Posted in Uncategorized, tagged drsvenkatesan, www.drsvenkatesan.co.in, www.drsvenkatesan.com, www.drsvenkatesan.wordpress.com, www.onlineheartcare.co.in on January 1, 2013| Leave a Comment »
The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.
Here’s an excerpt:
About 55,000 tourists visit Liechtenstein every year. This blog was viewed about 530,000 times in 2012. If it were Liechtenstein, it would take about 10 years for that many people to see it. Your blog had more visits than a small country in Europe!
Posted in Cardiology - Clinical, infective endocarditis, Infrequently asked questions in cardiology (iFAQs), tagged bacterial vegetation, cardiology, drsvenkatesan, healed vegetation, infective endocarditis, mitral valve, vancomycin on August 19, 2012| Leave a Comment »
When do you call a infected heart as healed ?
Should the vegetation disappear to call it a cure ?
Vegetation’s rarely disappear following treatment . Very small vegetation may dissolve – 20% . Many times it regress in size .
Often our aim should be restricted to sterilise the vegetation. This invariably happens in most of the patients who receive complete course of antibiotic. But healing and sterilizing is not enough in many vulnerable patients.If the vegetation is large the embolic risk is still there even with a healed vegetation.
So if there is a relatively large (>1.5cm) vegetation it is always better to remove by surgery.
Interventional techniques may soon allow capturing these vegetation by basket catheters .When technology is there to retrieve small bits of a thrombus inside a coronary artery it should be possible to remove a large vegetation with temporary aortic filters in place.
Also read
Posted in cardiology -Therapeutics, Cardiology lipids /dyslipidemia, tagged atorvastatin, cardiology, cholesterol, coronary artery disese, drsvenkatesan, dyslipidemia, effect of statin on HDL, hdl, hyperlipidemia, ldl, lipids, simvastain, statin on August 4, 2012| 2 Comments »
Statins have revolutionised the treatment of coronary artery disease .Intensive lipid lowering is the fundamental prerequisite in the management of both acute and chronic coronary syndromes. One question is always difficult to answer , ( rather reluctant to find the answer ) “The effect of statins on the HDL cholesterol”. Logic and the mechanisms of action would suggest HDL is not much affected , but in reality I believe , in a given patient statins do reduce the HDL by at-least 10-20 % .This might have some significance. However , the marked reduction in LDL may nullify the adverse effects of lowering HDL. Does this happen in all
What does the scientific evidence say ?
It says the opposite . It seems HDL is raised by statins that too significantly . The following paper also suggests mechanism of HDL elevation by statins .It is Independent to that of LDL reduction , I believe .
This JAMA article adds more evidence
http://jama.jamanetwork.com/data/Journals/JAMA/5100/jpc70001_499_508.pdf
This paper from the premier Journal of Lipid research agrees to the mechanism of HDL reduction by statin is a complex process but still it vouches for it .
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035518/?report=printable
In spite of all these evidence . . . it remains a huge suspect . . . from my personal point of view ( My patients are my evidence ! )
Coming soon
The above articles also raise an important concept of dysfunctional HDL. Simple raise in HDL is not suffice . . .it should be functional as well !
Posted in dr s venkatesan -Personal, general medicine, tagged best cardiologist india, cardiologist, cardiology fellows training, crash course on cardiology, dr s venkatesan, drsvenkatesan, ethical cardiologist, good cardiologist, madras medical college, teaching video in cardiology, venkatesan sangareddi on August 18, 2011| 11 Comments »
Here is a video recipe !
Posted in Echo library and gallery, echocardiography, Uncategorized, tagged dr s venkatesan, drsvenkatesan, echo clippings, echo clips, echo for diagnosis, echo quiz, echo spot diagnosis, echocardiography videos, interesting echo images, non compacted rv, pulmonary balloon valvotomy, ra rv dilatation, rare echo cases, rv dp/dt, rv dysfunction, sever vps, stunning echocardiography, valvular pulmonary stenosis, venkatesan s on November 5, 2010| 3 Comments »
A female child aged 14 was referred for progressive breathlessness and abdominal distension
Abnormally dilated right atrium with significant pericardial effusion .www.drsvenkatesan.com
Can you guess the diagnosis ?
Apart form RA ,RV dilatation , the RV apex is seen filled with coarse treabeculations.This is believed to be a type of non compaction http://www.drsvenkatesan.com
Still difficult to conclude ? Look at the following Image.
Tricuspid regurgitation is significant . http://www.drsvenkatesan.com
If you have thought . . .
All are acceptable differential diagnosis
But the real diagnosis is none of the above .
Need more time . . . the following Doppler tracing will settle the issue !
Doppler velocity in RVOT at 88mmhg. http://www.drsvenkatean.com
The final diagnosis was . . .
Here , RV functional assessment becomes vital , but it is difficult many times. A simple clue is , as the RV is able to generate 88mmhg pressure it implies , the contractility should be near normal .
RV EF %, RV Dp/Dt , Tricuspid annular motion by tissue Doppler are additional measures. Cine MRI can be a useful investigation prior to intervention.
Final message
Posted in bio ethics, cardiology -Therapeutics, cardiology-ethics, Uncategorized, tagged cardiac safety research consortium, cardiology, csrc, dcri, drsvenkatesan, duke university, ethics in cardiology, fda on June 20, 2010| Leave a Comment »
There are thousands of forums for medical science.
Most are aimed at research. Few are available to scrutinize research.
“Cardiac safety research consortium “
This one from Duke university , is a great beginning in collaboration with FDA .
Let us welcome , this whole heartedly and wish all success in it’s motto !
Namely , exposing all safety issues in the modern cardiac therapeutics .
Posted in cardiology journals, tagged cardaic pacing, cardiac arrhythmias in children, carto, ddr, drsvenkatesan, ECG, electrophysiology, endosense, ep study, heart rhythm society, IJEP, india, pace, pediatric cardaic arrhythmias, pediatric cardiology, vvi on February 5, 2010| Leave a Comment »
Here is the Link
Just sample an article : A great review about cardiac arrhythmias in congenital heart diseases , Must read by all cardiologists http://www.ipej.org/0906/khairy.htm
Posted in Cardiology - Clinical, tagged 64 slice ct, cardiology, cardiology journals, ct coroanry calcium, ct scan, drsvenkatesan, mdct on February 4, 2010| Leave a Comment »
Now we have a dedicated journal for cardiovascular CT scan .
Does it surprise you ? For me . . . It is !
Link to the current journal page . Get updated !
Posted in Cardiology - Clinical, Cardiology -Interventional -PCI, tagged 64 slice ct, alara, angiocardiography, cardiac catheterisation, cath lab, drsvenkatesan, hazards of ct scan, mdct scan, physician safety, radiation badge, radiation dose, radiation hazard, radiation safety on February 4, 2010| Leave a Comment »
There are millions of articles in cardiology . Some simply occupy valuable spaces without any purpose . Some give us knowledge . Some enlighten us. While few are so vital , it is almost a crime if we do not read such articles and apply it in day to day practice .
This an article written by Henri Justino that has a immense importance for the patients as well as the physicians .
Do not think the article which came in pediatric radiology is not applicable in adults !
Dr.S.Venkatesan MD 
ORBITA trial : First let us do some harm . . . second , we shall . . !?
Posted in Cardiology -Interventional -PCI, Cardiology -Technology, Cardiology -Therapeutic dilemma, cardiology -Therapeutics, Cardiology -unresolved questions, cardiology journal club, cardiology wisdom, Medical education, Medical ethics, Uncategorized, tagged ABUSE OF STENTS, ACC AHA ESC ORBITA GUIDELIES, CHRONIC STABLE ANGINA GUIDELINES, drsvenkatesan, HOW ORBITA TRIAL WILL CHANGE MY PRACTICE, INAPPROPRIATE USE CRITERIA AUC STENTS, LANCET ORBITA STUDY, ORBITA COURAGE BARI2D FAME 2, ORBITA IMPERIAL COLLEGE, ORBITA study, ORBITA TRIAL LANCET, ORBITA trial review and comments, ORBITA VS COURAGE, reviewing ORBITA trial study critically, TCTMD 2017 ORBITA, WAHT WE LEARN FROM ORBITA STUDY on November 6, 2017| 2 Comments »
Cardiologists at confused cross roads !
Perils of limited Intellect & Infinite greed
When not so appropriately trained cardiologists do Inappropriate things “use becomes misuse” . . . then, it won’t take much time for science to become total abuse. That’s what happened with the murky world of coronary stents .No surprise, it’s time to firefight the healers instead of the disease !
Now ,Comes the ORBITA study . Yes , it looks like a God sent path breaking trial that spits some harsh truths not only in cardiology, but also in behavioral ethics .Let us not work over time and hunt for any non-existing loop holes in ORBITA. Even if it has few, it can be condoned for sure as we have essentially lived out of flawed science for too long Injuring many Innocent hearts !
Yes , its enforced premature funeral times for a wonderful technology !
GIF Image courtesy http://www.tenor.com
Meanwhile, let us pray for a selective resurrection of stenting in chronic coronary syndromes and stop behaving like lesser professionals !
Postamble
Extremely sorry . . . to all those discerning academic folks , who are looking for a true scientific review of ORBITA , please look elsewhere !
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