Dr. Usman's Cardiology Notes

    Infection Prevention & Control Assessment   Total MCQs = 30   Key is given at the end.   1.   What is the primary objective of environmental cleaning in healthcare settings according to WHO?         A. To maintain a pleasant smell in patient areas          B. To meet hospital accreditation standards         C. To remove dirt and reduce the presence of microorganisms         D. To reduce laundry workload   2.   Which of the following surfaces requires the most frequent cleaning?         A. Walls         B. Bed rails         C. Ceilings         D. Windows   3.   According to WHO guidelines, how often should high-touch surfa...

  So the QRS !!!!!  A few have posed me this question about the true value of QRS , its morphological presentations ,especially the clues in it , for the identification of the various types of abnormalities especially the tachycardias based on these QRS features .  But To understand the abnormalities , one must be able to understand the normalities & especially the slight aberrations associated with the other wise normalities !  The QRS is usually a very well-defined electrical signal on surface ecg and is indicative of underlying ventricular depolarisation phase( since a large mass of muscle is activated almost synchronously hence the larger deflections & this time interval coincides with repolriazation of atrium, hence the latter repolriazation is masked in the QRS complex) . The QRS usually lasts about 100 msec or even less (on average May be of 60 msec to 80 msec duration) ! Generally a duration longer than 120 msec is considered longer! The even more ...

Mitral Valve Prolapse: A Comprehensive Review Mitral Valve Prolapse (MVP) is a common valvular heart condition characterized by the displacement of the mitral valve leaflets into the left atrium during systole. This article provides an in-depth look at the diagnosis, echo findings, and auscultation maneuvers used to identify MVP. Pathophysiology In MVP, the mitral valve leaflets bulge backward into the left atrium due to: 1. Myxomatous degeneration: Thickening and redundancy of the valve leaflets. 2. Chordal elongation: Stretching or rupture of the chordae tendineae. Echo Findings Echocardiography is the primary diagnostic tool for MVP. Key findings include: 1. Leaflet displacement: > 2 mm displacement of the leaflets beyond the mitral annular plane. 2. Leaflet thickening: Thickening of the leaflets (> 5 mm). 3. Mitral regurgitation: Color Doppler assessment of regurgitant flow. 4. Left atrial enlargement: Enlargement of the left atrium due to chronic regurgitation. Auscultation ...

✔Bidirectional VT The tachycardia with an identity crisis. What you'll see: Beat-to-beat alternation in QRS axis (often ~180) RBBB-like morphology, most visible in lead Il or aVF Regular rhythm, but clearly not your standard VT Why it most likely happens: Triggered activity (delayed afterdepolarizations) Classically: two competing ventricular foci or alternating fascicular exits Top causes: Digoxin toxicity (check that level!) CPVT (stress-induced VT in the young) Andersen-Tawil syndrome Rare: aconite poisoning, myocarditis Key point:  BiVT is rare - but when you see it, it narrows the differential dramatically.

  A Gerbode defect is a rare congenital heart defect characterized by a direct communication between the left ventricle (LV) and the right atrium (RA). This defect allows oxygenated blood to flow from the LV into the RA, bypassing the normal pathway through the aorta. Types of Gerbode Defects There are two main types of Gerbode defects: 1. Congenital Gerbode defect: This type is present at birth and is often associated with other congenital heart defects. 2. Acquired Gerbode defect: This type can occur due to trauma, infection, or as a complication of cardiac surgery. Clinical Presentation Patients with a Gerbode defect may present with: 1. Symptoms of heart failure (e.g., shortness of breath, fatigue) 2. Murmurs or abnormal heart sounds 3. Increased risk of endocarditis Diagnosis Diagnosis of a Gerbode defect typically involves: 1. Echocardiography: This can show the abnormal communication between the LV and RA. 2. Cardiac catheterization: This can help confirm the diagnosis and a...

  Case of Mahaim Fiber pathway related Tachycardia: During atrial pacing, the above tachycardia is induced. In Differentiating wide complex tachycardia following points should be considered. During atrial pacing (the 1st beat), the His catheter has the activation sequence proximal to distal (antegrade His activation). During the 2nd paced beat, the His deflection (on proximal His) gets buried within the ventricle (block of the AV node, maximal preexcitation) and antidromic tachycardia is induced. During tachycardia, the His activation sequence is reversed, and distal His is before proximal His. Therefore, the activation of the His bundle is retrograde during tachycardia, but still before ventricular activation. This is only possible in the presence of an extranodal pathway inserting in the fascicle just below the His bundle, most frequently the right bundle (Mahaim). Careful examination of the sequence of His bundle activation can lead to the correct diagnosis already at first gla...

The Link Between Red Meat and Heart Disease: Understanding the Role of Saturated Fat and TMAO Red meat has long been associated with an increased risk of heart disease, and recent research has shed light on the potential mechanisms behind this link. Two key factors that contribute to this association are high saturated fat levels in red meat and the production of Trimethylamine N-oxide (TMAO), a dietary byproduct formed by gut bacteria during digestion. Saturated Fat: A Contributor to Heart Disease Saturated fat, found in high levels in red meat, can increase the risk of heart disease by: 1. Raising low-density lipoprotein (LDL) cholesterol: LDL cholesterol can accumulate in the walls of arteries, forming plaques that narrow the blood vessels and restrict blood flow. 2. Increasing inflammation: Saturated fat can trigger inflammation in the body, which can further damage blood vessels and increase the risk of heart disease. TMAO: A Hidden Culprit Trimethylamine N-oxide (TMAO) is a dieta...