Know all about human heart: July 2011

[postlink]http://abcheart.blogspot.com/2011/07/cardiac-stress-echocardiogram.html?m=0[/postlink]http://www.youtube.com/watch?v=oIPaRAf6sQ0endofvid

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Cardiac stress echocardiogram.

What are you suppose to expect?

It is an ultrasound which is done to see your heart at rest, during and after exercise. This gives an estimate of your heart’s pumping capacity and response to exercise.

Who should get it?

Patient with risk factors for heart disease, to rule out any underlying heart disease.

Following a heart attack to assess the heart function.

Patients with heart disease prior to any major surgery

Patient with previous heart attack, who have symptoms of chest pain or breathing
difficulty at present.

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Cardiac stress echocardiogram

[postlink]http://abcheart.blogspot.com/2011/07/how-to-read-ekg-2.html?m=0[/postlink]http://www.youtube.com/watch?v=ijVu77eSukoendofvid

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Part 2 of EKG podcast by Dr. Dean Keller and Dr. Melissa Stiles. This segment focuses on cardiac rhythm identification and significance of “P” wave.

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How to Read an EKG - 2?

[postlink]http://abcheart.blogspot.com/2011/07/how-to-read-ekg.html?m=0[/postlink]http://www.youtube.com/watch?v=TOkpUURCm9Mendofvid

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Dr. Dean Keller and Dr. Melissa Stiles discuss the fundamental steps in reading an EKG
in this podcast. They talk about the injury and infarct pattern of ST segment in EKG.
Localization of Myocardial infarction based on ST changes in the particular EKG leads is
also discussed.

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How to Read an EKG?

[postlink]http://abcheart.blogspot.com/2011/07/how-to-use-intra-aortic-balloon-pump.html?m=0[/postlink]http://www.youtube.com/watch?v=RU1gEBNK1pYendofvid

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Intra aortic balloon pump (IABP) is used in patients with Cardiogenic shock. The procedure involves
passing a catheter through the groin like the cardiac catheterization. Through a guide wire the balloon is
placed with its tip distal to the left subclavian artery. This video explains the entire procedure in detail.
Trouble shooting the common problems encountered when a patient is on IABP is also well explained.

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How To Use Intra Aortic Balloon Pump (IABP)

[postlink]http://abcheart.blogspot.com/2011/07/intra-aortic-balloon-pump-iabp.html?m=0[/postlink]http://www.youtube.com/watch?v=o11fhdVOYWAendofvid

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What is Intra aortic balloon pump (IABP)? What is its function and how it helps patient with heart disease?

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Intra Aortic Balloon Pump (IABP)

[postlink]http://abcheart.blogspot.com/2011/07/what-is-shock.html?m=0[/postlink]http://www.youtube.com/watch?v=9a7N9AU1GiQendofvid

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What is shock? Why does it happen in patients after a heart attack or acute myocardial infarction?

In heart attack the part of the muscle that is deprived of its blood supply undergoes cell death and is

not able to perform its function. When the heart looses enough muscle it cannot perform its pumping

function. This in turn decreases the blood pumped by the heart to various organs like brain, kidney

etc. Decrease in blood flow leads to decrease in oxygen supply to vital organs and symptoms of shock

appear.

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What is Shock?

[postlink]http://abcheart.blogspot.com/2011/07/syntax-trial-2.html?m=0[/postlink]http://www.youtube.com/watch?v=PUEB7y2WA9Uendofvid

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Part II of the syntax trial. The panel experts dig further about the details of the SYNTAX trial. What is to be expected in future are more trials looking at the same focus. FREEDOM trial is on its way funded by National Heart Lung Blood Institute. (NHLBI)

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SYNTAX Trial -2

[postlink]http://abcheart.blogspot.com/2011/07/comparison-between-pci-and-cabg.html?m=0[/postlink]http://www.youtube.com/watch?v=FqEOEjENiU8endofvid
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The expert panel members are discussing about landmark SYNTAX trial which compared between
PCI and CABG for treatment of acute myocardial infarction. In practice for left main coronary artery
disease and complex 3 vessel coronary artery disease still CABG (coronary artery by pass grafting) is the
treatment of choice. But this trial makes us step back and think…
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Comparison between PCI and CABG

[postlink]http://abcheart.blogspot.com/2011/07/benefits-of-ivus.html?m=0[/postlink]http://www.youtube.com/watch?v=TZDAhkXjwWoendofvid
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Does use of IVUS change the outcome of acute myocardial infarction? Do patients benefit from use of
IVUS?
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Benefits of IVUS

[postlink]http://abcheart.blogspot.com/2011/07/ivus-intravascular-ultrasound.html?m=0[/postlink]http://www.youtube.com/watch?v=jpMC8RtciZAendofvid
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IVUS (Intravascular ultrasound) is an ultrasound probe used during cardiac catheterization to take a
closer look at the coronary artery and the blockage.
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IVUS (Intravascular ultrasound)

[postlink]http://abcheart.blogspot.com/2011/07/thrombus-aspiration-in-primary.html?m=0[/postlink]http://www.youtube.com/watch?v=_bUMm8E0w6sendofvid
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Thrombus aspiration is new technique in primary angioplasty. The clot is sucked by a catheter before
deployment of the stent. This reduces the risk of breaking of the clot during the procedure. Thus
reduces the risk of any new occlusion.
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Thrombus Aspiration in Primary Angioplasty

[postlink]http://abcheart.blogspot.com/2011/07/formation-of-blood-clot_19.html?m=0[/postlink]http://www.youtube.com/watch?v=36_qHWLFzI0endofvid
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Primary PCI. NEJM (New England Journal of Medicine) video. Explaining the pathology of acute STEMI.
The treatment option for primary PCI includes balloon angioplasty or placement of bare metal stent.
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Primary PCI

[postlink]http://abcheart.blogspot.com/2011/07/diagnosis-and-treatment-of-acute.html?m=0[/postlink]http://www.youtube.com/watch?v=v2dLSnzVvmEendofvid
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Diagnosis of ACS is made by a combination of chest pain, ekg changes and elevation in cardiac enzymes. Emergent managment includes pain relief with nitrate and/or morphine, Aspirin, Plavix, heparin, GP IIb IIIA inhibitor. Patient is sent to the cath lab for PCI after emergent management.
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Diagnosis and Treatment of Acute Coronary Syndrome (ACS)

[postlink]http://abcheart.blogspot.com/2011/07/door-to-ballon-time.html?m=0[/postlink]http://www.youtube.com/watch?v=YFcnt56o6HIendofvid
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In a patient with acute coronary syndrome going for PCI/ coronary angioplasty, the time from arrival to the hospital to the placement of the stent should be less 90 minutes to ensure optimal outcome.
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Door to Ballon Time

[postlink]http://abcheart.blogspot.com/2011/07/cardiac-enzymes.html?m=0[/postlink]http://www.youtube.com/watch?v=QkT8if1b6aoendofvid
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When a patient is admitted with Acute heart attack, a series of tests are run which includes a complete blood count, metabolic panel which includes lectroloytes and kidney function, Lipid panel and most important troponin (Cardiac enzyme which is released in to the blood due to heart muscle damage) which is checked every 6 hours.
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Cardiac Enzymes

[postlink]http://abcheart.blogspot.com/2011/07/glycoprotein-iibiiia-inhibitors-in.html?m=0[/postlink]http://www.youtube.com/watch?v=QGZwXBAWI_oendofvid
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Glycoprotein IIb/IIIa inhibitors are a group of drugs which your doctor might use if he is doing a cardiac catheterization and coronary angioplasty. It inhibits platelet function and keeps the blood thinner and hence prevents clot formation during the procedure.
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Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Coronary Angioplasty

[postlink]http://abcheart.blogspot.com/2011/07/who-should-take-statin.html?m=0[/postlink]http://www.youtube.com/watch?v=vhFasCO7PuIendofvid
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Does everyone at risk for heart disease should take a statin? It is still an ongoing debate! There has been convincing evidence that people who have ongoing inflammation in their body as measured by (CRP) C- reactive protein will benefit irrespective of the level of cholesterol. The commonly used statins including rosuvastatin, atorvastatin, simvastatin, lovastatin and pravastatin all should be beneficial though there is difference in their potency. Generic ones also share the same effect.
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Who Should Take Statin?

[postlink]http://abcheart.blogspot.com/2011/07/atorvastatin.html?m=0[/postlink]http://www.youtube.com/watch?v=82WTSCo4iCkendofvid
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Atorvastatin belongs to the group of statin drugs. Statins help in the reduction of blood cholesterol and hence decreases the plaque formation, which is the basis for heart disease. The main side effects are muscle damage and liver injury. Not all people can take statin, so ask your doctor if it is right for you.
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Atorvastatin

[postlink]http://abcheart.blogspot.com/2011/07/prasugrel-new-agent-added-to-clot.html?m=0[/postlink]http://www.youtube.com/watch?v=0x9MqoSqrgYendofvid
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Prasugrel is a similar drug like clopidogrl. Triton-TIMI 38 trial compared prasugrel to clopidogrel with aspirin. results have been favorable in greater reduction of cardiac events in prasugrel group. however the bleeding risk is also higher. It should be a clinical judgment at this point to favor one.
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Prasugrel - New Agent Added to the Clot Buster Block

[postlink]http://abcheart.blogspot.com/2011/07/platelet-inhibition-plavix.html?m=0[/postlink]http://www.youtube.com/watch?v=pkbr0WupJiUendofvid
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Clopidogrel popularly known as Plavix is an anti platelet medication. It is used in high doses before coronary angioplasty and also as long term in patients who have cardiac stent. When taken with aspirin it has additional anti platelet effect and hence greater reduction in clot formation.
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Platelet Inhibition - Plavix

[postlink]http://abcheart.blogspot.com/2011/07/aspirin-in-heart-disease.html?m=0[/postlink]http://www.youtube.com/watch?v=hL8oup_1tn4endofvid
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There have been changes in recommendations for aspirin in patients at risk for heart disease. Dr. ....explains the changing trends and his views. Another key video discusses if women should take aspirin, to see it click HERE.
This video explains the benefits of taking aspirin for prevention of heart disease in women over 65 years and with major risk for CAD.

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Aspirin In Heart Disease

[postlink]http://abcheart.blogspot.com/2011/07/formation-of-blood-clot.html?m=0[/postlink]http://www.youtube.com/watch?v=--bZUeb83uUendofvid
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It is important to review how a blood clot is formed to have a better understanding of the medicines used in the treatment of acute heart attack. To recollect, heart attack occurs when a clot blocks a coronary artery and cuts of the blood supply to a particular part of your heart.
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Formation Of Blood Clot

[postlink]http://abcheart.blogspot.com/2011/07/cardiac-catheterization-and-coronary.html?m=0[/postlink]

http://www.youtube.com/watch?v=N7nghr9TpSUendofvid
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This is a catheter based treatment for acute heart attack. It involves placement of a cardiac stent which is either a metal one or coated with a special drug to prevent blood clot over the stent. The stent remains in place and enlarges the artery to increase the blood flow to the heart.
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