Dr Shirish Agrawal

First in central India implanted synergy megatron stent exclusive for complex lesions left mains grt expansion limits

Sudden death of 18yr old
Diagnosis of hypertrophic cardiomyopathy on postmortem

A common genetic disease underdiagnosis due to unawareness
Death can b prevented by early diagnosis treatment and implanting AICD (shock Macine implanted under skin to prevent sudden death in these patients)

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When its ur birthday and u r in a relax mode with family and freinds.. and u get a call for ur duty to save life right at stroke of midnight on ur birthday, feeling blessed to almighty for giveing me opportunity to save life in a 50yr lady acute heart attack with shock, sucessfully did life saving angioplasty for this patient..
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High blood pressure is a silent killer
Its important how u measure blood pressure at home orat clinic to have accurate reading
High blood breasure causes heart attack, stroke, eyesight loss, kidney problem and may more...
Know ur no.... get ur blood pressure checked
If increased plz consult ur doctor...

Happy to share a complex case of HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY where cardiac muscle becomes abnormally thick leading to severe obstruction in outflow way of LV causing angina, heartfailure..
This was a 50 year lady presented in heart failure and angina on medication for HOCM
She had severe muscle thickenss of 2.6cm (normal0.6 to 1.1cm), causeing severe LV outflow obstruction with a pressure gradient of 170mmhg between LV and aorta with severe MR
She was offered for non surgical cath procedures ALCOHOL SEPTAL ABLATION where targted myocardial infarction is created using absolute alcohol injection into coronary artery
On table dramatic improvement was seen with absolute disappearence of LV gradient and MR reduced to mild
Challenge is in these patients if on medical treatment antianginals are contraindicated and diuretics for symptoms has to b given very judiciously so when pt is symptomatic on medical treatment then conventional surgical myoectomy was option, but this percutenious Cathlab procedrue is safe and effective alternatives..

Dr Shirish Agrawal
Consultant interventional cardiologist
9645162561

Its been tiring, exiting, past 24hrs, 3 young patients in thirtees presenting with acute myocardial infarction, another middle aged with acute mi, and lastly to finish up a cardiac tamponade....
Total 5 emergency cases, all 4 MI cases underwent sucessful primary angioplasty, and cardiac tamponade underwent pericardiocentesis (removing fulid accumulated around heart)
All 5 patients are stable and ready for discharge

Feeling proud to be cardiologist,

Bifurcation lesions are the tricky lesions, as the challenge is to save the branch and possiblity of side branch closure is high while doin angioplasty of main vessel, if side branch is large enough somtimes we have stent it too, its always challenging handling 2 stents and balloons simultaneously and open both vessels simultaneously and establish good flow...

Today sucessfully did angioplasty in a 60 year male, underwent pami (emergency angiogplasty in heart attack,) last month, he had another 90 percent block in 2 large branches... though not true bifurcation lesion .challenge was to avoid overlap of stents over eachother so that reblockage risk can be minimized..

Hole in heart is the most comman heart disease of children and majority get closed over time but certain patients these holes dont get closed by themselves and start causing heart failure in childern and adulthood, these holes are treated either with a open heart surgery, but now in certain subsets of patients these holes can be closed without open heart surgery using device like a umberlla and is placed in heart via small hole in groin, no cuts. No blood loss, patients go home in 48hrs walking... sharing a such case did recently in a 30yr lady having large ASD closed sucessfully with a device

Sucessfully did a difficult case today...
A elderly, underwent angioplasty (stent)elsewhere few years ago, presented with severe rest angina(heart pain), angiography showed reblockage of stent in right artery in its origin... its always challenging to open such blocks,...

Today at 8.30pm

Radio murchi indore 98.3 today..

Watch the interview on this link today
Do share

https://www.youtube.com/watch?v=BrNrpS41B6M

जानें दिल की बीमारी का क्या है इलाज ? डॉ. शिरीष अग्रवाल और डॉ. पारितोष कुमार राजपूत से.... जानें दिल की बीमारी का क्या है इलाज ? डॉ. शिरीष अग्रवाल और डॉ. पारितोष कुमार राजपूत से.... ...

Yet another challenging case done and dusted

65/M diabetic recent oncent crescendo angia(heart pain )
Coronary angiography done suggestive of diffusly diseased RCA with 99 percent stenosis

Councilled for angioplasty and fabulous result, artery reconstructed,
Visually evident

68/f acute Awmi (heart attack) stablised and came for further treatment angiography showed ostial LAD 80 stenosis with calcification (blockage at starting of artery) its always difficult and challenging for cardiologist for doing angioplasty in such patients especially when in a heart attack situation heart function is weak
Sucessfully did angioplasty, patient is back home in 48hrs walking...

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https://www.facebook.com/284133012030201/posts/1281029849007174/?sfnsn=wiwspmo

Giving a talk on irondefiency in heart failure tonight sharing the link
https://www.cvnwebinars.in/11

25 year old young lady unmarried with no obvious risk factor apart from overweight comes to opd with retrosternal discomfort and back pain for 10hrs went to a physicin was prescribed acidity and analgesic medicine
Came to me with no relief, hearing at her history if felt it could b cardiac pain but in back of mind there was a thought of young lady why will she have a heart disease without any critical risk factors still i got her ecg echo and trop i test done due to her history was very inciling towards heart disease

To my relief ecg was absolutely normal so i made up my mind nothing to wory and prescripted a anlgesic injection till other reports came

But when Trop-I test came it was strongly positive and i repeated ecg still no changes
Pt still had pain with less intensity after 2 hrs

Echo showed hypoiketic lcx territory

Did emergency angiography which showed to my shockingly 100percent occluded lcx artery , 70 percent blocked lad, 60% blocked rca with 40percent distal lm disease

Did primary ptca to lcx

Still i was wondering why this young girl has so extensive disease took her detailed history she had paternal side very strong family history of cardiac problems, later lipid prrofile showed LDL C 346mg

Summarizing dont ignore pt history heart attack can happen at any age, any gender, even if normal ecg and history is pressing plz get additional tests...

Presentation of a complex case in front of the experts in the subject
Exited and nervous

Heart attack dont see time

52 year hypertensive and diabetic reported at 11.30pm yesterday with chest pain for 4hrs initally thinking to be gasss

Turned out acute inferior wall mi

Pt councilled and taken up for gold standard treatment of acute heart attack primary angioplasty

Angioplasty completed at 12.30am and putting this post now at 1.10am

Every minute counts, time is muscle, longer we wait more and more heart muscle dies

In current covid times very few hospitals are taking up risk and doing the life saving procedure like primary angioplasty

We at shalby are 24*7 ready with fully ready staff and doctors for all cardiac emergencies

Intravascular lithotripsy via radial route