10 Comments

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.

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"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.

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The medical boards and the hospitals will allow ignorant physicians to remain in practice and employed. In fact, I'd argue it is part of the plan. Critical thinking physicians are impossible to control.

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

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

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

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Abrams's specialty involves human mules....

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

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The heart is visually seen to beat with PEA, but it doesn’t matter because no perfusing pulse is being generated

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My simplistic take from all this is that ultrasound is reflecting blood flow. ECG reveals electrical activity. So unless PEA is also associated with blood flow, no, it would not be picked up on ultrasound. Let’s see what Dr. Koka says.

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