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1/18 What if I told you that the Frank Starling mechanism which usually serves to ⬆️ the stroke volume with ⬆️ diastolic filling, can actually ⬇️ it in a certain condition?
Discover why this paradox occurs in this 🧵 on Brockenbrough-Braunwald-Morrow sign #CNshowmeasign
Discover why this paradox occurs in this 🧵 on Brockenbrough-Braunwald-Morrow sign #CNshowmeasign
2/ But first, some🥼 clinical features that are useful in suggesting a Dx of HCM & differentiating it from fixed valvular obstruction.
3/ Now, your patient has Sx & dynamic murmurs suggestive of HCM.
Congratulations! You have revived the art of bedside diagnosis #medtwitter.. but you still find yourself in a pickle 🥒😂
Echo shows LVOT gradient is <50mmHg at rest and with maneuvers.
What do you do next?
Congratulations! You have revived the art of bedside diagnosis #medtwitter.. but you still find yourself in a pickle 🥒😂
Echo shows LVOT gradient is <50mmHg at rest and with maneuvers.
What do you do next?
Physical exam in patients with heart failure is ✨essential✨
Did you know that you can assess the volume status of a heart failure patient using a blood pressure cuff and a stethoscope or doppler? 🤔
What is this sign called?
#CNshowmeasign
Did you know that you can assess the volume status of a heart failure patient using a blood pressure cuff and a stethoscope or doppler? 🤔
What is this sign called?
#CNshowmeasign
Valsalva maneuver assesses the blood pressure response during forced expiration. An abnormal response called “square-wave” can reflect states of ⬆️⬆️LV filling pressures.
To perform this maneuver:
☑️Inflate the BP cuff 10-15 mmHg above SBP
☑️Ask the patient to exhale or do abdominal straining against a closed airway
☑️Listen to Korotkoff sounds with a stethoscope or doppler throughout the phases
☑️Inflate the BP cuff 10-15 mmHg above SBP
☑️Ask the patient to exhale or do abdominal straining against a closed airway
☑️Listen to Korotkoff sounds with a stethoscope or doppler throughout the phases
Crochetage sign is a notch on the apex of R waves in the inferior leads. It can be associated with ostium secundum ASDs.
It is a result of delayed depolarization of the right ventricle because of L to R shunt. This is why ostium secundum ASDs are also associated with:
🚦Right axis deviation
🚦Incomplete RBBB
🚦Right axis deviation
🚦Incomplete RBBB
