Dr. Usman's Cardiology Notes

Highlights of the first day of the 2023 ESC Congress:  1- SGLT2 inhibitors are recommended as class I in HF mrEF and HFpEF (dapagliflozin and empagliflozin)  2- there is no change in the strategies of antithrombotic treatment in patients with ACS : Aspirin + P2Y12 inhibtirs for 12 months flooded by aspirin alone for life long (class I).  3- Surgery is recommended for early Prosthetic valve endocarditis (less than 6 months) with new valve replacement and complete debridement (class IC) 4- ACS management in cancer patients: Invasive strategy if the life expectancy >6 months  Conservative management if poor prognosis  Antithrombotic therapy according to platelet count 5- SGLT2 inhibitors are recommended as first line treatment ( class I) in type 2 diabetic patients with established ASCVD (to reduce CV risk independent of glucose control , in type2 diabetic patients with HF(to reduce HF hospitalizations ), and in type 2 diabetic patients with CKD (to reduce ...

BRADI mnemonic for reversible causes of bradycardia 1. BRASH/hyperkalemia Isolated hyperkalemia  BRASH syndrome (Bradycardia, Renal failure, AV node blockade, Shock and Hyperkalemia) 2. Reduced vital signs Hypoxia Hypoglycemia Hypothermia +/- hypothyroid 3. Acute coronary occlusion Inferior MI: nodal ischemia and vagal response, self-limiting or responds to atropine Anterior MI: infranodal ischemia, often requires pacing 4. Drugs: withdraw if stable, reverse if unstable Beta-blockers Calcium channel blockers Digoxin 5. Intracranial pressure, Infection (Lyme, endocarditis): treat underlying

BRASH Syndrome B - Bradycardia R - Renal failure A - AV nodal blockade S - Shock H - Hyperkalemia Typical ECG in BRASH: HR 30, peaked T waves, flattening of P waves (Bradycardia out of proportion to other findings of hyperkalemia) BRASH Treatment:  • Aggressive treatment of hyperkalemia  • Consider epinephrine (↑HR and drives K+ intracellularly)  • If hypovolemic, give IV fluids ("balanced fluids" > normal saline)  • If on a Ca2+ channel blocker, ß blocker, or digoxin, consider reversal strategy

    PISA Method for Mitral Regurgitation & Hemodynamic Assessment explained by Dr. Sunil Mankad MD ✅ Visit Echo MOCK Exam Section >> ✅ Visit Echo Board Review Lectures >>   ✅ Visit Echo MCQs Section >> ✅ Visit ECHO Library to explore more resources.     Keep Visiting for new collections &  Subscribe my YouTube Channel   for latest posts.      

    ✅ Visit Echo MOCK Exam Section >> ✅ Visit Echo Board Review Lectures >>   ✅ Visit Echo MCQs Section >> ✅ Visit ECHO Library to explore more resources.     Keep Visiting for new collections &  Subscribe my YouTube Channel   for latest posts.

  Current guidelines admit, however, that the management of patients with asymptomatic AS (including a normal exercise test) and normal left ventricular function remains controversial. Decision-making requires careful weighing of risk and benefit. In this regard, the fact that catheter interventional treatment of AS is rapidly evolving and recent data demonstrate that the risk of both, surgical AVR and transcatheter aortic valve implantation (TAVI) have markedly decreased over the years has an obvious impact as this may change the threshold to intervene in asymptomatic patients when weighing risk vs. potential benefit. On the other hand, the complexity of long-term planning considering the consequences for later re-interventions, access to coronary arteries after TAVI, and other aspects have been recognized. New important data including randomized controlled trials comparing watchful waiting vs. early surgery in asymptomatic AS have also been provided. Thus, it appears timely to re...

 Assessment of Low Flow, Low Gradient Aortic Stenosis by Echocardiography. ✅ Visit Echo MOCK Exam Section >> ✅ Visit Echo Board Review Lectures >>   ✅ Visit Echo MCQs Section >> ✅ Visit ECHO Library to explore more resources.     Keep Visiting for new collections &  Subscribe my YouTube Channel   for latest posts.