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Posts Tagged ‘dynamic echocardiography’

There are innumerable  stresses  to human beings in daily life .

Heart  experiences a few  either directly or indirectly.

  1. Physical stress
  2. Pharmacological  stress
  3. Mechanical stress
  4. Hemodynamic stress
  5. Mental stress

Squatting is rarely realised as a form of physical   stress to heart .  Rather , squatting can also  be termed as a  good exercise  ( Western toilets sans it !)

Squatting  raises the afterload at the level of aorta due to  increments  in SVR (exact mechanism not clear ,neural reflex ?)  and temporary reduction in venous return.

After load raise is synonymous with increased  ventricular wall stress  . So,  it is logical to expect wall motion defect in  vulnerable hearts* when confronted with sudden increase in afterload .(*Ischemic hearts with delicate coronary blood flow ) .Hence ,  sudden squatting , a seemingly simple  maneuver   ,  can  unmask  silent CAD .It can be aptly be named as poor man’s stress echo.

Of course , it  doesn’t   mean in any way ,  it should not be used in rich ! The  purpose of science  is  to make things simpler and cheaper . If squatting can replace  dobutamine with fair degree of accuracy  atleast in a few ,  it can help  control the escalating  costs of  cardiology triaging   due to   many futile diagnostics !

http://content.onlinejacc.org/cgi/reprint/46/5/931.pdf

When squatting  is a stress in normal persons , paradoxically it gives relief to patients with cyanotic heart disease

Read the related articles in this  site .

How squatting relieves hypoxia in TOF ?

Squat Echocardiography in TOF

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Squatting is an excellent hemodynamic adaptation in patients with TOF. Children with TOF assume this posture   in  a natural and effortless manner . For years cardiologists are fascinated by this maneuver  and the mechanism by which it gives relief  to those patients with TOF.

Now , we have realised  this posture  has a new diagnostic role in echocardiography ! This paper was presented in the recently concluded  Annual scientific sessions of cardiological society of India held in Kolkatta December 2010

Download  the full   presentation in PDF  format  (  Squat Echo)

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