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This week we review a work from the department of cardiology and department of cardiac surgery at Boston Children's Hospital on late hypertension in patients following coarctation repair. Late hypertension has been associated previously with late transverse aortic arch Z score but can this be predicted by the immediate postoperative transverse aortic arch Z score also? What factors account for late hypertension in the coarctation patient? Should more patients have their aorta repaired from a sternotomy? Dr. Sanam Safi-Rasmussen, who is a PhD candidate at Copenhagen University, shares her insights from a work she performed while a research fellow at Boston Children's Hospital. DOI: 10.1016/j.jtcvs.2024.08.049
This episode covers coarctation of the aorta.Written notes can be found at https://zerotofinals.com/paediatrics/cardiology/coarctation/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.
$5 Q-BANK: https://patreon.com/highyieldfamilymedicine Intro 0:30, Hypertension classifications 1:45, Lifestyle modifications 3:00, Thiazide diuretics 4:16, ACE Inhibitors and ARBs 5:59 Calcium channel blockers 8:15, Beta blockers 9:36, Mineralocorticoid receptor antagonists 10:49, Goal-directed medical therapy 12:49, Resistent hypertension 15:37, Other antihypertensives 16:38, Hypertensive emergency 20:33, Hypertension in pregnancy 23:00, Primary hyperaldosteronism 24:38, Renal artery stenosis 26:24, Cushing syndrome 27:22 Pheochromocytoma 28:53, Obstructive sleep apnea 30:26, Coarctation of the aorta 31:30, Practice questions 32:30
Commentary by Dr. Valentin Fuster
Commentary by Dr. Candice Silversides
Commentary by Dr. Candice Silversides
Commentary by Dr. Candice Silversides
Meredith, a mother in Ann Arbor, MI speaks with Dr. Fox about her pregnancy journey after being diagnosed with Gitelman syndrome, her child's diagnosis of coarctation of the aorta, and more.
1.18 Coarctation of the Aorta Cardiovascular system review for the USMLE Step 1 Exam.
We are happy to be joined by Dr Radek Debiec Cardiology and Congenital heart disease registrar at Glenfield hospital. Dr Debiec is going to discuss Coarctation of Ao- diagnosis and management. Listen to know more about one of the most common congenital heart disease.
In this episode, we review the high-yield topic of Coarctation of Aorta from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
$5 Q-BANK: https://www.patreon.com/highyieldfamilymedicine Intro 0:30, Fetal circulatory system 2:00, Persistent fetal circulation 6:38, Patent ductus arteriosus 8:02, Differential cyanosis 8:40, CCHD screening 9:24, Common themes 10:39, Non-cyanotic heart defects 13:26, Ventricular septal defects 14:08, Atrial septal defects 15:35, Eisenmenger syndrome 16:28, Aortic and pulmonary stenosis 17:42, Coarctation of the aorta 18:42, Double aortic arch 19:53, Interrupted aortic arch 21:07, Cyanotic heart defects 21:34, Tetralogy of Fallot 23:39, Transposition of the great arteries 28:03, Hypoplastic left heart syndrome 29:47, Persistent truncus arteriosus 31:09, Partial and total anomalous pulmonary venous connection 33:01, Scimitar syndrome 35:04, Tricuspid and pulmonary atresia 36:03, Prostaglandin E1 indications 36:31, DiGeorge syndrome 38:08, CHARGE syndrome 38:42, Dextrocardia 39:06, Situs inversus and total situs inversus 39:16, Ebstein anamoly 40:04, Noonan syndrome 40:34, Turner syndrome 41:11, Down syndrome 41:28, Marfan syndrome 40:52, Congenital heart blocks 43:03, Practice questions 43:27
Candide recounts a story of a traveler who visits the country of Cacao. There, he learns of a bizarre custom called the coarctation of the aorta. This law requires all women to wear G-strings in order to increase their fecundity. However, Candide is horrified by the sight of these slits in women's bodies and refuses to pay any attention to the woman selling him chocolate.
In this episode, we review the high-yield topic of Coarctation of the Aorta from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficialx Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message
Today we have another story from a heart mama. I wanted to fit them all into February, but I couldn't quite make it. So we are just creeping into March here with Dimitra and her story. Her son also had transposition of the great arteries (TGA), which we heard about in last week's episode. It's interesting to see where the two stories are parallel and where they differ. In this episode, we talk about… [1:51] Dimitra's family and background [3:37] Adapting to changes outside of our control [5:19] Getting the diagnosis of transposition of the great arteries (TGA) [14:05] Pregnancy after confirming a heart defect [18:59] Dimitra's son's birth [24:01] Coping with setbacks after birth [28:49] Finding out about her son's coarctation of the aorta [30:52] Dimitra's son's surgeries [39:36] Life after two heart surgeries [43:30] What Dimitra's son has taught her [48:30] How Dimitra processes and copes with her experiences now Connect with Dimitra: Instagram Website Have you heard? The Child Life On Call mobile app for parents, kids and their care team will be available in 2022. Sign up to stay informed here. Child Life On Call is a community of parents and professionals that share ideas, stories and resources to help YOU navigate your child's unique experiences. We give you strategies to support yourself and your family through life's challenges. We are so glad you are here. Website: childlifepodcast.com Merch: bonfire.com/store/childlifeoncall Instagram: instagram.com/childlifeoncall Facebook: facebook.com/childlifeoncall Twitter: twitter.com/childlifeoncall YouTube: https://www.youtube.com/channel/UCnh95T1MOYtbpBxJaZqg7rg
How can a heart camp, like Camp Del Corazon, enhance a Heart Warrior's life? What made one Heart Warrior decide to become a nurse and eventually to go back to Camp Del Corazon as a Camp Nurse? What is the next step for a Heart Warrior after she is too old for camp?Carrlee McGuire-Lim is a Heart Warrior who was born with Hypoplastic Right Heart Syndrome, Coarctation, and TGA. She has had several cardiac surgeries over her lifetime and a Pacemaker placed at age 5. Carlee also has severe scoliosis requiring surgical rod placement at age 13. Carrlee knew from a young age that she wanted to be a nurse, but always had concerns if her heart would be strong enough to work the long hours in a high stress environment. Beating the odds, Carrlee successfully graduated from nursing school in 2017 and works as a NICU nurse caring for tiny newborns, some with congenital heart disease too! Carrlee pursued more and graduated with her MSN and starting teaching nursing students in 2021.She married the love of her life in 2017 and has big plans for her future.Our Guest Host is Roslyn Rivera. She is also a Heart Warrior and a nurse! Roslyn is also a Medical Advisory Board member.Links mentioned in this program:Camp Del Corazon website: https://www.campdelcorazon.org/A video with Carrlee and Roslyn: https://www.youtube.com/watch?v=nH3dxB251cE Roslyn's former "Heart to Heart with Anna" episodes: A View From the Other Side of the BedCongenital Heart Defects Around the Globe: The Novick Cardiac AllianceNurse Burnout in the CHD Community Part 1Nurse Burnout in the CHD Community Part 2Please visit our Social Media and Podcast pages:Apple PodcastsFacebookInstagramMeWeTwitterYouTubeWebsiteAnna's Buzzsprout Affiliate Link (we both benefit if you sign up with Buzzsprout with my link - yay!) Support the show (https://www.patreon.com/HearttoHeart)
Looking for more information on this topic? Check out the Acyanotic Congenital Heart Defects: Foundations and Frameworks brick. If you enjoyed this episode, we'd love for you to leave a review on Apple Podcasts. It helps with our visibility, and the more med students (or future med students) listen to the podcast, the more we can provide to the future physicians of the world. Follow USMLE-Rx at: Facebook: www.facebook.com/usmlerx Blog: www.firstaidteam.com Twitter: https://twitter.com/firstaidteam Instagram: https://www.instagram.com/firstaidteam/ YouTube: www.youtube.com/USMLERX Learn how you can access over 150 of our bricks for FREE: https://usmlerx.wpengine.com/free-bricks/ from our Musculoskeletal, Skin, and Connective Tissue collection, which is available for free. Learn more about Rx Bricks by signing up for a free USMLE-Rx account: www.usmle-rx.com You will get 5 days of full access to our Rx360+ program, including nearly 800 Rx Bricks. After the 5-day period, you will still be able to access over 150 free bricks, including the entire collections for General Microbiology and Cellular and Molecular Biology.
What is Ebstein's Anomaly? How did living with congenital heart defects influence Tori Geiger's career choice? What does having Ebstein's Anomaly mean for a newly married couple wanting a family?Today's show is Resiliency: Overcoming Challenges with Ebstein's Anomaly and our Guest is Tori Geiger. We'll start today's program by learning a bit about Tori in Segment 1. In the second segment, we're going to talk about becoming an advocate and an author and in the final segment, we will discover what Tori and her husband have planned for the future. Heart Warrior Tori Geiger was diagnosed with Ebstein's Anomaly and Coarctation of the aorta. She had open-heart surgery at 4 days, 2 months, and 7 months of age. She had an ablation for Supra-ventricular Tachycardia in 7th Grade and in her freshman year of high school. These experiences have taught Tori a lot about resilience and overcoming obstacles. During school and college, Tori was a competitive athlete and still takes part in athletics today. She is the author of the inspirational book: From Vulnerable to Victorious: Turning Your Chronic Illness Into Your Victory Story, and has her own website and Instagram to motivate and inspire others. Tori lives with her husband Devin, who is her best friend and business partner, and their pet Goldendoodle Teddy. They hope to expand their family one day. Links for Show Notes:Tori's website: https://www.torijoygeiger.comInstagram: @torijoygeigerThe Heart Community Collection – https://www.theheartcommunitycollection.com/torijoygeigerPlease visit our Social Media and Podcast pages:Apple PodcastsFacebookInstagramMeWeTwitterYouTubeWebsiteAnna's Buzzsprout Affiliate Link (we both benefit if you sign up with Buzzsprout with my link - yay!) Support the show (https://www.patreon.com/HearttoHeart)
Welcome to episode to episode 12 of Women's Circle. I cannot believe how much this little project has grown over the past 3 months! It is such an honour to have made Apple Podcasts Top 100 list for parenting podcasts in Australia this month. Thank you for your support. I will continue to hold space for you to tell your important stories.Today on the podcast I am speaking to Shannon Saines. Shannon lives in Brisbane with her husband and two young children. Shannon works in online travel and shares her story today about a relatively smooth life until the birth of her second child. Lucas was born healthy and well until a routine check-up at three days old revealed some life-changing news.**There are themes of infant distress in this episode, if this brings up anything for you, please find, please find some useful information:PANDA – Perinatal Anxiety and Depression Australiahttps://www.panda.org.au/ Peachtree Perinatal Wellnesshttps://peachtree.org.au/ Lifeline13 11 14 We will be discussing:- Fear of loss, body image and being a ‘good mum' concerns pre-parenthood - The smooth journey from suburban life to mother of one- Practicing compassion and non-judgement as a new parent- Transferring a positive mindset from running training to parenting a newborn- Positive self-talk and reflection as skills to support yourself on hard days- Hearing our words reflected to us through our children- Bouncing back to exercise after a baby- Journey of second pregnancy and healthy birth- No femoral pulses at day 3 and discovery of a heart-condition- Healing post-surgery as a woman and familyWelcoming you to the space.Love, CarlieFounder, Mumma Got Skillswww.mummagotskills.com.auInstagram: @mummagotskillsFacebook: https://www.facebook.com/mummagotskills Resources and Links:Coarctation of the Aortahttps://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/coarctation-of-the-aorta-coa
Suddenly hit by PTSD with Danielle Allen Danielle Allen is a mum to three children. Her eldest son Louis was born with a congenital heart condition called Coarctation of the aorta.Suddenly six years later, and following the traumatic experience of Louis undergoing heart surgery at 10 days old, Danielle experienced what she describes as a big black cloud which came from nowhere. She describes the profound impact that had her and the subsequent diagnosis of Obsessive Anxiety Disorder and PTSD. For supportCharity: PTSD The NHS advise that if you or your child are experiencing problems after a traumatic experience, or if the symptoms are particularly troublesome you should contact your GP. Hosted by Chantal Boyle, Hidden Disabilities Sunflower. Want to share your story? email conversations@hiddendisabilitiesstore.com Visit the Hidden Disabilities Sunflower website.
Follow Tori on Facebook and Instagram @torijoygeiger. You can also join her Facebook Group, the Tori Joy Geiger Victory Tribe. You can purchase her book, "From Vulnerable to Victorious", on Amazon or on her website, torijoygeiger.com.Check out our website, myimmunesystempod.com, where you can get in contact with Chelsey, listen to old episodes, learn about the RA Warrior Group, buy a signed copy of Chelsey's book, and apply to be a guest on the show.Don't forget to rate and review the show, and follow us on Instagram and Facebook @myimmunesystempod***Any information discussed in this podcast is strictly my opinion and those of my guests and are for informational purposes only. We are speaking from our personal experiences and you should always consult with your doctor or medical team.
CardioNerds (Amit Goyal and Daniel Ambinder), ACHD series co-chair Dr. Agnes Koczo (UPMC), and episode FIT lead, Dr. Natasha Wolfe (Washington University) join Dr. Ari Cedars (Director of the Adult Congenital Heart Disease Program at Johns Hopkins) for a discussion about coarctation of the aorta. In this episode we discuss the presentation and management of unrepaired and repaired coarctation of the aorta in adults. We discuss the unique underlying congenital anatomy of coarctation and how that impacts physiology, clinical presentation, and diagnostic findings. We discuss the importance of long-term routine follow-up and screening of patients (including those who have been “repaired”) for common complications such as hypertension, re-coarctation, and aneurysm development. We end with a discussion of treatment options for coarctation and its complications. Audio editing by CardioNerds Academy Intern, Dr. Maryam Barkhordarian. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Claim free CME for enjoying this episode! Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Coarctation of the aorta can occur as a discrete stenosis or as a long and hypoplastic hypoplastic aortic arch segment. Most commonly it is a discrete stenosis located at the insertion site of the ductus arteriosus just distal to the left subclavian artery.Three quarters of patients with coarctation of the aorta also have a bicuspid aortic valve.Hypertension is the most common long-term complication of coarctation of the aorta, whether repaired or unrepaired. Unrepaired coarctation is a rare cause of secondary hypertension in young adults with a difference in upper extremity and lower extremity BP by ≥ 20 mmHg. Systemic hypertension may not be consistently identifiable at rest in those with repaired coarctation, thus guidelines recommend ambulatory blood pressure monitoring or stress testing to identify hypertension with exertion.Chest and brain imaging via CT or MRI should be done every 5-10 years to screen for other long-term complications including re-coarctation (rate ~11%), aortic aneurysm development (higher risk in those with concurrent bicuspid aortic valve), pseudoaneurysm, aortic dissection, and cerebral aneurysms.Repair of coarctation or re-coarctation is indicated for patients who are hypertensive with a BP gradient ≥ 20 mmHg (Class I recommendation). Catheter-based stenting is the preferred approach when technically feasible. Show notes 1. What is the proposed embryologic origin of coarctation of the aorta? The aortic arch and its branches develop at 6-8 weeks fetal gestation. We all start with six aortic arches that go on to become the great arteries of the head and neck. The 4th arch forms the thoracic aortic arch and isthmus. The 6th arch persists as the proximal pulmonary arteries and ductus arteriosus. Thoracic aortic coarctation is therefore a manifestation of abnormal embryologic development of the 4th and 6th arches.There are two main theories regarding how aortic coarctation occurs.
This episode covers congenital cardiac conditions.Written notes can be found at https://zerotofinals.com/surgery/cardiothoracic/congenitalcardiacconditions/ or in the cardiothoracic surgery section of the Zero to Finals surgery book.The audio in the episode was expertly edited by Harry Watchman.
Today I spoke with Louise about her son Lucas' story. Lucas is a twin with brother Logan, and was diagnosed postnatally at 9 weeks old with: - Coarctation of the Aorta - VSD (which closed on its own eventually) Lucas is now 8 years old and doing amazing after suffered 4 cardiac arrests within his first few weeks of life and undiagnosed after 3 hospital admissions. I talk to Louise about Lucas 'cool' scar, celebrating heart days and life since surgery. Louise mentioned the breathing mats that detected when Lucas went into cardiac arrest when they were all sleeping so wanted to place a link here as this seems like the best piece of baby equipment you could buy, when your baby has a heart condition and if not: https://www.amazon.co.uk/Angelcare-Ac027-Sensasure-Movement-Monitor/dp/B07RG5VV2Q/ref=asc_df_B07RG5VV2Q/?tag=googshopuk-21&linkCode=df0&hvadid=255468571917&hvpos=&hvnetw=g&hvrand=4469946355205776871&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=1007024&hvtargid=pla-782966069423&psc=1&th=1&psc=1
I read from coarctation to coaster. My wife's wood burning shop on Etsy! https://www.etsy.com/shop/FirewalkwithmeDesign The word of the episode is "coast". Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/ Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar 917-727-5757
Roles were swapped in this episode where previous guest Corey took the reigns and we chatted about Maisy's story. Maisy, born in September 2020, was a Covid Baby and was diagnosed with: - Coarctation of the Aorta - VSD (hole in the heart) We chat about juggling a baby in hospital with a toddler at home, speedy recoveries and a general consensus that these heart babies are very special. Links discussed in this episode: H&M - side button vests: https://www2.hm.com/en_gb/productpage.0814306002.html?utm_id=go_cmp-12828082241_adg-121943360096_ad-517954073900_pla-323567503382_dev-c_ext-_prd-en-0814306002005_sig-CjwKCAjw9uKIBhA8EiwAYPUS3ETf2mNo6r5nuGeJA-XLef2w7Pw47OdKZqvn65Zz_myxqY1I959liBoCgc0QAvD_BwE&utm_source=Google&gclid=CjwKCAjw9uKIBhA8EiwAYPUS3ETf2mNo6r5nuGeJA-XLef2w7Pw47OdKZqvn65Zz_myxqY1I959liBoCgc0QAvD_BwE H&M - footless babygros: https://www2.hm.com/en_gb/productpage.0769102088.html?utm_id=go_cmp-12796663563_adg-126516120652_ad-516052907653_pla-323810612138_dev-c_ext-_prd-en-0769102088007_sig-CjwKCAjw9uKIBhA8EiwAYPUS3Bt7KqCm1M_rrMYiQCNnmGs7jGxKZvdFsd-apsqzzrPPljdFjS-h0xoCijgQAvD_BwE&utm_source=Google&gclid=CjwKCAjw9uKIBhA8EiwAYPUS3Bt7KqCm1M_rrMYiQCNnmGs7jGxKZvdFsd-apsqzzrPPljdFjS-h0xoCijgQAvD_BwE Headspace - fear of the future meditation programme: https://www.headspace.com/articles/how-to-stop-worrying
Today we talked to Hannah who share's Imogen's story. Imogen was diagnosed at Hannah's 20 week scan with: - Coarctation of the Aorta - Hypoplastic left ventricle - Bicuspid valve (diagnosed after birth) - Hypoplastic aortic arch As a result of surgery Imogen also experienced: - Diaphragm palsy - Vocal cord palsy Hannah talks so candidly about her experience, and there are times within our chat where it became quite emotional so this could be triggering for some listeners. Hannah shares her experience of having an amniocentesis, having a baby during Covid and being sick on her husband's arm! Links to websites mentioned on the podcast: British Heart Foundation: https://www.bhf.org.uk/informationsupport/publications/children-and-young-people/understanding-your-childs-heart---coarctation-of-the-aorta Tiny Tickers parents group: https://www.tinytickers.org/virtual-parent-support-groups/
This is the second in a two part podcast series discussing Adult Congenital Heart Disease (ACHD) and how these patients may present to the Emergency Department (ED). Dr Sam Fitzsimmons, our guest on the podcast, is a Consultant in Adult Congenital Heart Disease at University Hospital Southampton. There is more information in this blog post. In this episode we discuss Eisenmenger Syndrome, Transposition of the Great Arteries and Coarctation of the Aorta.
This is the first in a two part podcast series discussing Adult Congenital Heart Disease (ACHD) and how these patients may present to the Emergency Department (ED). Dr Sam Fitzsimmons, our guest on the podcast, is a Consultant in Adult Congenital Heart Disease at University Hospital Southampton. There is more information in this blog post. Look out for Part 2, which will be released next week, where we discuss Eisenmenger Syndrome, Transposition of the Great Arteries and Coarctation of the Aorta. Background With advances in paediatric cardiac surgery, more and more patients with complex congenital heart disease are surviving to adulthood: in the 1950s you might expect a survival rate of about 10%, whereas now this is more like 85%. In fact, there are more patients in the adult congenital heart disease population than there are in the paediatric one (with 2.3 million adults vs 1.9 million children in Europe). Many patients with Adult Congenital Heart Disease are young and able to live a relatively normal life. This means that they can travel and take part in just the same sort of activities as those without ACHD. They may well turn up in your Emergency Department one day, regardless of whether you are a tertiary centre or a district general hospital (DGH). They are experts, and know their disease well, but this does not abstain you from a responsibility to know about them too! When these patients become unwell, they can go downhill very fast and you may not have the chance to discuss with them their exact lesion and its management. The anatomy and physiology of these patients is abnormal, so they may present in atypical ways, and may not respond to usual medical interventions: in fact, some of our usual treatments may even be harmful. However, starting with our usual 'ABC' approach is by far the best way to go, whilst gathering more information and contacting their specialist centre. Many patients will have their last clinic letter and ECG with them (which will also have the direct dial number of their specialist). And if they, or their relative, say there is something wrong you must believe them and do all you can to make sure they are fully investigated. The presence of scars may give you some clues as to the patient's underlying condition and previous surgical repairs. (BMJ 2016; 354: i3905) A General Approach Do your usual ABC assessment. Pay particular attention to the respiratory rate - this should be normal. Give oxygen if they look unwell. They should have a 'normal' blood pressure - any hypotension should be taken as abnormal and investigated. The Fontan Circulation This is not a condition in itself, but in fact the resulting circulation after a series of operations that could've been performed due to a number of different underlying conditions: Tricuspid Atresia Double Inlet Left Ventricle Atrio-ventricular Septal Defect – unbalanced Pulmonary Atresia Hypoplastic Left Heart Syndrome In essence these patients are born with a single functioning ventricle, that has to be utilised to supply the systemic side of the circulation, whilst the Fontan acts as a passive means of returning blood to the pulmonary circulation. It was first devised in the early 1970s by Dr Francis Fontan, so the majority of patients with this are in their mid thirties and younger. Potential reasons for admission to the ED - Fontan circulation 1, Arrythmia As the patient is entirely dependent on their systemic ventricle to work optimally, any disturbance of the delivery into it is very poorly tolerated. Thus, any arrhythmia is life threatening, even a mild atrial tachycardia. These patients need to be returned to sinus rhythm as quickly as possible and the recommended method for this is DC cardioversion in expert hands. Fontan patients have an incredibly fragile circulation and any change in their respiratory physiology can be life threatening, especially if it increases their pulmonary pressures (and thus prevents the passive flow within the Fontan circulation). These patients are not candidates for sedation in the ED and should have an experienced anaesthetist to manage them during the procedure. Beware if the patient comes in and tells you they are fasted! This means they have been in this situation before and needed DC cardioversion. 2, Haemoptysis Over time the patient develops venous hypertension within the Fontan connection. This causes the formation of collateral vessels, that may link into the bronchial arterial tree. If the patient presents in shock treat them as you would any other patient with emergency blood transfusion. Any haemoptysis, however small, may herald the beginning of a massive bleed. These patients need further investigation, probably a CT chest with contrast. These vessels may then be coiled by interventional radiology. 3, Cyanosis If the patient has a non fenestrated Fontan they should have normal oxygen saturations. However, if there is a fenestration there will be shunting and therefore a reduction in oxygenation. For patients this is trade of between being pink or blue, each of which have complications. Dr Sam Fitzsimmons Dr Sam Fitzsimmons is a Consultant Cardiologist in Adult Congenital Heart Disease (ACHD) at the University Hospital Southampton, UK. Sam also subspecialises in pulmonary hypertension and maternal cardiology. Working within a tertiary surgical ACHD centre, Sam delivers an ACHD on call service for emergency admissions, inpatient care, routine outpatient follow-up, intra-operative imaging and post-surgical care, as well as specialist clinics in Pulmonary Hypertension and Maternal Cardiology. Sam holds a Honorary Senior Clinical Lecturer post with the University of Southampton as she is passionate about teaching and in particular, she is enthusiastic about helping demystify congenital heart disease for many non-specialist to improve patient care. Sam is well published in peer review journals, cardiology textbooks and specialist guidelines.
This week we play a live podcast session from SCAI 2021 (April 30, 2021) on the topic of balloon angioplasty for native aortic coarctation in infants aged 3-12 months. We speak with the senior author of this recent work from Toronto Sick Children's Hospital - Professor Rajiv Chaturvedi. How often were complications encountered? How do results compare with surgical repair? Is high pressure required for these dilations? Professor Chaturvedi provides all the answers and more this week! doi: 10.1161/CIRCINTERVENTIONS.120.008938
This episode covers coarctation of the aorta!
Healing Hearts: Empowering Pediatric Critical Care Providers
In the cardiac lesion series, pediatric Intensivist, Dr. Laura Ortmann, describes the background of the cardiac lesion, what it looks like clinically, the most common complications post-operatively, and how the lesion is managed. In this episode, she will discuss the Cardiac Lesion, Coarctation of the Aorta. The information provided in this podcast is general in nature and is intended as a training tool for Children's Hospital & Medical Center personnel. This podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Each patient is unique and information provided in any educational forum must be tailored to each patient's unique situation. By recording this podcast, neither Children's, nor any provider, is engaged in the practice of medicine, nursing or any other health care service. Medical professionals and individual patient families should not attempt to use or rely upon any of the information provided to make medical decisions or to provide health care services. If you are a Children's employee and you have any questions about the content of this podcast, please discuss these with your supervisor. By listening to the podcast, you are agreeing with the terms of this disclaimer. All rights to this podcast are reserved. Copyright Children's Hospital & Medical Center 2020.
Board exam high yield points in Aortic coarctation, bicuspid aortic valve, and subclavian steal syndrome
Pediatric patients with suspicion of congenital heart abnormalities can be very intimidating! In this week's podcast Jacob speaks with one of our pediatric POCUS experts regarding congenital heart abnormalities and how the average provider might be able to evaluate them. Your point-of-care exam should never replace a cardiology-performed echo, but your exam can definitely help you in your work-up. Here are Russ's tips: Hypoplastic left heart - Look for a small left ventricle Coarctation of the aorta - Look at the pulsed-wave Doppler waveform of the abdominal aorta Heart failure - Look at the lungs
This episode covers the coarctation of the aorta.Written can be found at https://zerotofinals.com/paediatrics/cardiology/coarctation/ or in the cardiology section in the Zero to Finals paediatrics.The audio in the episode was expertly edited by Harry Watchman.
Listen as Dr. London Smith (.com) and his producer Cameron discuss Coarctation of the Aorta with special guest Klompy the Elf. Not so boring! http://www.londonsmith.com/jockdocpodcast/28-coarctation-of-the-aorta-klompy-christmas/ Performed by: London Smith, Cameron Clark, Cassie Walker, Dylan Walker. Written by: London Smith, Cameron Clark, Cassie Walker, Dylan Walker. Produced by: London Smith, Cameron Clark, Dylan Walker Cassie Walker. Created by: London Smith
In this episode, we dive into Congenital Heart Defects Part 1 of 3. In this podcast, we will review Coarctation of the Aorta and Transposition of the Great Vessels. Despite these patients often being transported by NICU teams, there are cases of Coarctation of the Aorta infants that have been undiagnosed that you may encounter on scene fights that decompensate once the PDA has closed. This places the care in the pre-hospital provider's hands and brings forth a high-stress case that can be overwhelming for most. Couple this with the high quantity of questions seen on all advanced certification exams and it is a must that we review these congenital heart defects. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
In this episode, we dive into Congenital Heart Defects Part 1 of 3. In this podcast, we will review Coarctation of the Aorta and Transposition of the Great Vessels. Despite these patients often being transported by NICU teams, there are cases of Coarctation of the Aorta infants that have been undiagnosed that you may encounter on scene fights that decompensate once the PDA has closed. This places the care in the pre-hospital provider's hands and brings forth a high-stress case that can be overwhelming for most. Couple this with the high quantity of questions seen on all advanced certification exams and it is a must that we review these congenital heart defects. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn't make this podcast without you. Thanks for listening! Thanks for listening!See omnystudio.com/listener for privacy information.
In the June 2019 episode of the JAAPA Podcast, hosts Kris Maday, PA-C and Adrian Banning, PA-C discuss articles on education techniques for contraception counseling, management of femoral pseudoaneurysm, coarctation of the aorta, and amoebic meningoencephalitis. Plus, coffee algorithms and bedtime stories in the Maday household have Adrian asking... "why?" Don't forget to leave us a rating and review! These articles and the rest of the June 2019 issue of JAAPA can be found at JAAPA.com
Listen to the podcast for why each multiple choice answer is right or wrong!1. A 9 YO boy presents to your clinic with widened pulse pressure, paradoxical splitting of S2 and a continuous machinery-type murmur that is heard best in the 2nd left intercostal space and widely transmitted over the precordium. No cyanosis present. What is the most likely diagnosis?A. Ventricular septal defect.B. Atrial septal defect.C. Coarctation of AortaD. Patent Ductus Arteriosus.2. A 15-year-old man presents after fainting while playing a basketball game. The patient states he was shooting when he felt lightheaded and subsequently passed out. On presentation, he is asymptomatic and has completely normal vital signs. Using your stethoscope, you hear a crescendo-decrescendo murmur at the left sternal border. What diagnosis should be suspected in this patient?A. Still's murmurB. Eisenmenger's syndromeC. Hypertrophic cardiomyopathyD. Venous hum3. It’s your 3rd week at your pediatric rotation and a 8-year-old girl is brought in by his mom for strange behavior. She’s had intermittent fevers at night for the past week and reports L knees, bilateral ankle and R elbows joint pain and swelling. As she’s sitting on your exam table, her hands are writing uncontrollably and she maintains she can’t control them. On exam, a diastolic murmur is noted at the right upper sternal border. Which of the following diagnoses is most consistent with her symptoms?A. Acute Rheumatic FeverB. Pulmonic stenosisC. Aortic stenosisD. Tetralogy of FallotAnswers1. D. Patent ductus arteriosus2. C. Hypertrophic cardiomyopathy3. A. Acute Rheumatic FeverFeel free to reach out with questions and suggestions at leonardsee94@gmail.com. IG: @lenny_see
This week we return to the world of adult congenital heart disease to review 2 related works on the topic of late cardiovascular risks in patients who have undergone prior coarctation repair. Are such patients at elevated risk for early coronary artery disease and stroke? What are the causes for these late complications? What role does hypertension play in the development of these late sequelae? Are there other factors that may explain these risks and how should patients be screened for these issues? These are amongst the questions we review with Dr. Sarah Pickard, Instructor in Pediatrics, Harvard Medical School and first author of 2 important new works from the team at Boston Children's Hospital and Brigham and Women's Hospital. doi: 10.1016/j.amjcard.2018.08.051 and doi: 10.1161/JAHA.118.009072
This week we return to the world of adult congenital heart disease to review 2 related works on the topic of late cardiovascular risks in patients who have undergone prior coarctation repair. Are such patients at elevated risk for early coronary artery disease and stroke? What are the causes for these late complications? What role does hypertension play in the development of these late sequelae? Are there other factors that may explain these risks and how should patients be screened for these issues? These are amongst the questions we review with Dr. Sarah Pickard, Instructor in Pediatrics, Harvard Medical School and first author of 2 important new works from the team at Boston Children's Hospital and Brigham and Women's Hospital. doi: 10.1016/j.amjcard.2018.08.051 and doi: 10.1161/JAHA.118.009072
This week we review 2 works on the topic of aortic coarctation. The first reviews outcomes of arch repair in the setting of a bovine arch and the second reviews the possible long term impact of having mild transverse arch hypoplasia after repair - a common problem afflicting many patients who have undergone coarctation repairs. Dr. Emile Bacha, Professor of Surgery at Columbia University and Dr. Ashwin Prakash, Associate Professor of Pediatrics and Director of the Cardiac MRI Service at Harvard University will speak to us directly about these papers and their thoughts on this important topic. Should coarctations be approached from the front or the side? Drs. Bacha and Prakash will offer us some answers.
This week we review 2 works on the topic of aortic coarctation. The first reviews outcomes of arch repair in the setting of a bovine arch and the second reviews the possible long term impact of having mild transverse arch hypoplasia after repair - a common problem afflicting many patients who have undergone coarctation repairs. Dr. Emile Bacha, Professor of Surgery at Columbia University and Dr. Ashwin Prakash, Associate Professor of Pediatrics and Director of the Cardiac MRI Service at Harvard University will speak to us directly about these papers and their thoughts on this important topic. Should coarctations be approached from the front or the side? Drs. Bacha and Prakash will offer us some answers.
References Baracco R et al. Pediatric Hypertensive Emergencies. Curr Hypertens Rep. 2014; 16:456. Belsha CW. Pediatric Hypertension in the Emergency Department. Ann Emerg Med. 2008; 51(3):21-24. Chandar J et al. Hypertensive crisis in children. Pediatr Nephrol. 2012; 27:741-751. Dionne JM et al. Hypertension Canada’s 2017 Guidelines for the Diagnosis, Assessment, Prevention, and Treatment of Pediatric Hypertension. Canadian J Cardiol. 2017; 33:577-585 *Flynn JT, Kaelber DC, Baker-Smith CM, et al; SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017; 140(3):e20171904 Gilhotra Y et al. Blood pressure measurements on children in the emergency department. Emergency Medicine Australasia. 2006; 18:148-154. Lurbe E et al. 2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens. 2016; 34:1-35. Patel NH et al. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies. Open Access Emergency Medicine. 2012; 4:85-92. Yang WC et al. Clinical Analysis of Hypertension in Children Admitted to the Emergency Department. Pediatr Neonatol. 2010; 1:44-51. Addendum: Causes of Malignant Hypertension by Age Infant to Toddler Preschool to School Age Adolescent to Adult Renal disease Renal disease Primary hypertension Coarctation of the aorta Coarctation of the aorta Medication non-adherence Bronchopulmonary dysplasia Drug induced/toxicologic Renal disease Increased intracranial pressure Increased intracranial pressure Increased intracranial pressure Volume overload Pheochromocytoma Pheochromocytoma Congenital adrenal hyperplasia Primary hypertension Drug induced/toxicologic Adapted from: Constantine E. Hypertension. In: Textbook of Pediatric Emergency Medicine, 6th Ed. Fleischer GR, Ludwig S, Henretig FM (Eds). Lippincott, Williams & Wilkins, Philadelphia. 2010; p315. This post and podcast are dedicated to Manpreet 'Manny' Singh for his collegiality, collaboration, and overall awesomeness.
In Episode 7, we take a moment of pause from discussing our usual training, competing, and physical culture in order to look at strength in a whole new light. We look at the strength of the human heart, both literally and figuratively. Jason Rule, owner of Driven Nutrition--one of the foremost nutritional supplement companies supporting CrossFit affiliated gyms, opens his heart to tell us and our listeners a story that few have heard: Lakin's story. In this first installment of a three-part story, strength is revealed in the love and strength of a mother willing to undergo indescribable pain for unconditional love. Strength is revealed in a father who doesn't know if his wife or unborn child will survive. Strength is revealed in parents who survive 10 minutes at a time as they sit with a newborn preparing for open heart surgery. Strength is revealed as Jason takes gratitude for life from his newborn son's challenges and channels them into building a brand that supports the health and well-being of Affiliate communities. Contact Jason: jason@drivennutrition.net Driven Nutrition https://drivennutrition.net Facebook: https://www.facebook.com/drivennutrition/ Instagram @drivennutrition Children's Hospital of Colorado https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/Coarctation-of-the-aorta/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
TSRA Podcast: Congenital - Coarctation of the Aorta (Corinne Tan & Carlos Mery) by TSRA
Some studies have suggested endothelial dysfunction in adult patients after repair of aortic coarctation (CoA), and it has been proposed to play a key role in the pathogenesis of arterial hypertension in the absence of re-coarctation. A study recently published in Heart aimed to assess the presence of endothelial dysfunction, the number of endothelial progenitor cells, and the levels of proinflammatory cytokines associated with endothelial injury in contemporary patients after CoA repair. Alistair Lindsay discusses what the work revealed with lead author Robert Radke, Division of Adult Congenital and Valvular Heart Disease, Department of Cardiology and Angiology, University Hospital Muenster. Read the full paper (for free): http://goo.gl/z32cOl
Carp with compasses, why we have earwax, what causes CIDP, can genes re-write their own code, do bananas in brown bags stay fresher longer, does hot water sound different, why veins look blue and what is coarctation of the aorta? Like this podcast? Please help us by supporting the Naked Scientists
Carp with compasses, why we have earwax, what causes CIDP, can genes re-write their own code, do bananas in brown bags stay fresher longer, does hot water sound different, why veins look blue and what is coarctation of the aorta? Like this podcast? Please help us by supporting the Naked Scientists