i****o
发帖数: 30 | 1 【 以下文字转载自 Medicine 讨论区 】
发信人: iaiayo (iaiayo), 信区: Medicine
标 题: 新生儿肺动脉瓣膜狭窄求助 pulmonary valve stenosis
发信站: BBS 未名空间站 (Fri Dec 25 21:01:51 2015, 美东)
大家圣诞节快乐！我的宝宝11/1/2015出生。他一出生医生发现他哭得费劲，马上住进
NICU，医生很快发现他心脏有问题：肺动脉狭窄。
第一次心脏echo结果11/2/2015 3:02:10 AM
PULMONARY VALVE:
The pulmonary valve is thickened and is doming. There is critically severe
pulmonary valve stenosis. The maximum velocity across the pulmonic valve is
3.89 m/s and the pe... 阅读全帖 |
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i****o
发帖数: 30 | 2 大家圣诞节快乐！我的宝宝11/1/2015出生。他一出生医生发现他哭得费劲，马上住进
NICU，医生很快发现他心脏有问题：肺动脉狭窄。
第一次心脏echo结果11/2/2015 3:02:10 AM
PULMONARY VALVE:
The pulmonary valve is thickened and is doming. There is critically severe
pulmonary valve stenosis. The maximum velocity across the pulmonic valve is
3.89 m/s and the peak instantaneous gradient is 60.6 mmHg. The mean gradient
across the pulmonic valve is 36.9 mmHg. There is trivial pulmonary valve
regurgitation.
然后马上... 阅读全帖 |
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S****a
发帖数: 2568 | 3 如果是新生儿，这个问题要特别小心，有可能会演变成moderate或severe degree，所
以要定期复查。开胸手术修复瓣膜或许是需要的。一般认为儿童有轻度pulmonary
valve stenosis是不影响生活的。
is
gradient
11
residual
5
.
regurgitation
catherization
mm |
|
发帖数: 1 | 4 11 月13日 终于找到另一股在我家害我的势力
昨天，这些人折腾了一天，白天，晚上皮啦啦，也不知道谁把谁杀了，谁把谁带走了。
反正我先生和孩子被绑架了，就不知道是不是已经遇害了。我本来是打算睡觉的，但他
们头上，地下装电磁波攻击器，让我几乎窒息。虽然我没倒下，但其实他们在我身上扎
的毒针已经蔓延，我能感觉到我的呼吸有窒息的感觉。我想我对他们已经非常仁慈了，
但他们不依不饶地攻击我，欲置我于死地，让我非常生气，特别是肆意伤害我家里的人
，绑架我先生和孩子，而且有许许多多无辜的生命毁于他们之手，有必要把他们曝光。
当然我还没分析这里边是那几个人具体攻击我，伤害我的，但他们显然都是一伙的。鉴
于他们伤害我的头部，胸部 和胃部，我就把这几部分的医生都曝光，受害者慢慢去调
查，追查他们吧。
Cleveland Clinic, Website: my.clevelandclinic.org
Call 855. REFER. 123 or 855.733.3712
Lung Cancer
Results: 57 Doctors
PREV123NEXT
Results per page:
Dav... 阅读全帖 |
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A*******s
发帖数: 9638 | 5 again，we are talking about symptomatic and asymptomatic stenosis. For
asymptomatic carotid stenosis, although some data support surgery over drug,
the benefit is small and depend on life expectancy and surgical skills.
For this patient, her syncope is not caused by carotid stenosis. I always
question cardiology why order carotid u/s for syncope? Vascular surgeon may
say, r/o bilateral carotid stenosis, give me a break.
Asymptomatic carotid stenosis for CEA is controversial. The problem is th... 阅读全帖 |
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s**********8
发帖数: 25265 | 6 http://en.wikipedia.org/wiki/Balloon_angioplasty
Angioplasty
From Wikipedia, the free encyclopedia (Redirected from Balloon angioplasty)
Jump to: navigation, search
Angioplasty
Intervention
Balloon angioplasty.
ICD-9-CM 00.6, 36.0 39.50
MeSH D017130
Angioplasty is the technique of mechanically widening a narrowed or
obstructed blood vessel, typically as a result of atherosclerosis. An empty
and collapsed balloon on a guide wire, known as a balloon catheter, is
passed into the narrowed locations... 阅读全帖 |
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s******t
发帖数: 579 | 7 (The patient was admitted because of MDD secondary to her debilitating LLE weakness, numbness and tightness. I'd like to focus on her neurological symptoms.)
CC:
A 72 y/o white F complains of LLE weakness, numbness and tightness.
HPI:
Pt was diagnosed lumbar spondylosis, lumbar spinal stenosis, low back pain and lumbar radiculopathy 2 yrs ago. Had a lumbar fusion 1 yr ago. Started to recover at the beginning, but had worsening of weakness and eventually required a hardware removal 6 months ago. ... 阅读全帖 |
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A*******s
发帖数: 9638 | 8 Surgery/stenting for asymptomatic carotid artery stenosis over 70% is still
controversial.
The key is what caused syncope?
Left carotid artery stenosis usually is not the cause of syncope. Basilar
artery stenosis, however, could induce brain stem ischemia and cause vertigo
and syncope. I did not see basilar artery flow direction on the U/S. If retrograde, a
subclavian steal could cause the syncope.
So you may fix the carotid artery stenosis but not the syncope. The patient
has to be informed pri... 阅读全帖 |
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A*******s
发帖数: 9638 | 9 First of all, medicine is the science.
1. Unilateral carotid stenosis is not the cause of Syncope. People with
unilateral lobectomy are fully awake.
2. Asymptomatic carotid stenosis does not necessorily need surgical
intervention. I have seen patients with bilateral carotid occlusion without
any stroke or TIA.
Second, medicine is also the art.
When physicians order some nonsense tests and incidentally find some
abnormalities, it takes time for explanations. In her case, I'll tell her
what I hav... 阅读全帖 |
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x********0
发帖数: 190 | 10 1. There is slight reversal of lordosis at the L1-L2 level and possibly
some very subtle dextroscoliotic curvature of the lumbar spine. Correlation
with plain film scoliotic series may be helpful as clinically indicated.
2. There is borderline congenital narrowing of the central canal along
the course of the mid to distal lumbar spine, however with no significant
central stenosis at any level .
3. At L5-S1 there is mild posterior annular disc bulging/diffuse endplate
spurring with slig... 阅读全帖 |
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s*******y
发帖数: 46535 | 11 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked... 阅读全帖 |
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s*******y
发帖数: 46535 | 12 一位朋友，65岁了，最近经常腰背疼，做了MRI，结果如下。我们大概对照wikipedia看
了一下，但是也不知道多少算是跟年龄有关的。请教一下情况有多严重
referring diagnosis: evaluate for herniated disc
technique: multislice multiweighted, 1.5 Teslah
comparison: none
findings:
alignment: no subluxations, there is lumbar levoscoliosis
multilevel degenerative loss of dis aignal and height
vertebral bodies: no compression fractures
L5-S1: within normal limits
L4-5: disc bulge and broad posterior disc protrusion, facet arthrosis and
redundant ligamentum flava produce marked... 阅读全帖 |
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g***r
发帖数: 285 | 13
术。
CCTA/coronary CT angiography or 冠状动脉CT is highly unreliable, >50%
stenosis will be called significant while in reality <70% stenosis is often
not flow limiting and will not cause ischemic symptoms, so for coronary
disease it's still best to have a cardiac cath as a diagnostic and even
possibly with potential PCI,
fo carotid stenosis, CTA is quite reliable but doubt his symptoms is from
that, he might have vertebrobasilar insufficieny resulting to his dizziness,
if it's the case, CEA might no |
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g*2
发帖数: 658 | 14 刚刚把堆积了几个星期的nejm翻看了一下，居然在11月底的那期case discussion就是
讲得这个病
http://www.nejm.org/doi/full/10.1056/NEJMcpc1103565
Case 36-2011 — A 93-Year-Old Woman with Shortness of Breath and Chest Pain
Presentation of Case
Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the
emergency department at this hospital because of chest pain and shortness of
breath.
The patient had been in her usual state of health, with hypertension and
chronic renal insufficiency, until the morning of admission, wh... 阅读全帖 |
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R*******t
发帖数: 367 | 15 Carotid stenosis and renal artery stenosis at 60-70% is not critical. I have
seen a lot of patients follow even more severe stenosis.
Your father eventually needs diagnostic angiogram with aortic and bilateral
lower extremities run-off to evaluate for occlusion. Or he should at least
get arterial dopplers to check the waveforms and ABI (ankle brachial index)
first. |
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n*******c
发帖数: 501 | 16 It is called occulo-stenosis reflex which is used in coronary angioplasty“
irresistible temptation … to perform angioplasty on any significant
residual stenosis,” here even an angiographically severe stenosis may not
cause ischemia not to mention those nonsignificant ones. |
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h*********t
发帖数: 116 | 17 a 78 year old male with past medical history of hypertension and DM
presented with an syncopal episode and had MRI and MRA head/neck. The MRI
showed no acute findings but MRA showed right vetebral artery high grade
stenosis. echo normal, no history of afib or sss, telemetry did not reveal
any arrhthmia. what would you do about the right vetebral artery high grade
stenosis? do you think his syncope is related to this vetebral art stenosis?
thanks!!! |
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A*******s
发帖数: 9638 | 18 一个不常见，容易忽视的诊断。
Subclavian stenosis disorder is a relatively rare disorder. There are only
about 2% in today’s population and about 7% of the clinical population that
suffer from subclavian stenosis. On most cases, SSP or subclavian steal
phenomenon is only incidentally found during sonography conducted in the
vertebral system. About 2% to 5% of those who are examined are discovered
this way. Of all these incidents, only 5% of the patients actually
manifested symptoms of subclavian stenosis syndr... 阅读全帖 |
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f********i
发帖数: 563 | 19 我妈妈刚做了一个脑MRI，下面是报告。家庭医生根据报告已经预约了脑专科医生，预
计要到1月份才能见。我妈妈有糖尿病（控制的挺好）。大约七年前在国内做过MRI，当
时医生说有过腔梗，但是已经发生，也没有做别的什么。
她偶尔运动多了会头痛（和麻），所以最近又做了这个MRI，因为还有两个月才能见医
生，想请问一下版上的内行，她的这个诊断报告，大约有多紧急？谢谢！
Severe narrowing of the cavernous segment of the right internal carotid
artery. 6 mm segmental fusiform enlargement of the distal right MCA M1
segment, about 3mm in diameter. No other hemodynamically significant
stenosis. Getal right PCA. Irregularity of the right greater than left
vertebral V4 segments without hemodyn... 阅读全帖 |
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f******I
发帖数: 769 | 20
when
most
which side is the carotid stenosis on? in addition to blood pressure control
, asa, also check her cholesterol profile and might need to add a statin if
her cholesterol is high,
signs of stroke would be like weakness, numbness on the opposite of her body
from the carotid stenosis, slurred speech and such,
hang in there, take good care, |
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f******I
发帖数: 769 | 21
left main of 75%, you'd have a very gutsy interventional cardiologist to
stent that(have seen it done, though), LAD with 80% stenosis, cx has 85%
stenosis, and RCA with 50-85% lesion, he will definitely need CABG, |
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g***r
发帖数: 285 | 22
50% stenosis can be treated medically, they won't do anything
interventionally unless if it's more than 70% stenosis or so,
bp meds with beta blocker and ace inhibitor, statin, asa, maybe even plavix, |
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c********e
发帖数: 496 | 23 I guess the stenosis of intracranial artery is due to atherosclerosis or
vessel spasm,
if the former, and there are dizziness, syncope, falls, and recovered in 24
hours, that's TIA. Aspirin is a must, check lipid panel, fasting blood sugar
, and further treatment depends on the location of the stenosis, severity
and other brain diseases.
if vessel spasm, some calcium channel blocker may help, and gingko
derivative meds works in some people. |
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w**********9
发帖数: 242 | 24 CT may not be the best, but it in this case detects lots of stenosis.
Therefore, angiogram is necessary in the next step management. And, bypass
is the only choice if the angiogram suggests multiple severe stenosis too.
The lesions appear complicated. Follow the local doctor's suggestions and
find a good hopsital in cardiology if possible. Bypass belongs to open heart
surgery. |
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k****j
发帖数: 6 | 25 1。 There is moderately severe spinal canal stenosis at L5/S1. The spinal
canal is 5 mm in maximal dimension. This is primarily due to disc material,
contributions from some ligamentous thickening and bony hypertrophic changes
. There is moderately severe compromise of the left and right lateral
recesses, as well as moderately severe compromise of the neural foramina
bilaterally. There is also evidence for a posterior annular tear with a high
intensity zone at this level.
2.There is mild to moder... 阅读全帖 |
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h***f
发帖数: 162 | 26 treatment for spinal stenosis is surgery. outcomes depends on the extent of
stenosis. nonetheless surgery is good for treating radicular symptoms such
as leg pain; it is less certain that the surgery will make back pain improve
much. |
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m****9
发帖数: 26 | 27 由于最近几个月来，一直头晕，四肢乏力，四肢发麻，去看了neurologist, 做了头部
，颈椎的MRI，刚拿到报告，医生说没有大的问题，需要进一步去看神经外科，但是我
看到头部MRI的报告显示有问题，这个让我很担心。 然后这个颈椎的问题能引起头晕么
？ 报告上写的是没有脊髓和神经压迫。 请帮忙看看怎么回事？ 暂时我还没拿到片子
，如果有需要，等拿到片子后，我也可以上传。 谢谢。
头部的报告内容：
MRI BRAIN WITHOUT AND WITH CONTRAST
History: Headaches, unsteady gait, and bilateral leg greater than arm
numbness. Evaluate for demyelinating disease.
Technique: Precontrast T1 axial, DWI axial, GRE T2 axial images were
obtained. Postcontrast 3 mm thick T2 axial, T1 axials, 3-D T1 series and 3-D
T... 阅读全帖 |
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l*h
发帖数: 4124 | 28 1. i don't have such experience. i just had a few drinks with some cardiac
surgeons and came here to answer your question. ok, the last sentence was a
joke. i have good knowledge on hemodynamics but don't have experience on
such surgical cases.
2. i don't think there is a way she can be 治好. but, if the burden on her
right ventricle is reduced, she should be able to have a better cardiac
function, a better quality of life and likely a longer life. the most
realistic option is to do something abou... 阅读全帖 |
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a**e
发帖数: 5094 | 29 asymptomatic carotid stenosis> exercise, dietary control, target LDL<100, if
not working, then go for statins
symptomatic carotid stenosis> aspirin + statins
I won't waste my money for those products never have been proved to be
effective. |
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J****C
发帖数: 1465 | 30 哦哟，我又不是严新大师，又不是海灯法师，隔空诊断好玄哦
听起来亚瑟姐你好像是腰椎的问题，右边腰丛，包括“股外侧皮神经”受压迫就会引起
你说的麻木症状。如果有low back pain或者腿痛，就更典型了。你这个要去看骨科或
者疼痛科，也许会要你做腰椎的MRI的，说不定有spinal stenosis 或者foraminal
stenosis
好嘛，我是江湖游医，意见仅供参考哈 |
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y***c
发帖数: 676 | 31 Pearls:
1. BILATERAL renal aa. stenosis with HTN: what med do you use to treat HTN
Calcium channel blocker. If it was unilateral stenosis then ACE inhibitors.
2. A male patient with thumb base pain: what is dx. De Quervain
Tenosynovitis; treatment is NSAIDs and intrathecal steroids.
3. How do you treat Cocaine abuser with 210/115 BP? Cocaine induced HTN -
treated with Benzo, Nitroglycerin or Nitroprusside drip and Phentolamine 1
mg IV. No beta blockers like propranolol.
4. Bilious vomiting in an |
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N***a
发帖数: 149 | 32 MEDICAL ETHICS 137 cases:
________________________
1. A 25- year old mother refused immunization for her 2-month old son. The
social worker spoke to the mother. (Important for Board examination)
Next step in management: immunization should be given for the benefit of the
child.
2. A 30-year old mother refused surgery for suspected appendicitis for her 6
-year old daughter. The social worker spoke to the mother. (Important for
Board examination)
Next step in management: surgical removal of the ap... 阅读全帖 |
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b*****l
发帖数: 8603 | 33 2007年的，不知道你们说的是不是这个。祝好。
medical ethics more than hundred cases
Sep 24th, 2007, 12:17pm
1. A 25- year old mother refused immunization for her 2-month old son. The
social worker spoke to the mother. (Important for Board examination)
Next step in management: immunization should be given for the benefit of the
child.
2. A 30-year old mother refused surgery for suspected appendicitis for her 6
-year old daughter. The social worker spoke to the mother. (Important for
Board examination)
Next step in ma... 阅读全帖 |
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e****0
发帖数: 678 | 34 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
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h****8
发帖数: 278 | 35 For 8 weeks, a 52-year-old man with a 5-year history of type 2 diabetes
mellitus has had deep burning pain in the ball of his right foot and big toe
when the foot is raised above chest level. He also has cramping in his
right calf when he walks more than 50 feet. He has smoked two packs of
cigarettes daily for 30 years. Femoral pulses are palpable; pedal pulses are
absent. Which of the following is the most likely diagnosis?
A
) Aortoiliac stenosis
B
) Femoral popliteal stenosis
C
) Mononeuropat... 阅读全帖 |
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f*****g
发帖数: 37 | 36 2nd page:
AAO 34mm AO sinus 32mm LA end systole 23mm
LA end diastole 37mm LVEF 60% IVS end diastole 6mm
LVPW end diastole 6mm AO root 14mm Left PA 3.5mm
Right PA 6mm RA end systole 38mm RV end systole 28mm
Forwarding flow 2.2m/s at RVOT. Echo shows:
RA, RV are enlarged. RV wall becomes thickened, 6mm. Left heart wnl. Wall
motion wnl.
Loss of Echogenicity at infundibulum septum.
Overriding AO, degree 55%. ROVT has m... 阅读全帖 |
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g****g
发帖数: 411 | 37 Please give your opinion and explanation, thanks in advance.
Question:
You are reading a study assessing whether ECG during graded treadmill
exercise stress testing can predict clinically significant(75% or more)
coronary artery stenosis as shown by arteriography(the gold standard). The
subjects are men, ages 55 to 75 years, with chest pain who were referred to
a cardiac center. Prevalence of greater than 75% stenosis in the study group
was 53%. Results of the study are as follows:
Sensitivi... 阅读全帖 |
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g****g
发帖数: 411 | 38 Please give your opinion and explanation, thanks in advance.
Question:
You are reading a study assessing whether ECG during graded treadmill
exercise stress testing can predict clinically significant(75% or more)
coronary artery stenosis as shown by arteriography(the gold standard). The
subjects are men, ages 55 to 75 years, with chest pain who were referred to
a cardiac center. Prevalence of greater than 75% stenosis in the study group
was 53%. Results of the study are as follows:
Sensitivi... 阅读全帖 |
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f****o
发帖数: 2770 | 39 我讲话难听由于家庭遗传，真不好意思。
我吧书本上的东西全部贴出来，你能看懂多少算多少吧。
Heart Failure
DEFINITION
Heart failure (HF) is a clinical syndrome caused by the inability of the
heart to pump sufficient blood to meet the metabolic needs of the body.
Heart failure can result from any disorder that reduces ventricular filling
(diastolic dysfunction) and/or myocardial contractility (systolic
dysfunction).
PATHOPHYSIOLOGY
Causes of systolic dysfunction (decreased contractility) are reduction in
muscle mass (e.g., myocardial infarctio... 阅读全帖 |
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A*******s
发帖数: 9638 | 40 A real case of mine.
A 21 years old male with severe mental retardation, was sent to ER for
mental status change and ataxia.
He was found to be dehydrated and had a UTI. After the dehydration and
sepsis being corrected, he still could not walk. Because he was not able to
cooperate for MRI, a CT of C-Spine and L-spine was ordered. Results were
not remarkable.
The patient was discharged back to nursing home.
At the followup, his family member finally showed up and told me that about
1 month a... 阅读全帖 |
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A*******s
发帖数: 9638 | 41 I think you father has cervical (spinal canal) stenosis. All his symptoms
fit the diagnosis. He needs surgery.
I have no idea about how radiofrequency therapy does on cervical stenosis. |
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m********4
发帖数: 607 | 42 We currently have these 2 patients. As a Doctor, how do you feel if they are
your patients?
Life is unfair, isn't it?
---------------------------------------------------
A: 46 yo patient multiple times hospital admissions.
-PAST MEDICAL HISTORY INCLUDES:
1. Hypertension.
2. Hyperlipidemia.
3. Diabetes type 2.
4. Hypothyroidism.
5. Obesity.
6. Congestive heart failure secondary to mitral stenosis status
post mitral and tricuspid annuloplasty in 2003 with known
physiology compl... 阅读全帖 |
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A*******s
发帖数: 9638 | 43 回答你的问题，首先我们要搞清楚一些基本概念， 大家有不同意见，请随便。
眩晕vertigo可以理解为位置感觉的错觉。 一个晕字可以是各种各样的症状。 眩晕分
为central和peripheral， central是CNS， 主要是脑干，小脑的问题； peripheral是
内耳的问题。
就像楼上说的，cervical degenerative disc disease or spondylosis是描述颈椎的
病变，如果引起vertigo， 主要是血液供应的问题， 可能你知道Vertibrobasilar
artery insufficiency， MRA可以看到basilar stenosis， 但vertibral artery
stenosis是不是可以引起临床症状有争论， 很多病人一侧的vertibral artery都封闭
了， 却没有任何临床症状。 所以如果MRA正常，central vertigo可能性就不大（当然
MRA经常underestimate）。 对于颈椎病， 因为骨刺引起椎动脉供血不足我是很少听说
， 但有一种情况我在一个thread里提过， 叫bow hu... 阅读全帖 |
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L****n
发帖数: 12932 | 44 this is simple logic my friend, rather than sciences or art. our difference
focus on the "syncopy" episode, whether it's neurological cause,
cardiological cause or some other whacky causes. I don't see how you can
rule out neurological cause based on past experience only, and against well
published literature. at most, i'd only say it's less likely, rather than it
is NOT the cause.
your mention of ASYMPTOMATIC stenosis going for CEA carries no weight in our
discussion of this patient, it was als... 阅读全帖 |
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A*******s
发帖数: 9638 | 45 我的病人除非有症状我才做carotid U/S， 如果over 70%, refer to surgeon。 这些
病人是symptomatic。
如果是syncope， 我从来不做carotid u/s。 因为将近90%是vasovagal 和
cardiogenic。 剩下的还要考虑orthostasis和seizure。 如果是TIA， 应该是基底动
脉的问题， carotid u/s不如MRA。
可恶的美国医疗体系是你order的test越多赚的钱就越多， 所以就有了过分的order
carotid， 一旦发现了超过70的stenosis， 就把他们refer到surgeon。 surgeon当然
求之不得， 可能是手术容易做， reimbursement高， 这些surgeon一看到我就提醒我
有没有case， 竞争不是一般的激烈。 可以想象他们的门槛会多低。
carotid stenosis并不见得一定是artery-to-artery amboli， 它的存在可能导致供血
不足， 而引起远端动脉的thrombosis。 所以清除plague只是改善血供， 不见得可以
消... 阅读全帖 |
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L****n
发帖数: 12932 | 46 闲话少说， i believe in evidence based medicine. I've shown reference to the
possibility of TIA presents as loss of consciousness, as well as study that
better long term outcome of CEA compare to conservative treatment in a
severely stenosed carotid artery (even if 1% better is 1% better), i have
yet to see any reference point the other way. Can you provide reference
support your argument pertain to:
1) this patient's loss of consciousness CAN'T POSSIBLY result from carotid
stenosis? this patient ac... 阅读全帖 |
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A*******s
发帖数: 9638 | 47 I would not worry about the stenosis. It is irrelevant to syncope.
grade
stenosis? |
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R*******t
发帖数: 367 | 48 There are multifocal severe stenosis of LAD and RCA. There are also disease
involving the left circ. I am not an interventional cardiologist, but in
interventional radiology, one of the contraindications for vascular stents
placement is multifocal stenosis, which doesn't respond well with stents or
angioplasty. With three-vessel CAD, bypass is not a bad option. |
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m****9
发帖数: 26 | 49 由于最近几个月来，一直头晕，四肢乏力，四肢发麻，去看了neurologist, 做了头部
，颈椎的MRI，刚拿到报告，医生说没有大的问题，需要进一步去看神经外科，但是我
看到头部MRI的报告显示有问题，这个让我很担心。 然后这个颈椎的问题能引起头晕么
？ 报告上写的是没有脊髓和神经压迫。 请帮忙看看怎么回事？ 暂时我还没拿到片子
，如果有需要，等拿到片子后，我也可以上传。 谢谢。
头部的报告内容：
MRI BRAIN WITHOUT AND WITH CONTRAST
History: Headaches, unsteady gait, and bilateral leg greater than arm
numbness. Evaluate for demyelinating disease.
Technique: Precontrast T1 axial, DWI axial, GRE T2 axial images were
obtained. Postcontrast 3 mm thick T2 axial, T1 axials, 3-D T1 series and 3-D
T... 阅读全帖 |
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f*****t
发帖数: 901 | 50 支架的例子正好是反过来。
我是这个领域的，国内动不动就建议人做支架，因为回扣高。这里谨慎得多。有好几个
父亲的同事在国内做个CT就建议支架，包括去301和安贞这样的好医院，我建议他们有
条件的过来检查，结果两个过来，一个stenosis 35%， 一个45%，远不到做支架的标准
。这边医生说不理解中国的诊断依据。 |
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