Re: imposter
Добавлено: Ср авг 15, 2018 11:37 am
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Re: imposter
Добавлено: Ср авг 15, 2018 11:39 am
last- blue jet from facing sinus,no visible collaterals and others features of retrograde inflow RCA
Re: imposter
Добавлено: Ср авг 15, 2018 2:57 pm
If i understood you correctly. Yes, all collegues who commented my case are great professionals and they are familar with ARCAPA. I thought their critical attitude was result for cource/way of my presentation, because i purposely hid some image for representing the way of my decision making. Finaly the correct diagnosis of PA to RCA fistula was establish during discussion.Wojtek Guzowski писал(а): ↑Ср авг 15, 2018 9:47 amWhen 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?
Re: imposter
Добавлено: Ср авг 15, 2018 3:03 pm
No risk,no Fun,in free translation: everyone can make an unadequate diagnosis, without affront
Re: imposter
Добавлено: Ср авг 15, 2018 3:10 pm
Talkin about your cases. What diagnosis have you established in these two boys. Im a little confused about the topic.
Re: imposter
Добавлено: Ср авг 15, 2018 3:28 pm
Let us talk about your 18 years old challenger.
Are you sure it is arteriovenosus coronary fistula?
What is a difference between CAF,coronary fistula and ARCAPA?
You were questioning about this artery near the RCA,what do you think,take a look at ostium in long axix, left aortic outflow tract,where is ostium ?Here we are,
picture
About the second artery next to RCA-> page 531 down TKDA Turkey But the second question is still actually, where is the ostium in correlation to Aorta Ascendens in nice picture of yours?
Is this ostium in Right Valsalva Sinus or not?
Are you sure it is arteriovenosus coronary fistula?
What is a difference between CAF,coronary fistula and ARCAPA?
You were questioning about this artery near the RCA,what do you think,take a look at ostium in long axix, left aortic outflow tract,where is ostium ?Here we are,
- red ostium,where is it?
- AO-RCA-2 ostium.gif (2.76 МБ) 5568 просмотров
About the second artery next to RCA-> page 531 down TKDA Turkey But the second question is still actually, where is the ostium in correlation to Aorta Ascendens in nice picture of yours?
Is this ostium in Right Valsalva Sinus or not?
Re: imposter
Добавлено: Ср авг 15, 2018 6:06 pm
I answered in my topic.
Re: imposter
Добавлено: Ср авг 15, 2018 7:18 pm
Of Course,you are right there are 2 coronary artery RCA and conal branch,ostia are seen in your picture.
Nikolan wrote.." От правого коронарного синуса тоже отходит артерия,..."- but this is not true,no way
This true is a contrafact to your opinion and implicates situation:
- RCA from PA- ARCAPA,
- Conus branch was misevaluated as a RCA.
another:
CAF- RCA to PA
CAF- anomalous origination and termination conal branch to PA
Nikolan wrote.." От правого коронарного синуса тоже отходит артерия,..."- but this is not true,no way
This true is a contrafact to your opinion and implicates situation:
- RCA from PA- ARCAPA,
- Conus branch was misevaluated as a RCA.
another:
CAF- RCA to PA
CAF- anomalous origination and termination conal branch to PA
Re: imposter
Добавлено: Ср авг 15, 2018 9:14 pm
An so, do you mean it is also conal branch ?
Re: imposter
Добавлено: Ср авг 15, 2018 9:38 pm
Who knows, nothing is impossible,but in this case Conus branch is not visible anyway.
But,young 18 years old Navyman has evident, visible conal branch,the question is about termination and exact origin.
But,young 18 years old Navyman has evident, visible conal branch,the question is about termination and exact origin.
Re: imposter
Добавлено: Ср авг 15, 2018 9:39 pm
Wojtek Guzowski писал(а): ↑Ср авг 15, 2018 10:01 amARCAPA is very crucial diagnosis.ВПС=VSD?filipkwa_20170213_Cardiac_0020.MP4filipkwa_20170213_Cardiac_0017.MP4filipkwa_20170213_Cardiac_0014.MP4filipkwa_20170213_Cardiac_0013.MP4
If "VSD" means ventricular septal defect, then ВПС=VSD in some cases, but not in that aforementioned. ВПС (врождённый порок сердца) means "congenital heart defect". All of them including VSD.
Good luck for everyone!
Re: imposter
Добавлено: Ср авг 15, 2018 9:46 pm
Vasilich писал(а): ↑Ср авг 15, 2018 9:39 pmWojtek Guzowski писал(а): ↑Ср авг 15, 2018 10:01 amARCAPA is very crucial diagnosis.ВПС=VSD?filipkwa_20170213_Cardiac_0020.MP4filipkwa_20170213_Cardiac_0017.MP4filipkwa_20170213_Cardiac_0014.MP4filipkwa_20170213_Cardiac_0013.MP4
If "VSD" means ventricular septal defect, then ВПС=VSD in some cases, but not in that aforementioned. ВПС (врождённый порок сердца) means "congenital heart defect". All of them including VSD.
Good luck for everyone!
THX,if you are so kind, what is ,how you call " post infarctum VSD"?
Is this in russian language "Aneurysma VSD"?
Re: imposter
Добавлено: Ср авг 15, 2018 10:32 pm
Wojtek Guzowski писал(а): ↑Ср авг 15, 2018 9:46 pmVasilich писал(а): ↑Ср авг 15, 2018 9:39 pmWojtek Guzowski писал(а): ↑Ср авг 15, 2018 10:01 amARCAPA is very crucial diagnosis.ВПС=VSD?filipkwa_20170213_Cardiac_0020.MP4filipkwa_20170213_Cardiac_0017.MP4filipkwa_20170213_Cardiac_0014.MP4filipkwa_20170213_Cardiac_0013.MP4
If "VSD" means ventricular septal defect, then ВПС=VSD in some cases, but not in that aforementioned. ВПС (врождённый порок сердца) means "congenital heart defect". All of them including VSD.
Good luck for everyone!
THX,if you are so kind, what is ,how you call " post infarctum VSD"?
Is this in russian language "Aneurysma VSD"?
Excuse me. I am not so professional in cardiology, as our colleagues. They'll answer your question in proper way.
Sincerely yours!
Re: imposter
Добавлено: Чт авг 16, 2018 12:01 pm
Re: imposter
Добавлено: Чт авг 16, 2018 12:34 pm
Подведем итог затянувшейся "дискуссии".
При проведении ЭхоКГ у профессиональных спортсменов и лиц занимающихся любительским спортом всегда нужно помнить о том, что порядка 15-18% внезапны смертей в спорте связано с аномалиями коронарных артерий. Оценка устьев коронарных артерий при проведении ЭхоКГ у лиц занимающихся спортом обязательна. Во всех остальных случаях, при любом подозрении на аномалии коронарных артерий, есть мультимодальная визуализация. МСКТ-коронарных артерий уже можно считать "золотым стандартом" для неинвазивной оценки коронарной анатомии у спортсменов. Проблема только в дефиците квалифицированных сердечно-сосудистых радиологов и хороших компьютерных томографов с соответствующим программным обеспечением.
P.S. Ниже приведена цитата из документа на который ориентируются все грамотные врачи занимающиеся спортивной кардиологией.
При проведении ЭхоКГ у профессиональных спортсменов и лиц занимающихся любительским спортом всегда нужно помнить о том, что порядка 15-18% внезапны смертей в спорте связано с аномалиями коронарных артерий. Оценка устьев коронарных артерий при проведении ЭхоКГ у лиц занимающихся спортом обязательна. Во всех остальных случаях, при любом подозрении на аномалии коронарных артерий, есть мультимодальная визуализация. МСКТ-коронарных артерий уже можно считать "золотым стандартом" для неинвазивной оценки коронарной анатомии у спортсменов. Проблема только в дефиците квалифицированных сердечно-сосудистых радиологов и хороших компьютерных томографов с соответствующим программным обеспечением.
P.S. Ниже приведена цитата из документа на который ориентируются все грамотные врачи занимающиеся спортивной кардиологией.
The ECG is an unreliable screening tool for suspecting or recognizing anomalous origin of coronary arteries before an event, and even stress tests are not uniformly positive among people with these anomalies. Clinical symptoms, such as exertional chest discomfort or dyspnea, may be helpful, but 2 reports suggest that 50% of SCDs associated with coronary artery anomalies were first events without prior symptoms. The best methods for identifying the anomaly include coronary angiography, computed tomography angiography, and magnetic resonance angiography. Although not uniformly successful, athletes undergoing echocardiographic studies for any reason should have careful attempts to identify the origins of the coronary arteries.
Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Preamble, Principles, and General Considerations A Scientific Statement From the American Heart Association and American College of Cardiology