Discover and read the best of Twitter Threads about #CardioTwitter

Most recents (24)

1a) Welcome to a 🆕#accredited #tweetorial on the importance of time in range #TIR in #diabetes . . . with additional emphases on #primarycare and on practice in 🇨🇦.
#FOAMed #endotwitter #MedEd @MedTweetorials #nephtwitter #cardiotwitter
1b) Hence we welcome2⃣ expert faculty from Canada: Ilana Halperin @ilanajhalperin, academic endocrinologist at @Sunnybrook and @uoftmedicine, and Noah Ivers @NoahIvers, #familydoc & researcher at Women's College Hospital @UofT ImageImage
2) Earn 0.75hr 🆓CE/#CME by following this🧵! This program is supported by an unrestricted educational grant from Sanofi Canada and is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
And so we begin . . .
Read 43 tweets
As an intern, chart checking new patients was intimidating and time-consuming.

Even as a cardiology fellow, I continue to refine my system.

Here are 7 tips and tricks to help you out!

#arjuncardiology #MedTwitter #MedEd #Cardiotwitter #IMG Image
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🧵 1/17 - Thread: Echo for Diagnosis and Management of obstructive HCM
Mechanisms of MR in these patients
Please, share your comments and experience

#echofirst #cardiotwitter #echothread
@NMerke @echo_stepbystep @iamritu @JaeKOh2 @dr_benoy_n_shah @EACVIPresident @StellEkaterinatwitter.com/i/web/status/1…
🧵 2/17 - Echo in obstructive HCM - Diagnosis / Management
✨Maneuvers (Valsalva, standing from Squatting) + Exercise Echo may unveil 33% latent obstructive HCM (37% rest -> 70% provocable)

@nat_echo @OAB1967 @echo_batman @papadocardio @robertomlang @fpmorcerf @mariovar55twitter.com/i/web/status/1…
🧵 3/17 - In a study of Maron BJ et al - JACC 2016 with 573 HCM patients, patients with rest obstruction had more progressive HF (7,4%/year), followed by patients with provocable obstruction (3,2%/year) and less in nonobstructive HCM (1,6%/year)
sciencedirect.com/science/articl…twitter.com/i/web/status/1… Image
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1a) Welcome to a live-tweeted, #accredited #tweetorial from @nationallipid #NLA23 in #Atlanta on advances in #hyperlipidemia management #LLT. Our expert returning faculty is Pam R. Taub, MD @PamTaubMD #cardiologist from @UCSDHealth ImageImageImage
1b) Dr. Taub is a clinician/scientist and is a frequent contributor to our #accredited programs. She is the founding director of the Step Family Foundation Cardiac Rehabilitation and Wellness Center at #UCSD.
#FOAMed #cardiotwitter @MedTweetorials #MedEd #lipids Image
2) This program is supported by an educational grant from Esperion Therapeutics & is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/. Earn 0.75 hr 🆓CE/#CME by following this 🧵!
Read 48 tweets
During my Internal Medicine training, I wrote 100s of History and Physicals (H&Ps).

Now as a Cardiology fellow, I read every single H&P for a new consult.

Here are 7 tips and tricks for effective H&Ps. #arjuncardiology #MedTwitter #MedEd #Cardiotwitter #IMG Image
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1) Welcome to a 🆕#accredited #tweetorial from @cardiomet_CE! Earn 0.5hr 🆓 CE/#CME by following this 🧵. Our expert faculty is Sanjiv J Shah MD @HFpEF, Cardiologist & Director, Northwestern HFpEF Program (hfpef.org). Director of Research, @NMCardioVasc
#FOAMed Image
1b) .@HFpEF will be sharing the algorithm he uses to treat #HFpEF based on evidence we have thus far and his anecdotal experience treating patients over the past 16 years in the @NMCardioVasc HFpEF Clinic.
#CardioTwitter #MedEd @MedTweetorials #HeartFailure
2) CE/#CMEcredit for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for accredited programs in #cardiometabolic space delivered wholly on Twitter!
Read 34 tweets
1) Welcome to a 🆕accredited tweetorial from @cardiomet_CE! We welcome back expert faculty @ChristosArgyrop to discuss screening for #CKD in pts w/ #T2D & the role of routine assessment for #microalbuminuria as an effective diagnostic, risk stratification, & patient ed tool.
2) Christos Argyropoulos MD, PhD @ChristosArgyrop is Division Chief, Nephrology @UNMHSC. #CKD is chronic #kidneydisease, #ESKD is end-stage kidney disease.
#FOAMed #nephtwitter #cardiotwitter @MedTweetorials @NephUCommunity @ISNkidneycare @KidneyDiseaseFm Image
3) This program is intended for #HCPs and is supported by an unrestricted educational grant from Bayer. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for more expert-authored #tweetorials and earn #MedEd
Read 43 tweets
#HeartFailure (HF) is classified on the basis of ejection fraction (EF) and then into classes and stages. Let's have a look at what each of these mean to a physician in a clinical setting . A 🧵 (1/13)

#MedTwitter #MedEd #medicine
#CardioTwitter #Cardiology
#Heartfailure 💔 is a clinical syndrome that results from a structural or functional impairment of one or both ventricles. Ventricular filling and ejection are thus, hampered.
(2/13)
On the basis of EF, HF is classified into
1️⃣Heart failure with reduced ejection fraction(HFrEF)
2️⃣Heart failure with improved ejection fraction(HFimpEF)
3️⃣Heart failure with mildly reduced ejection fraction(HFmrEF)
4️⃣Heart failure with preserved ejection fraction(HFpEF)
(3/13)
Read 13 tweets
2/
Classically placed in the arm
May be placed in the leg (eg in #pediatrics /neonates – which may then terminate in the infrarenal IVC/iliacs)
.
#criticalcare #cardiovascular
3/
Advantages:
- Lower infection rate then central lines
- Used in the outpatient setting
- Can be used for several weeks to months
- Duration of PICC lines may be from 4 weeks to 6 months
(although they have been known to be functional for more than 300 days)
Read 20 tweets
The @capher_india consultation meeting on #AirPollution & health to inform India’s revision of the National Ambient Air Quality Standards is now underway! Image
To learn more about CAPHER-India (Collaborative for Air Pollution and Health Effects Research—India), check out the website for the network > capherindia.org
Dr. Mukesh Sharma @IITKanpur gave an overview of considerations and questions in the NAAQS revision process.

He also highlighted that there is a need for broad engagement across stakeholder groups to ensure that all aspects are considered and different viewpoints are heard.
Read 14 tweets
T1/11
#Cardiotwitter #MedEd @MedTweetorials #EchoFirst
Multi-fenestrated ASD- mfASD

The prevalence of ASD is 0.88 per 1000 adults. The most common type of ASD is a secundum - a true deficiency in the region of the fossa ovalis. @iamritu @echo_stepbystep @alexsfelixecho @NMerke FIGURE 32-1 Development of ...
T2/11 mfASD
Standardized #EchoFirst evaluation includes TTE, TEE, Doppler & 3DEcho for assessment of rims for suitability for device closure, drainage of pulmonary veins, exclusion of sinus venosus-type ASDs, etc.
pubmed.ncbi.nlm.nih.gov/26239900/
T3/11 mfASD
Clinical case: 65yo, female, referring shortness of breath.
TT #EchoFirst findings: right chambers enlargement, preserved sistolic function, QP:QS: 2,5; deficiency in the region of the fossa ovalis sugestive of complex ASD
@VLSorrellImages @GARCIAEDINSON95 @almasthela
Read 11 tweets
📌#HeartFailure2023 #HFA_ESC ¿De qué se está hablando en Praga🇨🇿? Parte 2⃣.

💡Aquí info seleccionada de la cobertura & publicaciones de @WilfriedMullens @HanCardiomd @escardio

🔸Comenzamos:
📌STRONG-HF: subanálisis segun eGFR y edad..
#CardioTwitter #MedTwitter #CVD Image
📌ENACT-HF: terapia guiada por natriuresis🧂💦 Image
📌PARADISE: Camino del pte con disnea en ER🏥. Image
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On the left is a conventional adult transoesophageal echo probe

On the right is a neonatal TOE (TEE) probe

Occasionally, just occasionally, the latter is your friend (for an adult cardiologist/physiologist)...

A brief 🧵 on safe performance of TOE

#ECHOFIRST #cardiotwitter Image
TOE/TEE is actually one of the safer procedures we do, complications are less likely than with:

- Coronary angiography
- Pacemaker insertion
- Ablations
- PCI
- Valve interventions

And that's natural as it's an investigation, not a treatment/therapeutic procedure
Pharyngeal or oesophageal perforation/rupture is the most feared complication of TOE/TEE

It's incredibly rare - but does happen

TOE technique varies & how it is performed is crucial to minimizing the risk of major complication
Read 14 tweets
One of the most important diagnostic tests in Cardiology to interpret is the EKG. Here are my thoughts and notes. Let me know what you think!

Thread #19: Pericarditis

#arjuncardiology #medtwitter #CardioTwitter #MedEd #IMG
Acute Pericarditis:
- Inflammation of the pericardium
- May be caused by number of factors: viral/bacterial infection, metastatic tumors, collagen vascular diseases, MI, cardiac surgery, and uremia Image
ECG Changes w/ Acute Pericarditis:
- Early phase is characterized by ST segment elevation, due to inflammation of the epicardium, which accompanies inflammation of the overlying pericardium
- Can have generalized ST-T changes in both anterior and inferior leads Image
Read 9 tweets
@djc795 with his top 10 historical #IC trials to know; studies that have had fundamental impact on the field

(Note, this is a summary, but really was a lecture to attend in person. Phenomenal & super fun)

@rwyeh @nadia_sutton @DougDrachmanMD @SrihariNaiduMD
A thread🧵:
(1/6)
1️⃣ ACME & RITA2 - SIHD, randomized PCI v meds -> ⬇️angina (CCS class)

2️⃣ BOAT - directional atherectomy, “bigger is better”. Luminal gain is🤴🏼.

3️⃣ BARI & FREEDOM - angioplasty vs CABG, important interaction of diabetes; LIMA is 🔑

#Fellows2023 @crfheart
(2/6)
4️⃣ PAMI - PTCA v tPA, significantly ⬇️death/MI, 🚫ICH w/ PTCA

5️⃣ STRESS, Benestent 1&2 - angioplasty vs stenting, showed ⬇️ in binary restenosis and ⬆️ luminal gain w/ stenting. Also, design of monitoring w/ meds v. rpt PTCA on f/u impacts modern trial design

#Fellows2023
(3/6)
Read 7 tweets
Epidemiology of Diabetes and Atherosclerotic Cardiovascular Disease Among Asian American Adults: Implications, Management, and Future Directions: A Scientific Statement From the American Heart Association: @CircAHA

Nice statement on high risk group

Summary 👇👇👇 Image
1/ 🌏 Asian Americans (AsA) are the fastest growing ethnic group in the US 🇺🇸. They face high risks of Type 2 diabetes (T2D) & atherosclerotic cardiovascular disease (ASCVD) - major risks.
2/ 📊 Yet, most studies lump all AsA subgroups in one category, potentially hiding disparities in T2D & ASCVD prevalence.
Read 42 tweets
📌Deficiencia de Fe en Insuficiencia Cardiaca💔.
📄@HFSA Scientific Statement.

🔸Deficiencia de hierro (DdFe) ≈50%👥#HF.
🔹Se asocia⬇️CF,⬇️calidad de vida,⬆️mortalidad y 🏥
✅Evidencia d beneficio clínico c/tto IV en #HFrEF ❤️‍🩹

⏹️Algoritmo gral de manejo. #CardioTwitter Image
📌¿Cuándo se considera depleción de Fe en👥gral? Ferritina < 15-30.

🤔¿Cuándo se considera depleción de Fe en👥IC?
Ferritina < 100 o Ferritina entre 100-299 con Tsat < 20%.
✅¿Por que es diferente en pto de corte✂️? Porque es un reactante de fase aguda en IC. Image
📌¿Qué es la hepcidina?
👨‍🏫Hormona reguladora del Fe👉 producida en hígado. Controla suministro de Fe al plasma desde cel intestinales e inactiva la ferroportina, q transporta Fe al plasma🩸. En un sistema de retroalimentación endocrino clásico.
⚠️⬆️hepcidina en HF👉⬇️Fe Image
Read 6 tweets
📌Asociación entre tto intensivo vs standard d la PA e incidencia d trastornos d conducción (TdC)
🔸Post hoc del SPRINT.
👥3.9K <120 mmHg vs👥3.9K standard <140.
🔸67 a, 3.5 años seguimiento.

Conclusiones
🔹Tto intensivo⬇️26% RR d TdC (HR, 0.74)
⬆️edad, ♂️ y ECV se asoció a⬆️TdC Image
🔸Puntos clave ImageImage
⚠️Limitaciones #CardioTwitter Image
Read 4 tweets
One of the most important diagnostic tests in Cardiology to interpret is the EKG. Here are my thoughts and notes.

Let me know what you think!

Thread #18: Electrolyte Abnormalities #arjuncardiology #medtwitter #CardioTwitter #MedEd #IMG
Hyperkalemia:
- Distinctive sequence of ECG changes affecting both depolarization (QRS) and repolarization (ST-T)
- First change: Narrowing and peaking of T-waves ('tented' or 'pinched' shape) and can become tall Image
Hyperkalemia:
- Further elevation: PR intervals become prolonged, P-waves may disappear. Will have intra-ventricular conduction delay, with widening of QRS complexes.
- Can lead to large, undulating (sine wave) pattern with asystole and cardiac death Image
Read 11 tweets
◾Patent Foramen Ovale(PFO) and Cryptogenic Stroke: A short thread 🧵

🔶PFO is present in nearly 25% of general population

🔶Risk of Ischemic stroke due to PFO is low despite it's high prevalence

🔶 Hence it is important to determine whether PFO is incidental or causal
🔶First step in establishing causality is to exclude other mechanisms by performing relevant diagnostic testing

🔶These include brain imaging, intracranial and extracranial vascular imaging, ECG, cardiac telemetry and atleast 30 days of outpatient cardiac rhythm monitoring
🔶In patients with PFO after excluding high-risk ischemic stroke mechanisms :
• Researchers have suggested use of RoPE Score and PASCAL Classification System to help determine whether PFO is pathogenic or incidental in the causation of Cryptogenic Stroke
Read 9 tweets
We have been doing a series of studies, led by @jeb1426, on sex differences in symptom complexity & phenotypes in acute myocardial infarction (AMI) and their impact on diagnosis & treatment. Some imp findings. #Cardiology #MedTwitter @YaleMed @YaleCardiology @yuan_lu1 Image
@jeb1426 @YaleMed @YaleCardiology @yuan_lu1 In one study, we found 'Women had more variation in unique symptom phenotypes than men' greater symptom complexity & longer door-to-balloon times. Non-chest pain symptoms are more frequent in women, potentially delaying STEMI recognition. @CircOutcomes ahajournals.org/doi/full/10.11… Image
@jeb1426 @YaleMed @YaleCardiology @yuan_lu1 @CircOutcomes In another study, that focused on older patients... ' Women reported more symptoms and had significantly more symptom phenotypes than men.' @amjmed sciencedirect.com/science/articl… @YaleCardiology @YaleMed Image
Read 7 tweets
17 year girl with history of recurrent brief fainting episodes (> 8) preceded by palpitations & "anxiety". Normal vitals + physical exam on arrival at the ED.
Dismissed as panic attacks by multiple doctors, her first ever ECG.

Would you diagnose the same?
#MedTwitter Consent ✅ Image
Her ECG shows short PR intervals with slurred upstroke on the QRS complexes: Delta waves - signifying the presence of an accessory pathway which may lead to aberrant conduction & electrical "short circuits"
This is NOT a panic attack.
This is Wolff-Parkinson-White syndrome (WPW). ImageImage
Pre-conceived anchoring bias and subsequent dismissal in clinical practice of medicine is not just #gaslighting, but also causes harm.

⛽🔥
#FOAMed #meded #CardioTwitter #EPeeps #MedStudentTwitter @EM_RESUS
Read 4 tweets
📌#Revisión & #Metaanálisis. Revascularización en Cardiopatía Isquémica c/FEY <35%: para quienes y como.
4⃣ECR & 2.4K👥
🔹HEART (#HF #Revascularisation Trial)
🔸STICH (Surgical Treatment for #Ischemic HF)
🔹PARR-2 (PET and Recovery Following Revascularization)
🔸REVIVED-BCIS2 Image
🔹HEART (6%👥) FEY 24%. CABG vs OMT. Viabilidad todos.
🔸STICH/STICHES (49%👥) FEY 28%. CABG vs OMT. Viabilidad discrecional🩺.
🔹PARR-2 (17%👥) FEY 27%. tto guiado x imágenes
🔸REVIVED (28%👥) FEY 27%. PCI vs OMT. 14% TCI y 58% DA prox. Viabilidad todos.
👇Para guardar Image
📌Rol de la isquemia:
🔸Basado en estudios históricos: MASS II.
🔹STICH (nuclear) no mostró beneficio y sí un pequeño subanálisis del ISCHEMIA (gráfico)
🔸Aún👉recomendación clase I p/👥c/ enf. multivaso + isquemia inducible y FEY severa, aunque la evidencia actual no lo avala⛔️ Image
Read 7 tweets

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