CardiovascularCorner
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Surgical Implantation of a Bioprosthesis in the Aortic Position
CardiovascularCorner24,689 Aufrufe • vor 1 Monat
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Watch this remarkable video demonstrating hemopericardium on autopsy.
CardiovascularCorner16,117 Aufrufe • vor 2 Monaten
Woltman sign, classically seen in myxoedema, refers to a delayed relaxation of a deep tendon reflex, most easily appreciated at the Achilles tendon. When the ankle jerk is tested, the initial plantar flexion is normal, but the foot lingers, returning slowly to its resting position. This lingering, “hung-up” response is the hallmark of the sign. In hypothyroidism, this happens because thyroid hormone deficiency interferes with calcium reuptake in slow-twitch muscle fibres. As a result, muscles take longer to contract and relax. While this isn’t true myotonia, the reflex was historically labelled “pseudomyotonic” because of its similar appearance. The same underlying problem explains the patient’s constipation. Low thyroid hormone levels slow gastrointestinal motility, reflecting the broader pattern of physiological slowing that also affects neuromuscular function. Historical and clinical context Woltman sign was formally described at the Mayo Clinic in the 1920s and quickly became linked to hypothyroid neuromuscular dysfunction. For many years, it was considered almost pathognomonic of untreated myxoedema. Even today, it can serve as a useful bedside clue, especially in patients who also complain of fatigue, cold intolerance, weight gain, bradykinesia, or general slowing. That said, the sign is not entirely specific. Delayed reflex relaxation can also be seen in elderly individuals with normal thyroid function, in patients taking β-blockers, and in conditions such as anorexia nervosa, diabetes mellitus, or late pregnancy. Because of this, Woltman sign is now best regarded as a suggestive finding rather than a definitive one. Clinical takeaway When constipation is paired with a delayed ankle reflex relaxation, hypothyroidism should be high on the differential, and thyroid function tests are warranted. Even in the age of modern lab diagnostics, Woltman sign remains a classic physical finding,one that highlights the intimate connection between endocrine function and the neuromuscular system. Further reading:
CardiovascularCorner26,615 Aufrufe • vor 5 Monaten
1. What is the name of the procedure 2. Its indications?
CardiovascularCorner18,749 Aufrufe • vor 7 Monaten
🟩TIMI TIMI (Thrombolysis in Myocardial Infarction) flow is an angiographic grading system used to describe the degree of epicardial coronary blood flow after reperfusion therapy (thrombolysis or PCI) in acute myocardial infarction. It was developed by the TIMI study group to provide a standardized, reproducible way to assess coronary perfusion on angiography. TIMI flow grades 🟥TIMI 0: No perfusion There is no antegrade flow beyond the point of coronary occlusion. 🟪TIMI 1: Penetration without perfusion Contrast passes beyond the obstruction but fails to opacify the entire distal coronary bed and appears to stagnate. 🟦TIMI 2: Partial perfusion Contrast crosses the obstruction and opacifies the distal bed, but flow and/or clearance is slower than in normal or non-affected coronary segments. 🟩TIMI 3: Complete perfusion Normal antegrade flow with rapid filling and clearance of contrast in the distal coronary bed, comparable to an uninvolved vessel. Key point TIMI flow reflects epicardial coronary artery patency, not microvascular perfusion. Achieving TIMI 3 flow is strongly associated with better clinical outcomes after myocardial infarction. CardiovascularCorner
CardiovascularCorner10,986 Aufrufe • vor 4 Monaten
TIMI Flow: A Key Indicator of Coronary Perfusion TIMI (Thrombolysis in Myocardial Infarction) flow grading is a crucial angiographic tool to assess blood flow in coronary arteries, particularly after an intervention like PCI. 🔹 TIMI 0 (No Flow) – Complete occlusion; no antegrade flow beyond the blockage. 🔹 TIMI 1 (Penetration without Perfusion) – Minimal flow beyond the occlusion but without adequate distal vessel opacification. 🔹 TIMI 2 (Partial Flow) – Delayed but complete filling of the distal vessel; flow is slower than normal. 🔹 TIMI 3 (Normal Flow) – Full, brisk perfusion with normal distal vessel filling, comparable to a non-diseased artery. TIMI 3 flow is the gold standard for successful reperfusion in PCI, improving outcomes in STEMI and other coronary syndromes. #Cardiology #TIMIFlow #CathLab
CardiovascularCorner18,450 Aufrufe • vor 1 Jahr
Jugular venous pulsation Adapted from André Martin Mansoor
CardiovascularCorner13,007 Aufrufe • vor 11 Monaten
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