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NB Heart Centre CV Rounds
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Добавлен 13 май 2020
NBHC Stats Week 2
Dr Colin Barry presents the stats from the Cardiac Catheterization Laboratory at the NBHC
Просмотров: 129
Видео
NBHC Stats Week 3
Просмотров 632 года назад
Dr S Toal presents the annual stats from the Electrophysiology program at the NBHC
CV Surgery Stats at the NBHC
Просмотров 622 года назад
Our annual stats dinner has been postponed for a few years due to Covid so join JF as he discusses the stats from the CV surgery program
ECMO and Covid 19
Просмотров 1182 года назад
Dr C White, CV Surgeon NBHC, discusses the impact of Covid 19 on the ECMO program
Delirium in the Post Op CV Surgery Patient
Просмотров 852 года назад
Dr R Arora, CV Surgeon and expert on post op delirium, discusses patient experiences with delirium and the current research on management of this complex complication
PVCs When Should We Worry
Просмотров 8 тыс.2 года назад
Join Dr Fadahunsi, NBHC Electrophysiologist, as he discusses premature ventricular contractions and their significance
Mechanical Valve Thrombosis
Просмотров 1,3 тыс.2 года назад
DR JF Legare discusses making the diagnosis of mechanical valve thrombosis and the caveats of patient management
Intramural hematoma on CT scan
Просмотров 4752 года назад
Dr Z Pozeg, CV Surgeon NBHC discuss the management of patients who present with an intramural hematoma on CT scan
Congenital Sinus Venosus
Просмотров 2442 года назад
Dr D Horne discuss the management of Congenital sinus venosus ASD management
Covid and the Impact of Cardiovascular Health
Просмотров 262 года назад
Join Alison Greene as she discusses the impact Covid 19 has had on CV wellness
The Forgotten Ventricle
Просмотров 902 года назад
Dr Amie Noel from the NBHC discusses right ventricular failure and the challenges in management
Mitraclip Update
Просмотров 1072 года назад
Dr JF Legare, Chief of CV Surgery, NB Heart provides an update on the mitraclip program
The TITAN Trial
Просмотров 762 года назад
Join Dr Pozeg, CV Surgeon NB Heart, as he discusses the surgical management of descending aortic aneurysms.
Modern management of Pulmonary Emboli
Просмотров 1,2 тыс.2 года назад
Join Dr Chris White, CV Surgeon NB Heart, as he explores the management of pulmonary embolisms
Transthyretin Cardiac Amyloid
Просмотров 2312 года назад
Join Dr David Bewick, Cardiologist NB Heart, for a comprehensive look at transthyretin cardiac amyloid. Assisting us in recognizing it is under recognized, under diagnosed and also under treated.
Simulation Debriefing following a CV surgery patient cardiac arrest
Просмотров 5602 года назад
Simulation Debriefing following a CV surgery patient cardiac arrest
Emergency salvage surgery after failed TAVI
Просмотров 772 года назад
Emergency salvage surgery after failed TAVI
ACLS, I just follow the algorithm, right??
Просмотров 982 года назад
ACLS, I just follow the algorithm, right??
Why is my patient waiting so long for CV Surgery
Просмотров 402 года назад
Why is my patient waiting so long for CV Surgery
Mitral valve surgery - is it time we start thinking outside the box?
Просмотров 1132 года назад
Mitral valve surgery - is it time we start thinking outside the box?
Deconstructing the AHA 2020 aortic valve guidelines
Просмотров 5503 года назад
Deconstructing the AHA 2020 aortic valve guidelines
Clinical research in 2021 - tying together the researcher, the hospital and the university
Просмотров 533 года назад
Clinical research in 2021 - tying together the researcher, the hospital and the university
Simulation and medicine - practice makes perfect
Просмотров 303 года назад
Simulation and medicine - practice makes perfect
What is sedation? And should we be using it for TAVIs?
Просмотров 1123 года назад
What is sedation? And should we be using it for TAVIs?
MR and nuclear imaging in infiltrative cardiomyopthies
Просмотров 873 года назад
MR and nuclear imaging in infiltrative cardiomyopthies
Should we be offering the Ross procedure for non elderly patients with severe aortic stenosis?
Просмотров 9143 года назад
Should we be offering the Ross procedure for non elderly patients with severe aortic stenosis?
♥️♥️Great information, all explained so one can understand ♥️♥️……sorta♥️♥️
57 yr old woman in Canada. 4.6cm Ascending Aortic Aneurysm. They have left me awaiting to see someone at The Aortic Clinic at our Major Hospital. In Canada nothing moves quickly. My GP actually wrote me an email that said, “If you get a nose-bleed let my office know” Um, that’s not a thing from ANY research I’ve done. I have chest pain for a year now and weak and nauseated, they told me 8 mos til a CT scan (we are supposed to be covered in Can as you may know) SO I paid $1300 to get one myself. That is how they saw the aneurysm. I just had an echocardiogram, waited 2 mos. For that. Cardiac surgical nurse told me get a graft sooner than later. So here I sit at home, no idea what to do. A decent % of thoracic ascending ruptures in women happen prior to 5cm. Also experienced surgeons say “make sure they have successfully done these surgeries MANY times before”. In Canada you don’t get to shop for the best. Man, I feel like my hands are tied, no meds nothing. Oh my GP did prescribe me Clonazepam for my sleepless nights. Thanks! I sound frantic, I’m not, just wondering wtf is GOOD Canada?!! I would like some care and to get on with it. My sense of humour can only take me so far.
Dear Lord, what is going on?
I'm 56 and 4.3mm😢
I am living proof that the LVAD is helpful. Dr Legare inserted my LVAD (HN II) in Halifax in 2016, ten years post an Ischemic MI. This helped reduce my pulmonary hypertension to the point I could be placed on the transplant list. Fast-forward about a year and a half and (after one false start) I received a transplant. I have done well with it so far and am very pleased to have have been able to have the medical treatment I've received. Cheers Dr. Legare...Halifax's loss was indeed our gain here in New Brunswick...in my opinion.
I am 78, PVCs noticeable since 20's, increased in early 2023 to cause extreme fatigue, mental fog, lethargy. History of taking atenolol but stopped in 2021 due to bradychardia and pulse lower than 50 at rest. June 2023 fitted with Zio recorder, but cardiology PA said rate 10.3%, not serious but should see electrophysiologist. First appointment available late September, had gone through terrible summer. Cardiologist in September at Heart Hospital looked at same data, recognized problem, scheduled me for cardiac MRI to determine heart damage. Heart was found to be healthy (had stent in 2000 likely result of Vioxx for arthritis) but no sign of ever having heart attack (blockage determined from stress echo and angiogram). Results of cardiac MRI, electrophysiologist said I had serious problem he could resolve by ablation. Ablation was 3 weeks ago and as of now, feeling great. 10.3% rate insignificant to first cardiologist but 4 months later cardiologist looking at same data recognized daytime periods of 33% was not recognized by computer analysis. Happy my electrophysiologist recognized.
Are endovascular stents an option for <5.5cm AAA's?
I am a 53yo male, 5'7", 175 pounds, and I walk about 28 miles a week. My blood pressure is good. However, I do have a bicuspid valve, a maternal grandfather that died at 62 of a heart attack, a father who had heart problems. I was also injured when I was younger in an auto accident and I have portal vein thrombosis and espophageal varices due to a loss of my spleen, and I almost bled to death this year due to the varices bleeding. As a result of various tests, I was diagnosed with a 4.8 cm ascending aortic aneurysm. My doctor is willing to do surgery now. My thinking is I don't want this hanging over me, a growth rate of 14mm/year means I'll be at the 5.0 threshold in a couple of years, and I am very fit and healthy otherwise now and never going to be healthier or younger. I really don't want open heart surgery. But I also think it is time to have the surgery. Anyone have any thoughts?
Did you have the surgery? I am 55 and in great shape but have a 4.7mm ascending aneurism with oderate to severe aortic stenosis from bicuspid valve. Doctor want to operate in 4 weeks. I am scared, but I feel like you, the best shape of my life, so now is the time.
seems like age should be a significant factor in decisions. Putting off surgery for a 60 year old places potential surgery into later years when surgery is higher risk. And there is a compounding effect, with a certain percent mortality that compounds each year, vs surgery which is a discrete event, once and done.
My brother’s (73 )new doctor sent him to cardio because he thought he had a fib. Turned out to be ascending aortic aneurysm (4.8cm). They’re watching it. Family history , both mother and father) father had an abdominal AA , had surgery at 66 years and lived to 87. Cousin on dads side dropped with no warning, mothers side: her sister had abdominal AA; her brother had one that “blew out” in 1965 and died in 2002 at 82; another of her brothers refused surgery and he died from burst aneurysm. My brother and I are 11 1/2 mos apart and because of our family history my cardiologist is recommending complete testing and I concur.
62 year old male at 5.1 AAA and have good bp and descent cholesterol. Surgeon wants to wait till next summer and monitor it. Also have a leaking valve .This has been monitored for 20 years and has just increased this year.
Why are you “managing” diabetes? Why not cure it? Would you manage cancer?
Absoultely outstanding. Thank you very much indeed for posting this disucssion. Help a great deal with the worry about such a finding on Echo. 4.2 dialtion of aortic root. BP well controlled as is weight. Question about profession - semi-professional athelets. I did find a couple of studies mostly focused on cardiac hypertrophy and LV diastolic dysfucntion..grade 1. Low normal EJ 50 -55%. So looking at the mechanics. This dysfucntionand dilation seems a little more complicated with a low EJ? Best wishes to all on this. Once again thank to Dr. Pozeg.
excellent
In April 2023 I went into the hospital with chest pain, shortness of breath, heart pounding, lightheadedness, slight nausea and slow heart rate. They verified several PVCs, did echo's, tried several drugs. They released me after 3 days with PVCs continuing. With a 24hr Holter monitor on the 4th day after hospitalization, it showed, heart rate of 45 to 135 multifocal atrial tachycardia, 1-6 beat runs of Super Ventricular Tachycardia, Bigeminy and Trigeminy, occasional PACs and frequent isolated PVCs at a rate of 26,827 in that 24 hr. period. Scheduled an ablation, and on the day of the ablation while on the table, the PVCs stopped and they couldn't do the ablation. Now waiting for an appointment at UCLA for a more in-depth heart mapping system. Currently running zero to a max of 30 PVCs per minute (Aug 13th). Frequency has been slowing down over the months, but hoping to have PVCs next time I am in the lab.
How are you now?
Not feeling well. Some part of the day I experience 0 pvcs, while a few minutes later I will have 4 pvcs/min. On the 26th of Dec I started having pounding and measured 16 pvcs/min for about 1/2 hr with chest pain. UCLA is sending me a Holter monitor on the 9th Jan to put on for 5-7 days. Today the heart pounding woke me up at 3:30am and I'm still awake. Today 9:44am I measure 6 pvcs/min Bigeminy.
@@thomasl2193 are you able to exercise by little bit for example athletics?
My aortic root measured 4.4cm on a CT calcium test, but a CTA 1 week later measured 3.7cm. How should I interpret this?
Hi! What is CTA?
Computed Tomography Angiography (CTA)
@DB-hf7di, maybe CTA is a more precise instrument
Excellent presentation sir. Am doing cardiology from India…
*You Did Not Choose To Be Classified As Diabetic, But You Can Choose To Fight Back Against Diabetes* 💪
Thanks , 71 yr old male just discovered 3.7 cm ascending aortic aneurysm by CT scan w/contrast.
Im 42 and need a aortic aneurysm repair my number is 6.2 cm. And i need a valve replacement. Severe aortic stenosis with regurgitation. I literally getting a review now and find out what the gameplan is. Im was born with aortic valve disease. But im optimistic and just want to getbit done and over with fairly healthy besides this issue. Thanks for video nice to know whats gonna happen. Nov 14th my surgery 🎉🎉🎉
Hey.. wish you speedy recovery from surgery !
Wish you complete recovery
How did your surgery go? Hope you are doing well. My aortic was 4.8 cm a few months ago.
Yea it’s definitely a detail if family has had the same previously , it was discovered a 7.7 in my aorta ( wich burst on my father at same age of 62 , followed by death 3 days later ) in wich they immediately operated on 5 weeks ago, my brother also has had the same one
Are you going to have surgery?
Did you already have a successful surgery? My thoracic aorta is 5.0. I do not want to want surgery. 😢
Huge info / data at 10:30
Please explain
63 y.o. w.m... just clocked in at 4.3 aorta read... chol. 157... Bp 137 / 83 ... Follow up in june ... 🙏🤞🧐😎
PLS! PLS! Help, I'll promote you, pay you, get fundraising and donations to U...I'm terminally ill with PVE but despite having no cardiac implications, feeling normal...why won't they operate...it's not that bad, I have Staphylococcus on antibiotics...I want surgery ..
more volume please
My mom is 56 years old just diagnosed with dilated ascending aorta of 4.95 mm she is 5.3 inches tall and 122 lbs, my world is collapsing I don’t know what to think or do, leaving in another country didn’t see her since 5 years 😢
Thank you for your talk and video. It is refreshing to hear someone recognise that the data on this problem are not robust. I was monitored for 20 years up to 2017 for an enlarged aorta but dissected at an ascending diameter of 4.6 (@CT 1 year before dissection), and was almost certainly assessed against 5.5 cm. I really want no-one else to have to go through what I have. I certainly hope the TITAN:SvS trial produces some clearer figures. Please don't forget that diameter is only one of four variables in the Laplace equation, and variability in the other three (BP, wall thickness and allowable stress value) will be the resaon for the different diameters at dissection. CTDs considerably affect the allowable stress, body size and type affect the wall thickness, BP is modifiable. Agree on getting BP down immediately and effectively.
I have a question about a dilated aortic root and exercise. What kind of exercise is okay to do? What types of exercise should one avoid?
You cardiologist should address that depends on size and if you have any connective tissue disorders
Thank you for sharing. Just had a patient 30%PVC burden completely asymptomatic and no structural abnormalities and stress test was negative and I was scared by the high burden but I kinda came up with the plan to just do an echo and holter in 6mons and sounds like that is an appropriate plan. Thank you!
Hi i have a PVC burden of 25% on holter monitor with several couplets and no vt, should this be taken seriously? Just curious.
Fantastic overview of the post cardiac surgery arrest protocol. We started to implement all your points in the CSICU, except turning off the drugs being infused prior/during arrest. Any additional suggestions why turning drugs off will benefit arrest outcome will be appreciated.
From the very first I day came across Dr Igudia RUclips channel, I knew that was going to be the end of my type 2 diabetes. And to my surprise his herbs actually cured my Diabetes
I am ONLY 22 years old, I have over 20,000 PVCs a day and feel every single one 247, all day long. I recently got a cardiac ablation a month ago, and it was unsuccessful. I have no idea why this is happening. I am miserable. Metaprolol does not help. Nothing helps.
Try acebutolol, it's an older beta blocker but it's active metabolite works as an anti-arrhythmic. It's one of the only things that helped me.
Have they evaluated you for cardiac sarcoidosis? Especially if you have any autoimmune issues in you or your family. It's one of those Zebra diagnoses that most practitioners don't think of.
Grateful for all the RUclips promotions on this topic though I hardly research myself. I was diagnosed with a 4.0 ascending aortic aneurysm in June 2021. And I have been jerked around with getting help from doctors who tell me I was referred to the wrong doctor after I see a doctor. I was denied insurance through Keurig Dr Pepper in 2022 and assaulted out of that job position. Now I can only get hired on by temp agencies. My twin has had heart issues due to HBP after a leg injury he had surgery on and he deals with pain while working and his HBP rises. He had an artery rupture and he was told his heart is rubbing against something in his chest. He has to take HBP for an untreated injury and so far the solution is just to focus on his heart and not the pain or what causes his HBP. I have gotten more information from RUclips algorithms than I have from doctors. I am also 40 and I was diagnosed at 38 years old. I'd have heart problems over ten years and I was rushed to ER multiple times and ignored. Once they gave me an MRI or chest scan years before 2021 and they saw nothing. So I am shocked they found a 4.0 cm aneurysm only a little more than a few years later.
د اسماعيل اخبار حضرتك انا محمود من اسوان بتاع مجدي يعقوب
I am shocked that even though T2 Diabetes is now quite well understood and easily reversible by weight loss, medics are still only talking about what drugs to use to treat the symptoms! These people are living in the past.
71 y.o. Male with 4.3 aorta. Being monitored biannually bp normally 120/70 low cholesterol and good blood chemistry. Are there lifestyle changes I should consider to minimize risk? Very active physically, good diet, medium alcohol consumption
jayyarnell4710, I am 70, 4.3 cm. High cholesterol in my instance but otherwise I am just like you. Did you have to take medicine or you have gotten away with just adjustment of the lifestyle?
That was great! Thank you!
This doctor isn't a good communicator. I sent his office a question about this video, and he can't bother to respond, or recommend that I schedule a visit for a consult. Very poor communication style.
OMG
This doctor is NOT a flake .. imo. Extremely helpful !!
@@michaelh1889 Opposite experience for me. Very poor communication style on his part, as I mentioned.
Rounds are for other doctors, not for potential patient questions on youtube. Go through your own doctor. He is busy doing heart surgeries, you know, those things that nobody wants to wait very long for. I do not cardiac experts spending time responding to youtube audience questions. That is ridiculous.
@marshhen Excessively negative and dogmatic on your part. Getting opinions and going in for consults with more than one doctor prior to major heart surgery is perfectly reasonable. A doctor could certainly say to come in for a consult - a reasonable response which most doctors would do - and this doctor could not bother to do that.
Hello, when is the discussed study supposed to have some results ?
I have a 4.3 aortic aneurysm in my aortic root learning how to cope
Times used to be very Challenging, I had the worst days of my life living with Type 2 diabetes, I appreciate you so much Dr Igudia, You have restored me my life that was lost already . Thank you so much for curing me of my diabetes with your natural Herbs 😊
Thank you…:)
My wife is 75 years old, weighs 45 kgm and is 5'2" (158cm) tall. She had a CT scan and she was found to have an Upper Ascending Aortic Aneurysm of 5.2 cm and I have calculated her Index Ratio based on the formula given at 13.4, which is significantly beyond the index of 10 - 12 stated. She is nimble, agile and her general health is very good other than this asymptomatic aneurysm. The question is should she have the surgery to prolong her life with all the associated risks taken into account (potential strokes, depression, etc) or should she just carry on with medication to reduce her blood pressure?
Wish I knew... I trust my doctor... My aaa is still just under 5... I know that my hypertension is the biggest concern - so beta-blockers seem to keep me well. She needs to eat very well - no smoking - no booze... good diet... and keep blood pressure in the healthy range. I have to say, Christianity is the greatest medicine.
@@matthewstokes1608 thanks for the advice. I totally agree with you that faith in God and clean living with a healthy diet are best medicines for a happy and healthy life, supported by medical intervention as and when necessary. She had the Upper Ascending Aorta Aneurysm open surgery and Aortic valve repair last month and it's still relatively early days as to the ultimate success of the surgery. She has some complications following the surgery however; low sodium, Atrial Fibrillation, rapid heart rate and fluid build up in the lungs. These are being addressed and we realise it's a long slow road to as full a recovery as possible. With prayer and God's guiding hand we hopefully will achieve it.
@@phillipdavies9233 my prayers for you both - keep the faith and all will be well 👍🙏
What do you think about aortic wrapping?
62 year old here I have three of them yikes one of them is 4.5 my Dr. Told me not to worry to come back in a year but I do a whole lot it’s the only thing on my mind all the time dont sleep very well Should I worry or am I over reacting? Someone help !!!
Hi Curtis, my husband was told the same, not to worry, since his is also 4.5. All we can do is follow the guidelines to manage this, and be aware of symptoms in case of a dissection. Since you have 3, maybe you should also see another doctor. Knowing that you are taking actions to manage this condition should help alleviate stress. Sleep is vital to cardiovascular health. Best wishes to you.
Dr apparently isn’t concerned or you would be checked every 6 months. Treatment options are getting better by the day. It won’t be long until they take care of aneurysm’s through the groin. Hopefully mine holds off that long.
Ascending Aorta normally grows .07cm a year. I was at 4.3 in Dec 2020. In june of 2023, it was <4.5. So it is pretty much tracking with that figure. It is the slowest growing Aorta Aneurisms. The AAA grows at a rate of .19 cm a year. A big difference. So unless there is an issue with it picking up its growth rate, to reach 5.5cm will take 15years. It could stop growing. It could increase in size . If grows .5cm in 6months, they will get concerned. Hope this helps.
My daughter felt sick on a Monday, by Wednesday she went in to cardiac arrest in a ER waiting room, she was then flown to a children’s hospital, she was of perfect health, the only one vaccinated in our family, she was on ECMO that Wednesday, she remained on ECMO till clots developed in the tubes. She needed ECMO for heart and lung, we had to take her off ECMO 3 weeks later… she was 17. #alltheloveforaubrynn
If you come across diabetic foot, the antimicrobial shoe insole Podophylus works very well to help healing, As it releases Iodine gas to keep the shoe and foot sterile
All thanks to DR. harry herbs i contacted through RUclips for cuing me from diabetes typed 2 with his herbs medicine, true natural medicine is powerful.
All thanks to DR harry herbs i contacted through RUclips for cuing me from type 2 diabetes with his herbs medicine, true natural medicine is powerful.
I'm having PVCs originating from Left posterior fasicle, currently 11k ectopicsand have been put on Metoprolol. If I ever decide to get a RFA, what will be the success rate and will there be any challanges for the RP or is it done regularly. I would really appreciate if you could reply me, thank you so much, 🙏
not RP I meant EP*
Are you able to lift heavy weights in the gym while medicated? Has your situation improved?
My situation has improved alot brother, although I didn't take METOPROLOL but I've been taking Magnesium Glycinate for the past two months and the ectopic beats have reduced a lot, to almost none. Magnesium Glycinate contains about 121mg of elemental Magnesium which is way below the RDA, which is around 400mg i suppose. Magnesium has also helped me with my anxiety which according to me are the sole reason for the ectopics beats and my anxiety was worst post covid. Now I'm better and you're free to ask me whatever you want, I can understand your situation and know how scary it feels sometimes.
@@Ferien7 and btw I haven't done any exercise since i've started magnesium. I shall give it a try and update you.
@@pgpg3783 On last 4th of July I was in the ER with a very low heart rate: 39!!!! They did a cardiac cath, they saw a blockage on my RCA and fixed it with a stent. And was diagnosed with PVCs although never had a symptom, I was discharged with Plavix, Asp 81, Metoprolol, BP medication (although I don't have high BP), Statin. All these caused my anxiety to go through the roof and only then I started feeling some PVCs. Couldn't take the side effects of Metoprolol so I took it as needed (not regularly). Went back to cardiologist that changed the beta clocker and gave me Cardizem. I took only 1 and that night couldn't sleep and had palpitations all day after that; I refuse to continue this medication. I want to go into Magnesium Taurate, Glycinate and Taurine that I'm sure will help my anxiety (created by my Doctors after the initial diagnosis) I have normal BP, normal Echo, No other comorbidities. PVCs barely bother me and definitely not as much as the meds I was prescribed. What prevents me from switching from meds to supplements is that I don't know if it is safe to do it when on Anti-platelet meds (because of the stent I have to be on it for 1 year; have another 6 months to go) I will try and see the cardiologist soon and if he tells me there is no interaction I will no doubt go with magnesium and it will be the solution to my problem. My heart is not "sick", it's acting in response to my anxiety. I think you did the right thing by going on Magnesium and definitely not taking Metoprolol !!!! (people that take Metoprolol take another 6 meds to control side effects and I don't want. that) Wish you the best. A very healthy and happy life.