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Alexander Mladenow MD

@alex1708ander • 5,694 subscribers

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

Shorts

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

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

16,166 views

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)🦶?

28,927 views

Coronary artery territories in TTE #echofirst

Coronary artery territories in TTE #echofirst

45,334 views

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 views

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

Fireflies 🔥at the pulmonary crossroads (PSAX) #echofirst

18,809 views

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 views

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 views

#echofirst what is this ⁉️🤨#CardioTwitter

#echofirst what is this ⁉️🤨#CardioTwitter

61,667 views

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

12,317 views

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 views

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 views

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

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

14,330 views

#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

35,473 views

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

13,939 views

#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 views

What is this #echofirst

What is this #echofirst

10,481 views

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

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

15,595 views

Videos

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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

10,176 views • 8 days ago

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

17,688 views • 22 days ago

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

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

29,260 views • 5 months ago

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 views • 3 months ago

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 views • 9 months ago

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 views • 2 months ago

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 views • 2 months ago

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

13,114 views • 2 months ago

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

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

Alexander Mladenow MD

12,369 views • 2 months ago

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

10,855 views • 2 months ago

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

17,066 views • 4 months ago

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

24,411 views • 8 months ago

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 views • 1 year ago

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

13,473 views • 3 months ago

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 views • 4 months ago

Great point NephroPOCUS 🌟 Yes - in acute PE the septal shift is often most pronounced in late systole and early diastole rather than uniformly throughout systole. 👉 adult and pediatric patients with acute PE #echofirst 👉 TG mid SAX

Great point NephroPOCUS 🌟 Yes - in acute PE the septal shift is often most pronounced in late systole and early diastole rather than uniformly throughout systole. 👉 adult and pediatric patients with acute PE #echofirst 👉 TG mid SAX

Alexander Mladenow MD

12,625 views • 3 months ago

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

12,065 views • 3 months ago

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 views • 4 months ago

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 views • 8 months ago

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 views • 5 months ago