Discover and read the best of Twitter Threads about #echofirst

Most recents (7)

1/Tweetorial on #TMVR for #ASEchoJC 12/11 8 pm
bit.ly/2EiJQ1v

transcatheter mitral valve replacement #TMVR for failed valve & ⬆️ #STS risk

#VHD 2017 update reoperation➡️ reintervention bit.ly/2P9bX4G

🎈expandable SAPIEN S3 only @FDA bioprosthesis for implant
2/#Transeptal developed @MayoClinicCV 48 pts

After 🇨🇦 initial experience with #transapical 2009

sick patients with ⬇️ EF #transeptal preserves EF better avoids apical purse string suture

Currently #TMVR registry
>50 % are transeptal & in house mortality 7%
3/#EchoFirst #TTE
#PLAX & off-axis( inflow can be II to septum not apex/posteriorly & eccentric/coanda
👀 origin MR➡️#TMVR may 🚫resolve severe paravalvular MR
#Apical
#CWD #MV proximal flow convergence location: on ventricular side in regurgitation & on atrial side in stenosis
Read 10 tweets
Assessing the whole body with #ultrasound #WBU impacts the outcome? a look at the literature part 1 Van Der Horst I at #LIVES2018 #FOAMus #FOAMcc #FOAMed @ESICM #echofirst #FOAMcc
Assessing the whole body with #ultrasound #WBU impacts the outcome? a look at the literature part 2 Van Der Horst I at #LIVES2018 #FOAMus #FOAMcc #FOAMed @ESICM #echofirst #FOAMcc
Assessing the whole body with #ultrasound #WBU impacts the outcome? a look at the literature part 3 Van Der Horst I at #LIVES2018 #FOAMus #FOAMcc #FOAMed @ESICM #echofirst #FOAMcc
Read 3 tweets
1/#Tweetorial #papillary #fibroelastoma for
#ASEchoJC 10/23

🐙= #PFE 1975 named #papillary #fibroelastoma by #armed #forces #institute of #pathology

#papilloma 1973

#Collagen core with elastic fibers & matrix covered by endothelium sheath
Attached by stalk
multiple fronds
2/ What is the incidence of #PFE 🐙 compared to #myxoma (diagnosed in same time period)?

#PFE 511 vs. #myxoma 112

#PFE incidence ~1/1000

common “benign”primary ❤️tumor #modern #EchoFirst (Most common @MayoClinicCV)

#myxoma (autopsy based prevalence)

bit.ly/2Am05Y9
3/How to tell if a #PFE🐙by #echofirst ?
(Vs.Atypical myxoma,SBE,
Llambl’s)
small mobile mass attached #endocardial surface frondlike extensions #independent motion stippled border
Usually on atrial surface of AV valves or either side of semilunar valves,🚫interfere valve Fxn
Read 10 tweets
Evaluation of Cardiac Masses:
A Tweetorial for #FITSurvivalGuide 🚨 #ACCImaging @ASE360 @SCMR @journalofCMR @ACCinTouch
Dedicated:@dr_chirumamilla & all #ACCFIT in #CardioTwitter
Main Ref: link.springer.com/article/10.100… Palaskas, et al. Curr Treat Options Cardio Med (2018) 20: 29.
Usually, it all starts with an abnormal finding in an echo suggestive of intracavitary mass. How can we tell one from the other? It can be confusing.
For artifacts, I did a Tweetorial already that describes the most common ones. Basic understanding of ultrasound physics is needed to be able to explain them: twitter.com/i/moments/1030…
Read 24 tweets
#FITSurvivalGuide on Restrictive Cardiomyopathy (RCM) vs Constrictive Pericarditis (CP).

In both:

💠Diastolic RV & LV impaired; systolic function preserved
💠HFpEF phenotype, predominant “R sided” signs (­JVP, edema, ascites)

1/12
@dr_chirumamilla @Pooh_Velagapudi @bcostelloMD
🔑 to understanding different filling:
RCM = myocardial disorder
CP = pericardial disorder.

2/12
@majazayeri @fawazalenezi55 @SanChris999 @GuruKowlgi @Nidhi_Madan9 @sabeedak1 @noshreza @SaggerMawri @nsivcd @DrManiCardio @khandelwalMD @drjohnm @heartdoc45 @zainasadEP @docaward
RCM

💠Stiff myocardium➡️early diastolic ⏫­­LV and RV pressure w/small vol ∆
💠 Echo: early diastolic abnormalities
💠High initial flow (= E wave; so E/A >2); ends abruptly (⬇️E decel time)

⚠️Restrictive pattern also in stage 3 HFrEF w/abnl early diastole

3/12
Read 12 tweets
#FITSurvivalGuide: The Forgotten Valve-#TricuspidRegurgitation (#TR) #tweetorial for the new #ACCFIT!

1⃣ Anatomy
2⃣ Etiologies
3⃣ Classification
4⃣ Diagnosis
5⃣ Treatment

Resources: @ASE360 @JACCJournals @CircAHA @ACCCardioEd @UMNews @Medtronic

1/10
cc: @dr_chirumamilla
[2/10] Impt to understand #TricuspidValve 1⃣ Anatomy

3 leaflets ⬇️ + fibrous annulus + 2 papillary 💪🏽 + chordae tendinae + RA/RV ❤️

⬛️ Anterior 🍃 (largest)
◾️Posterior
▪️Septal (smallest)

(note: throughout #tweetorial, see image descriptions for more content) TV is largest and most apically displaced valve (normal TV area is between 7 and 9 cm^2).  Tricuspid annulus = complex nonplanar 3D structure w/low posteroseptal portion (towards the RV apex) & high anterolateral portion.TV has 2 distinct pap muscles (ant & post) + 3rd variable septal pap muscle. Largest pap = typically anterior w/chordae supporting ant & post leaflets. Posterior pap supports post + septal leaflets. Septal pap is variable: absent in up to 20% of normal patients or small, or multiple.Note attachments of leaflets/chordae to papillary muscles, RV free wall, moderator band.
[3/10] 2⃣ Etiologies = Structural (1º) vs. Functional (FTR)

Keep chart ⬇️ DDx in mind when reading #EchoFirst

~80% of significant TR = FTR/2º to TA dilatation + leaflet tethering ⬅️ RV remodeling ⬅️ volume and/or pressure overload

Structural (1º) cause = less common
Read 12 tweets
1/11
Today's #FiTSurvivalGuide for basic #EchoFirst views

Parasternal Long Axis:
Left lateral decubitus
3rd L intercostal space. Move⬆️or⬇️ to find window
👀descending aorta, coronary sinus, pericardium, LV, both leaflets of MV, LA, aortic valve & root, RV
2/11
RV Inflow View:
Medial angulation of scan plane

👀RA, Tricuspid valve, RV
Further angulate probe to remove portion of LV (seen in A, but not in B)
3/11
Parasternal short
👀annulus, 3 cusps of aortic valve (open in systole, close in diastole), coronary ostia (LM at 4 & RCA at 11), LA, IAS, RA, TV, RVOT, pulmonary valve, proximal pulmonary artery (slight superior angulation for R & L branches)

#FiTSurvivalGuide
Read 12 tweets

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