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Alexander Mladenow MD

@alex1708ander • 5,972 subscribers

Pediatric & Adult Cardiothoracic Anesthesia | 💉🫀Echocardiography | EACVI Board certified in TEE, TTE and CHD Echo @dhzcharite 🇩🇪 Prof account #3D Education

Shorts

Vascular ultrasound assessment prior to central venous catheter placement in a young patient undergoing elective cardiac surgery. What is the flap most likely? 🫀 #echofirst #POCUS #echofirst NephroPOCUS Ross Prager Robert Jones, DO

Vascular ultrasound assessment prior to central venous catheter placement in a young patient undergoing elective cardiac surgery. What is the flap most likely? 🫀 #echofirst #POCUS #echofirst NephroPOCUS Ross Prager Robert Jones, DO

23,426 Aufrufe

Coronary artery territories in TTE #echofirst

Coronary artery territories in TTE #echofirst

45,413 Aufrufe

In a patient who recently underwent cardiac surgery, what is the most likely explanation for the “cyclops eye” 🧿 appearance seen on this #echofirst ? What would be your next (echo)🦶?

In a patient who recently underwent cardiac surgery, what is the most likely explanation for the “cyclops eye” 🧿 appearance seen on this #echofirst ? What would be your next (echo)🦶?

28,934 Aufrufe

16 yo with SOB #echofirst Different perspective 🫀

16 yo with SOB #echofirst Different perspective 🫀

12,005 Aufrufe

What structures are the arrows pointing at in this adult patient? #echofirst 💙💜

What structures are the arrows pointing at in this adult patient? #echofirst 💙💜

16,239 Aufrufe

4 “valves” in one view🫀 But one is an impostor… #echofirst

4 “valves” in one view🫀 But one is an impostor… #echofirst

12,546 Aufrufe

Two patients of similar age (20+), both fit until recently ⛴️🏃‍♀️. Two distinct diagnoses. Two distinct LV motion patterns - yet one shared TEE view and a unified treatment pathway #echofirst

Two patients of similar age (20+), both fit until recently ⛴️🏃‍♀️. Two distinct diagnoses. Two distinct LV motion patterns - yet one shared TEE view and a unified treatment pathway #echofirst

17,274 Aufrufe

TTE in a patient in PACU after surgery for valve disease. Already extubated. Slightly hypotensive. Abnormal ECG. Elevated CK, CK-MB 👉 what’s most likely the reason? 👉 A-L-P-I-S? #echofirst 👉 which valve was operated on?

TTE in a patient in PACU after surgery for valve disease. Already extubated. Slightly hypotensive. Abnormal ECG. Elevated CK, CK-MB 👉 what’s most likely the reason? 👉 A-L-P-I-S? #echofirst 👉 which valve was operated on?

33,782 Aufrufe

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

18,900 Aufrufe

#echofirst what is this ⁉️🤨#CardioTwitter

#echofirst what is this ⁉️🤨#CardioTwitter

61,747 Aufrufe

Adult patient with normal segmental anatomy (no CHD). Which are the structures labelled with 🔢? #echofirst Learning point: 3D echo anatomy

Adult patient with normal segmental anatomy (no CHD). Which are the structures labelled with 🔢? #echofirst Learning point: 3D echo anatomy

19,056 Aufrufe

Type IV tricuspid valve morphology on TEE - the rarest TV morphology type, reported in ~2% of cases #echofirst

Type IV tricuspid valve morphology on TEE - the rarest TV morphology type, reported in ~2% of cases #echofirst

12,326 Aufrufe

PML retraction resulting in eccentric MR. A good example from Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 nicely demonstrating that the eccentricity can be caused either by hypermobility of one leaflet or hypomobility of the other one #echofirst Same MR jet direction, different causes

PML retraction resulting in eccentric MR. A good example from Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 nicely demonstrating that the eccentricity can be caused either by hypermobility of one leaflet or hypomobility of the other one #echofirst Same MR jet direction, different causes

15,292 Aufrufe

The Smoking LV: a heart whispering before it screams 🚬❤️ #echofirst Mid-esophageal 4-Ch view tells the whole story. Two patients. Two NSTEMIs. Same message from the left atrium 💔

The Smoking LV: a heart whispering before it screams 🚬❤️ #echofirst Mid-esophageal 4-Ch view tells the whole story. Two patients. Two NSTEMIs. Same message from the left atrium 💔

10,599 Aufrufe

#echofirst you are called on ICU for a patient with LVAD, doubtful of tamponade. What is this ? structure #POCUS

#echofirst you are called on ICU for a patient with LVAD, doubtful of tamponade. What is this ? structure #POCUS

35,483 Aufrufe

Adult male with dyspnea. What do you see #echofirst?

Adult male with dyspnea. What do you see #echofirst?

14,330 Aufrufe

To label the LV walls in TTE, use the same mnemonics (A-L-P-I-S) but read the letters clockwise 🔁. If you don’t like A-L-P-I-S, delete the letter “P” and make L-I-S-A instead #echofirst

To label the LV walls in TTE, use the same mnemonics (A-L-P-I-S) but read the letters clockwise 🔁. If you don’t like A-L-P-I-S, delete the letter “P” and make L-I-S-A instead #echofirst

13,946 Aufrufe

#echofirst M. 60 yo, TIA recently. Depression. No other past medical history. What do you think? #CVimaging American Society of Echocardiography

#echofirst M. 60 yo, TIA recently. Depression. No other past medical history. What do you think? #CVimaging American Society of Echocardiography

16,740 Aufrufe

What is this #echofirst

What is this #echofirst

10,481 Aufrufe

#echofirst #CardioTwitter #CHD What is the name of this procedure?

#echofirst #CardioTwitter #CHD What is the name of this procedure?

15,595 Aufrufe

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M40. Stroke one month ago. No past medical history. Something here is unusual. #echofirst Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Batman-Echo Alex Felix Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Wouter L’Hoyes Ekaterina Stellbrink Manuel G. Correa Nicolas Merke

M40. Stroke one month ago. No past medical history. Something here is unusual. #echofirst Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Batman-Echo Alex Felix Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Wouter L’Hoyes Ekaterina Stellbrink Manuel G. Correa Nicolas Merke

Alexander Mladenow MD

16,550 Aufrufe • vor 13 Tagen

A short educational hook🪝on the aortic complex: What do we actually measure on intraoperative TEE? And when?🫀#echofirst Bonus: histology🔬

A short educational hook🪝on the aortic complex: What do we actually measure on intraoperative TEE? And when?🫀#echofirst Bonus: histology🔬

Alexander Mladenow MD

19,723 Aufrufe • vor 20 Tagen

Which cardiac valve are we looking at in this 3D TEE? 🫀#echofirst Teenager. No previous cardiac surgery. And what is the structure marked 🤔?

Which cardiac valve are we looking at in this 3D TEE? 🫀#echofirst Teenager. No previous cardiac surgery. And what is the structure marked 🤔?

Alexander Mladenow MD

14,939 Aufrufe • vor 1 Monat

$In this #3D TEE mid-esophageal RV in-out view you can better understand the location of different types of VSD in echo #echofirst supracristal VSD lying more cranial than the infracristal. 👉 for more morphological details check this out$

In this #3D TEE mid-esophageal RV in-out view you can better understand the location of different types of VSD in echo #echofirst supracristal VSD lying more cranial than the infracristal. 👉 for more morphological details check this out

Alexander Mladenow MD

42,858 Aufrufe • vor 6 Monaten

Young female patient presenting with excruciating back pain. Treated by the emergency physician at the scene (subway) and transferred to the hospital for CT. Transferred from an outside hospital, where cardiac surgery was not available. How would you proceed? #echofirst

Young female patient presenting with excruciating back pain. Treated by the emergency physician at the scene (subway) and transferred to the hospital for CT. Transferred from an outside hospital, where cardiac surgery was not available. How would you proceed? #echofirst

Alexander Mladenow MD

17,699 Aufrufe • vor 2 Monaten

Beyond basic echo anatomy #echofirst 🌟Elevating the way we see the interatrial septum in TEE 🥽 The interatrial septum is more than anatomy 🫀- it’s a procedural roadmap📍 TEE guidance for: 1️⃣ M-TEER (transseptal puncture) 2️⃣ PTC of ostium secundum ASD

Beyond basic echo anatomy #echofirst 🌟Elevating the way we see the interatrial septum in TEE 🥽 The interatrial septum is more than anatomy 🫀- it’s a procedural roadmap📍 TEE guidance for: 1️⃣ M-TEER (transseptal puncture) 2️⃣ PTC of ostium secundum ASD

Alexander Mladenow MD

15,673 Aufrufe • vor 2 Monaten

TTE 🆚 TEE #echofirst 💡 Tri-, bi- or monocuspid AV? Asymptomatic young athlete and martial arts practitioner - a cardiac murmur was detected during a pre-employment fitness assessment. Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Alex Felix Ekaterina Stellbrink Tuğba Kemaloğlu Öz, A/Prof Brian Wood

TTE 🆚 TEE #echofirst 💡 Tri-, bi- or monocuspid AV? Asymptomatic young athlete and martial arts practitioner - a cardiac murmur was detected during a pre-employment fitness assessment. Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Alex Felix Ekaterina Stellbrink Tuğba Kemaloğlu Öz, A/Prof Brian Wood

Alexander Mladenow MD

10,628 Aufrufe • vor 1 Monat

52 yo male collapsed after intense emotional stress. Coronary angiography showed normal coronaries. What would you be concerned about? #echofirst

52 yo male collapsed after intense emotional stress. Coronary angiography showed normal coronaries. What would you be concerned about? #echofirst

Alexander Mladenow MD

22,846 Aufrufe • vor 5 Monaten

We gave this patient a chance. On ECMO he has gradually stabilized, EEG was normal throughout. 10 days after the admission we decided to operate on him - infarction VSD patch closure, MVR & temporary RVAD, which was later removed. Patient was discharged on POD # 90 Deutsches Herzzentrum der Charité

We gave this patient a chance. On ECMO he has gradually stabilized, EEG was normal throughout. 10 days after the admission we decided to operate on him - infarction VSD patch closure, MVR & temporary RVAD, which was later removed. Patient was discharged on POD # 90 Deutsches Herzzentrum der Charité

Alexander Mladenow MD

38,937 Aufrufe • vor 10 Monaten

RV volume overload 🆚 RV pressure overload #echofirst 🔻Volume overload 👉 enddiastolic D-sign 🔻Pressure overload 👉 endsystolic D-sign Credit:

RV volume overload 🆚 RV pressure overload #echofirst 🔻Volume overload 👉 enddiastolic D-sign 🔻Pressure overload 👉 endsystolic D-sign Credit:

Alexander Mladenow MD

33,809 Aufrufe • vor 1 Jahr

When blindly introducing a Swan Ganz PA-catheter from the left neck side, another dangerous surprise could be the unexpected presence of LSVC (left superior vena cava) #echofirst ⚠️ Inflating the balloon of the catheter can cause a fatal rupture of the coronary sinus ⚠️

When blindly introducing a Swan Ganz PA-catheter from the left neck side, another dangerous surprise could be the unexpected presence of LSVC (left superior vena cava) #echofirst ⚠️ Inflating the balloon of the catheter can cause a fatal rupture of the coronary sinus ⚠️

Alexander Mladenow MD

24,440 Aufrufe • vor 9 Monaten

Identification of the left and right fibrous trigones is essential for accurate sizing of the mitral annuloplasty ring, as they define the intertrigonal distance and the anterior annular dimension. #echofirst

Identification of the left and right fibrous trigones is essential for accurate sizing of the mitral annuloplasty ring, as they define the intertrigonal distance and the anterior annular dimension. #echofirst

Alexander Mladenow MD

12,228 Aufrufe • vor 3 Monaten

Think spatially #echofirst The leaflet orientation of the mechanical mitral valve prosthesis on 3D echocardiography can be predicted from the 2D TEE image. Chittur Sivaram MD MACP MACC

Think spatially #echofirst The leaflet orientation of the mechanical mitral valve prosthesis on 3D echocardiography can be predicted from the 2D TEE image. Chittur Sivaram MD MACP MACC

Alexander Mladenow MD

12,768 Aufrufe • vor 4 Monaten

Family member collapsed while visiting patient on ICU #echofirst #FOAM #EUS #POCUS (PLAX & PSAX) in sitting 🪑 position (⏲️10s)

Family member collapsed while visiting patient on ICU #echofirst #FOAM #EUS #POCUS (PLAX & PSAX) in sitting 🪑 position (⏲️10s)

Alexander Mladenow MD

17,096 Aufrufe • vor 6 Monaten

Next-level scary #echofirst 🦠 Enterococcus faecalis in the blood🩸culture 👉 underwent double valve replacement NephroPOCUS Ritu Thamman MD Chittur Sivaram MD MACP MACC Nicolas Merke Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Ekaterina Stellbrink Alex Felix Tuğba Kemaloğlu Öz, A/Prof Vladyslav Kavalerchyk 🇺🇦 🇩🇪

Next-level scary #echofirst 🦠 Enterococcus faecalis in the blood🩸culture 👉 underwent double valve replacement NephroPOCUS Ritu Thamman MD Chittur Sivaram MD MACP MACC Nicolas Merke Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Ekaterina Stellbrink Alex Felix Tuğba Kemaloğlu Öz, A/Prof Vladyslav Kavalerchyk 🇺🇦 🇩🇪

Alexander Mladenow MD

13,182 Aufrufe • vor 4 Monaten

13-year-old girl with exertional dyspnea, TTE & TEE #echofirst

13-year-old girl with exertional dyspnea, TTE & TEE #echofirst

Alexander Mladenow MD

12,377 Aufrufe • vor 4 Monaten

The THEBESIAN VALVE covers the coronary sinus #echofirst 📌 deep esophageal view Adam Christian Thebesius (1686-1732)

The THEBESIAN VALVE covers the coronary sinus #echofirst 📌 deep esophageal view Adam Christian Thebesius (1686-1732)

Alexander Mladenow MD

15,278 Aufrufe • vor 5 Monaten

Coronary artery injury is not common but a possible complication in patients undergoing surgery for valve heart disease ⚠️ #echofirst ➡️ following MV surgery - 👀 postero-lateral LV wall (possible RCX lesion) ➡️ following AV surgery- 👀 inferior LV wall (possible RCA lesion)

Coronary artery injury is not common but a possible complication in patients undergoing surgery for valve heart disease ⚠️ #echofirst ➡️ following MV surgery - 👀 postero-lateral LV wall (possible RCX lesion) ➡️ following AV surgery- 👀 inferior LV wall (possible RCA lesion)

Alexander Mladenow MD

21,684 Aufrufe • vor 9 Monaten

When stress cardiomyopathy meets structural rarity - not your average Takotsubo #echofirst How would you manage this combo? Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Alex Felix Brian Wood

When stress cardiomyopathy meets structural rarity - not your average Takotsubo #echofirst How would you manage this combo? Ritu Thamman MD Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Alex Felix Brian Wood

Alexander Mladenow MD

13,474 Aufrufe • vor 5 Monaten

When performing TEE, don’t chase the multiplane angle (rotation sign). Chase the anatomy. Identify the landmarks that define the target view and use probe manipulation to bring those structures into the imaging plane. The angle displayed on the screen is only a guide #echofirst

When performing TEE, don’t chase the multiplane angle (rotation sign). Chase the anatomy. Identify the landmarks that define the target view and use probe manipulation to bring those structures into the imaging plane. The angle displayed on the screen is only a guide #echofirst

Alexander Mladenow MD

10,862 Aufrufe • vor 3 Monaten