Your scary medical video of the day (not graphic)

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

This is an echocardiogram of a heart.

That white thing you see bouncing around is a blood clot in the left atrium.

Once it bounces out of there, it can hop into the left ventricle, and from there...anywhere into the body.

Stroke.
Kidney.
Leg.

Jeebus. This is scary AF.

Mik

Holy crap. That clot is huge.

mark

Wow!

Can it be fixed?

bachophile

@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.

Isn’t medicine kewl?

Klaus

Are such clots always a problem, or are there harmless outcomes, too? If so, is there any data on the probability that it will result in something harmful?

I guess that particular clot is not necessarily the only problem but more that the body as such has a higher likelihood of producing clots.

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@klaus said in Your scary medical video of the day (not graphic):

Are such clots always a problem, or are there harmless outcomes, too? I

As long as it stays where it is, it's probably harmless. This sucker looks so big that it might not even get across the mitral valve into the LV. The danger is when it does cross, it will go into the systemic circulation. Imagine an artery clogged by something that big.

Also, these thrombi can break apart, sending a shower of clots througough the circulation. This is a very bad thing.

Note how irregularly that heart is beating - the EKG shows atrial fib as well. If i had to guess (and I'm no echocardiography), this is a case of mitral stenosis causing left atrial enlargement (it should NOT be that big) and atrial fibrillation. It could be that the mitral stenosis is what's keeping the clot in the LA. But, as I said, there's nothing preventing it from breaking up and sending clot everywhere.

89th

Some days I prefer not to think about how incredible (and fragile) the human body is.

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

Mik

That would seem like a too big screw for the application.

Jolly

That's what she said...

Jolly

@bachophile said in Your scary medical video of the day (not graphic):

@mark that’s why people with atrial fibrillation take Coumadin. A fibrillating atrium is the reason thrombi form in the heart. The idea is the anti coagulant will suppress thrombus formation. The way it’s fixed is the bodies own system for breaking down thrombi, called fibrinolysys.

Isn’t medicine kewl?

Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@jolly said in Your scary medical video of the day (not graphic):

@bachophile said in Your scary medical video of the day (not graphic):

Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?

Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..

Terrible terrible drug.

The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.

Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.

Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

Axtremus

@george-k said in Your scary medical video of the day (not graphic):

There is a Grey's Anatomy episode on a mistake like that. In that episode, the fictitious patient died.

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@axtremus

https://en.wikipedia.org/wiki/Jeff_Chandler

While working on Merrill's Marauders in the Philippines, on April 15, 1961, Chandler injured his back while playing baseball with U.S. Army Special Forces soldiers who served as extras in the film. He had injections to deaden the pain and enable him to finish the production.

On May 13, 1961, he entered a hospital in Culver City, California, and had surgery for a spinal disc herniation. Severe complications arose; an artery was damaged, and Chandler hemorrhaged. On May 17, in a seven-and-a-half-hour emergency operation following the original surgery, he was given 55 pints of blood. A third operation followed, on May 27, where he received an additional 20 pints of blood. He died on June 17, 1961. The cause was a blood infection complicated by pneumonia.

bachophile

@george-k omg

George K · "Now look here, you Baltic gas passer... " - Mik, 6/14/08

@bachophile I saw something similar in the early 1980s. An orthopedic surgeon, while doing a laminectomy, or a fusion, happened to bag the aorta with a rongeur. I have no idea what he was doing so far anteriorly, but the bleeding was fast and spectacular.

Fortunately, it was during the daytime, and there was a vascular surgeon around who could repair the damage.

No, I don’t remember the details, and it wasn’t my case, thank goodness!

mark

@89th said in Your scary medical video of the day (not graphic):

Some days I prefer not to think about how incredible (and fragile) the human body is.

Burning Rope

The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon who seduced you
Then finally loosed you

You climbed upon a burning rope to escape the mob below
But you had put the flaming out so that others could not follow
To be out of the bounds and the barks of those who do not wish you well
You must blaze a trail of your own, unknown, alone

But keep in mind
Don't live to-day for tomorrow like you were immortal

The only survivors on this world of ours are
The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon who seduced you
Then finally loosed you

You're old and disillusioned now as you realise at last
That all you have accomplished here will have soon all turned to dust
You dream of a future after life, well that's as maybe, I don't know
But you can't take what you left behind, you're all alone

So keep in mind
Don't live to-day for tomorrow like you were immortal

The only survivors on this world of ours are
The warming sun, the cooling rain
The snowflake drifting on the breath of the breeze
The lightning bolt that frees the sky for you
Yet only eagles seem to pass on through
The words of love, the cries of hate
And the man in the moon...

brenda

@george-k said in Your scary medical video of the day (not graphic):

@jolly said in Your scary medical video of the day (not graphic):

@bachophile said in Your scary medical video of the day (not graphic):

Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?

Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..

Terrible terrible drug.

The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.

Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.

Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.

And Eliquis?

brenda

@brenda said in Your scary medical video of the day (not graphic):

@george-k said in Your scary medical video of the day (not graphic):

@jolly said in Your scary medical video of the day (not graphic):

@bachophile said in Your scary medical video of the day (not graphic):

Problem with Coumadin is getting the dose regulated to where the doc wants it and then keeping it there. Will Clopidogrel or some if the newer drugs be as effective?

Coumadin (warfarin) is a shitty drug, and dosing is a nightmare, as Jolly said. Mrs. George was on it for a couple of months after a DVT. EVERYTHING affects dose - activity, diet..

Terrible terrible drug.

The advantage is that, if you need surgery, it's readily reversible and you won't bleed too much.

Plavix (clopidogrel) is a platelet inhibitor. Difficult (impossible) to reverse. Lasts a long time.

Other anticoagulants work elsewhere in the clotting scheme. Dabigatran (Pradaxa) was just coming into common use when I retired, and it's not on my radar any more. Ditto Rivaroxaban (Xarelto). Both have to be discontinued before elective surgery for at least 48-72 hours. If it's an emergency that can't wait, you do what you can. I hated those drugs.

And Eliquis?

BTW, Hubby participated in a genetic study for Mayo, and learned his body will not metabolize Plavix, so they put him on the Eliquis.

The New Coffee Room

Your scary medical video of the day (not graphic)