Discover and read the best of Twitter Threads about #PERT

Most recents (4)

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 ImageImageImage
🔹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)
🔹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)
Read 6 tweets
1/ We clinched the Dx, but how do we treat it?
Are these clot 📸 the best approach for #PE Rx?

Let’s dive into the 🌎 of "escalation of care" therapies

@CardioNerds 🧵 part 2...

Hold on to your 🎩 for this one
@PERTConsortium #PERT #CardioTwitter #ACCMedStudent Courtesy of @GoldbergJBCTMD [Dr. Joshua Goldberg]
2/ Why is PE so dangerous❓

⚠️thrombus in 🫁 ➡️obstruction ➡️ sudden ⬆️ RV afterload ➡️ pressure➕volume overload ➡️ ⬇️RV output➕RV ischemia ➡️ ⬇️LV preload ➡️ ⬇️ 🫀output ➡️ shock ❤️‍🔥

⚠️Hypoxic & neurohormonal mediated pulmonary vasoconstriction ➡️ ⬆️ RV afterload Figure 2 from the 2019 ESC Guidelines https://pubmed.ncbi.nl
3/ How do we treat❓

Based on risk stratification, we have several options: ⭐️Anticoagulation (AC) alone

Escalation of Care (EOC) therapies:
⭐️Systemic Thrombolysis (ST)
⭐️Catheter Directed Therapies (CDT)
⭐️Surgical Embolectomy (SE)
⭐️ECMO
Read 28 tweets
1/ A 40-year-old man presents with Dyspnea and this finding on CTPA ⬇️. How do we treat?

WOAHHH hold your 🐎! Although the CT is black & white, the approach to pulmonary embolism (PE) is more nuanced

Let's talk about PE diagnosis - A @CardioNerds 🧵...

@PERTConsortium #PERT CTA case courtesy of Henry ...
2/ Let’s start with PE Epidemiology 🧮

👉3rd leading cause of CV mortality
👉Annual incidence worldwide is 1 in 1000
👉120 per 100,000 in US
👉PE diagnosis continues to 📈

ahajournals.org/doi/10.1161/CI… Image
3/ Let’s follow the 5️⃣ steps of PE management:

1️⃣Suspect PE
2️⃣Estimate Risk of PE
3️⃣Diagnose with imaging
4️⃣Risk Stratification
5️⃣Treatment

Shoutout to @AmitGoyalMD for this framework Image
Read 13 tweets
(1/22) Acute PE treatment. An ever evolving landscape.

How about a #tweetorial on acute pulmonary embolism (#PE) and how to use mechanical #thombectomy with @InariMedical #FlowTriever?? Lets goooooo!

#InariFellowsEdition #IRad #IC #cardiotwitter
Pic credit @Jonathan_PaulMD Image
2/ From @CDCgov data one American dies of a blood clot every....? #VTE #PE @PERTConsortium #InariFellowsForum
3/ Acute #PE stats

📊100,000–180,000 PE-related deaths annually in US

📊PE is the most preventable cause of death among hospitalized patients

📊3rd leading cardiovascular cause of death after coronary disease and stroke

⏱ 1 American dies of a blood clot every 6 seconds Image
Read 25 tweets

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