Discover and read the best of Twitter Threads about #Cardiotwitter

Most recents (24)

I am overwhelmed by the support & unity of cardiologists, scientists & physicians of all specialties who have supported me & spoken out abt online bullying of women physicians on social media. As a cardiology fellow w/ a passion for prevention & nutrition, this means a lot to me.
Although I utilize a plant based diet to help my patients, I recognize & respect there are many dietary patterns that help patients. Normally I recommend a low fat plant based diet, but about 10 months ago I started to utilize plant based diets of all macronutrient profiles.
Read 20 tweets
1/ Preventive Cardio-Oncology Tutorial #PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology

“The time has come for cardiovascular disease (CVD) prevention to play a more prominent role in cardio-oncology.”…
2/ “A myriad of novel cardiotoxic chemotherapeutic & immunotherapeutic drugs are continuously being developed in #Oncology, with diverse cardiovascular (CV) effects.”…

#PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology
3/ Chest radiation “can result in accelerated atherosclerosis, pericardial disease, valve disease, conduction abnormalities, & cardiomyopathies.”…

#PrevCardioOnc @PrevCardioOnc #CardioOnc #CardioOncology
Read 12 tweets

Today we’ll talk about Warfarin!

The year is 1920.
Farmers across North America & Canada notice that their cattle 🐮 are haemorrhaging after minor procedures & sometimes spontaneously, causing them to bleed to death. (cont’d)
#medtwitter #cardiotwitter
1921: Frank Schofield, a Canadian veterinary pathologist, determines that the cattle were ingesting moldy hay made from sweet clover. Only spoiled hay made from sweet clover (grown exclusively in North America) produced the disease . (cont’d)
Schofield separated good clover stalks and moldy clover stalks from the same hay mow, and fed each to a different rabbit 🐰.
The rabbits that ingested the bad stalks died from hemorrhagic illness. The other rabbits remained well . (cont’d)
Read 11 tweets
1/19 Alright #CardioTwitter, here’s my first series of 2 #Tweetorials, and I’m going to call it: “The Aorta is Not Just a Pipe.” This is Tweetorial #1 focusing on normal aortic function. Tweetorial #2 will focus on abnormal aortic function.
2/19 The aorta is often viewed as a passive conduit of blood, when in fact, it has essential functions that aim to maximize cardiovascular efficiency and protect the end-organs. The conduit function is only 1 of the aorta’s functions.
3/19 All arteries pulsate, and for a particular function: which each beat, the heart generates a pulsatile energy – this energy is stored in the arterial wall during systole and released during diastole, allowing blood to keep moving forward throughout the cardiac cycle.
Read 21 tweets
38y/o, gout and previous knee surgery. Chief complaint of acute dyspnea. NTproBNP of 4,000. RV enlargement.

What would you offer, besides anticoagulation?
@krychtiukmd @mrubini @umityasarsinan1 @DanielSierraMD8 @jpcostabel

#Cardiology #cardiotwitter
@pulidot waiting for the cardio pulmonary opinion!
Read 3 tweets
Interesting case presentation today @ellamimasamayor of a 20 yo, female, with an episode of hematemesis. EGD done revealed H. pylori +, duodenal ulcers. CT scan showed pancreatic head mass. Referred due to elevated blood pressure, recurrent hypokalemia and blurring of vision.
Upper Ext - R 200/120. L 160/100
Lower Ext - R 160/100. L 170/100
PE did not show cushingoid features. CV exam showed decreased pulses on the left arm. Rest was unremarkable
Read 25 tweets
1/ Today, at #ESCcongress2019 DAPA-HF trial showed amazing results. I love the complex story behind developing these novel #diabetes drugs and their impact on CVD so I'm going to share it in this tweetorial #cardiotwitter
2/ First let me start by sharing DAPA-HF results. Basically, in pts with HFrEF, Dapagliflozin (SGLT-2i) arm had 26% reduction in primary outcome & 18% reduction in CV death REGARDLESS of #diabetes. Link to tweet w/results thx to @rladeiraslopes

3/ Pre 2008, the FDA approved anti-diabetic medications based on their ability to reduce biomarkers, glucose and A1C, without the need for clinical outcome trials. Basically, anything that lowers A1c in diabetics got approved
Read 11 tweets
💥Current American Diabetes Association guidelines recommend Metformin as the 1st line therapy for all T2DM patients👇🏽
⚡️But should Metformin be the 1st line therapy in T2DM patients with cardiovascular disease?
💥Let’s review the following about

⚡️Mechanism of action
⚡️Safety profile
⚡️Cardiovascular benefits
💥How does Metformin work?

⚡️It inhibits gluconeogenesis in the liver by mitochondrial inhibition & by ⬆️ activation of AMP-kinase👇🏽
⚡️It ⬆️ insulin sensitivity
⚡️It may have additional pleiotropic
Read 12 tweets
38 yo M with IVDA comes in with MRSA bacteria and sepsis. Over 5 cm vegetation on TV.
Surgical options not particularly attractive with platelets of 28K, Hgb of 7.8 and INR 1.5. So #Angiovac performed with 70% reduction of the mass.
A successful result under the circumstances. Patient off pressers in under 24 hours and platelets and petichial rash improving. #Structural #cardiotwitter
Read 4 tweets
⚡️ #YesCCT Coronary Plaque Assessment #Tweetorial ⚡️

By @CoronaryDoc + @AChoiHeart

✅ Why Plaque Assessment?
✅ High Risk Plaque Features
✅ Plaque Characterization/Quantification
✅ Supporting Clinical Data

#CardioTwitter #ACCImaging #SCCT2019 @heart_scct @journalCCT
As #SCD or #MI is 1st symptom of #atherosclerosis in 2/3 of pts, early ID of #CAD is of paramount importance

#YesCCT allows for
✅ ID of plaque
✅ Quant. of plaque
✅ Characterization of plaque
✅ Arterial remodeling

Lin, @LubbDup & @lesleejshaw:
Serial angiographic studies have demonstrated an accelerated & rapid plaque progression before most cases of ACS

Rapid plaque growth ➡️ plaque rupture ➡️ thrombus formation ➡️ MI

@LubbDup & @JonathonLeipsic et al:
Read 14 tweets
A 68 y o male with type-2 DM, CAD, CCF (EF~35%), PAD, and history of gouty arthritis presented with dyspnea and LL edema.

Which of the following drugs is appropriate therapy for his edema?

A) Furosemide
B) Indapamide
C) Empagliflozin
D) Bumetanide
E) Metolazone

Correct answer is (C)

Hyperuricemia is a common adverse effect of loop or thiazide diuretics and may precipitate acute gouty arthritis.

Treating type-2 DM with an SGLT2 inhibitor promotes osmotic diuresis, natriuresis, and reduces uric acid by increasing its excretion.
Lowering uric acid by SGLT2 inhibition reduces CV events and slows the progression of CKD in type-2 DM.

SGLT2 inhibition is useful in the treatment of gout and gouty arthritis, especially when co‐existent with diabetes.…
Read 5 tweets
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.
short axis view with PW of the RVOT shows mid systolic notching
Read 17 tweets
Happy Memorial Day Weekend to all cardiology fellows!

I thank m'learned friend Prof Simon Thom for showing me the funniest paper of the year.

I will discuss it tomorrow.

What approach should I take?

Thank you to everyone for paying attention to the buses I sent round that said there would by £350,000,000 per week for your country's health system, if you voted the way I wanted you to.

Now I can tell @rallamee that I am only listening to the Will of the People.
The problem with starting an article with a clear, true and useful statement, like this...
Read 117 tweets
(1/18) A Brief History of Coronary Angioplasty and the Roots of the Interventional Cardiology Field -- a #Tweetorial

#Cardiotwitter #FOAMed #ACCFIT #histmed @ACCCardioEd

Courtesy of @PopmaJeffrey & @ACCinTouch
(2/18) Dr. Werner Forssman (🇩🇪) performs 1st human #RHC (1929) by inserting a 65cm urologic catheter into his own antecubital vein and walking up to the X-ray department for imaging. Reportedly, he did this repeatedly! He left urology for primary care & shared @NobelPrize (1956).
(3/18) Dr. Fariñas (🇨🇺) performs aortography via femoral🔪 cut down (1941). Dr. Euler (🇩🇪) performs thoracic angiography by direct aorta puncture via esophagus (1949). Drs. Cournand & Dickinson (🇺🇸) open 1st US #cath lab (1945), publish extensively, and shared @NobelPrize (1956).
Read 26 tweets
Here is my attempt at organizing the massive number of replies to my request for physicians on Twitter to follow for my #MPLSVAGrandRounds talk “Social Media in Medicine”
Here is the original thread, which has lists of people in just about every specialty you could think of, and quickly went beyond my ability to organize.
When going through these lists, @Doctor_V reminded me this important point:
Read 27 tweets
Interesting take (both in the article and by @Angiologist about telemed. I have a slightly different view. I work in a system (@MdAtlPermanente @KPMidAtlantic) that uses a lot of virtual care. Not just consults, Also telephone, video, secure messaging, remote monitoring etc. 1/n
In fact more than 50% of our patient interactions are non face to face. And here is what we have learned. All of these technologies are just technologies. It is not what they are but how they are used that matters 2/n
For ex, we use virtual chart reviews for all of our preop CV assessments. We worked with our preop team on questions to ask (functional status, etc) and now, we can review the hx/ekg and give an opinion on the same EHR while saving the patient a trip to see a cardiologist. 3/n
Read 15 tweets
THREAD (1) In preparation for the upcoming @AHAMeetings #QCOR2019 early career programming, @mad_sters, @MikeTPhD, and I, wanted to start a conversation around best-practices for collaboration on manuscripts to maximize success and to avoid common pitfalls and missteps
(2) Although this thread is focused on collaboration on manuscripts, we feel that some of the principles can be extended/adapted to grants and other kinds of collaborations
(3) We'd love input and your stories on best practices and also what are your pet peeves when being engaged as a co-author on a manuscript?
@rwyeh @boback @JeremySussman @hmkyale @MuntnerPaul @DaichiShimbo @berthahidalgo @angiefagerlin @rhessmd @JDodsonMD @jordy_bc @kejoynt
Read 52 tweets
Hi guys! I’m kind of in the mood to give a talk this night. So why not talk about #CardioOnc & #whyCMR? #CardioTwitter #JACCCardioOnc
We started our small “shop” in mid 2013, with the help of @DipanJShah, he allowed me to start a small CMR practice at @HMethodistCV. I did that until we got #CardsRads right, then @XRayDUG supported me and I was able to practice CMR at MD Anderson, then our volumes have been ⬆️
In 2017, when we got +300, I got so happy, that we wrote about our CMR experience in a major cancer center. Jon Weinsaft had a great practice at MSK already, so we couldn’t claim it was the first CMR practice in a major cancer center, still we were very happy about it.
Read 10 tweets
#Cardiotwitter thank you for transforming the field of cardiology.

This paper is a testimony of that transformation brought upon by the use of #SoMe in #CV medicine. Published today in @JACCJournals…

Here is a tweetorial on why #SoMe in #CVmedicine
If you are new to twitter look at this slide from my #SoMeGR at @LLUHealth
Engagement = Likes +Retweets
Impressions= Users that tweeted the tweet x no of their followers
More in the basics of #SoMe in…
@adityadoc1 @AdiAJoshi @poojaotherwise @almasthela
Make sure to use the hashtags to increase your engagement
List of the popular hashtags used on #cardiotwitter below- look at the reach of those hashtags!

Don’t forget Imaging hashtags: #echofirst #whyCMR #yesCCT #ACCimaging #CVimaging
More at…
Read 13 tweets

For my first #Tweetorial, I will start with a question:

Which of the following medications from the SGLT2 inhibitor class have been shown to decrease cardiovascular morbidity and mortality?

#Diabetes #EndoTwitter #MedEd #MedTwitter #DM2 #T2D #CardioTwitter

Sodium glucose transporters (SGLT) in proximal tubules mediate glucose reabsorption.

Na/K ATPase moves Na out & K into the cell ➡️gradient for Na to flow intracellular

SGLT uses this potential to move glucose against its gradient from the tubular fluid into the cell.

SGLT2 inhibitors block glucose reabsorption
➡️renal glucose excretion
➡️glucose levels⬇️

Because this has nothing to do with insulin, they usually don’t cause hypoglycemia or weight gain.

Actually, because of the osmotic diuresis, they decrease blood pressure & weight.
Read 15 tweets
1/ Get your #ECG learning on with this new #12leadthursday today! #FOAMed
2/ What #pathophys helps explains those delta waves? #cardiotwitter
3/ Lets get into #arrhythmia associated with WPW
Read 4 tweets
1/ Happy #12LeadThursday!

Practice your skills and take a swing at our latest EKG. What’s the diagnosis?

Use your system:

#FOAMEd #cardiotwitter #medtwitter
2/ We’re mixing it up today: we’ve got one finding that’s a throwback to a previous #12LeadThursday, combined with a new finding that’s a little more specific.

Low voltage + electrical alternans = ?
3/ Remember, specificity = true negatives / (true negatives + false positives). Highly specific findings rarely produce false positives, so you can be pretty sure this 🚴🏽‍♀️ has developed tamponade physiology.

What do you do next?
Read 4 tweets
A thread.
So the @US_FDA @SGottliebFDA issued a warning re: Fluoroquinolones (FLQ) and aortic dissection (AD) or aneurysm (AA). Do FLQs cause AD/AA? Not really. Is there an association? Maybe. Let’s go throw the evidence and you can decide for yourself.
#CardioTwitter #MedEd
1/ Why was this association even studied? FLQ are known to be associated with Achilles tendon rupture, tendinopathy, retinal detachment. How? 1)decrease collagen synthesis and increase MMP (especially 2, 9) activity (among others). Aorta is affected by these processes
2/First study was published in 2015 using a national database in Taiwan. 1477 cases (662 AD, 850 AA) matched to 147 700 controls. There was signal of the association of FLQ and AD; rate ratio ranging 1.37 - 2.11 with any FLQ use (
Read 13 tweets

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