زكاة العلم الدكتور محمد البيضاني

شوفوا الاعلان لهل تطبيقات راح تفيدكم هواي اني شخصيا كنت استخدمهن. مرحبا جمعياً اذا چنت تبحث عن الاشتراك بواحد من ذني التطبيقات ف وفرناها باسعار بسيطة جداً 🔴 ٣ اشهر اب تو ديت ( اونلاين واوفلاين) وبجهازين تگدر تسجل دخول ب 15 الف رصيد اسيا او زين كاش فقط للاشتراك الاول (و 10 الف لتجديد الاشتراك اذا چنت مشترك عدنه سابقاً) 🔴 اشتراك bmj best practice ننطي بي سنتين ضمان ب 15 الف فقط 🔴 اشتراك dynamed ننطي بي ضمان ٦ اشهر بخمسة الاف فقط 🔴 ٣ اشهر amboss (نفس مميزات الاشتراك الشهري العادي بموقعهم الرسمي) ب ١٠ الاف فقط ( العدد محدود جداً) للطلب راسلونه ع رابط الواتساب https://wa.me/message/DK5EM25F27GEI1 قناة التلي ننشر بيها اخر العروض عن الاشتراكات بالتطبيقات الطبية https://t.me/+gWJDZEeH8hoxMjJi

شوفوا الاعلان لهل التطبيقات راح يفيدكم هواي. مرحبا جمعياً اذا چنت تبحث عن الاشتراك بواحد من ذني التطبيقات ف وفرناها باسعار بسيطة جداً 🔴 ٣ اشهر اب تو ديت ( اونلاين واوفلاين) وبجهازين تگدر تسجل دخول ب 15 الف رصيد اسيا او زين كاش فقط للاشتراك الاول (و 10 الف لتجديد الاشتراك اذا چنت مشترك عدنه سابقاً) 🔴 اشتراك bmj best practice ننطي بي سنتين ضمان ب 15 الف فقط 🔴 اشتراك dynamed ننطي بي ضمان ٦ اشهر بخمسة الاف فقط 🔴 ٣ اشهر amboss (نفس مميزات الاشتراك الشهري العادي بموقعهم الرسمي) ب ١٠ الاف فقط ( العدد محدود جداً) للطلب راسلونه ع رابط الواتساب https://wa.me/message/DK5EM25F27GEI1 قناة التلي ننشر بيها اخر العروض عن الاشتراكات بالتطبيقات الطبية https://t.me/+gWJDZEeH8hoxMjJi

16 years old male presented with palpitations - irregular - wide QRS - No p wave - rapid heart rate - different morphological base of QRS - delta wave Conclusion: AF with pre excitation (WPWS) Acute treatment: - synchronised DC - IV procainamide - amidarone controversy Definitive treatment: ablation of accessory pathway.

عدنا والعود احمدُ Old age male with history of frequent syncopal attack?

العزاز شنو نوع ال heart block ؟😹

نعتذر عن عدم النشر هل فتره بسبب الشد والتوتر قبل اتخاذ قرار الاختصاص الطبي😢

الله لايحيركم بحيره اختيار الاختصاص ☹️.

-(4)- Arrythmogenic right ventricular dysplasia ( ARVD). - Autosomal dominant genetic disorder of myocardium in which there is fatty infiltration of the right ventricular free wall, predisposing to paroxysmal ventricular arrhythmias, sudden cardiac death, and biventricular failure. - Second most common cause of sudden cardiac death in young people (after HOCM), accounting for up to 10% of sudden cardiac deaths in patients < 65 yrs of age • Prevalence ~ 1 in 5000 • Diagnosis is difficult and relies on a combination of clinical, electrocardiographic and radiological features, as defined by the (horribly complicated). Clinical Features • ARVD causes symptoms due to ventricular ectopic beats or sustained VT (with LBBB morphology), and typically presents with palpitations, syncope or cardiac arrest precipitated by exercise • The first presenting symptom may be sudden cardiac death • Over time, surviving patients develop features of right ventricular failure, which may progress to severe biventricular failure and dilated cardiomyopathy • There is usually a family history of sudden cardiac death ECG features • T wave inversion in right precordial leads V1-3, in absence of RBBB (85% of patients) • Epsilon wave (most specific finding, seen in 50% of patients) • Localised QRS widening in V1-3 (> 110ms) • Prolonged S wave upstroke of 55ms in V1-3 • Ventricular ectopy of LBBB morphology, with frequent PVCs > 1000 per 24 hours • Paroxysmal episodes of ventricular tachycardia (VT) with LBBB morphology (RVOT tachycardia). Imaging • Echocardiography is the first-line investigation, and may demonstrate a dilated, hypokinetic right ventricle with prominent apical trabeculae and dilatation of the RV outflow tract • The imaging modality of choice in many centres is cardiovascular MRI, which can accurately demonstrate structural and functional features of ARVD such as fibrofatty infiltration and thinning of the RV myocardium, RV aneurysms, RV dilatation, regional wall motion abnormalities and global systolic dysfunction • Histological diagnosis, either via endomyocardial biopsy or at autopsy, provides a definitive diagnosis but is impractical, and for those patients diagnosed at post-mortem… far too late! Risk Assessment Patients with ARVD are considered to be at high risk of sudden death if they have any of the following: • A history of syncope due to cardiac arrest • Recurrent arrhythmias not suppressed by anti-arrhythmic drug therapy • A family history of cardiac arrest in first degree relatives Treatment Options Primary treatment involves arrhythmia suppression and prevention of thrombus formation: • In patients with no high risk features, initial treatment is with anti-arrhythmic drugs such as beta-blockers or amiodarone to suppress cathecholamine-triggered ventricular arrhythmias. Currently, the most effective drug for this is sotalol. Warfarin is often recommended to prevent thrombus formation due to RV hypokinesis • In patients with persistent symptomatic arrhythmias, radiofrequency ablation of conduction pathways may be attempted. However, progression of disease means over half ocases recur • Patients with any high risk features require urgent insertion of an implantable cardioverter-defibrillator (ICD) • Heart failure is treated in the usual way, with diuretics, ACE inhibitors and anticoagulants. In severe cases, cardiac transplantation may be required

تكمله موضوعنا عن sudden cardiac death -(3)- Hypertrophic cardiomyopathy previously termed hypertrophic obstructive cardiomyopathy (HOCM) or idiopathic hypertrophic subaortic stenosis (IHSS), is one of the most common inherited cardiac disorders. Complete the topic in first comment.

Syncope or presyncope related to position with constitutional symptoms like fever , weight loss and arrythragia >>> atrial myxoma until prove otherwise

Aortic stenosis and prognosis - those how develope angina >>> 3-5 years of untreated - those who develope syncope >>> 2-3 years if untreated - those who develop congestive heart failure >>> 1-2 years if untreated Note - sever aortic stenosis once become symptomatic should be replaced - those who decide to replace should be do angiography to see if there is vessel to do GABG at time of open heart surgery

Can you give short history for this patient?

هذا ملخص من دهاليز مضلمه Cocaine : Is the most commonly used illicit drug among patients presenting to emergency departments, and associated cardiovascular consequences include - ischemia and infarction, myocardial diastolic and/or systolic dysfunction - arrhythmias. The mechanisms of myocardial ischemia and infarction include (1) increased myocardial oxygen demand in the setting of limited oxygen supply. (2) intense coronary arterial vasoconstriction, and/or enhanced platelet aggregation and thrombogenicity. (3) In addition, the vascular injury caused by cocaine may lead to increased endothelial permeability and accelerated atherogenesis. Notes : 1- Cocaine use increases the risk of myocardial infarction (MI) 24-fold over the following 60 minutes in individuals otherwise at low risk for MI. 2- the occurrence of myocardial infarction after cocaine is not associated with the amount ingested, route of administration, or frequency of use. 3- Mechanisms of myocardial dysfunction after long-term cocaine use include (1) myocardial ischemia or infarction, (2) cardiomyopathy due to repeated sympathetic stimula-tion, and (3) altered myocardial and endothelial cytokine production. 4- also myocardial dysfunction can also occur acutely after cocaine use, likely reflecting drug-associated metabolic disturbances or direct toxic effects of the drug.