ANNEXA-A and ANNEXA-R trials. Andexanet alfa, a new drug designed to reverse factor X a inhibition.

In the trial, Andexanet…

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Approach to the management of Venous thromboembolism

Approach to the management of Venous thromboembolism

Step 1 :Confirm PTE or DVT diagnosis

Step 2: Look for contraindications for full dose anticoagulation. If contraindications exist then insert IVC filter.

Step 3 : If no contraindication then look for impending venous gangrene (in case of DVT) or cardiopulmonary collapse (cardiogenic shock/ RV dysfunction in case of PTE). If yes then start thrombolysis

Thrombolysis for DVT:

Indications :…

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Myocardial Infarction- Third Universal definition and classification

Myocardial Infarction- Third Universal definition and classification

Definition of myocardial infarction

Criteria for acute myocardial infarction :

The term acute myocardial infarction (MI) should be used when there is evidence of myocardial necrosis in a clinical setting consistent with acute myocardial ischaemia. Under these conditions any one of the following criteria meets the diagnosis for MI:

• Detection of a rise and/or fall of cardiac biomarker values[pref…

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Cardiology MCQ 27.09.15

Pseudo-pacemaker syndrome occurs due to

1. Uncoupling at ventricular level

2. Uncoupling at AV level

3. Significant interatrial conduction delay

4. Pacemaker malfunction

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AMBITION: Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension

AMBITION: Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension

Data on the effect of initial combination therapy with ambrisentan and tadalafil on long-term outcomes in patients with pulmonary arterial hypertension are scarce.

METHODS In this event-driven, double-blind study, patients were randomly assigned, in a 2:1:1 ratio, participants with World Health Organization functional class II or III symptoms of pulmonary arterial hypertension who had not…

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Approach to Arrhythmia part 1: Bradycardia

Approach to Arrhythmia part 1: Bradycardia

Approach to Arrhythmia part 1: Bradycardia

Bradycardia is defined as heart rate <60/min. To understand the cause of bradycardia we have to understand the structures involved in the production and conduction of cardiac impulse.

The normal cardiac structures involved in electrical activity of the heart are 1. SA node- It is the pacemaker of the heart, because it fires at the highest rate hence…

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Cardiology MCQ 18.5.15

Q. All of the following are effective in the management of reflex syncope except

A. Life style modifications like avoiding triggers

B. Physical counterpressure maneuvers

C. Beta blockers

D. Cardiac pacing in patients with cardioinhibitory reflex syncope

Explanation:

According to ESC guideline 2009, beta blockers are no longer recommended and have been given class III recommendation for the…

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Revised Jones Criteria for Acute Rheumatic Fever - 2015 guideline

Revised Jones Criteria for Acute Rheumatic Fever – 2015 guideline

Acute rheumatic fever remains a serious healthcare concern for the majority of the world’s population despite its decline in incidence in Europe and North America. This statement reviews the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and updates those criteria to also taking into account the use of Doppler…

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Cardiology MCQ 26.4.15

All of the following statements about Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy are correct except

A. Pathogenic mutations can be identified in 50% of patients

B. The clinical presentation is between 2nd to 5th decade of life

C. Left dominant arrhythmogenic cardiomyopathy most commonly involves apical septal segment of left ventricle

D.  Left-dominant disease is more commonly seen…

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Cardiology MCQ 22.4.15

 CARDIOLOGY MCQ & REVIEW

Q. All of the following statements about accessory pathways (AP) are correct except

A. Majority of APs conduct both antegradely and retrogradely

B. Around 50% of patients with preexcitation have bypass tracts that conduct only antegradely.

C. Retrograde only conduction is more common than antegrade only conduction via APs

D. In around 10% of patients spontaneous…

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Cardiology MCQ 21.4.15

CARDIOLOGY MCQ & REVIEW

Q. All of the following statements about atrial flutter – fibrillation in WPW syndrome are correct except

A. Atrial fibrillation can precipitate ventricular fibrillation in patients with accessory pathways

B. The incidence of atrial flutter and/or fibrillation appears to be higher in patients with A-V bypass tracts than in the normal population

C. Prevalence of atrial…

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Cardiology MCQ 20.4.15

Cardiology MCQ & Review

Q. Which of the following drugs is found to be useful in idiopathic ventricular fibrillation ?

A. Quinidine

B. Bisoprolol

C. Verapamil

D. Sotalol

  Explanation:

Idiopathic ventricular fibrillation has a high recurrence rate.

The recommended therapy is implantation of implantable cardioverter defibrillator. Currently, recommendations for a specific drug therapy are not…

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Cardiology MCQ 18.4.15

Cardiology MCQ & Review

All of the following statements about fascicular reentry ventricular tachycardia are true except

A. Fascicular VTs  account for around 10% of idiopathic VTs

B. Left posterior fascicular VT is the most common, with a narrow right bundle, left inferior axis QRS morphology.

C. Left anterior fascicular VT is less common and has right bundle, right inferior axis QRS morphology.

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