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Methods We present the first described case of using two leadless pacing systems manufactured by separate companies implanted within the same patient to provide atrial and ventricular pacing due to complex congenital anatomy. Laser-lead extraction and temporary atrial pacemaker placement was performed.
Diagnostic cardiac catheterization may be needed especially in tetralogy of Fallot with pulmonary atresia, to assess the pulmonary anatomy, including size and distribution of peripheral pulmonary arteries. Another important role is for detection of coronary anomalies, which can also be seen on echocardiogram sometimes.
Although he had a normal echocardiogram and stress test a year ago at a different hospital, due to his symptoms and intermediate-high risk probability of coronary artery disease (CAD), the decision was made to proceed with a cardiac catheterization using a trans-radial approach with a horizontal sweep technique.
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chest pain to Dr. McLaren. See this case: what do you think the echocardiogram shows in this case? His response: “subendocardial ischemia.
The image shown here is an animated 2 dimensional echocardiogram. This one is an older mode known as time-motion mode or M-Mode echocardiogram. A good knowledge of the anatomy of the heart is needed for interpretation of images from each view. Unlike the previous 2 dimensional imaging, this is a single dimensional imaging.
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