EAPCI certification
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This document provides information about the eligibility requirements and structure of the EAPCI certification exam for interventional cardiologists. The exam has two parts - Part A is a 100 question multiple choice exam testing theoretical knowledge, delivered online over 3 hours. Part B demonstrates training, skills and experience through an e-logbook. The document lists exam dates and resources for preparation, including guidelines, required textbook chapters, videos on OCT and IVUS interpretation, and recommended books and question banks. Sample exam questions are provided on topics like STEMI, NSTE-ACS, and valvular interventions. The author wishes all exam takers the best of luck.
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fractional flow reserve FFR dr md toufiqur rahman FSCAI FAHA FAPSICPROFESSOR DR. MD. TOUFIQUR RAHMAN
The document discusses fractional flow reserve (FFR), a technique used in coronary catheterization to measure pressure differences across a coronary artery stenosis to determine if it impedes blood flow. FFR is measured using intracoronary pressure wires during maximal hyperemia induced by intravenous adenosine. While FFR allows real-time assessment of lesion severity, it does not provide information on plaque morphology and requires an invasive procedure.Asd ppt
The document discusses atrial septal defects (ASDs), including indications for closure, procedural details, and echocardiographic assessment. Key points include:
- ASD closure is recommended in the presence of right-sided heart volume overload or symptoms. It prevents further deterioration and helps normalize heart size.
- Indications for closure include hemodynamically significant ASD, paradoxical embolism risk, and transient cyanosis. Contraindications include irreversible pulmonary hypertension.
- Echocardiography is used to assess defect size, rims, and shunt severity. Deficient rims, especially aortic and superior vena cava, increase erosion risk post-closure.
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Left ventricular angiogram (1)
Left ventricular angiography is used to assess global and regional left ventricular function and anatomy. It involves inserting a catheter into the left ventricle and injecting contrast dye to visualize the ventricle on x-ray imaging. The procedure provides key information on mitral valve function, ventricular shape and wall motion abnormalities, and congenital defects like VSD. LV volumes and ejection fraction are calculated from the images to quantify function. Regional wall motion is graded and correlated to coronary artery territories. Characteristic appearances are seen in conditions like cardiomyopathy, mitral regurgitation, and septal defects. Potential complications include arrhythmias and endocardial injury.
IVUS Image Interpretation and Analysis
IVUS may not be clinically warranted in all interventions, and should be seen as an adjunct to angiography. IVUS provides information about vessel morphology, plaque topography, and therapeutic outcomes that is often either equivocal or unavailable in angiographic images.
There are 3 situations in which IVUS has the most clinical utility:
Small vessel stenting: Studies have shown that post-stent restenosis rates are higher in small vessels. This is particularly true for vessels with diameters of 3.0mm or less, wherein small increases in stent diameter have been shown to significantly decrease the rate of restenosis. A study by Moussa et al showed that, as measured by IVUS, the incidence of restenosis has an inverse relationship to the post-procedure in-stent lumen CSA1.
In-Stent restenosis: In these cases, IVUS helps to determine whether the restenosis is due to inadequate stent deployment (underexpansion or incomplete apposition) due to intimal hyperplasia. IVUS will also help you select the proper device size for treatment of the stented area.
Difficult to assess lesions: At times, images of a lesion and the adjacent reference segment are often hazy. IVUS should be used to identify whether the angiographic appearance is due to dissection, thrombus, residual plaque, or is benign.
hemodynamic in cath lab: aortic stenosis and hocm
1) Cardiac catheterization can provide key information about aortic stenosis including transvalvular pressure gradients, the level of stenosis, and estimation of valve area.
2) Low-flow, low-gradient aortic stenosis can be further classified as either having a decreased ejection fraction or a paradoxically normal ejection fraction.
3) In hypertrophic cardiomyopathy, cardiac catheterization can identify dynamic intraventricular pressure gradients that may only be provoked with maneuvers like the Valsalva maneuver.
Coronary artery dissection
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction characterized by a non-traumatic separation of the coronary arterial wall. It most commonly affects younger women and the left anterior descending artery. SCAD results from an intimal tear or bleeding of vasa vasorum that leads to the formation of a false lumen filled with blood. This can cause the artery to narrow and restrict blood flow. SCAD is increasingly recognized and can be caused by conditions affecting connective tissue or hormonal factors during pregnancy. Angiography is used to diagnose SCAD but findings may be subtle, with long diffuse narrowing being most common. Management involves conservative treatment but revascularization may be needed for ongoing ischemia
How to read coronary angiography
Simple approach to interpret coronary angiography views.
Youtube lecture link:
https://youtu.be/Xb8BSJsSJq4
Stress echocardiography
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cath Lab Hemoduhynamic
This document discusses hemodynamic principles and various cardiac pressures measured in the circulatory system. It begins by explaining how electrical activity leads to mechanical functions that generate pressure waves. It then discusses how to measure and interpret pressures in different parts of the heart including the aorta, pulmonary artery, right and left ventricles, and right atrium. Factors that influence pressures and common abnormalities are provided. Diagrams of normal pressure waveforms are displayed. The document concludes by defining pulmonary and systemic vascular resistances.
Echo in restrictive cardiomyopathy
This document provides an overview of echocardiographic evaluation of restrictive cardiomyopathy. Key points include:
- Restrictive cardiomyopathy is characterized by a nondilated left ventricle with abnormal diastolic function and typically normal systolic function.
- Causes include infiltrative diseases like amyloidosis and storage diseases. Echocardiography can help diagnose but it is more difficult than other cardiomyopathies.
- Findings include low diastolic volume, normal ejection fraction, diastolic dysfunction with rapid early mitral inflow. Echocardiography helps differentiate restrictive cardiomyopathy from constrictive pericarditis.
Pressure, Damping and Ventricularization_Crimson Publishers
This document discusses pressure changes that can occur during coronary angiography, specifically damping and ventricularization. Damping is defined as a significant decrease in pressure at the coronary ostium when the catheter is placed, accompanied by the disappearance of pressure waveforms, suggesting no antegrade flow. Ventricularization occurs when blood circulates within a coronary artery like a closed system, deforming the aortic pressure waveform. The document emphasizes the importance of the operator recognizing abnormal pressure changes to avoid complications, and provides solutions like catheter replacement or intracoronary nitroglycerin to address issues.
Normal variants of heart structures
This document discusses several normal anatomic variants that can be mistaken for pathologies in echocardiographic imaging of the heart structures. It describes variants commonly seen in the right atrium, left atrium, left ventricle, aortic valve, and right ventricle which include things like Eustachian valves, Chiari networks, prominent trabeculations, moderator bands, and false tendons. It emphasizes that recognizing these normal variants is important to avoid misdiagnosis and unnecessary treatment based on imaging findings alone.
Ventricular Septal defects Echocardiography
Ventricular septal defects (VSDs) are openings in the wall separating the ventricles of the heart. There are four main types classified by location: membranous, muscular, supracristal, and inlet VSDs. Echocardiography is useful for diagnosing VSDs and assessing their characteristics like location, size, and impact on cardiac function. VSDs range from small and asymptomatic to large defects causing heart failure or pulmonary hypertension. Surgical or catheter-based closure may be required for large VSDs.
Coronary angiogram
This document discusses techniques for coronary angiography including cannulating coronary arteries and grafts, angiographic views, and interpreting angiograms. Key points include different techniques for cannulating the left and right coronary arteries as well as grafts like saphenous veins and internal mammary arteries. Common angiographic views are described for visualizing different coronary segments. The document also covers quantitatively and visually assessing coronary narrowings and diagnosing coronary spasm.
Guide catheters in coronary intervention
Guide catheters are essential for coronary interventions as they deliver hardware into the arteries. The document discusses the properties and types of guide catheters, highlighting how their structure provides support and torque control. It describes commonly used guide catheters like the Judkins, Amplatz and EBU catheters, noting what vessels each is best suited for. Specialty guide catheters for difficult anatomies are also reviewed. Proper guide selection and positioning are emphasized for coaxial engagement and optimal device delivery during interventions.
PBMV:Tips and Tricks
Percutaneous Balloon Mitral Valvuloplasty (PBMV) is a procedure to dilated the mitral valve in the setting of rheumatic mitral valve stenosis. A catheter is inserted into the femoral vein, advanced to the right atrium and across the interatrial septum. Then the mitral valve is crossed with a balloon and it is inflated to relieve the fusion of the mitral valve commissures effectively acting to increase the mitral valve area and reduce the degree of mitral stenosis. Mitral regurgitation is a potential complication and thus PBMV is contraindicated if moderate or severe regurgitation is present. The Wilkins score examines mitral valve morphology and is determined via echocardiography to assess the likelihood of using PBMV based on certain echocardiographic criteria.
Coronary lesion assessment
This is a comprehensive description of coronay lesion assessment from routinely used angiography to advanced imaging modalities like IVUS/OCT including their functional significance by FFR
Coronary guide wires
This document discusses coronary guidewires used in percutaneous coronary intervention (PCI). It begins by outlining the history of angioplasty and guidewire development. It then covers the purpose, components, classifications, and appropriate uses of guidewires. The main components include the core, tip, coils, covers, and coatings. Guidewires are classified based on flexibility, device support, and clinical usage. Complications like vessel perforation, pseudolesions, and entrapment are also discussed. Proper guidewire manipulation and strategies for difficult lesions are outlined to maximize safety and efficacy.
Echo assesment of as and ar
This document discusses the echocardiographic assessment of aortic stenosis and regurgitation. It begins by describing normal aortic valve anatomy and various echocardiographic views used to visualize the aortic valve. It then covers the causes, anatomical presentations, and echocardiographic findings of various types of aortic valve disease including calcific stenosis, bicuspid aortic valve, rheumatic stenosis, and others. The document focuses on Doppler assessment of aortic stenosis, including peak velocity, mean gradient, valve area calculation using the continuity equation, and limitations. It also discusses low-flow low-gradient aortic stenosis and the role of dobutamine stress echocardiography.
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Intraluminal coronary thrombus aspiration in patients with STEMI was studied in randomized trials. Results showed thrombus aspiration before stenting improved myocardial perfusion scores and ST-segment resolution compared to conventional PCI alone. Meta-analyses found manual thrombus aspiration reduced distal embolization and improved angiographic and electrocardiographic outcomes, while its effect on mortality is unclear. Larger randomized trials are still needed to definitively establish the benefits of routine thrombus aspiration in STEMI.
Right heart catheters
This document provides information about right heart catheters and angiographic catheters. It discusses the history of right heart catheters from 1929 to 1970. It then describes the diagnostic and therapeutic indications for right heart catheterization. The document outlines the parts of a catheter including the hub, body, and tip. It summarizes several general purpose catheters used for right heart catheterization including the Cournand, Goodale-Lubin, multipurpose, and Swan-Ganz balloon flotation catheters. Finally, it discusses several angiographic catheters used including the pigtail, NIH, Berman, Gensini, and Lehman catheters.
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Contenu connexe
Tendances
FASCICULAR VENTRICULAR TACHYCARDIA( VT)
Fascicular ventricular tachycardia is a type of ventricular tachycardia that originates in the Purkinje fibers near the fascicles of the left bundle branch. It typically presents in young males as palpitations or dizziness. The electrocardiogram shows a narrow QRS complex tachycardia with right bundle branch block morphology that is sensitive to verapamil. The reentrant circuit involves abnormal Purkinje fibers as the slow pathway and the left posterior fascicle as the fast pathway. Radiofrequency ablation targeting Purkinje potentials in the left ventricular septum is effective for treatment.
Left ventricular angiogram (1)
Left ventricular angiography is used to assess global and regional left ventricular function and anatomy. It involves inserting a catheter into the left ventricle and injecting contrast dye to visualize the ventricle on x-ray imaging. The procedure provides key information on mitral valve function, ventricular shape and wall motion abnormalities, and congenital defects like VSD. LV volumes and ejection fraction are calculated from the images to quantify function. Regional wall motion is graded and correlated to coronary artery territories. Characteristic appearances are seen in conditions like cardiomyopathy, mitral regurgitation, and septal defects. Potential complications include arrhythmias and endocardial injury.
IVUS Image Interpretation and Analysis
IVUS may not be clinically warranted in all interventions, and should be seen as an adjunct to angiography. IVUS provides information about vessel morphology, plaque topography, and therapeutic outcomes that is often either equivocal or unavailable in angiographic images.
There are 3 situations in which IVUS has the most clinical utility:
Small vessel stenting: Studies have shown that post-stent restenosis rates are higher in small vessels. This is particularly true for vessels with diameters of 3.0mm or less, wherein small increases in stent diameter have been shown to significantly decrease the rate of restenosis. A study by Moussa et al showed that, as measured by IVUS, the incidence of restenosis has an inverse relationship to the post-procedure in-stent lumen CSA1.
In-Stent restenosis: In these cases, IVUS helps to determine whether the restenosis is due to inadequate stent deployment (underexpansion or incomplete apposition) due to intimal hyperplasia. IVUS will also help you select the proper device size for treatment of the stented area.
Difficult to assess lesions: At times, images of a lesion and the adjacent reference segment are often hazy. IVUS should be used to identify whether the angiographic appearance is due to dissection, thrombus, residual plaque, or is benign.
hemodynamic in cath lab: aortic stenosis and hocm
1) Cardiac catheterization can provide key information about aortic stenosis including transvalvular pressure gradients, the level of stenosis, and estimation of valve area.
2) Low-flow, low-gradient aortic stenosis can be further classified as either having a decreased ejection fraction or a paradoxically normal ejection fraction.
3) In hypertrophic cardiomyopathy, cardiac catheterization can identify dynamic intraventricular pressure gradients that may only be provoked with maneuvers like the Valsalva maneuver.
Coronary artery dissection
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction characterized by a non-traumatic separation of the coronary arterial wall. It most commonly affects younger women and the left anterior descending artery. SCAD results from an intimal tear or bleeding of vasa vasorum that leads to the formation of a false lumen filled with blood. This can cause the artery to narrow and restrict blood flow. SCAD is increasingly recognized and can be caused by conditions affecting connective tissue or hormonal factors during pregnancy. Angiography is used to diagnose SCAD but findings may be subtle, with long diffuse narrowing being most common. Management involves conservative treatment but revascularization may be needed for ongoing ischemia
How to read coronary angiography
Simple approach to interpret coronary angiography views.
Youtube lecture link:
https://youtu.be/Xb8BSJsSJq4
Stress echocardiography
Stress echocardiography enables evaluation of cardiac function at rest and during exercise or pharmacologic stress. It can detect wall motion abnormalities indicative of ischemia and assess valvular function, left ventricular outflow tract gradients, and pulmonary pressures. Exercise or pharmacologic agents like dobutamine are used to induce stress. Indications include evaluating known or suspected coronary artery disease, viability, and valvular diseases. The test is contraindicated in acute coronary syndromes or hemodynamically significant valvular stenosis. Imaging is performed at rest and peak stress to detect new or worsening wall motion abnormalities. Doppler can also evaluate hemodynamic changes with stress.
cath Lab Hemoduhynamic
This document discusses hemodynamic principles and various cardiac pressures measured in the circulatory system. It begins by explaining how electrical activity leads to mechanical functions that generate pressure waves. It then discusses how to measure and interpret pressures in different parts of the heart including the aorta, pulmonary artery, right and left ventricles, and right atrium. Factors that influence pressures and common abnormalities are provided. Diagrams of normal pressure waveforms are displayed. The document concludes by defining pulmonary and systemic vascular resistances.
Echo in restrictive cardiomyopathy
This document provides an overview of echocardiographic evaluation of restrictive cardiomyopathy. Key points include:
- Restrictive cardiomyopathy is characterized by a nondilated left ventricle with abnormal diastolic function and typically normal systolic function.
- Causes include infiltrative diseases like amyloidosis and storage diseases. Echocardiography can help diagnose but it is more difficult than other cardiomyopathies.
- Findings include low diastolic volume, normal ejection fraction, diastolic dysfunction with rapid early mitral inflow. Echocardiography helps differentiate restrictive cardiomyopathy from constrictive pericarditis.
Pressure, Damping and Ventricularization_Crimson Publishers
This document discusses pressure changes that can occur during coronary angiography, specifically damping and ventricularization. Damping is defined as a significant decrease in pressure at the coronary ostium when the catheter is placed, accompanied by the disappearance of pressure waveforms, suggesting no antegrade flow. Ventricularization occurs when blood circulates within a coronary artery like a closed system, deforming the aortic pressure waveform. The document emphasizes the importance of the operator recognizing abnormal pressure changes to avoid complications, and provides solutions like catheter replacement or intracoronary nitroglycerin to address issues.
Normal variants of heart structures
This document discusses several normal anatomic variants that can be mistaken for pathologies in echocardiographic imaging of the heart structures. It describes variants commonly seen in the right atrium, left atrium, left ventricle, aortic valve, and right ventricle which include things like Eustachian valves, Chiari networks, prominent trabeculations, moderator bands, and false tendons. It emphasizes that recognizing these normal variants is important to avoid misdiagnosis and unnecessary treatment based on imaging findings alone.
Ventricular Septal defects Echocardiography
Ventricular septal defects (VSDs) are openings in the wall separating the ventricles of the heart. There are four main types classified by location: membranous, muscular, supracristal, and inlet VSDs. Echocardiography is useful for diagnosing VSDs and assessing their characteristics like location, size, and impact on cardiac function. VSDs range from small and asymptomatic to large defects causing heart failure or pulmonary hypertension. Surgical or catheter-based closure may be required for large VSDs.
Coronary angiogram
This document discusses techniques for coronary angiography including cannulating coronary arteries and grafts, angiographic views, and interpreting angiograms. Key points include different techniques for cannulating the left and right coronary arteries as well as grafts like saphenous veins and internal mammary arteries. Common angiographic views are described for visualizing different coronary segments. The document also covers quantitatively and visually assessing coronary narrowings and diagnosing coronary spasm.
Guide catheters in coronary intervention
Guide catheters are essential for coronary interventions as they deliver hardware into the arteries. The document discusses the properties and types of guide catheters, highlighting how their structure provides support and torque control. It describes commonly used guide catheters like the Judkins, Amplatz and EBU catheters, noting what vessels each is best suited for. Specialty guide catheters for difficult anatomies are also reviewed. Proper guide selection and positioning are emphasized for coaxial engagement and optimal device delivery during interventions.
PBMV:Tips and Tricks
Percutaneous Balloon Mitral Valvuloplasty (PBMV) is a procedure to dilated the mitral valve in the setting of rheumatic mitral valve stenosis. A catheter is inserted into the femoral vein, advanced to the right atrium and across the interatrial septum. Then the mitral valve is crossed with a balloon and it is inflated to relieve the fusion of the mitral valve commissures effectively acting to increase the mitral valve area and reduce the degree of mitral stenosis. Mitral regurgitation is a potential complication and thus PBMV is contraindicated if moderate or severe regurgitation is present. The Wilkins score examines mitral valve morphology and is determined via echocardiography to assess the likelihood of using PBMV based on certain echocardiographic criteria.
Coronary lesion assessment
This is a comprehensive description of coronay lesion assessment from routinely used angiography to advanced imaging modalities like IVUS/OCT including their functional significance by FFR
Coronary guide wires
This document discusses coronary guidewires used in percutaneous coronary intervention (PCI). It begins by outlining the history of angioplasty and guidewire development. It then covers the purpose, components, classifications, and appropriate uses of guidewires. The main components include the core, tip, coils, covers, and coatings. Guidewires are classified based on flexibility, device support, and clinical usage. Complications like vessel perforation, pseudolesions, and entrapment are also discussed. Proper guidewire manipulation and strategies for difficult lesions are outlined to maximize safety and efficacy.
Echo assesment of as and ar
This document discusses the echocardiographic assessment of aortic stenosis and regurgitation. It begins by describing normal aortic valve anatomy and various echocardiographic views used to visualize the aortic valve. It then covers the causes, anatomical presentations, and echocardiographic findings of various types of aortic valve disease including calcific stenosis, bicuspid aortic valve, rheumatic stenosis, and others. The document focuses on Doppler assessment of aortic stenosis, including peak velocity, mean gradient, valve area calculation using the continuity equation, and limitations. It also discusses low-flow low-gradient aortic stenosis and the role of dobutamine stress echocardiography.
Intraluminal coronary thrombus aspiration in patients with STEMI. Prof. Andre...
Intraluminal coronary thrombus aspiration in patients with STEMI was studied in randomized trials. Results showed thrombus aspiration before stenting improved myocardial perfusion scores and ST-segment resolution compared to conventional PCI alone. Meta-analyses found manual thrombus aspiration reduced distal embolization and improved angiographic and electrocardiographic outcomes, while its effect on mortality is unclear. Larger randomized trials are still needed to definitively establish the benefits of routine thrombus aspiration in STEMI.
Right heart catheters
This document provides information about right heart catheters and angiographic catheters. It discusses the history of right heart catheters from 1929 to 1970. It then describes the diagnostic and therapeutic indications for right heart catheterization. The document outlines the parts of a catheter including the hub, body, and tip. It summarizes several general purpose catheters used for right heart catheterization including the Cournand, Goodale-Lubin, multipurpose, and Swan-Ganz balloon flotation catheters. Finally, it discusses several angiographic catheters used including the pigtail, NIH, Berman, Gensini, and Lehman catheters.
Tendances (20)
Pressure, Damping and Ventricularization_Crimson Publishers
Pressure, Damping and Ventricularization_Crimson Publishers
Intraluminal coronary thrombus aspiration in patients with STEMI. Prof. Andre...
Intraluminal coronary thrombus aspiration in patients with STEMI. Prof. Andre...
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Watch the webinar video recording at: https://youtu.be/7ObxATifDds.
Certification handbook
The document provides information about ASQ's certification exam development and administration process. It describes the many phases of exam development, including job analysis surveys, advisory committees, body of knowledge committees, question writing committees, and exam review committees. It also discusses exam grading, scoring, and frequently asked candidate questions about preparing for exams, deciding which exam is appropriate, applying, languages other than English, and interpreting score reports. The development process aims to ensure exam validity and integrity through extensive review by subject matter experts.
Career Summit 2022.pptx
This document provides information about foreign medical licensing requirements and processes for doctors seeking to practice medicine abroad. It discusses licensing pathways and requirements in the UK, USA, Canada, Australia and Gulf countries. It provides salary details for doctors in different high-income countries. Specific licensing exams for the UK, USA, Australia and their processes are described in detail. Requirements, exam formats and costs for PLAB, AMC, MRCP, MRCS, MRCOG exams are summarized. Options for licensed doctors who already have postgraduate degrees are also mentioned.
Save face rpl welcome pack
This document provides information about the Recognition of Prior Learning (RPL) programme offered by Save Face to help aesthetic practitioners gain an Ofqual regulated Level 7 qualification in Aesthetic Medicine. There are two pathways for RPL depending on experience level: beginner/intermediate candidates must submit a portfolio including 10 observed and 10 performed treatments, while very experienced candidates need a portfolio demonstrating at least 3 years of experience or 150 procedures, case studies, and a logbook. The qualification consists of 8 units assessed through short answer questions, objective structured clinical exams, and a verified portfolio.
Career Summit 2022.pptx
This document provides information about foreign medical licensing requirements for doctors seeking to practice medicine abroad. It discusses the licensing processes and exams required in several countries, including the United States (USMLE), United Kingdom (PLAB, MRCP, MRCS), Canada, Australia (AMC), and Gulf countries. It provides details on exam formats, prerequisites, costs, and passing standards. The highest paying countries for doctors are listed as the USA, Canada, Australia, and some European nations. Contact information is provided for various licensing boards and agencies.
Career Summit 2022.pptx
a short brief about foreign licensing.
will help Bangladeshi students to find out their path after graduation.
CCHP-A: Advanced professional certification
The document discusses the NCCHC's Advanced Certification for CCHPs (CCHP-A). The CCHP-A recognizes experienced CCHPs who demonstrate excellence in correctional healthcare. It involves a rigorous application process assessing experience and knowledge, as well as a challenging written exam involving complex case studies. The exam tests understanding of systemic and operational issues in correctional healthcare like developing a hospice unit. Maintaining certification requires ongoing education and leadership in the field. The CCHP-A thereby promotes high standards and professionalism among experienced correctional healthcare providers.
Options Institute: Exams & Courses
Ricardo A. VanEgas has completed several online options trading courses through Cboe's Options Institute. The document lists certificates of completion for 18 courses ranging from beginner to advanced levels, covering topics such as spreading techniques, trading strategies, volatility, and index options. All courses were completed between January 5, 2018 and April 2, 2018.
CRISC sertifikacija
BKA renginio "Kaip tapti lyderiais IT valdymo, saugos ir audito srityje?" pranešimas apie CISM (Certified Information Security Manager) sertifikaciją. Renginys vyko balandžio 18 d., 2013.
Syllabus
This document is a syllabus for Cambridge International A & AS Level Biology. It outlines the aims, assessment objectives, content, and assessment details of the course. The aims are to provide students with an educational experience in biology, develop relevant skills and attitudes, and stimulate interest in biology. The course is assessed through multiple choice, structured, and practical exam papers that test knowledge, handling information, and experimental skills. The syllabus content is divided into core topics and applications.
diplomasupplement
This document is a Diploma Supplement for Rosaria Velon who earned a Master of Science in Human Resource Management from the Open University. It provides information about the qualification including the name and level, fields of study, length of study, modules and credits completed, and grades achieved. It also describes the Open University's distance learning format, credit system, levels, and assessment methods. The supplement is intended to provide transparent information to explain the qualification to employers or for further study admission.
Canberra Chapter Certification Information Session
This document provides information about ISACA certification programs. It discusses the CISA, CISM, CGEIT, and CRISC certifications, including requirements to earn each certification, exam structure and content areas, study materials, and continuing education requirements to maintain certification. It also provides details about ISACA as an organization, including its history, members, and chapters worldwide.
Quality Assurance for Engineering Programs in Lebanon
Factors contributing to QA
Basic data: HE in Lebanon & Regulations
What has been done (2006-2014)
What we were doing
Emerging Trends
SelfAssessment_Online
The Self-Assessments are publications developed by the Board of Certified Safety Professionals (BCSP) to help candidates evaluate their knowledge in key areas outlined in each certification's exam blueprint. The Self-Assessments contain sample questions matching the exam blueprints without using actual exam questions. Candidates can use the Self-Assessments to identify their strengths and weaknesses to focus their exam preparation. While BCSP does not provide direct training, the Self-Assessments assist individuals in strategizing their exam preparation approach.
Use of an e-portfolios tool to support specialisation in physiotherapy
The Australian Physiotherapy Association is using an ePortfolio tool to support physiotherapists pursuing specialization. The tool allows candidates to develop learning contracts, upload evidence of meeting professional standards, and discuss ideas with peers and facilitators online. Initial training programs using the ePortfolio focused on musculoskeletal and sports specializations. Participants found the ePortfolio inspiring and a great learning opportunity. The APA plans to expand use of ePortfolios for additional professional development programs.
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211344558 certified-six-sigma-black-belt-asq-cssbb (1)
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CSSD EXAMS THAT YOU CAN TAKE TO HELP BOOST YOUR PROFESSIONAL CAREER
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ISACA Lietuva. Asociacija, sertifikacijos ir mokymai
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OECD Webinar | Concluding remarks - Mirjam Luijten
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Coronary shock wave lithotripsy balloon (IVL)
This document discusses intravascular lithotripsy (IVL), a new technique for treating calcified coronary lesions. It provides an overview of IVL, including how it works using shockwaves to fracture calcium, the components of the system, and how to perform the procedure. The document outlines when IVL may be used compared to rotational atherectomy, such as for heavily calcified lesions, stent failure, or bifurcations. It presents examples of calcium fractures achieved with IVL and a practical algorithm for deciding between IVL and rotational atherectomy based on lesion characteristics.
EECC.pdf
This document provides guidance on preparing for the European Exam in Core Cardiology (EECC). It outlines the exam format, resources for preparation, and topics covered. The key points are:
- The exam takes place once per year, with the next one in June 2024. It is 3 hours long and contains 120 multiple choice questions.
- Main resources for preparation include ESC Guidelines, the EECC free preparatory course, BJCA course, question banks, and mock exams. Guidelines and courses focus on algorithms, guidelines summaries, lectures, and imaging.
- Topics covered include heart failure, valvular disease, coronary artery disease, arrhythmias, and others. Guidelines should be reviewed
Angina pectoris
This document discusses angina pectoris, or chest pain caused by reduced blood flow to the heart. It begins with an introduction and overview of angina. The main causes of angina are coronary artery disease and atherosclerosis which can lead to plaque buildup and blockages in the arteries supplying the heart. The document then covers clinical evaluation of patients with chest pain through medical history, physical exam, electrocardiograms and imaging tests. It outlines treatment goals of slowing disease progression, preventing heart attacks and relieving symptoms through risk factor control, medications like statins, blood pressure medications, aspirin and nitrates as well as procedures like coronary stenting. The role of lifestyle changes like diet, exercise and smoking cessation are
Novel management options for tricuspid endocarditis
- Tricuspid valve endocarditis is managed either surgically or percutaneously depending on factors like resistant infection, recurrent infection showers, or resistant heart failure.
- Surgical options include excision with bicuspidization or patch repair, while percutaneous options include aspiration of vegetations using the AngioVac system or the newer Flow Triever system.
- The AngioVac system uses a self-expanding nitinol funnel tip and cardiopulmonary bypass to aspirate vegetations, showing technical success in 90% of cases and resolution of bacteremia in 75% within 48 hours.
Cardiac examination
This document provides guidance on performing a cardiac examination, including examination of:
1. The general patient (e.g. build, position)
2. Specific areas (hands, head, neck, legs, abdomen, lungs) to examine signs like clubbing, edema, jugular vein distension
3. The local heart (palpation for enlarged chambers or thrills, auscultation to identify affected valves or sounds like murmurs, clicks)
It describes what to listen for at different auscultation sites and how heart sounds and splits may indicate different cardiac issues. Additional signs like S3 and S4 gallops or pericardial rubs are also covered.
ECG made easy
This document provides an overview of how to read an electrocardiogram (ECG). It describes the basic anatomy and electrical conduction system of the heart and how the ECG machine records and displays the heart's electrical activity. It then outlines a systematic approach for interpreting an ECG, including evaluating the rhythm, rate, axes, voltages, waves, segments, intervals, and any signs of ischemia, injury, or arrhythmia. Localization of abnormalities is also addressed. Examples are provided throughout to illustrate various normal and pathological ECG patterns.
Descending aortic aneurysm
This document discusses descending aortic aneurysms, including their etiology, diagnosis, treatment options, and follow up. It notes that descending aortic aneurysms can be either true or false aneurysms. True aneurysms are usually degenerative in nature and share risk factors with abdominal aortic aneurysms like age, male sex, smoking, and hypertension. Imaging like CT or MRI is used to diagnose and monitor aneurysm size. Treatment depends on aneurysm size and anatomy, and may involve open surgical repair or endovascular stent grafting. Follow up care involves monitoring repaired aneurysms for complications like endoleaks. The overall goals are to control risk factors, intervene when aneurysms reach a certain size threshold based on guidelines, and
pericardial ESC guidelines
This document provides guidelines on the management of pericardial diseases from the ESC. It discusses the etiology, diagnosis, and treatment of various pericardial conditions including pericarditis, cardiac tamponade, constrictive pericarditis. For constrictive pericarditis specifically, it highlights two key pathophysiological characteristics - exaggerated ventricular interdependence and the halting of intrathoracic pressure changes on the ventricles by a thickened pericardium. Surgical pericardiectomy is the definitive treatment for constrictive pericarditis when medical management fails.
Cardio oncology guidelines ESC 2022
1. This document discusses cardiovascular risks associated with cancer therapies. It highlights three main stations: risk factor assessment, surveillance during therapy, and risk stratification after therapy.
2. Different cancer treatments can cause different types of cardio-toxicity, such as anthracyclines causing heart failure, HER2 inhibitors causing drops in ejection fraction, and immune checkpoint inhibitors causing myocarditis.
3. Clinical scenarios are presented involving patients receiving various therapies who present with new cardiovascular issues, and the document discusses recommended next steps for evaluating and managing these patients.
Voltage discordance
Voltage discordance between precordial and limb leads on an ECG can indicate dilated cardiomyopathy. It is defined as a QRS amplitude less than 5 mm in all limb leads but greater than 10 mm in two or more contiguous precordial leads. This pattern is seen in 60% of dilated cardiomyopathy cases. In dilated cardiomyopathy, the enlarged heart brings myocardium closer to the chest wall, increasing the electrical forces detected by precordial leads via the Brody effect. Meanwhile, limb leads have lower recorded voltages due to their bipolar nature and replacement of muscular tissue with fibrotic scarring in cardiomyopathy.
LV non-compaction cardiomyopathy
Left ventricular non-compaction cardiomyopathy (LVNC) is a rare genetic heart condition characterized by a thickened myocardium with prominent trabeculations. It occurs when the myocardium fails to compact properly during fetal development. LVNC can be isolated or associated with other heart defects, and presents variably from being asymptomatic to causing heart failure, arrhythmias, blood clots, or sudden cardiac death. Diagnosis is made through echocardiogram, cardiac MRI, or CT scan finding an excessive trabeculated myocardium. Treatment focuses on managing complications like heart failure or arrhythmias. Prognosis depends on symptoms and ejection fraction, with mortality over 40% at 5 years in symptomatic patients.
OCT in coronary PCI
This document discusses optical coherence tomography (OCT) in coronary artery disease. It provides an overview of OCT, including its history and clinical evidence. It then outlines how to perform an OCT study and presents an algorithmic approach to interpreting OCT images, including assessing plaque morphology, stent sizing and apposition. The document discusses several clinical applications of OCT, such as evaluating acute coronary syndrome, plaque vulnerability, and stent failure. It also reviews limitations and future directions of OCT, including hybrid OCT/IVUS catheters and the use of artificial intelligence.
Ventricular septal rupture .pptx
Ventricular septal rupture (VSR) is a devastating complication following myocardial infarction. It occurs in 0.17-0.31% of cases post-primary PCI, usually 2-8 days post-MI. Risk factors include older age, female sex, late presentation, extensive MI, hypertension, and lytic therapy. Diagnosis involves acute deterioration, auscultation findings, echocardiogram, and CT scan. Management uses a hybrid approach of primary PCI of the culprit vessel followed by transient mechanical support like IABP, then definitive surgical or percutaneous repair. Without treatment, mortality is over 90% at 1 year. Challenges include friable tissue that cannot hold sutures early on and
Cardiovascular sequelae of Covid-19 (ACC consensus 2022)
Summary of the recently published ACC consensus 2022 about the cardiovascular sequalae of Covid-19 infection
Lecture link: https://youtu.be/7JBG2v8YLpA
Temporary pacemaker
This document discusses how to insert a temporary pacemaker. It begins by providing historical context, noting the first patient to be kept alive for months using a pacemaker device. It then outlines the key steps for inserting a temporary pacemaker, including obtaining venous access, positioning the pacing lead under fluoroscopy or echocardiography guidance, and setting up the pacemaker device. Potential complications are addressed, as well as troubleshooting loss of capture or sensing. Special situations like externalized batteries or congenital vascular anomalies are also covered.
Pericardiocentesis
1) Pericardiocentesis is performed to drain fluid from the pericardial sac surrounding the heart. It was first done in 1840 by Franz Schuh in Vienna on a patient with a mediastinal tumor.
2) There are several potential access sites for the procedure including sub-xiphoid, left and right parasternal, and apical approaches. Ultrasound is typically used to guide needle placement and confirm proper positioning within the pericardial sac.
3) After fluid is drained, samples are obtained for analysis. The drainage catheter is then sutured in place and connected to a drainage system. Complications can include laceration of nearby organs or vessels,
Focused bedside Echocardiography
How to perform rapid focused bedside Echocardiography
Youtube lecture link:
https://youtu.be/_AHiQDfMo7k
SGLT2 inhibitors
SGLT-2 inhibitors have shown promising cardiovascular and renal benefits:
1) Trials have found SGLT-2 inhibitors reduce the risk of cardiovascular death in patients with type 2 diabetes and established cardiovascular disease, as well as reducing heart failure hospitalizations in those with diabetes and cardiovascular risk factors.
2) Studies also show SGLT-2 inhibitors improve outcomes for patients with heart failure with reduced ejection fraction, reducing rates of heart failure hospitalization and mortality regardless of diabetes status or background heart failure therapies.
3) SGLT-2 inhibitors were also found to reduce the risk of renal death or progression to end-stage kidney disease in patients with type 2 diabetes and macroalbuminuria.
Coronary bifurcations
1) Two-stent strategies can be used either as bail-out during provisional stenting if the side branch is compromised, or electively for complex bifurcation anatomies with predictors of side branch compromise.
2) Common two-stent techniques discussed include T/TAP stenting, mini-crush, culotte, and DK crush. Factors such as vessel diameters, angles, and lesion lengths help determine the appropriate technique.
3) Key steps discussed include optimal kissing balloon inflation, proximal optimization of the main vessel stent, and respecting the bifurcation anatomy. Being familiar with one or two techniques and using intravascular imaging is recommended.
AHA Valvular guidelines 2020, What is new?
The document summarizes key changes in the 2020 American Heart Association valvular heart disease guidelines compared to previous versions. Some notable changes include a lower threshold for intervention in aortic and mitral regurgitation to prevent ventricular dysfunction, expanded recommendations for mitral valve repair with transcatheter edge-to-edge repair for primary and secondary mitral regurgitation, consideration of early intervention for severe symptomatic isolated tricuspid regurgitation, and recognition of catheter-based treatments like valve-in-valve as reasonable options for treating prosthetic valve dysfunction in selected patients. The presentation also reviews guidelines on infective endocarditis prophylaxis, medical management of chronic regurgitation, and decision-making factors for biopropro
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
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Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
LOOPS in orthodontics t loop bull loop vertical loop mushroom loop stop loop
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Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Identifying Major Symptoms of Slip Disc.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
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• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
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EAPCI certification
- 2. Eligibility • Interventional cardiologists practicing in ESC member country Check at (https://www.escardio.org/The-ESC/Member-National- Cardiac-Societies) • EAPCI member > Join for free (https://www.escardio.org/Marketing/EAPCI-Membership- offer) • National board certification in cardiology, or in cardiology specialist training (fellow)> (letter of confirmation is required)
- 3. Two parts • Part A: Exam > to test the theoretical knowledge • Part B: E-logbook – to demonstrate training, skills and experience
- 4. Part A • Exam dates announced 3 months ahead on (https://www.escardio.org/Education/Career- Development/Certification/Interventional-Cardiology) • 100 MCQ questions over 3 hours • Delivered using online proctoring platform (ProctorU®).
- 6. Exam resources • STEMI > Will be updated in 2023 • NSTE-ACS > Will be updated in 2023 • CCS > Will be updated in 2024 • ESC revascularization guidelines • Valvular (Focusing in -structural Percutaneous) > Will be updated in 2025 • -GUCH (Focusing in Percutaneous intervention) • -Aorta (Focusing in Percutaneous intervention) > Will be updated in 2024 • -Peripheral (Focusing in Percutaneous intervention)> Will be updated in 2024 https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines
- 7. EAPCI core curriculum webinar series https://esc365.escardio.org/event/400 Use link below, After sign in, choose
- 13. Useful book or MCQ exercise
- 14. Part B Enrollment in training program for 24 months
- 15. Best YouTube learning channel and book Channel link
- 16. Course link A course that put me on the track !
- 17. Best of luck for every one…