Discover and read the best of Twitter Threads about #CTEPH
Most recents (6)
As someone just getting started in IC, this talk by @jaygirimd was inspiring. #VTE/#PERT is such an exciting space with rapid development & study 🙌🏽
(Also shoutout to my mentor @GoldbergJBCTMD who’s work is displayed in Dr Giri’s slides)
My takeaways, a🧵:
(1/6)
#Fellows2023
(Also shoutout to my mentor @GoldbergJBCTMD who’s work is displayed in Dr Giri’s slides)
My takeaways, a🧵:
(1/6)
#Fellows2023
🔹Risk stratification and patient selection is key.
🔸Risk scores may not accurately stratify younger patients
🔹Full risk assessment has to include with the bedside eval w/ imaging + lab markers as adjunctive data
🔸Be on the lookout for normotensive shock
#Fellows2023 (2/6)
🔸Risk scores may not accurately stratify younger patients
🔹Full risk assessment has to include with the bedside eval w/ imaging + lab markers as adjunctive data
🔸Be on the lookout for normotensive shock
#Fellows2023 (2/6)
🔹Patients can be sick - upfront MCS with ECMO may be the first treatment needed in tackling high risk PE
🔸Contralateral arterial access during thrombectomy in case urgent MCS is needed
🔹always start with a RHC to establish severity of disease
#Fellows2023 (3/6)
🔸Contralateral arterial access during thrombectomy in case urgent MCS is needed
🔹always start with a RHC to establish severity of disease
#Fellows2023 (3/6)
🚨🚨🚨New @EuroRespSoc @escardio #PulmonaryHypertension guidelines 2022
There is a lot of new guidance, this is just a short thread to begin with the most notable changes...
Let's go! 🧵 👇👇👇 (1/10)
There is a lot of new guidance, this is just a short thread to begin with the most notable changes...
Let's go! 🧵 👇👇👇 (1/10)
1⃣New definition:
📌Same mPAP threshold as Nice 2018 (mPAP> 20 mmHg)
📌Lower PVR threshold (PVR >2 WU)! 👈
📌No more DPG to differentiate Ipc & Cpc
📌Re-introduction of #ExercisePH in definition!👈
(2/10)
📌Same mPAP threshold as Nice 2018 (mPAP> 20 mmHg)
📌Lower PVR threshold (PVR >2 WU)! 👈
📌No more DPG to differentiate Ipc & Cpc
📌Re-introduction of #ExercisePH in definition!👈
(2/10)
2⃣Diagnostic algorithm:
📌Fast track for referral to a #PH centre at any point of warning signs or #PAH or #CTEPH suspected
📌Individualised route for suspected #LungDisease but rapid cross-referral if necessary
📌If eventually PAH/CTEPH suspected, follow to tables 😵💫
(3/10)
📌Fast track for referral to a #PH centre at any point of warning signs or #PAH or #CTEPH suspected
📌Individualised route for suspected #LungDisease but rapid cross-referral if necessary
📌If eventually PAH/CTEPH suspected, follow to tables 😵💫
(3/10)
1) Welcome to a new #accredited #tweetorial about an important complication of #pulmonaryembolism (#PE): chronic thromboembolic pulmonary hypertension #CTEPH. Follow this thread to earn 0.75h CE/#CME #physicians #physicianassociates #NPs #nurses #pharmacists.
2) I am Jason Weatherald @AlbertaPHdoc of @UAlberta and you may recall my previous tweetorial in this feed. It's still available for credit at cardiometabolic-ce.com/pah2/. @cardiomet_CE is your ONLY home for earning CE/#CME entirely on Twitter! Howdy to @vic_tapson @lauralynndonah1
3) This program is intended for #healthcare providers and is supported by educational grants from Actelion, Bayer, Chiesi, & AstraZeneca. Faculty disclosures are listed at cardiometabolic-ce.com/disclosures/. Prior programs, still available for credit, are at cardiometabolic-ce.com
1/20
New in @ATSBlueEditor, the culmination of over 4 years of work in the @bradleymaron lab, in which we identify that #NEDD9 is a hypoxia-regulated pulmonary endothelial protein that directly binds activated platelets to promote pulmonary thrombosis.
atsjournals.org/doi/10.1164/rc…
New in @ATSBlueEditor, the culmination of over 4 years of work in the @bradleymaron lab, in which we identify that #NEDD9 is a hypoxia-regulated pulmonary endothelial protein that directly binds activated platelets to promote pulmonary thrombosis.
atsjournals.org/doi/10.1164/rc…
2/20
The @bradleymaron lab previously discovered that the malignancy protein #NEDD9 promotes endothelial fibrosis by regulating collagen synthesis in human pulmonary artery endothelial cells (HPAECs), which could be targeted to inhibit #PAH in vivo.
stm.sciencemag.org/content/10/445…
The @bradleymaron lab previously discovered that the malignancy protein #NEDD9 promotes endothelial fibrosis by regulating collagen synthesis in human pulmonary artery endothelial cells (HPAECs), which could be targeted to inhibit #PAH in vivo.
stm.sciencemag.org/content/10/445…
3/20
As a pro-metastatic protein, #NEDD9 interacts with pro-thrombotic cell types, & it was shown to be ⬆️ via #HIF1α in cancer cells to promote migration. We hypothesized that #NEDD9 is ⬆️ by hypoxia in HPAECs ➡️ pathogenic platelet-EC adhesion.
cancerres.aacrjournals.org/content/70/10/…
As a pro-metastatic protein, #NEDD9 interacts with pro-thrombotic cell types, & it was shown to be ⬆️ via #HIF1α in cancer cells to promote migration. We hypothesized that #NEDD9 is ⬆️ by hypoxia in HPAECs ➡️ pathogenic platelet-EC adhesion.
cancerres.aacrjournals.org/content/70/10/…
#Pulmonary Hypertension (pHTN) can really take your breath away!
For today's #MTC, Chief @photon_ick, PGY3 Dr. Armando Martinez, & #CTEPH expert Dr. Demos Papamatheakis reviewed a super cool case of a legit #SPY diagnosed with pHTN & CTEPH, flown to #UCSD for management!
For today's #MTC, Chief @photon_ick, PGY3 Dr. Armando Martinez, & #CTEPH expert Dr. Demos Papamatheakis reviewed a super cool case of a legit #SPY diagnosed with pHTN & CTEPH, flown to #UCSD for management!
1. pHTN is increased pressure in the #pulmonaryarteries
2. Most common symptoms include: EXERTIONAL #dyspnea, fatigue, pleuritic chest pain, and even #hemoptysis🩸
3. It's typically diagnosed on #ECHO showing dilated arteries, right❤️strain, & elevated RV systolic pressure!
2. Most common symptoms include: EXERTIONAL #dyspnea, fatigue, pleuritic chest pain, and even #hemoptysis🩸
3. It's typically diagnosed on #ECHO showing dilated arteries, right❤️strain, & elevated RV systolic pressure!
4. There are 5 #WHO Classes of pHTN, distinguished based on physiology and treatment options:
1⃣ Pulmonary Arterial Hypertension
2⃣ pHTN 2/2 LV failure
3⃣ pHTN 2/2 Respiratory/Lung disease
4⃣ CTEPH
5⃣ Other causes
1⃣ Pulmonary Arterial Hypertension
2⃣ pHTN 2/2 LV failure
3⃣ pHTN 2/2 Respiratory/Lung disease
4⃣ CTEPH
5⃣ Other causes
CTEPH (a thread)
One of the best learning cases of my residency training at Temple with @PForfiaPHDOC , I recently presented this case at a CTCV conference.
HPI: female pt in her 40s, hx recurrent PE/DVT, IVC filter, on anticoagulation, presents with SOB.
One of the best learning cases of my residency training at Temple with @PForfiaPHDOC , I recently presented this case at a CTCV conference.
HPI: female pt in her 40s, hx recurrent PE/DVT, IVC filter, on anticoagulation, presents with SOB.
Echo
short axis view with PW of the RVOT shows mid systolic notching
