Category: Cardiology
Posted: 1/27/2013 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Category: Cardiology
Posted: 1/20/2013 by Semhar Tewelde, MD
(Updated: 9/7/2024)
Click here to contact Semhar Tewelde, MD
· Cyanosis in the newborn is defined as an arterial saturation <90% and a PO2 <60 torr
· To help differentiate between cardiogenic and non-cardiogenic causes initially obtain an arterial saturation on room air and obtain a subsequent measurements on 100% oxygen
· Infants w/neurogenic or pulmonary causes of cyanosis will demonstrate increases in arterial blood saturation on 100% oxygen while infants with congenital heart disease show minimal elevation
· There are 3 general sources of arterial desaturation in neonates with structural heart disease:
1.) Lesions with decreased pulmonary blood flow (tetralogy of Fallot, severe pulmonary stenosis/atresia, and tricuspid atresia)
2) Admixture lesions, in which desaturated systemic venous blood mixes with intracardiac blood, and then enters the aorta (transposition of great vessels, partial anomalous pulmonary venous drainage)
3) Lesions with increased pulmonary blood flow and pulmonary edema, in which diffusion barriers and intrapulmonary shunting prevent proper oxygenation (truncus arteriosus)
Flanagan MF, Taylor DC, "Cardiac Disease". In Avery GB, Fletcher MA, MacDonald MC, eds. Neonatology. Philadelphia: J.B. Lippincott. 1994:519.
Turley K. Intermediate results from the period of the Congenital Heart Surgeons Society Transposition Study 1985-1989. Ann Thorac Surg. 1995;60:505-510.
Category: Cardiology
Keywords: VAD (PubMed Search)
Posted: 1/13/2013 by Semhar Tewelde, MD
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Klein T, Jacob M. Management of Implantable Assisted Circulation Devices. Cardiology Clinics. 2012;30(4):673-682.
Category: Cardiology
Posted: 1/6/2013 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Bock J, Benitez M. Blunt Cardiac Injury. Cardiology Clinics. 2012;30(4):545-55.
Category: Cardiology
Posted: 12/30/2012 by Semhar Tewelde, MD
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Category: Cardiology
Posted: 12/23/2012 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Armstrong E, MD, Kulkarni A, Hoffmayer K, et al. Am J Cardiol 2012;110: 345–349
Category: Cardiology
Keywords: Pulmonary Arterial Hypertension (PAH) (PubMed Search)
Posted: 12/17/2012 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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A. Yao. Journal of Cardiology 60 (2012) 344–349
Category: Cardiology
Posted: 12/8/2012 by Semhar Tewelde, MD
(Emailed: 12/9/2012)
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Hijazi K. Coarctation of the aorta: From fetal life to adulthood. Cardiology Journal. 18(5):487-95, 2011
Category: Cardiology
Keywords: Kawasaki Disease, Mucocutaneous lymph node syndrome (PubMed Search)
Posted: 12/2/2012 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Scuccimarri R. Kawasaki Disease. Pediatric Clin N Am 59(2012)425-445
Category: Cardiology
Keywords: Rheumatic fever, rheumatic heart disease (PubMed Search)
Posted: 11/25/2012 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Marijon E. Mirabel M. Celermajer DS. Jouven X. Rheumatic heart disease. Lancet. 379(9819):953-64, 2012 Mar 10.
Category: Cardiology
Keywords: Torsades de pointes, prolonged QT syndrome (PubMed Search)
Posted: 11/18/2012 by Semhar Tewelde, MD
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Congenital and Acquired Long QT Syndrome.Cardiology in Review. 12(4):222-34, 2004 Jul-Aug.
Category: Cardiology
Posted: 11/11/2012 by Semhar Tewelde, MD
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Bazett's Formula QTc = QT/RR1/2
Category: Cardiology
Keywords: Long QT Syndrome (PubMed Search)
Posted: 11/11/2012 by Semhar Tewelde, MD
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Congenital and Acquired Long QT Syndrome.Cardiology in Review. 12(4):222-34, 2004 Jul-Aug
Category: Cardiology
Keywords: de Winter T wave, proximal LAD occlusion (PubMed Search)
Posted: 11/3/2012 by Semhar Tewelde, MD
(Emailed: 11/4/2012)
(Updated: 11/4/2012)
Click here to contact Semhar Tewelde, MD
An ECG pattern that signifies occlusion of the proximal left anterior descending coronary artery (LAD) without ST-segment elevation
de Winter R, et al. A New ECG Sign of Proximal LAD Occlusion. NEJM Nov, 2008:359;19
Category: Cardiology
Keywords: E-point septal separation (EPSS), left ventricular function, bedside emergency ultrasound (PubMed Search)
Posted: 10/28/2012 by Semhar Tewelde, MD
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EPSS is an accurate and rapid bedside estimation of left ventricular function
First an image of heart should be obtained in the parasternal long-axis view
The ultrasound cursor should be placed through the anterior leaflet of the mitral valve
Subsequently, M-mode is applied and the distance between the anterior leaflet and the interventricular septum is measured during early diastole
A measurement of 7mm or greater indicates poor EF (see attachment below)
Secko MA, Lazar JM, Salcicciolo LA, Stone MB. Can junior emergency medicine physicians use E-point septal separation to accurately estimate left ventricular function in acutely dyspneic patients. Acad Emerg Med. 2011;18:1223-6
Category: Cardiology
Posted: 10/20/2012 by Semhar Tewelde, MD
(Emailed: 10/21/2012)
(Updated: 10/21/2012)
Click here to contact Semhar Tewelde, MD
Cardiac amyloidosis can present along a spectrum from asymptomatic to severe CHF w/conduction abnormalities
ECG with low voltage + echocardiogram with thickened myocardium should heighten suspicion
Definitive Dx. is myocardial biopsy identifying the infiltrative lesion (MRI w/gad is also supportive)
AL (light chain) amyloidosis is an acquired disease from improperly functioning plasma cells
¨ Rapidly progressive and life threatening
¨ Tx. w/chemotherapeutic agents (+/- BMT)
Transthyretin-related (TTR) amyloidosis is produced by the liver (2 types)
Familial transthyretin-related amyloidosis (ATTR)
Senile systemic amyloidosis (SSA)
¨ Both are slowly progressive
¨ Tx liver transplant (ATTR) and supportive care (SSA)
Quarta C, Kruger J, Falk R. Cardiac Amyloidosis. Circulation. Sept 2012;126(2)178-182
Category: Cardiology
Keywords: Chagas Disease, AV Block (PubMed Search)
Posted: 10/13/2012 by Semhar Tewelde, MD
(Emailed: 10/14/2012)
(Updated: 10/14/2012)
Click here to contact Semhar Tewelde, MD
Etiological agent is the parasite Trypanosoma cruzi
Elizari M, Chiale P. Cardiac arrhythmias in Chagas' heart disease. Journal of cardiovascular electrophysiology.1993 vol:4 iss:5 pg:596 -608
Category: Cardiology
Keywords: Autoantibody-associated Congenital Heart Block, neonatal lupus, CHB (PubMed Search)
Posted: 10/7/2012 by Semhar Tewelde, MD
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Autoantibody-associated congenital heart block (CHB), also know as neonatal lupus, is responsible for the majority (~60-90%) of CHB
This is secondary to maternal antibodies that cross the placenta and may disappear postnatal
Neonatal lupus can result in diffuse myocardial disease both with and without conduction disturbances, structural defects, and electrophysiologic anomalies
Overall mortality is up to 30%, with 15% mortality before 3 months of age
More than 65% of surviving newborns require pacemakers
Maternal screening and fetal echocardiography has allowed routine prenatal diagnosis
Capone C, Buyon J, Friedman D, Frishman W. Cardiac Manifestations of Neonatal Lupus: A Review of Autoantibody-associated Congenital Heart Block and its Impact in an Adult Population. Cardiology Review. 2012, Mar-Apr;20(2):72-76
Category: Cardiology
Keywords: Heyde s Syndrome, aortic stenosis, angiodysplasia (PubMed Search)
Posted: 9/30/2012 by Semhar Tewelde, MD
(Updated: 9/7/2024)
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Aortic valve (AV) stenosis associated with gastrointestinal angiodysplasia
Proteolysis of Von Willebrand (type 2A) as it passes through the stenotic valve is one culprit of bleeding
Hemostatic abnormalities e.g. GI bleed are often corrected after AV replacement
Valve replacement is only recommended for cardiac symptoms
Vincentelli A, Susen S, et al. Acquired von Willebrand Syndrome in Aortic Stenosis. N Engl J Med 2003; 349:343-349
Category: Cardiology
Keywords: Brugada syndrome (PubMed Search)
Posted: 9/23/2012 by Semhar Tewelde, MD
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Mizusawa Y, Wilde A. Brugada Syndrome. Circ Arrhythm Electrophysiol. 2012;5:606-616.