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Re: imposter

Добавлено: Вт авг 14, 2018 8:06 am
Wojtek Guzowski
At this time,I have no doubt this is ALCAPA.
But several days after, another 15 years old boy came to Echo.
Here is he,very similar blue flow with the first boy,there is no red retrograde flow in position of LCx.
Neither the first nor the second has angio CT.I have not an access to CT.
Echocardiography for certificate of Polish football association/PZPN.

Re: imposter

Добавлено: Вт авг 14, 2018 9:57 am
nikolan70
:D i really impressed!
In first time If i had no access to CT in such case, stress-echo would be my option.

Re: imposter

Добавлено: Вт авг 14, 2018 10:58 am
Wojtek Guzowski
Adenozinum stress-Echo?Rather?

Re: imposter

Добавлено: Вт авг 14, 2018 11:27 am
nikolan70
I prefer supine bicycle, but if we want assess CFR adenosin will be a better choise (because dyipyridomole isn't available in russia).

Re: imposter

Добавлено: Вт авг 14, 2018 12:20 pm
Wojtek Guzowski
Adenosinum is high costly,in Poland 1amp- 140$.
But bicycle exercise is not diagnostic in ALCAPA,opinion

Re: imposter

Добавлено: Вт авг 14, 2018 1:47 pm
nikolan70
Really! By the way, adenosine also is inavailable in Russia, we use ATP for this reason.
I have no expirience in stress-echo in alcapa patients, but there are some case in literature discribing wall motion abnormalities during stress-echo. In patients wthis good image equality also posible asess flow in LAD during supine(!)bicycle exercise stress-echo.
In this two case these findings may be a great cardiac vein, as you said before.

Re: imposter

Добавлено: Вт авг 14, 2018 2:03 pm
nikolan70
Sorry i forgot to attach image with poible LCX flow in previous answer. Now i did it.

Re: imposter

Добавлено: Вт авг 14, 2018 10:06 pm
nikolan70
Finaly, if you couldn't find RCA, it may be anomalous RCA origin from PA or LCA with steal flow from left to right artery.
This PW-flow pattern mostly diastolic, cardiac vein flow tipicaly systolo-diastolic with interruption during atrial contraction

Re: imposter

Добавлено: Вт авг 14, 2018 11:23 pm
Wojtek Guzowski
Nikolan,do you have any echo images of anomalous CA,yours?
Can you show?
Coronary fistulas,something like that, to see?

Re: imposter

Добавлено: Вт авг 14, 2018 11:30 pm
nikolan70
Yes, one case i presented here

Re: imposter

Добавлено: Вт авг 14, 2018 11:47 pm
Wojtek Guzowski
First look: ARCAPA,but final diagnosis is CAF?
SAX: evident collaterals from LCA to RCA-> blue jet
Amazing
$ versus chestnuts for ARCAPA,No doubt there is a steal phenomenon with ischaemia,functionally ARCAPA.Maybe partial ARCAPA- one RCA from right SV,and the second RCA from pulmonary artery
That is the way it is.
Insidious,sneaky functional ARCAPA with sudden impact with no warning.

Re: imposter

Добавлено: Ср авг 15, 2018 12:32 am
Pyankov Vasily
Guideline for cardiovascular screening of sports participants

https://www.bsecho.org/media/99004/spor ... or_web.pdf
BSE sport cardiac screening protocol.jpg
BSE sport cardiac screening protocol.jpg (117.61 КБ) 5051 просмотр

Re: imposter

Добавлено: Ср авг 15, 2018 9:47 am
Wojtek Guzowski
corresponding to your ARCAPA,16 years old,without symptoms,Polish Navy Highschool schoolboy.
Something wrong?
When I was reading your post about 18 years old boy with ARCAPA one thing is ror sure- very critical attitude of the others,but it is very difficult and critical diagnosis,do they know?
filipkwa_20170213_Cardiac_0012.MP4
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PA
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LAX

Re: imposter

Добавлено: Ср авг 15, 2018 10:01 am
Wojtek Guzowski
ARCAPA is very crucial diagnosis.ВПС=VSD?
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opposite positions of Ao and PA
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Re: imposter

Добавлено: Ср авг 15, 2018 11:29 am
Wojtek Guzowski
ECG- early repolarisation,without hipertrophy
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