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

Perforated posterior mitral leaflet

Intracardiac Lipoma

The moon over Texas tonight

PVCs can occasionally save the patient a Dobutamine study. ➡️ Low-flow, low-gradient, 𝙩𝙧𝙪𝙚 severe AS unmasked by a potentiated post-PVC beat.

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

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]

Papillary muscles behavior in MVP versus secondary MR.

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🍷

Cardiac tamponade —> Electrical alternans

The spectral Doppler evidence of underlying apical HCM

Intra + Extra cardiac shunt

Subaortic membrane

Spot diagnosis

Well-child visits can help us tackle fourth trimester barriers to care. Time for a collaborative approach! American Academy of Pediatrics ACOG SMFM UTHealthObGyn Preeclampsia Fndn The ObG Project

MR Classification