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Alexander Mladenow MD

@alex1708ander • 5,496 subscribers

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

Shorts

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)🦶?

28,659 Aufrufe

Coronary artery territories in TTE #echofirst

Coronary artery territories in TTE #echofirst

45,068 Aufrufe

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

18,782 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

12,169 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

18,899 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?

33,769 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

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

15,226 Aufrufe

#echofirst what is this ⁉️🤨#CardioTwitter

#echofirst what is this ⁉️🤨#CardioTwitter

61,667 Aufrufe

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

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

14,316 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

13,854 Aufrufe

What is this #echofirst

What is this #echofirst

10,481 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

#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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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

12,038 Aufrufe • vor 24 Tagen

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

22,775 Aufrufe • vor 2 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

10,824 Aufrufe • vor 26 Tagen

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 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

28,963 Aufrufe • vor 3 Monaten

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

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

Alexander Mladenow MD

12,318 Aufrufe • vor 1 Monat

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

13,047 Aufrufe • vor 1 Monat

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

38,926 Aufrufe • vor 7 Monaten

You are called in from home ☎️ on a weekend for a 60 yo patient with DCMP and LCO who is admitted from external hospital for urgent Impella support. The patient is not intubated. In the OR you perform preop TTE and see this. Would you proceed with Impella? #echofirst

You are called in from home ☎️ on a weekend for a 60 yo patient with DCMP and LCO who is admitted from external hospital for urgent Impella support. The patient is not intubated. In the OR you perform preop TTE and see this. Would you proceed with Impella? #echofirst

Alexander Mladenow MD

12,037 Aufrufe • vor 1 Monat

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

17,024 Aufrufe • vor 3 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

15,202 Aufrufe • vor 2 Monaten

How would you name this #echofirst NephroPOCUS Chittur Sivaram MD MACP MACC Ritu Thamman MD

How would you name this #echofirst NephroPOCUS Chittur Sivaram MD MACP MACC Ritu Thamman MD

Alexander Mladenow MD

14,101 Aufrufe • vor 3 Monaten

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

24,403 Aufrufe • vor 6 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

33,508 Aufrufe • vor 11 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

21,581 Aufrufe • vor 6 Monaten

LA thrombus in transit (in seconds) caught on TEE #echofirst … it landed in the 🧠 leading to fatality

LA thrombus in transit (in seconds) caught on TEE #echofirst … it landed in the 🧠 leading to fatality

Alexander Mladenow MD

13,660 Aufrufe • vor 3 Monaten

Left & Right Pulmonary Veins in TEE wan 📌 To get both LLPV & LUPV use the ME 2Ch view 📌 To get both RLPV & RUPV use the ME bicaval view

Left & Right Pulmonary Veins in TEE wan 📌 To get both LLPV & LUPV use the ME 2Ch view 📌 To get both RLPV & RUPV use the ME bicaval view

Alexander Mladenow MD

10,917 Aufrufe • vor 2 Monaten

The stress begins when the echo image confuses the team #echofirst You’re called to ICU to perform TEE in an intubated patient 😱🫣😳🤔

The stress begins when the echo image confuses the team #echofirst You’re called to ICU to perform TEE in an intubated patient 😱🫣😳🤔

Alexander Mladenow MD

12,191 Aufrufe • vor 3 Monaten

Restriction or constriction #echofirst Chittur Sivaram MD MACP MACC Edgar Argulian Jae K. Oh

Restriction or constriction #echofirst Chittur Sivaram MD MACP MACC Edgar Argulian Jae K. Oh

Alexander Mladenow MD

13,351 Aufrufe • vor 4 Monaten

Anatomic relationship of the mitral and aortic valves #echofirst in #3DTEE from atrial (surgeon’s) and ventricular aspect Ritu Thamman MD Nicolas Merke Alex Felix Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Ekaterina Stellbrink Vladyslav Kavalerchyk 🇺🇦 Brian Wood Batman-Echo Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Benoy Shah MD Jorge Parras

Anatomic relationship of the mitral and aortic valves #echofirst in #3DTEE from atrial (surgeon’s) and ventricular aspect Ritu Thamman MD Nicolas Merke Alex Felix Chittur Sivaram MD MACP MACC Dr G Rajesh (Gopalan Nair Rajesh). Ekaterina Stellbrink Vladyslav Kavalerchyk 🇺🇦 Brian Wood Batman-Echo Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 Benoy Shah MD Jorge Parras

Alexander Mladenow MD

13,528 Aufrufe • vor 4 Monaten