Kashif J. Piracha, MD FACP’s Post

Ready to up-skill in ECG analysis and interpretation? 💓atrial fibrillation 💓ischaemic heart disease 💓valve disease 💓heart failure This 3 hour course aims to improve your confidence in the diagnosis and management of important cardiology conditions in primary care. Presented by Dr Nick Jones, join us on 27th April. #PrimaryCare #ECG #HeartDisease

A 48-year-old woman presents to the clinic with a 3-month history of intermittent cough, shortness of breath, and fatigue. She reports that her symptoms worsen when she spends time in her bird aviary, where she raises various types of birds, including pigeons and parrots. She denies fever, weight loss, or night sweats. She has no significant past medical history and does not smoke. Physical examination: Temperature is 98.6°F (37°C) Blood pressure is 124/76 mmHg Heart rate is 82 beats per minute Respiratory rate is 18 breaths per minute Oxygen saturation is 94% on room air Lung examination reveals diffuse inspiratory crackles bilaterally. Cardiac and abdominal examinations are unremarkable. Laboratory results: Complete blood count (CBC): within normal limits Arterial blood gas (ABG) on RA: PaO2 72 mmHg, PaCO2 38 mmHg Serum lactate dehydrogenase (LDH): mildly elevated Pulmonary function tests reveal a restrictive pattern with a reduced diffusion capacity for carbon monoxide (DLCO). Which of the following is the most appropriate diagnosis for this patient? A) Hypersensitivity pneumonitis B) Emphysema C) Tuberculosis Please like, follow, share, repost, and comment if you like my content. I try my best to respond to every comment personally. If you want to see all of my future posts, hit the bell icon next to my profile. If you like this, you will love my FREE High-Yield Must-Know Esophageal Images e-book. Check it out here: https://lnkd.in/g8ng9z9y

An 87-year-old patient presents to the Emergency Department with dyspnea and desaturation without fever. Medical history includes multiple comorbidities, including severe COPD and chronic biventricular heart failure with cor pulmonale. Blood tests show neutrophilic leukocytosis, elevated C-reactive protein, and increased proBNP. Chest X-ray reveals bilateral pleural effusion, more pronounced on the right side. The case was initially assessed as heart failure secondary to a COPD exacerbation. Treatment with antibiotics and diuretics was started, and the patient was transferred to a subacute intermediate care setting. Upon my evaluation, the patient was dyspneic, requiring oxygen, afebrile, and hemodynamically stable. Thoracic POCUS showed hepatization of the right lower lobe with massive, loculated pleural effusion. I suspect a right basal pneumonia and pleural empyema. The patient was urgently referred back to ED for thoracentesis and further diagnostic workup. This is an interesting case illustrating how ultrasound can be superior to X-ray and comparable to CT in thoraco-pulmonary diagnostics. #POCUS #pointofcareultrasound #empyema

Noted Pulmonary edema (bat wing appearance) This could be because of cardiac causes like heart failure, Arrhythmias, Coronary Artery disease, Valvular heart diseases. Types of Pulmonary Edema: 1. Cardiogenic Pulmonary Edema: This is caused by heart failure or other heart conditions such as myocardial infarction, high blood pressure or valve disease. 2. Non-cardiogenic Pulmonary Edema: This type is caused by factors other than heart problems, including lung injury, infections (like pneumonia), inhaling toxic substances, or certain medications. Symptoms: Shortness of breath (dyspnea) Difficulty breathing while lying flat A feeling of suffocation or drowning Coughing, sometimes producing frothy or pink sputum Rapid breathing Swelling in the lower extremities (in the case of heart failure). Diagnosis: Diagnosis is typically based on symptoms, physical examination, and imaging studies such as a chest X-ray. Blood tests and an echocardiogram may be used to assess heart function. Treatment: The treatment of pulmonary edema aims to reduce the fluid in the lungs and address the underlying cause. This may include: Diuretics to remove excess fluid Medications to improve heart function (e.g., ACE inhibitors, beta-blockers) Oxygen therapy In some cases, mechanical ventilation if breathing becomes severely impaired. #Medical #Radiology #Imed

Intra pulmonary thrombolysis A 23 years old female, known case of P1L1/LSCS (POD-2) at outside hospital. She was referred with complaints of sudden onset of syncopal attack followed by breathlessness Echo done outside showed acute corpulmonle/acute pulmonary thromboembolism. Pre-procedural DVT Well’s score was 06/09. On examination : Patient conscious, oriented, afebrile, PR : 120/ min BP :110/70 mmHg CVS: S1 S2 (+) RS : Bilateral air entry (+) P/A : soft CNS: NFND Pulmonary thromboembolism refers to the condition in which a single large thrombus or multiple thrombi migrate from the systemic circulation to the pulmonary vasculature. Most of the blood clots arise from the “deep veins “of the lower and upper extremities. Patients with pulmonary thromboembolism may present with atypical symptoms, such as the following: seizures, syncope, abdominal pain, fever, productive cough, wheezing, decreasing level of consciousness, new onset of atrial fibrillation, haemoptysis, flank pain, delirium (in elderly patients). Click here to read the full journal : https://lnkd.in/guAT5VKd

We are excited to share our latest contribution to the European Journal of Heart Failure: Management of acute decompensated valvular heart disease Valvular heart disease is a common cause of decompensated heart failure. Patients less commonly present with acute heart failure and/or cardiogenic shock, and evidence-based recommendations regarding management with medical therapy (including inotropic support), hemodynamic monitoring, ventilation, mechanical circulatory support, as well as surgical and interventional treatments for these patients are lacking from most recent international guidelines. In this comprehensive review, we summarize available evidence, particulary assessing the outcomes of interventional treatments in the setting of acute heart failure caused by valvular heart disease and provide evidence-based management algorithms to guide clinicians engaged in the management of these challenging patients. https://lnkd.in/dSaFskCQ

Hello everyone .... Today i share about my article-Right bundle branch block In normal cardiac conduction, impulses travel equally down the left and right bundles, with the septum activated from left to right and the formation of small Q waves in lateral leads In RBBB, the left ventricle is activated normally, thus the early part of the QRS complex correlating to septal depolarisation is unchanged There is delayed activation of the right ventricle as depolarisation originates from the left ventricle across the septum. This produces a secondary R wave (R’) in the precordial leads, and a wide, slurred S wave in lateral leads Normal activation of the left ventricle means that cardiac axis remains normal in isolated RBBB ECG QRS Morphology QRS Morphology in V1 Sometimes rather than an RSR’ pattern in V1, there may be a broad monophasic R wave or a qR complex. Causes of Right Bundle Branch Block Right ventricular hypertrophy / cor pulmonale Pulmonary embolus Ischaemic heart disease Rheumatic heart disease Congenital heart disease (e.g. atrial septal defect) Myocarditis Cardiomyopathy Lenègre-Lev disease: primary degenerative disease (fibrosis) of the conducting #snsdesignthinking #snsdesignthinkers #snsinstitution

As part of HeartFlow’s commitment to investing in clinical evidence, we are excited to announce the expansion of the DECIDE Registry to ~20,000 patients across ~40 sites, now including asymptomatic patients and those with prior PCI. As the largest prospective study of its kind, the DECIDE Registry will provide crucial multi-site, real-world data to understand how HeartFlow Plaque Analysis influences medical management decisions and clinical outcomes for those with suspected coronary artery disease. Together, we’re paving the way to improved patient outcomes through enhanced insights and more personalized cardiovascular disease care: https://bit.ly/4dVH8fC. #HeartFlow #DECIDERegistry #HeartFlowPlaqueAnalysis #Plaque

Published today, Cardiopulmonary Exercise Testing Across the Lifespan in Congenital Heart Disease, a scientific statement from the American Heart Association. Cardiopulmonary exercise testing (CPET) is a tool that qualitatively evaluates dynamic cardiovascular function, but many providers who care for these patients need more confidence in interpreting these findings. This document focuses on the key CPET findings in those with congenital HD across their lifespan. http://spr.ly/6042vhWgM 📷 The range of peak oxygen consumption across the spectrum of congenital heart disease