Discover and read the best of Twitter Threads about #thepeoplesventricle

Most recents (6)

ICU Reminders:

RV-predominant cardiogenic shock

RV failure criteria: Image
RV pressure-volume loops: Image
Etiologies of RV failure: Image
Read 6 tweets
#MiniTweetorial #Part1 on #RVFailure based on the @NEJM paper by @RyanTedfordMD @Brian_Houston12 !

A must read for all cardiology #ACCFIT fellows and @ACPIMPhysicians residents!
nejm.org/doi/pdf/10.105…

Let's begin !

Part 1 - Mechanisms of RV failure
Let's get started with a poll.

Do you know the various mechanisms of RV failure?
#1 #Pathophysiology

4 Mechanical Mechanisms➡️ >1 can co-exist and are interconnected :
✅Increased preload
✅Increased afterload
✅Decreased contractility
✅Decreased lucitropy Image
Read 9 tweets
A case of low ScvO2 (60%), high PvaCO2 (8.2 mmHg), fluid intolerance (CVP 11) and fluid responsiveness (PPV 17). What's the physiology and what to do?
#FOAMcc #Hemodynamics #ThePeoplesVentricle #FOAMed #Fluidtolerance #Cardiotwitter #CriticalCare
Post-cardiac surgery. MAP 70, HR 95, low dose pressor. High CVP (11 mmHg) with pathologic waveform of x < y-descent. PPV > 17 despite low Vt (< 6 mL/kg). Normal blood gasses, normal lactate.
#EchoFirst #POCUS #TEE: Mildly reduced LV function; #MAPSE 5.75 mm. EF visually 45-50%. Small EDV.
Read 11 tweets
This study shows that more than 1/3 of patients with new-onset #HeartFailure have #RVD

📌During up-titration of #GDMT, 49% show normalization of RV function

📌The improvement is associated with better outcomes, independent of LV function

onlinelibrary.wiley.com/doi/abs/10.100… @ESC_Journals ImageImage
RV dysfunction as a predictor of clinical outcome in newly-Dx #HeartFailure

This analysis demonstrates #RVD at baseline and follow-up was associated with a higher risk of all-cause ☠️ [ HR- 1.66 (1.27-2.16) ] and HF 🏥 [ HR -2.20 (1.51-3.21) ]

onlinelibrary.wiley.com/doi/abs/10.100… #EJHF
Recovery of RV function is associated with better outcomes

This study also stated that improvement of TAPSE to ≥ 17mm during follow-up was associated with a reduction in all-cause ☠️ and #HeartFailure 🏥 (HR- 0.56[0.31-0.99] ), independent of
baseline TAPSE, age, sex, and LVEF
Read 4 tweets
What's the diagnosis? 🧐🧐

Round 2 for today!

Compare and contrast with

Non-cardiologists only please.

I'll post answer tomorrow.

#ThePeoplesVentricle #POCUS #echofirst #FOAMed
How is this different than case #1 today? Hint, it's one of the answers submitted. I think it will be good to discuss.

@KalagaraHari
@NephroP
@dr_benoy_n_shah
@NMerke
@iceman_ex
@RJonesSonoEM
@UAlberta_Sono
@Thind888
@msiuba
@CalgaryPHdoc
@katiewiskar
@GoughCJ
Read 5 tweets
RV resuscitation! screen for RV failure with POCUS (and records if you have em) #thepeoplesventricle #StoweEM20 by @mattroginski ImageImageImage
incorrect probe rotation can cause RV size to be underestimated! Matt’s own echo has great TAPSE #humblebrag #StoweEM20 by @mattroginski ImageImage
badness:
D sign on short axis
RV dilation in subcostal
#StoweEM20 by @mattroginski ImageImage
Read 5 tweets

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