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Kussmaul sign! . . Described as a paradoxical rise in jugular venous pressure. . . Causes: constrictive pericarditis and restrictive cardiomiopathy as well as other causes of right ventricular failure . . #cardiologyquestions #cardiology #medicine #semiology #internalmedicine #medstudent #medstudents
Supraventricular tachycardia reversal! #cardiologyquestions #cardiology #arrhythmia #er #emergency #emergencyroom #emergencydepartment
3d Echo of a atrial myxoma! . . Beautiful image from @cardiologyoncall . . #cardiologyquestions #cardiology #medicine #echo #echocardiography #echocardiogram
What’s your answer? . . #cardiologyquestions #cardiology #echo #echocardiography #echocardiogram #echocardiographer
Did you know this device? Do you think this would be helpful? . . #cardiologyquestions #cardiology #medicine #acls #cpr #medschool #meded #medicallearning
SEVERE TRICUSPID REGURGITATION! . . Have you ever seen something like this? . . Video: @grepmed . . #cardiologyquestions #cardiology #medicine #internalmedicine #semiology
Have you ever seen something like this???? Posted @withregram • @cardiologyoncall COVID and clotting! . . . Here’s an amazing case presented by Dr. Mohammad Joumma on Twitter- . . . “Inferior ST elevation and reciprocal changes in a middle age AA male. Patient presented with mental status changes, respiratory distress and fever.Echo shows large mobile thrombus in multiple chambers and aorta likely DIC!Patient is possible #COVID19 thoughts?” . . . This is extensive thrombosis involving the left heart from the left atrium into the LV. From my limited experience I’ve run into significant thrombosis with COVID patients. Mainly venous however I suspect arterial thrombosis is occurring primarily being one of the causes for the acute renal failure we are seeing (renal microemboli)? More and more evidence seems to be emerging that COVID causes a DIC like reaction which may be causing the rapid decline and multi organ failure we are seeing in many patients. . . . Has anyone else seen this degree of thrombosis? Comment below! . . . #Covid19 #covid #coronavirus #DIC #corona #instadoc #cardiology #covid19fighter #covid19cardiologycoalition #ccc #accfit #clot #hospital #frontlines #ppe #covidmichigan
Cardiac Axis in ECG! Beautiful way to understand! . . #cardiology #cardiologyquestions #medicine #ecg #electrocardiogram #medstudents
In constrictive pericarditis (CP) there is a thickening, healing and eventually calcification of the pericardium that limits the diastolic filling of the ventricles. The pericardium becomes fibrotic and inelastic and the total cardiac volume cannot vary so results in an elevation and equalization of cardiac pressures determining ventricular interdependence. In inspiration, intrapleural pressure becomes more negative resulting in increased diastolic filling and RV inflow velocity with consequent reduction in LV inflow. With the progression and severity of the pathology, the cardiac output becomes lower and the systemic venous pressure higher and fluid retention may occur (limb edema, ascites, pleural effusion). Confirmation of the diagnosis should be made by imaging and hemodynamic data. Echocardiography remains the initial test of choice, with the ability to provide morphological, functional and hemodynamic understanding of the heart and pericardium. Echocardiographic findings suggestive of CP: • Two-dimensional mode: increased pericardial thickening (> 4mm), plethora of the inferior vena cava, dilation of the hepatic veins, enlargement of the atria and rectification of the left ventricular posterior wall. • Doppler: increased E-wave velocity, shortened deceleration time, and reduced A-wave. Mitral influx decreased by 25 to 40% and tricuspid velocity increased by more than 40 to 60% in respiratory variation. Increased tissue Doppler velocity (e') of the medial mitral annulus relative to the lateral mitral annulus. • Reverse diastolic flow in the hepatic vein increases on expiration. There is a reversal of flow progression during exhalation as the size of the right ventricular cavity is reduced due to a change in the interventricular septum side becoming less compliant than left ventricular filling. Source: Bispo IGB, Gimenes VML. HCor Echocardiography Practical Guide. Rio de Janeiro, Atheneu 2019 #cardiologyquestions #questionsin
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