10 Comments
Sep 26, 2022Liked by Anish Koka MD (Cardiology)

Pediatric Cardiologist with over 30 yrs experience in fetal cardiology, Abrams is correct only that with her body habitus ultrasound would be difficult even later in gestation but that does not change the anatomic or mechanical facts of heart development. Ultrasound as you nicely summarizes uses sound waves bounced off the fetal heart muscle and as they form valves. The sound produced by Doppler ultrasound and images by traditional ultrasound show cardiac activity. The patients interpretation of the sound is rooted in whether they want a pregnancy or not. If pregnancy planned or wanted then yes it yields joy not delusion or confusion. The next question often asked is whether the heart of the fetus is normal which is more complex issue and current technology though lowering the fetal age question can be answered can evolve through gestation. My wife who is not anti-abortion always points out any non-medical discussion of abortion that you must except that abortion ends a life that is in fact a human life. The debate is timing that abortion should be accepted in our societies. Attacking confirmed embryological and fetal development, physics of ultrasound / Doppler technology does not answer the political or moral questions involved to use them particularly inaccurately is disqualifying. In fact, if the draconian new California bill extended beyond covid argument about fetal ultrasound and Doppler denying it shows heart beat / heart activity would be subject ot fine and potential loss of medical license.

Expand full comment

"But saying that a cardiac ultrasound is picking up electrical activity is a factually incorrect statement. A cardiology trainee making this statement would, or should, be laughed out of their training program."

Any physician who believes ultrasound identifies electrical activity rather than hemodynamics of blood flow (in chambers of differing pressures and flow) ought to receive medical board censure. Pure dogma over science.

Expand full comment
Sep 26, 2022Liked by Anish Koka MD (Cardiology)

Thank you. People should not distort the truth to try to win a "political argument." So much lying these days.

Expand full comment
Sep 26, 2022Liked by Anish Koka MD (Cardiology)

Many thanks for this clear and extremely accessible explanation, Doctor.

Expand full comment
Sep 26, 2022Liked by Anish Koka MD (Cardiology)

I never miss your newsletter. Excellent writing every single time. Thank you.

Expand full comment

Abrams's specialty involves human mules....

Expand full comment

If an ultrasound probe is applied to a patient with PEA, should we expect to hear heart sounds?

Expand full comment