Discover and read the best of Twitter Threads about #Cardiology

Most recents (24)

1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Cardiologist’s Perspective! Our expert author is Giuseppe Galati MD, MMSc in Heart Failure, @GiuseppeGalati_ , Consultant #Cardiologist #HeartFailure & #Cardiomyopathies Image
2) @GiuseppeGalati_ is at San Raffaele Research Hospital, Milan 🇮🇹 @SanRaffaeleMI. This program is intended for #healthcare professionals & is accredited for 0.75h CE/#CME credit for #physicians #physicianassistants #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
3) @cardiomet_CE is supported by educational grants from AstraZeneca, Bayer, Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company, & Chiesi. Earn credit from archived programs at cardiometabolic-ce.com. Disclosures at cardiometabolic-ce.com/disclosures/.🙏 FOLLOW US !
Read 56 tweets
Dad bleed to death 5 years ago today.
I usually prefer to remember his life, but ever since I got the letter from @CVSHealth PBM Caremark saying I couldn't continue on the anticoagulant with the lowest risk of major bleeding, Dad's final moments have been heavy on my mind. 🧵
I got the call around 4am from my parent’s neighbor saying there was blood everywhere in Dad’s bedroom. Mom was hysterical. EMS were on the scene. 2/
Dad was stabilized at their small rural hospital before being transported an hour to a large academic hospital. He had a major bleed in his lungs. Despite best efforts over the next 48 hours, he had one final traumatic bleed out which could not be stopped.3/
Read 22 tweets
Results of the randomized #ADVOR trial are soon coming your way! It's the largest diuretic trial in acute #heartfailure ever conducted (N=519) and will test acetazolamide on top of loop diuretics. Recruitment is finished and full database lock is anticipated. Find out more (1/9). Image
Appropriate and thorough decongestion is class I recommendation in HFA-ESC guidelines (2/9).
academic.oup.com/eurheartj/arti…
#Cardiotwitter #Cardiology #FOAMed #Cardiorenal #MedEd #MedTwitter #Nephrology #ADVOR #HeartFailure2022 #HFA_ESC Image
Only 15% of AHF included in DOSE trial were decongested after 72 hours of high-dose loop diuretic (LD) therapy (3/9).
nejm.org/doi/full/10.10… Image
Read 9 tweets
What to do if the eGFR drops from 50 to 42 ml/min/m2 during decongestive therapy in acute #HeartFailure ?
Short #Tweetorial on worsening renal function (WRF) (1/9).
#Cardiotwitter #Cardiology #FOAMed #Cardiorenal #MedEd #MedTwitter #Nephrology #ADVOR #HeartFailure2022 #HFA_ESC
There is an underappreciated risk of poor outcome in heart failure patients discharged with ongoing congestion and WRF (2/9).
Pivotal paper of @MarcoMetra ahajournals.org/doi/10.1161/ci…
Appropriate and thorough decongestion is class I recommendation in HFA-ESC guidelines so DON'T stop decongestive efforts during WRF (3/9).
academic.oup.com/eurheartj/arti…
Read 9 tweets
Which statement is correct with regards to the use of diuretics in #HeartFailure with congestion?

Short #Tweetorial on how to use diuretics in heart failure (1/9).

#Cardiotwitter #Cardiology #FOAMed #Cardiorenal #MedEd #MedTwitter #Nephrology #ADVOR #HeartFailure2022 #HFA_ESC
Door to ‘diuretic’ time: earlier administration of loop diuretics is associated with improved outcomes independent of HF severity (2/9).
jacc.org/doi/abs/10.101…
The first dose of the loop diuretic should be 40 mg furosemide (=1 mg bumetanide) in diuretic naïve and twice the home dose in patients on loop diuretic (3/9).
Read 9 tweets
Our paper in @JACCJournals today:
Childbearing Among Women Cardiologists
The Interface of Experience, Impact, and the Law
with my coauthors @pamelasdouglas @drmalissawood @sarma_amy @DrToniyaSingh @Drroxmehran Dr. Bairey Merz & legal experts Joan Williams,Rachel Korn,Jessica Lee Image
👉Rate of ⬆️ of #WIC is just 0.3%/year
👉No Federal Mandate for Maternity Leave in🇺🇸
👉Issues related to childbearing affect practicing cardiologists
💃purpose of this study was to examine
the impact of pregnancy & maternity leave &
associated institutional policies/practices WIC ImageImageImageImage
📌323 Respondents: ~35% of #WIC so quite good for a survey
📌Practices: Academic🎓/Hospital🏥/🏠Private
📌37% report extra call/service prior to MatLeave
📌<8% have RVUs prorated for MatLeave
📌41% had salary⬇️ during pregnancy year
📌23%: no paid MatLeave Image
Read 5 tweets
🪦🌹Hong Kong Garden🌹🪦

"A total of 224 560 first doses and 162 518 second doses of Pf👁️zr were administered to adolescents.
43 adolescents had myocarditis-related hospitalization following receipt of vaxxination, and 84% OF THE HOSPITALIZATIONS (36 OF 43) OCCURRED AFTER THE>
2nd DOSE. The incidence rate was 3.12 and 22.15 per 100 000 persons for the 1st and 2nd dose, respectively. The number needed to harm for the 1st and 2nd dose were 32 051 and 4515, respectively. The crude risk ratio of the second dose vs first dose was 7.11">
Read 6 tweets
💔 Heartbreaker 💔

The 💉police💉in New💉York💉City,
chased 💉a boy💉right 💉through the park,
In a💉case of💉mistaken identity,
they 💉put a💉 bullet💉through his❤️.
Read 4 tweets
1/10. Wat is the most important driver of worsening renal function in #HeartFailure ?

Look at #Tweetorial on central hemodynamic derangements in heart failure

#Cardiotwitter #Cardiology #FOAMed #Cardiorenal #MedEd #MedTwitter #Nephrology #ADVOR
2/10. The kidney is a remarkable vascular organ. Renal blood flow = 1000 ml/min, renal plasma flow = 600 ml/min.
3/10. Elevated central venous pressure affects renal function significantly more than reduced cardiac output in heart failure. jacc.org/doi/10.1016/j.…
Read 10 tweets
Tweet: renal sodium avidity in #HeartFailure

Do you ever wonder what is happening in the kidney in Heart Failure patients? Here’s a short #Tweetorial on renal physiology in HF (1/6).
#Cardiotwitter #Cardiology #FOAMed #Cardiorenal #MedEd #MedTwitter #Nephrology #ADVOR
Glomerulus: renal blood flow ↓ in HF, but the kidney tries to maintain GFR by afferent arteriolar vasodilation and efferent arteriolar vasoconstriction. This leads to single-nephron hyperfiltration initially preserving total GFR, but further damaging the glomerulus. (2/6)
Proximal tubules: hyperfiltration leads to ↑ water and solutes filtered, but ↓ remaining in the peritubular capillaries. Due to ↑ peritubular capillary oncotic pressure + ↑ renal lymph flow -> ↑ water and Na+ reabsorption in the proximal tubules (3/6)
Read 6 tweets
🧒🩸 Let Your Love Flow 🩸🧒

"When we look at Covid infections the spike protein part of the virus... it causes enormous amounts of clotting.
It can directly infect the myocardium and the vascular endothelium, the cells within the vessels. @ 29:28>
podcastaddict.com/episode/135012…
We know IN AND OF ITSELF it can cause certain things.
IF WE'RE GONNA USE A 💉 TO STOP THAT, WE DON'T WANT THE 💉 to do the same thing.
And that's what we're seeing with the RNA/DNA💉utilizing the spike protein. Our concern, as we started looking at people, it initially started>
started out as 1 in 50,000 chance of someone who had gotten the💉that they would get myocarditis. But then as, more and more people got it, we started looking a bit more closely. There was the study that looked at Big 12 athletes, they didn't tell us whether they were💉or not.>
Read 9 tweets
75 yo man. Tracings 2 years apart. #ECG #Cardiology #fellowsfirst ImageImage
These tracings are compatible with
We all love to diagnose the syndrome of right bundle branch block with alternating left anterior and left posterior hemiblock. This is a form of trifascicular block, described by the Argentinian school of electrocardiography. Image
Read 7 tweets
Ecografía pulmonar 🫁. Guía fácil y práctica de como utilizarla. ABRO HILO
#POCUS #CardioEd #echofirst #ENARM #medicaleducation #ultrasound #MedEd #Cardiology Image
Es curioso porque clásicamente se decía que la ecografía pulmonar no era posible. Harrison afirmaba que " los ultrasonidos (US) se disipan rápidamente en el aire por lo que carecen de utilidad en la evaluación del parénquima pulmonar" ¿Qué ha cambiado? Image
Daniel Lichtenstein, un intensivista francés, redescubrió la ecografía pulmonar. Es cierto que los US no se transmiten bien por el aire, pero Lichtensein descubrió que pequeñas alteraciones en la relación aire-agua a nivel pulmonar formaban artefactos ecográficos característicos. Image
Read 25 tweets
Such a well written editorial this in @Open_HeartBMJ Superb..!! openheart.bmj.com/content/8/2/e0…
a must read for everyone... #MedTwitter #Cardiology
interesting points a 🧵👇
Metabolic acidosis is a chronic condition that
many people in the Western world have but
do not realize it... It occurs when there is
retention of acid in the body, which leads to
a depletion in the bicarbonate stores of the
body. Ways to test for low-grade metabolic acidosis👇
what are the Four main mechanisms that compensate for chronic latent metabolic acidosis?
Read 8 tweets
1/ #tweetorial

💠 Remember to Obtain a Rightsided ECG in a Patient with an Inferior MI

➡️ Inferior MI typically causes ST Elevation in leads II,III,aVF and ST Depression or T-wave inversion (TWI) in lead I,aVL.

-- Read More: manualofmedicine.com/topics/cardiol…

#medtwitter #meded #foamed
2/

➡️ STD or a new TWI in lead aVL is often the first ECG abnormality seen in Inferior MI.

➡️ When an inferior MI is diagnosed, a right-sided ECG should be obtained to exclude concomitant right ventricular MI (RVMI). RVMIs can complicate 30% to 50% of acute IMIs.

#cardiology
3/

➡️ A right-sided ECG is performed by taking leads V3-V6 and placing them on the right side of the chest. These leads are labeled V3R-V6R.

➡️ STE of 0.5 mm or greater in one or more of leads V4R-V6R has a sensitivity of 90% and specificity of 91% for RVMI.

#cardiotwitter
Read 7 tweets
1/ #tweetorial

💠 Ventricular Assist Devices (VAD) - Key Points

➡️ The left ventricular assist device (LVAD) is the most common VAD in clinical practice

-- Read More : manualofmedicine.com/topics/emergen…

#meded #foamed #medtwitter #CardioTwitter #Cardiology
2/

➡️ Indications for placement of a VAD:

👉as a bridge to recovery when cardiac function is temporarily diminished (i.e., myocarditis)
👉as a bridge to cardiac transplantation
👉as destination therapy for patients who are not candidates for cardiac transplantation
3/

➡️ ED Evaluation of a VAD Patient

👉Begin with assessment of the patient’s airway, breathing, and circulation
👉Pulse - pulse is often absent or markedly diminished (current VA devices deliver a continuous flow of blood)
Read 11 tweets
Following yesterday's #echofirst images of SAM, it’s time for another #tweetorial!

By senior fellow @NoahHaroian

#ACCFIT #Meded #FOAMed #cardiology #cardiotwitter

In this tweetorial, you will learn:
🟢The “ingredients” for SAM
🟢Who is at-risk for SAM
🟢How to treat SAM
Why are humans a set up for SAM?

Simple - because we have a cardiac loop.
Wait, what is the “cardiac loop”?

Answer: blood’s “U-turn” through the left ventricle. Image
Read 16 tweets
The JVP exam has been with us since 1930 when Sir Thomas Lewis first proposed this exceptionally clever technique. A #pocus thread. Image
He knew that in heart failure there in “congestion of the veins” and when they become engorged can be detected on the neck.
Here is a phenomenal example in a very thin patient with prominent veins.
Read 10 tweets

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