cardiology - doc_heart

[ArchivalUser]

hey, how about traetment with new method of alcohol injection?

[ArchivalUser]

sorry you typed it while I was typing also!

[ArchivalUser]

VAlsalva maneuvar decrease the venous return in the LA, so we will have decrease blood in the LV and that will lead to decrease LV pressure and that will lead to INCREASE-PROLONG A-V gradient and that will INCREASE THE MURMUR-this is seen in HOCM...+a DANCER , so w enee dthe RX of the HOCM an dteh problem here is DYNAMIC OBSTRUCTION OF THE Lv OUTFLOW TRACT .Thos epeople died from :
1.arrythmias
2.suden ischemia
so teh tretament will be nothing BUT ???

[ArchivalUser]

hey peds
i din get the ans for this Q right away as doudig usually answers Qs quickly...so addressed doudig n others to answer it.....thats all was abt "dig it out"

Of course theres nothing special in the Q to dig it out just meant to get it answered.

[ArchivalUser]

got it doc that is why I said on my previous message....just happened to go to second page and mine looks weird there now! hahaha thanks

[ArchivalUser]

yeah
thats exactly wat happened....even mine looks awkward ....cuz it got posted after the Qs was answered

[ArchivalUser]

alcohol septal ablataion if there s siginificant, symptomatic obstruction.( hypertrophic cardiomyopath: only 1/4 of cases have significant obstruction)

[ArchivalUser]

so that subaortic is an old trem an dnow is just HOCM , AD inheretance, thick ventricle , PECULIAR ASSYMETRIC HYPERTHROPHY OF TH EIVS (the upper part )=ASA -ASSYMETRIC SEPTAL HYPERTHROPHY.
It si teh msot common caus eof death in YOUNG PEOPLE
PATHOPHYSIOLOGY a sI mentined above =OBSTRUCTION OF THE LVOT (LV outflow tratc)whic is below the aotrtic valve and is part of the IVS (LV ) and below the aorta (that is why si called before subaortic )...
Whever the heart contrcat , the myocardium thickens and here w ehave IVS that is already thicken assymetrically on teh top , so wjhile forming the LVOT below the aorta is STENOTIC and cann't EMPTHY the blood properly , so w ehave ablock and teh heart is hypercontarcting but since can't tak ethe blood out leads to volumene overload -CHF

On ECG we can see LVH, and Deep Q wave (pseudo waves ) in V1 and V2.
On ECHO we can see SAM (SYSTOLIC ANTERIOR MOTION OF MV )

So w ecan give here BETA BLOCKERS or CA -Chanel blocker,,,NO DIGOXIN !!!!!!!!111bc the more you wipe the horse , the worse it get's ...or later you can do surgery ..
This people can die from SUDDEN V-FIB bc myocytes are not UNIFORM and not properly oriented , but hva ethe HAPAZARD PATTERN-ZUG -ZAK ..