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2D-Echo in ICU
The intensive care unit (ICU) is among the more important settings in which echocardiography plays a pivotal role. The ease of use, speed of execution, and completeness of information on heart anatomy and function that echocardiography is able to provide makes this tool the perfect diagnostic technique in patients for whom exhaustive information must be quickly obtained by physicians who sometimes lack specific skills in cardiovascular imaging. However, the clinical entities encountered by ICU clinicians are often difficult to distinguish and patient symptoms may not be obvious. This brief review describes three common clinical scenarios that benefit from echocardiography in the ICU, based on symptoms frequently claimed by patients admitted to the ICU. For each symptom we describe the most likely clinical possibilities, underlining the fundamental role that echocardiography plays in the differential diagnosis, and the echocardiographic elements most relevant to obtain the correct diagnosis and to guide treatment.
About the Speaker
Dr Viny Kantroo
MRCP(London), DNB Respiratory Diseases, IDCCM(Critical Care), EDARM
Fetal Cardiology: In Utero Diagnostics and Care
Fetal cardiology involves diagnosing heart conditions in unborn babies to enable timely intervention and management. Techniques like fetal echocardiography and Doppler ultrasound allow detailed visualization of the fetal heart's structure and function. This non-invasive imaging technique helps identify congenital heart defects, assess blood flow, and guide treatment planning.Fetal cardiology is crucial in pregnancies with maternal diabetes, genetic syndromes, or a family history of heart disease. Fetal cardiologists provide parents with information about the heart condition, prognosis, and available treatment options. Fetal cardiology teams often include obstetricians, neonatologists, geneticists, and pediatric cardiologists to ensure comprehensive care. Some heart conditions can be treated before birth to prevent complications postnatally, such as balloon valvuloplasty for stenotic valves. Fetal Heart Rate Monitoring: Continuous monitoring of the fetal heart rate helps detect irregularities and potential cardiac issues.
Ventilator Basics: Key concepts
A ventilator is a medical device used to support or replace a person's breathing when they are unable to do so effectively on their own. Ventilators deliver a mixture of oxygen and air to the patient's lungs, either through a tube inserted into the windpipe or through a mask placed over the nose and mouth. The key concept behind ventilators is mechanical ventilation, which involves the use of positive pressure to push air into the lungs and facilitate the exchange of oxygen and carbon dioxide. Ventilators have various modes of operation, including volume-controlled ventilation, pressure-controlled ventilation, and pressure-support ventilation, among others. Volume-controlled ventilation delivers a set volume of air with each breath, while pressure-controlled ventilation delivers air at a set pressure. Positive end-expiratory pressure (PEEP) is a crucial concept in ventilator use, as it helps maintain lung recruitment and prevent collapse of the alveoli during exhalation. Ventilators also have adjustable parameters such as respiratory rate, tidal volume, inspiratory time, and FiO2 (fraction of inspired oxygen) to meet the patient's specific needs. Ventilators can provide both invasive ventilation, where a tube is inserted into the airway, and non-invasive ventilation, which is delivered through a mask or nasal interface.
Overexertion and Heart Health
Overexertion refers to the act of pushing your body beyond its normal limits. This can lead to a number of health problems, including heart disease. Heart disease is the leading cause of death worldwide. There are many different factors that can contribute to heart disease, including overexertion. Overexertion can cause the heart to work harder than it should, which can lead to damage over time. This can include damage to the heart muscle, as well as other parts of the cardiovascular system. Overexertion can also increase the risk of developing high blood pressure, which is a major risk factor for heart disease. High blood pressure can cause damage to the walls of the arteries, which can lead to a range of cardiovascular problems. Overexertion can also increase the risk of developing coronary artery disease, which is a condition where the arteries that supply blood to the heart become narrowed and blocked.
Mitral Valve stenosis: An overview
Laparoscopic myomectomy is a minimally invasive surgical procedure performed to remove uterine fibroids, which are non-cancerous growths that develop in the uterus. During a laparoscopic myomectomy, the surgeon makes small incisions in the abdomen and inserts a laparoscope, a thin tube with a camera and light, to visualize the uterus and fibroids. The surgeon then uses specialized surgical instruments to remove the fibroids while preserving the healthy tissue of the uterus. Benefits of laparoscopic myomectomy include smaller incisions, less pain and scarring, shorter hospital stays, and quicker recovery times compared to traditional open surgery. However, not all women are candidates for laparoscopic myomectomy, and the procedure may not be appropriate for large or numerous fibroids or certain locations within the uterus.
Myocarditis: case report
Myocarditis is a condition that occurs when there is inflammation in the heart muscle. The causes of myocarditis can vary widely and include viral infections, bacterial infections, fungal infections, drug reactions, and autoimmune disorders. Symptoms of myocarditis can include chest pain, shortness of breath, fatigue, palpitations, and fever. Treatment of myocarditis depends on the underlying cause, but may involve rest, medications to reduce inflammation or control the immune system, and supportive care such as fluids and oxygen. In severe cases of myocarditis, complications can occur such as heart failure, arrhythmias, and even sudden cardiac death. Prevention of myocarditis involves avoiding exposure to infectious agents and seeking prompt medical attention if symptoms develop.