Cardiology Notes: Clinical Cases including ECG, Echocardiography, Cath, and MOCK Exams to sharpen your cardiology data interpretation skills. Healthcare is stressful!!! Learning cardiology shouldn't be !!!
Search This Blog
Nuclear Cardiology Case: A 49-year-old woman with history of postprandial chest pain for the last 3 weeks
A 49-year-old woman with history of postprandial chest pain for the last 3 weeks. Evaluate for ischemia. SPECT myocardial perfusion studies were performed using Tc-99m-Sestamibi. Images representing myocardial perfusion were obtained at rest and peak stress .
Stress protocol is Treadmill / Bruce
Duration of stress is 4 min 39 sec
Heart rate (basal --> peak) is 76 --> 162 (85%=145)
Systolic BP (basal --> peak) is 140 --> 170
Double product (peak rate x BP) is 27,500
Reason for termination is Dyspnea.Atypical chest pain
ECG findings are Upsloping ST depression during stress, 1 mm horizontal ST depression during recovery
Brugada ECG vs Incomplete Right Bundle Branch Block (iRBBB) Why this differentiation matters Brugada pattern is a malignant channelopathy associated with sudden cardiac death, while incomplete RBBB is usually a benign conduction variant. Mislabeling Brugada as iRBBB can be fatal; overcalling iRBBB as Brugada can lead to unnecessary anxiety and ICD implantation. --- 1. Basic Definitions Brugada ECG Pattern Primary repolarization abnormality Genetic sodium-channel disorder Characteristic ST-segment elevation in V1–V3 Risk of ventricular fibrillation and sudden death Incomplete RBBB (iRBBB) Depolarization abnormality Delay in right ventricular conduction Common in healthy individuals Usually asymptomatic and benign --- 2. ECG Morphology: Side-by-Side Comparison QRS Duration Brugada: QRS usually <120 ms iRBBB: QRS <120 ms, but with RBBB morphology --- V1–V2 Pattern (Key Differentiator) Brugada Pseudo-RBBB appearance ST elevation ≥2 mm ST segment is coved or saddleback Terminal QRS bl...
Acute Treatment of Hyperkalemia – A Practical, Bedside-Oriented Guide Hyperkalemia is a potentially life-threatening electrolyte abnormality that demands prompt recognition and decisive management. The danger lies not only in the absolute potassium value but in its effects on cardiac conduction, which can rapidly progress to fatal arrhythmias. Acute treatment focuses on three parallel goals: stabilizing the cardiac membrane, shifting potassium into cells, and removing excess potassium from the body. Understanding this stepwise approach helps clinicians act quickly and rationally in emergency settings. Why Hyperkalemia Is Dangerous Potassium plays a key role in maintaining the resting membrane potential of cardiac myocytes. Elevated serum potassium reduces the transmembrane gradient, leading to slowed conduction, ECG changes, ventricular arrhythmias, and asystole. Importantly, ECG changes do not always correlate with potassium levels, so treatment decisions should be based on clinical c...
Comments
Post a Comment
Drop your thoughts here, we would love to hear from you