Mom ❤️❤️❤️

80s mode: ON. Horse girl era with my sister Subesha #80s trend

How a Heart Attack Begins: Plaque Rupture in Seconds

When the best company shows up unannounced and looks this good doing it. ❤️❤️ Just me and Ms. Egret, matching energy without saying a word. 🦩

Heimlich maneuver. A successful live demo. Learn how to do it. You may save a life! #MedTwitter

An iPhone compatible endoscope with a diameter of 5.2mm and a 3.2mm working channel

Just now in the presence of Union Ministers Sh. JP Nadda, Dr. Jitendra Singh and the senior leaders of Apex Body of Leh Ladakh I finally broke my fast after 26 days. Earlier 65 members of parliament from different political parties had visited or signed letters urging me to break the fast. This was done after long negotiations on various conditions and in view of possible violence in the country. I will explain the conditions in detail in a separate video very soon. Meanwhile I urge you all to stay very vigillant about not allowing violence of any kind anywhere.

ABHI BHI ZINDA HUN.... DAY 25

Edema

STEMI in LBBB or Ventricular-Paced Rhythm Diagnosing acute coronary occlusion can be difficult because LBBB and ventricular-paced rhythms produce secondary ST-T changes that may mask ischemia. The Modified (Smith) Sgarbossa Criteria improve the detection of acute coronary occlusion compared with the original Sgarbossa criteria. A positive result is present if any one of the following criteria is met: ◻️Concordant ST elevation ≥1 mm in a lead with a positive (upright) QRS complex. ◻️ Concordant ST depression ≥1 mm in leads V1, V2, or V3. ◻️ Excessively discordant ST elevation with an ST/S ratio ≤ −0.25. This means the ST elevation is disproportionately large compared with the depth of the preceding S wave. Unlike the original Sgarbossa criteria, the Modified Sgarbossa Criteria do not use a point system. Meeting any one of these criteria strongly suggests acute coronary occlusion (OMI) and should prompt urgent clinical evaluation and consideration of reperfusion therapy in the appropriate clinical setting. References Smith SW, et al. Ann Emerg Med. 2012;60(6):766–776. 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain.

Approach to managing dyspepsia 🔥💡

The cardiac cycle is a precisely coordinated sequence of electrical activation, pressure changes, valve motion, and blood flow that allows the heart to pump efficiently with every beat. At a normal heart rate of 75 beats/min, one complete cardiac cycle lasts approximately 0.8 seconds: - Atrial systole: 0.1 s - Ventricular systole: 0.3 s - Complete cardiac diastole (joint relaxation): 0.4 s It can be divided into two major phases: 🟥Diastole: Ventricular relaxation and filling. ⬜ Systole: Ventricular contraction and blood ejection. The sequence begins with electrical activation at the sinoatrial (SA) node, causing both atria to contract. After a brief delay at the atrioventricular (AV) node, both ventricles contract. Mechanical contraction always follows electrical depolarization by a short interval, which is why the QRS complex precedes ventricular systole on the ECG. The left ventricle passes through four key mechanical phases: 🔻Isovolumic relaxation: Aortic valve closes, mitral valve remains closed. Ventricular pressure falls while volume remains unchanged. 🔻 Ventricular filling: Mitral valve opens, allowing blood to flow into the relaxing ventricle. 🔻 Isovolumic contraction: Mitral valve closes, producing the first heart sound (S1). Pressure rises rapidly, but no blood is ejected because both valves are closed. 🔻 Rapid ventricular ejection: Once ventricular pressure exceeds aortic pressure, the aortic valve opens and blood is ejected. A normal ventricle ejects more than 60% of its end-diastolic volume. Closure of the aortic valve produces the second heart sound (S2). Pressure gradients, not the valves themselves, determine valve opening and closure. Valves simply open and close in response to changing pressures, ensuring one-way blood flow. Typical left-sided pressures: - Left ventricle: 120/15 mmHg - Aorta: 120/80 mmHg Understanding the cardiac cycle is fundamental to clinical cardiology. It explains: - Normal and abnormal heart sounds - The timing of systolic and diastolic murmurs - Pressure-volume loops and the Wiggers diagram - Echocardiographic assessment of chamber function and valve disease - Hemodynamic changes seen in heart failure, valvular disease, arrhythmias, and congenital heart defects Every heartbeat is a synchronized interaction between electrical conduction, myocardial contraction, valve function, and pressure gradients. Mastering this physiology is essential for interpreting ECGs, echocardiography, cardiac catheterization, and bedside cardiac examination.

How long should anticoagulants be withheld before elective surgery? ◻️Apixaban: 1 day (low/moderate bleeding risk), 2 days (high risk) ◻️Rivaroxaban: 1 day (low/moderate), 2 days (high) ◻️Edoxaban: 1 day (low/moderate), 2 days (high) ◻️Dabigatran: 1-4 days depending on bleeding risk & renal function ◻️ Fondaparinux: 36-42 hours ◻️ LMWH: 12 h (prophylactic), 24 h (therapeutic) ◻️ UFH: IV 4-6 h; SC 12–24 h ◻️ Warfarin: Stop 5 days before surgery; confirm INR before the procedure. Adjust timing for renal impairment, neuraxial anesthesia, and individual patient risk. Bridging is reserved for selected high-thrombotic-risk patients. Reference: 2024 AHA/ACC Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery, Table 13.

I believe that the very purpose of life is to be happy. From the very core of our being, we desire contentment. In my own limited experience I have found that the more we care for the happiness of others, the greater is our own sense of well-being. Cultivating a close, warmhearted feeling for others automatically puts the mind at ease. It is the principal source of success in life.

Which connective tissue disorder is strongly associated with aortic dissection? a) Turner syndrome b) Klinefelter syndrome c) Marfan syndrome d) Down syndrome

Cute ❤️❤️💕💕

Understanding the anatomy of the aortic root is essential for echocardiography, aortic valve surgery, and transcatheter aortic valve replacement (TAVR). The aortic root contains three important circular rings: Sinotubular junction - The upper boundary of the aortic root where the sinuses become the ascending aorta Surgical annulus - Also called the anatomic ventriculo-arterial junction - The structure where surgeons anchor a surgical prosthetic valve Virtual aortic annulus - An imaginary ring formed by connecting the lowest points (nadirs) of the three aortic valve cusps - This is the key measurement used for TAVR valve sizing jacc.org/doi/10.1016/j.jacc.…

Heart anatomy

1/ Right bundle branch block (RBBB) occurs when conduction through the right bundle branch is delayed or interrupted. The left ventricle depolarizes normally, but right ventricular activation is delayed, producing a widened QRS complex with characteristic ECG findings. 🧵

Coronary Anatomy: