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Hypertrophic cardiomyopathy (HCM) is characterized by abnormal thickening of the left ventricular myocardium. Apical HCM is a less common variant of HCM where the hypertrophy is limited to the apical segments and can be challenging to diagnose based on traditional echocardiography alone. Patients with HCM can present with exertional angina. We present a series of four different cases, where patients were advised computed tomography (CT) coronary angiography for the evaluation of coronary artery disease. While CT coronary angiography excluded obstructive coronary artery disease, a detailed evaluation of the retrospective electrocardiogram-gated CT coronary angiography data helped in establishing the diagnosis of apical HCM in these patients. We discuss the importance of a systematic analysis of cardiac CT for diagnosing HCM variants and highlight the utility of reconstructed static and cine CT images which are readily available from the data obtained during retrospective gated CT coronary angiography for diagnosing HCM. [ABSTRACT FROM AUTHOR]

Adenosine is extensively utilized in myocardial stress perfusion imaging for the detection and risk stratification of coronary artery disease. It has a well-established safety profile. The majority of the undesirable effects experienced during adenosine infusion are transient (owing to its brief half-life of ~10 s) and arise from the stimulation of receptors in the atrio-ventricular (AV) node (AV block) and bronchial smooth muscles (bronchospasm). We hereby report an unusual electrocardiographic finding during adenosine stress perfusion imaging, in a patient who had previously undergone single chamber pacemaker insertion and was referred for the assessment of atypical chest pain. [ABSTRACT FROM AUTHOR]

Point-of-care ultrasound (POCUS) is an essential skill in various specialties like anesthesiology, critical care, and emergency medicine. Anesthesiologists utilize POCUS for quick diagnosis and procedural guidance in perioperative and critical care settings. Key applications include vascular ultrasound for challenging venous and arterial catheter placements, gastric ultrasound for aspiration risk assessment, airway ultrasound, diaphragm ultrasound, and lung ultrasound for respiratory assessment. Additional utilities of POCUS can include multi-organ POCUS evaluation for undifferentiated shock or cardiac arrest, ultrasound-guided central neuraxial and peripheral nerve blocks, focused cardiac ultrasound, and novel applications such as venous excess ultrasound. This review highlights these POCUS applications in perioperative and intensive care and summarizes the latest evidence of their accuracy and limitations., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Abhilash Koratala declare(s) a grant from KidneyCure and the American Society of Nephrology’s William and Sandra Bennett Clinical Scholars Grant. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dhir et al.)

Competing Interests: None