Dr. Usman's Cardiology Notes

Case 76: 80 year old man with severe Left ventricular systolic dysfunction secondary to ischemic cardiomyopathy, what are the findings in this ECG? Click the button below to view answer: Show Answer

Bicaval view showing ASD closure device in Interatrial septum

A 78 year old female, diabetic, overweight and hypertensive presented with severe shortness of breath, orthopnea and paroxysmal nocturnal dyspnea. She has limited mobility at home due to easy fatigue. On examination she was restless , tachycardiac with heart rate of 130 beats per minute, respiratory rate of 26 per minute and Blood Pressure of 110/60 mmHg. Auscultation revealed ejection systolic murmur at upper sternal border radiating to neck, S 3 gallop and a displaced PMI on palpation. There were bilateral crackles in the chest. ECG showed ST depression in anterior precordial leads. Labs revealed a Troponin of 170, Creatinine of 2.0 mg/dl and BNP of 1617. Chest X-Ray revealed pulmonary edema. Echocardiography revealed EF of 35%, global hypokinesia, Aortic Valve Area of 0.8cm 2 and a mean gradient of 28 mmHg. a) What are the treatment options available and which would you recommend for her? b) Name recent trial conducted for such intermediate to high risk patients and its result inter...

A 40 years old male diabetic with previous history of myocardial infarction and LVEF 35% presented with shortness of breath and chest pain. His functional capacity is poor due to underlying dyspnea on exertion. He was apprehensive, tachycardiac and maintaining his BP around 100/60 mmHg. ECG showed gross ST depression in precordial leads more than 2mm with non-progressive R waves. Trops were negative. Immediately on arrival to CCU he suddenly collapse and started gasping, monitor showed monomorphic VT with rate of 200bpm. He was resuscitated with 200Jshock and CPR for 5minutes. On revival, he was shifted to cath lab where coronary angiogram showed TVCAD a)       What is the reason for monomorphic VT b)       Would you consider ICD for this patient during his hospital stay c)       What additional workup is indicated before surgery d)       What is the mortality of CABG? Answers: a.  ...