Subaortic membrane

Intra + Extra cardiac shunt

The spectral Doppler evidence of underlying apical HCM

[Puffer fish heart]
Large pericardial effusion + complete AV block
➡️Long enough diastolic time to fill the chambers and resist high intrapericardial pressures.

Cardiac tamponade —> Electrical alternans

The mitral valve (anterior leaflet) is designed to direct blood flow towards a smooth sliding path which begins at the basal posterior wall and ends at the LVOT—thereby minimizing LV energy expenditure during ejection.
Cheers🍷

Papillary muscles behavior in MVP versus secondary MR.

Intra- and extra- cardiac shunts can coexist.

Bubbles flow pattern and timing are key to differentiate the two.

•PFO: transient quickly disappearing bubbles.
•AVM: continuous incremental flow of bubbles.

[PFO in a liver cirrhosis patient with AVM]

𝐏𝐮𝐥𝐦𝐨𝐧𝐚𝐫𝐲 𝐫𝐞𝐠𝐮𝐫𝐠𝐢𝐭𝐚𝐭𝐢𝐨𝐧 𝐣𝐞𝐭 𝐢𝐧𝐭𝐞𝐫𝐫𝐮𝐩𝐭𝐞𝐝 𝐛𝐲 𝐚𝐭𝐫𝐢𝐚𝐥 𝐟𝐥𝐮𝐭𝐭𝐞𝐫 𝐢𝐧𝐝𝐮𝐜𝐞𝐝 𝐑𝐀 𝐤𝐢𝐜𝐤𝐬:
𝐑𝐀 𝐜𝐨𝐧𝐭𝐫𝐚𝐜𝐭𝐢𝐨𝐧—>⬆️𝐑𝐕 𝐩𝐫𝐞𝐬𝐬𝐮𝐫𝐞—>⬇️𝐏𝐀-𝐑𝐕 𝐝𝐢𝐚𝐬𝐭𝐨𝐥𝐢𝐜 𝐠𝐫𝐚𝐝𝐢𝐞𝐧𝐭—> 𝐈𝐧𝐭𝐞𝐫𝐫𝐮𝐩𝐭𝐞𝐝 𝐏𝐑 𝐣𝐞𝐭.

PVCs can occasionally save the patient a Dobutamine study.

➡️ Low-flow, low-gradient, 𝙩𝙧𝙪𝙚 severe AS unmasked by a potentiated post-PVC beat.

The moon over Texas tonight

Intracardiac Lipoma

Perforated posterior mitral leaflet

Always proud of being an AUBite! AUB continues to offer a glimmer of hope for a better future in Lebanon. AUB= resilience #excellencethroughadversity American University of Beirut American University of Beirut Medical Center Dr. Fadlo Khuri WilliamZoghbi Carlos El-Tallawi, MD “HeartToProve”

Detailed mechanism of diastolic mitral regurgitation.

DeBakey Cardiovascular Journal: ncbi.nlm.nih.gov/pmc/articles/P…

Complimentary role of echo + CMR in HF risk stratification. Now online JACC Journals. Congratulations to former Houston Methodist CV Imaging Fellow David Lewandowski, Sherif F Nagueh and entire #DeBakeyCMR team. ttps://authors.elsevier.com/a/1gj1p,i2XruoC3#.ZAkDjlx1nTY.twitter

Severe TR with IVC flow reversal.