Feeds:
Posts
Comments

Posts Tagged ‘drsvenkatesan ppt’

  

Psychological factors both depression and anxiety do confer a significant risk for CAD. However, a distinction must be made between risk factors and triggers. It is highly likely, depression has more consistent correlation with chronic CAD than anxiety. 

Primary anxiety per-se is of less of a risk factor for chronic CAD, while it can still be a trigger for cardiac events. (when it occurs over heightened baseline risk) Primary depression increases the CAD risk many fold by slowing the system making it sedentary and promote endothelial dysfunction, which is the key promotor of atherogenic CAD.

It is also noted, anxiety is less associated with obesity (when compared to depression). Further,catecholamine fluctuations that are so common in anxiety states may act like an exercise equivalent ( It’s my quirky hypothesis to be tested by future generations)

Emotions have a complex equation with neuro cardiac axis .Sudden emotional deaths due to possible arrhythmias or stress cardio-mypathies are important areas for research.

Sharing my presentation in one of the Annual physiologists conference held at Chennai in 2016.

Topic: Emotional Triggers in ACS 

 

Click here fro PDF version of the presentation

 

 

Read Full Post »

Its almost like playing a billiards game in absolute blindness.

It is not an unusual scenerio, to see the balloon catheter delicately bending at IAS puncture site , dodging and deflecting with random jerks as it tries to steal a entry in a few diastolic milliseconds time window when the fish mouthed mitral valve opens in sub square cm areas of MVO trembling in fast atrial fibrillation.

Agree ?

Gathered some tips to cross a difficult mitral valve during PTMC.

This is a PPT presentation taken from archive (Made in 2012)

Please pardon , it lacks audio.

PDF version : Prof SV PTMC mitral valve crossing

Final message

Often times Its noted we tend to struggle more at the mitral valve crossing than at IAS puncture during PTMC. Experience prevails over Image assistance. Assessment of LA size , IAS plane , and sub valvular disease seem to be critical. Probably the secret of success which I found out was , smart guys never hesitate to repeat IAS puncture site for optimal trajectory .Over the wire technique is not forbidden.

Unfortunately, TTE guidance is of little use to cross the mitral valve. Co-registration of fluro/3D TEE is promising , but most cardiologist continue to rely on their experience.

This always Intrigues me ! why we have abandoned retrograde crossing through the Aortic valve that avoids the dreaded IAS puncture. (Refer Dr V.K.Bahl AIIMS Newdelhi in a large series from Greece : Retrograde PTMC J Am Coll Cardiol 1998;32:1009–16)

Read Full Post »