Discover and read the best of Twitter Threads about #accfit

Most recents (24)

@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
#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
#ACC23 #WCCardio is jam packed w/ >300 sessions over 3 days w/ >80 live-streaming sessions around the world 🔥

Here’s how you can make the most of it👇🏻 (🧵)

@ACCinTouch @DougDrachmanMD @EdwardFryMD @Pooh_Velagapudi @agtruesdell @KBerlacher @taraloujones @SarasVallabhMD

1/5… Image
1. Are you attending #ACC23 #WCCardio in-person?

Great!

‘Coz you can install the App & get everything you need to navigate the meeting 👇🏻

iPhone: apps.apple.com/us/app/acc-23-…

Android: play.google.com/store/apps/det…

#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd

2/5…
2. Not very App savvy? No problem!

You can use ACC Online Program Planner to build an itinerary that meets all your needs 👇🏻

abstractsonline.com/pp8/#!/10674

#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd #MedStudentTwitter

3/5…
Read 6 tweets
Give a talk on tips for getting a paper published for early career docs. I had fun putting it together with my own reflections as a jr. author, sr. author, peer reviewer, and editor. I thought I would share a 🧵 @SVM_tweets #ACCFIT #SVMNextGen #publishing
#1. Choose Journal to submit with care. Consider fit as well as prestige (impact factor, IF). Make sure paper fall within scope of journal. Review journal website and consider pre-submission inquiry to editorial office.
#1.5 IF is but 1 factor; need to be sure your paper will be assessed by knowledgeable reviewers in its field a timely fashion with possibility of ultimate acceptance. Others may disagree, but I think it’s helpful to identify your first choice journal before writing the paper.
Read 19 tweets
🔥Review on optimal targets in #CardiogenicShock in @JACCJournals #Advances by @benhibbertMDPhD & team 👏
Clinical, biochemical & hemodynamic targets to guide therapy & escalation of therapy.
@Sadeer_AlKindi @baileyannRN #ACCEarlyCareer #ACCFIT
👉jacc.org/doi/10.1016/j.…
Current guidelines focus on the t/t of inciting event & restore end-organ perfusion; inotropes/pressors to target MAP ≥65 mm Hg.
🏷 Asses serial markers of systemic perfusion- lactate, ScVO2, UOP, Cr, LFTs, mentation, temp, and invasive hemodynamics & target accordingly
🏷Difference in #SCAI classes A-B & C-E is presence of hypoperfusion- clinical signs like cool mottled skin, poor UOP, confusion, & biochemical abnormalities like ⬆️ lactate, renal insufficiency, and ⬆️ LFTs.
🏷 RAP, ⬆️ shock stage over time, and late deterioration ⬆️ mortality
Read 21 tweets
“Fast is slow, slow is smooth, smooth is fast”.

A🧵for interventional cardiology #ACCFIT
You’re likely to hear a variation of this phrase during your training in the cath lab. So what does it mean? And why do interventional cardiologists find it so compelling?

Let’s break it down.
Most sources attribute the phrase to the Navy Seals, a celebrated military group that takes pride in its culture and shared set of values.
Read 25 tweets
2021 #ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
jacc.org/doi/10.1016/j.…
#ACCFIT #CardioTwitter #medtwitter #ACCIC
10 Take-home messages:

1. Coronary revascularization should be based on clinical indications, regardless of sex, race, or ethnicity.
2. In patients being considered for coronary revascularization for whom the optimal treatment strategy is unclear, a multidisciplinary Heart Team approach is recommended.
3. For significant LM disease, CABG is indicated to improve survival relative to that likely to be achieved with medical therapy. PCI is a reasonable compared with medical therapy, in low to medium complex CAD and LM disease that is equally suitable for CABG or PCI
Read 10 tweets
74 y/o previous PCI of the prox LAD LM at that time IFR -; IVUS with dLM nodule but adequate lumen. 6 months later progressive anginal sxs. Nodule eruptive MLA down from 7.5 to 6.7ish and %stenosis 71 with heavy plaque burden. Utilized #shaveandshock w/ @csi360 and @ShockwaveIVL ImageImageImageImage
with Impella support (flat-lined while using 4.0 shockwave). MLA 6.7 -> 11.7 m2! Closed up the hole with a 14French @TeleflexCardiol manta with excellent results. Home following day!
Read 3 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
On my last day as a trainee, I’m reflecting back on the best advice I’ve received at each stage.

Hopefully this 🧵 may offer something. #MedStudentTwitter #medtwitter #internalmedicine #cardiotwitter #ACCFIT #meded #cardioed

1/
2/ Pre-clinical med students—Immerse yourself in what you’re learning. Remember that you’re building a foundation to be a great doctor, not just preparing for exams.
3/ Clinical med students—Spend time with your patients; you have more time now than ever again. Keep an open mind about each specialty. Once you decide, pay even more attention on all the rotations you won’t pursue. They will be your colleagues one day; learn how they think.
Read 7 tweets
Awesome first day of presentations.

Some of the key slides below from Chapter 1 - Left Main PCI

 #TCTAP2021 #APVALVES2021 #COMPLEXPCI2021  @summitmd_cvrf @aayshacader @mirvatalasnag @AmitSinghMD @YongcheolKim2
#CardioTwitter #CardioEd #RadialFirst #ACCFIT #ACC @BotPci @APSIC6
1/4 Left Main bifurcation and PCI by Dr Mario Gaudino ImageImageImageImage
2/ ImageImageImageImage
Read 24 tweets
Quiz for fellows and sonographers #MondayMotivation
70 year old male presenting with a systolic murmur. What is this Mitral M-mode redux of? #echofirst @AAH_StLukesCV
#cardiotwitter #ACCFIT Image
Here is another clue! Hint Hint!!! Image
Read 7 tweets
Step-by-step tweetorial on percutaneous post-infarct VSD closure. Late presenting inferior MI.
Cardiac CT can be very helpful in planning the approach and in noting nearby structures. Here, the defect is quite basal - semilunar valves can disrupted.
1- GA and TEE guidance. Note proximity of the defect to the tricuspid valve.
Read 17 tweets
**VALVE CASE OF THE WEEK**

Last case of 2020!

@BrHeartValveSoc @TheBJCA @global_wic @BSEcho @ASE360

This is a tough one! This will separate the men from the boys, the women from the girls...are you Luke Skywalker or are you already the Obi-Wan Kenobi of valve disease?!
Mid 70s patient, known ischaemic cardiomyopathy & aortic stenosis.
⬆️⬆️ dyspnoea.
Clinical signs suggest severe AS.
BP 90/50mmHg, HR 60bpm.
This is the resting ECG (hint - showing this for a reason - 😉)
Here is PLAX view of the AV...👇🏽
Read 25 tweets
#CardioNerds & #EPeeps, ready for an EKG Challenge⁉️⁉️

✍️Answer to follow on Monday 11/23 🗓️

🏥You see this 58 yo🧍‍♂️w/ ischemic CM in clinic.

🤔What's the rhythm❓

Brought to you by EKGaction: ekgaction.com Image
Would you use a CardioNerds EKG Case of the Week - shared weekly?
Read 37 tweets
Great 1st session of #SCAISHOCK. @HenrytTimothy started by providing an excellent crash course on shock definitions.

Important to know and communicate using SCAI SHOCK stages.

#ACCFIT #AHAFIT #SCAIFIT @UIowaCVFellows @SrihariNaiduMD @BillONeillMD @ArasiMaran @agtruesdell
. @BurkhoffMd discussing advanced hemodynamics in cardiogenic shock during #SCAISHOCK. Fantastic session!!

Really important to understand the hemodynamic response to drugs and devices which are variable due to baseline characteristics

#ACCFIT #AHAFIT #SCAIFIT @UIowaCVFellows
Dr. Angela Taylor discussing “Inotropes and Pressors” during #SCAISHOCK. Very informative and HY slides. #ACCFIT #AHAFIT #SCAIFIT @UIowaCVFellows
Read 5 tweets
**VALVE CASE OF THE WEEK**

Old case from 2010...but you know what they say...old is gold! 😁

Female, mid 70s, inter-hospital transfer for urgent angiography due to chest tightness with ischaemic ECG. CP came on 12hrs after distressing news of sudden family death. ECG 👇🏽 Image
Exam - loud systolic murmur, so urgent TTE requested before angio. Here is PLAX. Apologies no ECG, cables on portable Vivid-i were broken!

@angularboxoid @JonathanWHinton @hannahcvimaging @cardiodan @hannahzr @TharushaGunawa4 @MayooranShan @DrMarkMills @dorsetcardio @brwcole
PLAX Zoom...
Read 28 tweets
**VALVE CASE OF THE WEEK**

OK, this starts off about valves...but then isn't really about valves...but it's the broader educational point (which is relevant to valves) that I want to make this week...no poll I'm afraid, but as always, comments encouraged! 😁

@BrHeartValveSoc
In my office doing Admin, lot to get through & a very busy morning ahead. Asked to r/v a TTE for helping determine AS severity. Pt admitted with heart failure, clinically severe AS is all I know at this point. Now, the golden rule in this situation is *review the whole study*...
Not just one or two images.

But I was super-busy, I BROKE MY OWN RULE and just looked at the relevant images. Here's the PW and CW Doppler tracings (Pt in AF)...
Read 15 tweets
An #ACCEarlyCareer #ACCFIT #tweetorial from the @WeillCornell Graphics Lab on common ECG Lead Switches (boards ❓favorites).

In case you missed it - we are considering the infarct related artery responsible for the following pattern of injury in a 69yoM presenting with a STEMI: Image
Most guessed the LCx or D1 of the LAD from the STEs in leads 1 & L (as we did) with reciprocal depressions inferiorly - a high lateral (maybe posterolateral with V2 depression) infarction.

The angiogram prompted a welcome phone call from our spicy🌶 interventionalist: "You ECG readers think you are *SO* perfect. Take this!😂It was the RCA all along!": Image
Read 20 tweets
#ACCFIT #AHAFIT #cardiotwitter @MyASNC. This Thursday, follow me for live updates from the #ASNC2020 as we bring you the second session in the series on #SoMe "Steering Your Tweetanic: Basics and Advanced Outline". Don't forget to join us: bit.ly/31GG8ZY. 4-530p EDT. Image
Join us to learn from the 🌟s of #SoMe including @VietHeartPA @iamritu @RBP0612 @FarrisTimimi @CoronaryDoc @krishnapatel888 @NitiCardio as they bring the discussion regarding various topics related to #SoMe and guide us on carrying out and improving our presence on #SoMe. #cvnuc
Read 3 tweets
When use #ldtra during a #radialfirst approach?

👌if no #STEMI and:
1⃣ dialysis or CABG w/radial graft likely (better
radial artery patency) or
2⃣ left radial preferred (e.g. prior CABG: better pt
and👩‍⚕️comfort) or
3⃣ pt has thick forearm (better hemostasis) When to use #ldtra (distal ...
❓How-to #ldTRA?

Twitterature: @ferdikiem and many others provide great tips from U/S guidance to compression and more

Literature is catching up:
ongoing studies➡️NCT03611725, NCT04232488, NCT04318990, NCT04194606, NCT04171570 Literature vs Twitterature
Read 3 tweets

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