Dr. Usman's Cardiology Notes

  Managment of STEMI as per ACC/AHA guidelines

Treatment of Narrow Complex Tachycardia (e.g., SVT) During Pregnancy • Vagal manoeuvres ↓ • Adenosine ↓ • Beta-blocker or Verapamil If the patient is unstable → DC shock

Tei Index (Myocardial Performance Index) in Echocardiography The Tei index, also known as the Myocardial Performance Index (MPI), is a simple, reproducible echocardiographic parameter that integrates systolic and diastolic ventricular function into a single numerical value. It is widely used for both left and right ventricular functional assessment and is relatively independent of heart rate and ventricular geometry. --- What Is the Tei Index? The Tei index reflects global ventricular performance by combining time intervals from Doppler echocardiography. Formula: \text{Tei Index (MPI)} = \frac{\text{IVCT} + \text{IVRT}}{\text{ET}} Where: IVCT = Isovolumic contraction time IVRT = Isovolumic relaxation time ET = Ejection time A higher Tei index indicates worse ventricular function. --- How Is Tei Index Measured on Echocardiography? 1. Pulsed-Wave Doppler Method (Conventional) Place PW Doppler at mitral inflow (LV) or tricuspid inflow (RV) Measure interval ‘a’ = time from end of one inflo...

CT Coronary Calcium Scoring (CAC Score): A Practical, Evidence-Based Guide for Clinicians Introduction CT coronary calcium scoring is a non-invasive, rapid, and widely validated tool for quantifying coronary atherosclerotic burden. By detecting and measuring calcified plaque in the coronary arteries, the CAC score refines cardiovascular risk assessment beyond traditional risk factors and directly influences preventive cardiology decisions—especially statin initiation and intensity. --- What Is CT Coronary Calcium Scoring? Coronary calcium scoring uses non-contrast, ECG-gated cardiac CT to detect calcified atherosclerotic plaques in the coronary arteries. The amount of calcium is quantified as an Agatston score, which correlates strongly with total plaque burden and future atherosclerotic cardiovascular disease (ASCVD) events. --- How the Test Is Performed Scan type: Non-contrast, ECG-gated CT Scan time: ~5–10 minutes Radiation dose: Low (≈1 mSv or less with modern scanners) Preparation...

MASTER COMPENDIUM — MAJOR CARDIOLOGY TRIALS (Ischemia, ACS, PCI, CABG, Lipids, HTN, Valves, HF-adjacent, VTE, PAD, Diabetes CVOTs, Stroke,Cardiac Electrophysiology, CRT, ICD, Atrial Fibrillation, VT etc.) --- DOWNLOAD PDF OF ALL CARDIOLOGY TRIALS HERE CLICK HERE 👉 DOWNLOAD   👇 Or You can Read All Here 👇  1. ACUTE CORONARY SYNDROME / MYOCARDIAL INFARCTION / FIBRINOLYSIS ISIS-2 Conclusion: Aspirin + streptokinase after acute MI markedly reduced mortality vs neither therapy. Key Points: Established aspirin as essential; demonstrated benefit of early reperfusion with fibrinolysis. GISSI-1 / GISSI-2 Conclusion: Early fibrinolysis reduced mortality; later GISSI refined therapies and showed benefits of ACE inhibitors and other measures. Key Points: Important early large trials shaping acute MI care pathways. GUSTO-I Conclusion: Accelerated tPA strategy reduced 30-day mortality versus streptokinase in STEMI. Key Points: Emphasized speed of reperfusion; informed primary PCI era tran...

Anti-Obesity Therapies in Cardiology — Modern Approaches Transforming Cardiometabolic Care Obesity is no longer seen as a lifestyle problem—it is a chronic, progressive, relapsing disease that directly amplifies the burden of cardiovascular morbidity and mortality. For cardiologists, effective weight-reduction strategies are now a core part of disease-modifying therapy, particularly for heart failure, coronary artery disease, hypertension, and atrial fibrillation. With the emergence of powerful anti-obesity medications and metabolic interventions, our therapeutic landscape has changed dramatically. --- 🔍 Why Obesity Management Matters in Cardiology Excess adiposity drives cardiac disease through multiple mechanisms: Hemodynamic stress: increased blood volume & cardiac output → LV hypertrophy, pulmonary pressures Metabolic dysfunction: insulin resistance, endothelial dysfunction, atherogenic dyslipidemia Inflammation: adipokines promote vascular inflammation & plaque instabilit...

  Central Line Lumens and Their Clinical Uses Overview Central venous catheters (CVCs) are indispensable tools in modern inpatient medicine. Their versatility comes from multiple lumens, each designed for simultaneous, independent access to the venous system. Proper knowledge about lumen size, flow characteristics, pressure capacity, compatibility of infused agents, and infection/thrombosis considerations is vital for ICU, ED, and cardiology teams. This article covers: ✔ Types of CVC lumens ✔ Functions of each lumen ✔ Best-practice allocation ✔ High-risk medication guidance ✔ Pearls for troubleshooting --- 1. What Is a Central Line Lumen? A lumen is an independent channel within a single catheter. Each lumen opens at a separate exit point on the catheter tip or shaft and has its own hub, allowing: Multiple infusions without mixing Blood sampling without disrupting infusions Titration of life-saving medications CVP monitoring High-flow resuscitation --- 2. Types of CVCs Based on Num...