All About Cardiovascular System and Disorders

MAY 3, 2024

Usual colour Doppler echocardiogram is superimposition of colour Doppler images on a two dimensional echocardiogram. Colour M-Mode is superimposition of colour Doppler images on an M-Mode echocardiogram. Stenosis of the valves can be made out by the reduced opening at the time when it is supposed to be open.

Ultrasound 52

Ultrasound Echocardiogram VSD Stenosis 52

Heart BMJ

FEBRUARY 23, 2024

A transthoracic and transoesophageal echocardiogram are shown in figure 1A–C , Ventricular function was normal, with no significant valvar stenosis or regurgitation. The ECG and chest X-ray were essentially normal. Question What is the next best step in the management?

Echocardiogram 40

Echocardiogram Stenosis 40

Dr. Smith's ECG Blog

AUGUST 26, 2024

Comparison Summary: ANTEROLATERAL ST CHANGES ARE NOW MORE PRONOUNCED, RATE DEPENDENT VS ISCHEMIC CHANGES Here is the Queen's diagnosis: The cath lab was activated: Culprit Lesion (s): Thrombotic 99% mid LAD stenosis with TIMI II flow Peak troponin not measured, unfortunately. So we don't have a good idea how large the final infarct size was.

Myocardial Infarction 120

Myocardial Infarction Critical Care Echocardiogram Ischemia 120

Open Heart

JUNE 21, 2022

Background Increase in left ventricular filling pressure (FP) and diastolic dysfunction are established consequences of progressive aortic stenosis (AS). However, the impact of elevated FP as detected by pretranscatheter aortic valve replacement (TAVR) echocardiogram on long-term outcomes after TAVR remains unclear.

Aortic valve 52

Aortic valve TAVR Aortic AFIB 52

Dr. Smith's ECG Blog

JULY 11, 2024

An echocardiogram showed severely reduced global systolic function with an EF of 20-25% and an LV apical thrombus. The red arrow shows a roughly 80% stenosis of the proximal LAD. The blue arrow shows another stenosis of the LAD distal to the first diagonal branch of about 99%. An echocardiogram showed an EF of 20-25%.

Outcomes 112

Outcomes Stenosis Outpatient Echocardiogram 112

EMS 12-Lead

AUGUST 25, 2024

Patent Foramen Ovale 4. Severe calcific Aortic (valve) Stenosis 5. Mechanical prosthetic valve Severe carotid artery stenosis is also implicated in embolic stroke. In the pre-hospital setting the varying modalities needed to rule-in/rule-out these causative factors are not available (eg, Chest X-ray, Echocardiogram, etc).

AFIB 59

AFIB Atrial Fibrillation Embolism RN 59

Dr. Smith's ECG Blog

OCTOBER 4, 2010

An echocardiogram confirmed aortic stenosis with a large pressure gradient. Now there is much less ST segment deviation, less elevation and less depression. The troponin returned positive, and the maximum troponin was 3.8 The next day, and angiogram showed normal coronary arteries. He awoke and did well.

Cardiac Arrest 52

Cardiac Arrest Ischemia Stenosis STEMI 52

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Additionally, a bedside echocardiogram showed no wall motion abnormality and normal LV function. Angiography revealed a 30% nonobstructive stenosis of the mid LAD. There was a 70% culprit stenosis of the first obtuse marginal branch in a right dominant system. Patient 1 remained in the hospital overnight.

Chest Pain 115

Chest Pain STEMI Echocardiogram Stents 115

Dr. Smith's ECG Blog

NOVEMBER 9, 2023

She underwent exercise echocardiogram in mid October where she exercised for nearly 7 minutes on the standard Bruce protocol and had typical anginal pain and shortness of breath. Baseline echocardiogram showed moderate LV systolic dysfunction with no wall motion abnormalities. Lesion on Dist RCA: 90% stenosis reduced to 0%.

Chest Pain 77

Chest Pain Echocardiogram Blog Ischemia 77

Circulation

NOVEMBER 11, 2024

The LPA to RPA ratio on initial and most recent echocardiogram, intervention on the LPA at initial surgery and subsequent reintervention on the LPA were compared between the two groups.Results:The 22q11 deletion and control group had a similar mean age at time of study 6.9±3.4 0.27, p=0.002) echocardiogram.

Pulmonary 40

Pulmonary Risk Factors Heart Disease Echocardiogram 40

Stroke Journal

FEBRUARY 1, 2024

Transesophageal Echocardiogram (TEE) has traditionally been the gold standard for LAA clot detection. The yearly prevalence of new stroke is 3-7.5% But it is semi-invasive and have risks.

Echocardiogram 40

Echocardiogram Bicuspid/Mitral Stenosis Strokes 40

Dr. Smith's ECG Blog

JUNE 18, 2011

The patient had a critical LAD stenosis. When flow is restored, wall motion may completely recover so that echocardiogram does not detect the previous ischemia. Tight proximal LAD stenosis explains STE in precordial leads and I and aVL. All troponins were u ndetectable (less than 0.04 He underwent CABG. Conclusions: 1.

STEMI 52

STEMI Pericarditis Hospital Aneurysm 52

Dr. Smith's ECG Blog

OCTOBER 30, 2023

The first hs troponin I returned at 1100 ng/L Angiogram Lesion on 1st Obtuse Marginal : Proximal subsection = 90% stenosis Stented. Pre procedure TIMI III flow was noted. Post Procedure TIMI III flow was present.

STEMI 122

STEMI Heart Failure Stents Stent 122

Dr. Smith's ECG Blog

JUNE 11, 2024

Angiogram findings included: 95% mid RCA stenosis with occluded distal right PDA secondary to thrombus (peristent OMI). Successful drug-eluting stent placement opening up 95% mid RCA stenosis to 0% residual Nonobstructive left system disease. Formal echocardiogram: Systolic function is at the lower limits of normal.

Chest Pain 112

Chest Pain STEMI Blog Exercise 112

Journal of Cardiovascular Electrophysiology

JANUARY 11, 2024

Afterward, a transesophageal echocardiogram guided implantation of both a Micra AV 2 (Medtronic) leadless pacemaker in the interventricular septum within the right ventricle and an Aveir (Abbott) leadless pacemaker in the superior base of the right atrial appendage was performed with successful pacing.

Pacemaker 40

Pacemaker Congenital Heart Disease Congenital Anatomy 40

Dr. Smith's ECG Blog

APRIL 24, 2015

An echocardiogram showed: Left ventricular hypertrophy concentric. The estimated left ventricular ejection fraction is 58 % Aortic stenosis, mild, 9.0 A third ECG was done about 25 minutes after the first: This shows resolution of all apparent ischemia. The patient thus did not need immediate angiography. mmHg mean gradient.

Cardiac Arrest 52

Cardiac Arrest Defibrillator Atrial Fibrillation Ischemia 52

EMS 12-Lead

JULY 24, 2023

Category 2 : An increase in myocardial oxygen demand due to tachycardia, elevated ventricular afterload (BP or aortic stenosis), or increased wall stretch (admittedly this latter is more complicated) or a decrease in oxygen supply due to hypotension, anemia, hypoxia, or a combination of all of the above. Aortic Stenosis f. g/dL, WBC 7.4

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

Circulation

NOVEMBER 11, 2024

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.

Coronary Artery Disease 40

Coronary Artery Disease Angioplasty Anatomy Angina 40

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

A transthoracic echocardiogram showed an LV EF of less than 15%, critically severe aortic stenosis , severe LVH , and a small LV cavity. The aortic valve in this example also had critical stenosis by Doppler The patient continued to be hemodynamically unstable with poor cardiac output and very high LV filling pressures.

Ischemia 40

Ischemia Cardiogenic Shock Aortic Stenosis 40

All About Cardiovascular System and Disorders

JANUARY 14, 2024

Another important role is for detection of coronary anomalies, which can also be seen on echocardiogram sometimes. Post operatively there could be branch pulmonary artery stenosis, residual right ventricular outflow tract obstruction, pulmonary regurgitation or residual left to right shunts noted during long term follow up.

Congenital Heart Disease 52

Congenital Heart Disease Pulmonary Anatomy Congenital 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

First troponin I returns at 48 ng/L ECG 5 143 min No significant change ECG 6 261 min Same hs Troponin I profile (peaked at 1849): Formal Echocardiogram SUMMARY The estimated left ventricular ejection fraction is 74 %. Eur Heart J 2018. Full text link. The estimated pulmonary artery systolic pressure is 27 mmHg + RA pressure.

Chest Pain 115

Chest Pain Myocardial Infarction STEMI Pericarditis 115

Dr. Smith's ECG Blog

JUNE 27, 2024

The echocardiogram showed a normal EF without any abnormalities. With ongoing transcutaneous pacing, Cardiology emergently took the patient to the cath lab for temporary pacing wire placement via right IJ which she tolerated well. Troponins were all negative. There was no apparent reversible cause found for the worsening heart block.

Blog 119

Blog Pacemaker Bradycardia Tachycardia 119

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

EKG initially negative but repeat shows a few T wave abnormalities… There is a chance this could be non-cardiac pain” At 1518, an echocardiogram showed normal LV size and systolic function with hypokinesis of the mid and distal anterior wall and the mid and distal septum. RAO Caudal view: This is the RAO Caudal view.

Chest Pain 119

Chest Pain Blog Hospital Tachycardia 119

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. Angiographic monitoring of responses to thrombolytic therapy has shown that after lysis of the offending thrombus, the underlying stenosis is often not the cause of the critical stenosis of the artery.

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Smith's ECG Blog

MARCH 9, 2013

For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. The peak troponin I was 0.364 ng/ml.

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

History sounds concerning for ACS (could be critical stenosis, triple vessel), but differential also includes dissection, GI bleed, etc. See this case: what do you think the echocardiogram shows in this case? 2 cases of Aortic Stenosis: Diffuse Subendocardial Ischemia on the ECG. His response: “subendocardial ischemia.

Ischemia 52

Ischemia STEMI Stenosis Chest Pain 52

All About Cardiovascular System and Disorders

APRIL 4, 2024

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. Planimetry of mitral valve area can be obtained in parasternal short axis view in case of mitral stenosis. Wall motion of the left ventricle can be assessed in this view also.

Bicuspid/Mitral 40

Bicuspid/Mitral Echocardiogram Tricuspid Aortic 40

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex. The cardiologist called this 20% stenosis. Initial hscTnI was 10 ng/L (ref. <14).

Plaque 65

Plaque Stents Stent Chest Pain 65

Dr. Smith's ECG Blog

DECEMBER 19, 2023

link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. His echocardiogram showed normal wall motion. This is written by Willy Frick, an amazing cardiology fellow in St. Before and after of the LAD shown below.

Plaque 126

Plaque Angina Blog Stents 126

All About Cardiovascular System and Disorders

APRIL 9, 2024

Echocardiogram in parasternal long axis view shows dilated left ventricle, left atrium, aorta and a small portion of the right ventricle, which is usually the outflow region. When there is associated mitral stenosis, the colour Doppler jet of mitral flow merges with that of aortic regurgitation in the left ventricle as both occur in diastole.

Aortic 40

Aortic Bicuspid/Mitral Aortic valve Stenosis 40

Dr. Smith's ECG Blog

OCTOBER 28, 2013

An echocardiogram on day 3 showed no wall motion abnormality (but of course, these can resolved with reperfusion, and the more time it has to resolve from "stunning", the more likely it is to be resolved). The troponin I peaked at 8.1.

Cardiac Arrest 52

Cardiac Arrest Ischemia Defibrillator Electrocardiogram 52

Dr. Smith's ECG Blog

JANUARY 28, 2023

hours after that first diagnostic ECG) : Mid-LAD culprit lesion, 99% stenosis, no pre-intervention TIMI flow available, but described as "severe subtotal lesion", which was stented with reported TIMI 3 flow resulting. Another lesion in the proximal LAD with 80% stenosis was stented as well. Culprit is 100% stenosis in the Proximal LAD.

STEMI 52

STEMI Chest Pain Stents Stent 52

Dr. Smith's ECG Blog

JULY 16, 2022

A 3rd troponin returned before the angiogram was done and was 2956 ng/L Here is the angiogram description: The distal RCA has mild diffuse disease and bifurcates to give a large RPDA which is without significant stenosis. The RPAV has flush occlusion with TIMI-0 flow and is likely the culprit.

Chest Pain 52

Chest Pain Bradycardia Blog Critical Care 52

Dr. Smith's ECG Blog

NOVEMBER 1, 2022

After discussing all of the above with ED staff, we have made a decision to get stat echocardiogram and assess overall LV function and wall motion abnormalities and defer cath lab activation at the time." On the other hand, stable EKG over an hour in the setting of ongoing acute coronary syndrome is again unusual.

Chest Pain 52

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

EMS 12-Lead

AUGUST 22, 2022

Indeed, bedside Echocardiogram revealed severe left ventricular impairment of Takotsubo cardiomyopathy. The coronary angiogram revealed no critical stenosis, or acute plaque ulceration. Furthermore, pertinent electrolyte values (e.g. potassium) were within normal parameter.

Tachycardia 52

Tachycardia Cardiomyopathy Electrophysiology ICU 52

Dr. Smith's ECG Blog

MARCH 28, 2017

She was treated medically for NonSTEMI, pending next day cath, which showed ulcerated plaque and a 60% thrombotic stenosis in the LAD distal to the first diagonal. A formal contrast echo was done at this point : Normal estimated left ventricular ejection fraction, 65%. Regional wall motion abnormality-distal septum and apex. It was stented.

STEMI 40

STEMI Risk Factors Bicuspid/Mitral Ultrasound 40

Dr. Smith's ECG Blog

JULY 3, 2018

Here are the images from the cardiac cath: Mid to distal-LAD in-stent stenosis with 100% occlusion and TIMI flow 0 LAD post-DES placement with TIMI 3 flow The amount of territory supplied by this vessel becomes obvious here (and goes on for a few more frames below this still). No further echocardiograms were available after cath.

Pericarditis 52

Pericarditis Chest Pain Stents Stent 52