Discover and read the best of Twitter Threads about #stemi
Most recents (15)
1/ For the fellows and #ACCEarlyCareer!
It’s a coronary thrombus! When to consider thrombectomy? What do you do? Let’s walk through this…#Tweetorial
#Cardiotwitter #Cardiology #STEMI
It’s a coronary thrombus! When to consider thrombectomy? What do you do? Let’s walk through this…#Tweetorial
#Cardiotwitter #Cardiology #STEMI
2/ Middle age patient with hx of CAD and PCI to LAD presents with significant SOB and elevated Hs-Trop. No chest pain. No ECG changes. Echo with inferior hypokinesis.
Here’s the diagnostic with a JR4.
Notice the filling defect in the RCA. This is thrombus. How do we know?
Here’s the diagnostic with a JR4.
Notice the filling defect in the RCA. This is thrombus. How do we know?
3/ Keys of #thrombus on angiogram
🔑 contrast staining
🔑 Lack of calcium on non con image
🔑 ovoid filling defect (complete lumen)
#Cardiotwitter #STEMI #TIMI
🔑 contrast staining
🔑 Lack of calcium on non con image
🔑 ovoid filling defect (complete lumen)
#Cardiotwitter #STEMI #TIMI
2/8 However, our study was unique in design compared w/ prior studies, allowing for more accurate estimates of mortality risk: 1) larger, more representative cohort; 2) more contemporary control groups
3/8 We characterized mortality risk separately for pts with pre-hospital and in-hospital #STEMI
Don’t miss a new accredited #tweetorial launching Monday here on @cardiomet_CE. Our newest core faculty member, #interventionalist & #SoMe education enthusiast @aayshacader will be discussing #antiplatelet tx in an oh-so-tough scenario--#cardiogenicshock complicating #STEMI.
FOLLOW US now and be there! @DLBHATTMD @DrMauricioCohen @SVRaoMD @HeartBobH @HeartOTXHeartMD @Heart_SCCT @TCTMD @GreggWStone @gabrielsteg @cpcannon @agtruesdell @evandrofilhobr @SCAI @SripalBangalore @mmamas1973 @SABOURETCardio @PCRonline @Pooh_Velagapudi #CardioTwitter
1) Welcome to a tweetorial on antiplatelet therapy for #STEMI in #cardiogenic shock #CS! Accredited for 0.50 credits by @academiccme! I am @aayshacader. Be sure to see prior tweetorials on this topic and still earn credit at cardiometabolic-ce.com/category/plate…
1/ 🧵
Time for a #tweetorial on simple #ECG interpretation
When I learned to read ECGs, my biggest fear was to miss an important finding!
To avoid that: Be systematic❗️
My simple approach to ECGs with 8 steps 🪜👇
#medicalstudent #education #cardiotwitter #medtwitter #EPeeps
Time for a #tweetorial on simple #ECG interpretation
When I learned to read ECGs, my biggest fear was to miss an important finding!
To avoid that: Be systematic❗️
My simple approach to ECGs with 8 steps 🪜👇
#medicalstudent #education #cardiotwitter #medtwitter #EPeeps
2/
‼️ All following ECGs are with paper speed of 25 mm/s and a signal gain of 10 mm/mV ‼️
Therefore:
1 small square = 40 ms
1 big square = 200 ms
Now we are ready to read the ECG systematically
‼️ All following ECGs are with paper speed of 25 mm/s and a signal gain of 10 mm/mV ‼️
Therefore:
1 small square = 40 ms
1 big square = 200 ms
Now we are ready to read the ECG systematically
3/
1⃣ Rhythm
Sinus rhythm or abnormal rhythm?
(Also note if regular or irregular)
Normal: One P-wave precedes each QRS complex (sinus rhythm)
Interpret from the lead that shows the P-wave most clearly (usually lead II)
1⃣ Rhythm
Sinus rhythm or abnormal rhythm?
(Also note if regular or irregular)
Normal: One P-wave precedes each QRS complex (sinus rhythm)
Interpret from the lead that shows the P-wave most clearly (usually lead II)
INTERESTING CASE 🧵 1/5
52 yo 🙍🏻♂️recent hospitalized for pneumonia +#COVID19
Consult for chest pain.
#STEMI #CardioTwitter
@smithECGBlog @EM_RESUS @drdargaray @ECGQuizzes @ECGfan @ecgrhythms @ECGcorner @SIAC_cardio @PCRonline @mmamas1973 @SeNani2908 @cachoraggio
52 yo 🙍🏻♂️recent hospitalized for pneumonia +#COVID19
Consult for chest pain.
#STEMI #CardioTwitter
@smithECGBlog @EM_RESUS @drdargaray @ECGQuizzes @ECGfan @ecgrhythms @ECGcorner @SIAC_cardio @PCRonline @mmamas1973 @SeNani2908 @cachoraggio
3/5 Cardiogenic Shock ⏩Stent thrombosis ⏩PCI / IABP
While #EuroPCR is in full swing, here is a special #ACC21 #tweetorial brought to you by @ANazmiCalik focusing on what you need to remember about the results of the main #interventionalcardiology trials 📈📉📊 released at the conference! #CardioTwitter
⤵️⤵️
⤵️⤵️
1/9 #ACC21 #Tweetorial @ANazmiCalik
#ADAPTABLE: Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness
Take 🏠:
-if the patient isn't on Aspirin, START w/ 81mg
-if the patient is on 81 mg Aspirin, STAY
-if the patient is on 325mg, MAY STAY
#ADAPTABLE: Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-term Effectiveness
Take 🏠:
-if the patient isn't on Aspirin, START w/ 81mg
-if the patient is on 81 mg Aspirin, STAY
-if the patient is on 325mg, MAY STAY
2/9 #ACC21 #Tweetorial @ANazmiCalik
#LAAOS III: Left Atrial Appendage Occlusion Study III
Take home 🏠 message:
Among patients with AF undergoing cardiac surgery, surgical LAA occlusion reduces ischemic stroke by 33%, compared to no occlusion.
#LAAOS III: Left Atrial Appendage Occlusion Study III
Take home 🏠 message:
Among patients with AF undergoing cardiac surgery, surgical LAA occlusion reduces ischemic stroke by 33%, compared to no occlusion.
Letzter Thread für die diesjährige #DGKJahrestagung mit der Zusammenfassung der
🔥Highlight Session🔥
Danke allen Organisatoren und der Administration der @DGK_org (Frau Wilke, Frau Kacmaz, Frau Kersken und allen anderen die im Verborgenen bleiben) von meiner Seite!
RESPEKT!
🔥Highlight Session🔥
Danke allen Organisatoren und der Administration der @DGK_org (Frau Wilke, Frau Kacmaz, Frau Kersken und allen anderen die im Verborgenen bleiben) von meiner Seite!
RESPEKT!
Danke auch meinen #DGKAmbassadors-Kollegen und vor allem meinen @AGIKinterv-Buddies (@kaschenke @HolgerNef @MarcVorpahl @thiele_holger) für tolle Zusammenarbeit für die #DGKJahrestagung 2021:
1.1/ ➡️Highlights "Experimentelle Kardiologie" by Jürgen Schrader | Düsseldorf
PART1
#DGKJahrestagung 2021
PART1
#DGKJahrestagung 2021
1. Hot off the press - #EHJACVC Issue 1/2021 tweetorial 🔽
The issue opens with an editorial by new EiC @VranckxPascal, highlighting the aims of the journal, presenting the new editorial board and thanking @cvrints, former EiC academic.oup.com/ehjacc/article…
#ACVC_ESC #cardiotwitter
The issue opens with an editorial by new EiC @VranckxPascal, highlighting the aims of the journal, presenting the new editorial board and thanking @cvrints, former EiC academic.oup.com/ehjacc/article…
#ACVC_ESC #cardiotwitter
2. Issue focus: #CardiogenicShock (CS) management.
In the new "Sciencepulse", chaired by @ingo_ahrens, David Morrow from @BrighamWomens and @thiele_holger discuss differences and commonalities in CS management in Europe and North America academic.oup.com/ehjacc/article…
In the new "Sciencepulse", chaired by @ingo_ahrens, David Morrow from @BrighamWomens and @thiele_holger discuss differences and commonalities in CS management in Europe and North America academic.oup.com/ehjacc/article…
3. In an editorial titled "Potential growth in cardiogenic shock research though an international registry collaboration", @seanvandiepen and Dave Morrow call for a Hub-of-Spokes model in #CardiogenicShock research academic.oup.com/ehjacc/article…
#EHJACVC #CardioEd
#EHJACVC #CardioEd
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)
👌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)
❓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
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
Source: sciencedirect.com/science/articl… from our team @MHIF_Heart
#cardiotwitter #ACCFIT #SCAIFIT #ACCEarlyCareer
#cardiotwitter #ACCFIT #SCAIFIT #ACCEarlyCareer
Here’s the ECG Computer Read:
"Non-specific ST abnormality, consider anterior subendocardial ischemia."
[2/x]
"Non-specific ST abnormality, consider anterior subendocardial ischemia."
[2/x]
Take a good look at Leads V1-V3 and burn these morphologies and this pattern into your mind.
THIS is what Posterior #STEMI looks like on a Standard 12-Lead ECG!
[3/x]
THIS is what Posterior #STEMI looks like on a Standard 12-Lead ECG!
[3/x]
Lots of talk about the expected surge in ICU and hosp beds with #COVID. I’ve been hearing about reducing elective case burden (great thread from @ajaykirtane about that). We should also be rethinking our hospital approach to conditions that will continue in the covid era 1/n
Most obvious is with #STEMI care. If your hospital doesn’t have an ED bypass protocol for stemis - probably a good time to develop one. Ours at @VHC_Hospital has 1 min pitstop in ed w ems txp to cath lab - less pt exposure time to ED and less burden on ED resources 2/n
Also with #STEMI care - No icu for stable pts w normal EF should be standard. For most of these pts ICU is not necc and creates unneeded exposure for pt and occupies much needed ICU beds. (I think @agtruesdell had a great thread on this a while back) 3/n
1/
9⃣1⃣1⃣ #STEMI 🚨 example
➕ST elevation 3>2
➕Right sided leads (shown): ST elevation in V4R-V6R leads
____________
=Inferior MI with RV involvement
⚠️ caution with nitroglycerin in this patient
👉 Preload dependent
🛑⇪Vagal tone may lead to heart block
#CardioNerds
9⃣1⃣1⃣ #STEMI 🚨 example
➕ST elevation 3>2
➕Right sided leads (shown): ST elevation in V4R-V6R leads
____________
=Inferior MI with RV involvement
⚠️ caution with nitroglycerin in this patient
👉 Preload dependent
🛑⇪Vagal tone may lead to heart block
#CardioNerds
2/
A nice algorithm when confronted with inferior STEMI
A nice algorithm when confronted with inferior STEMI
THREAD
Recently in our #MICU, I took pics of the oxygen sats of patients on oxygen supplementation.
What is the optimal oxygen supplementation strategy for a clinically stable patient in the ICU?
Follow me down this #tweetorial rabbit hole. #medtwitter #pulmcc #AIMW19
1/
Recently in our #MICU, I took pics of the oxygen sats of patients on oxygen supplementation.
What is the optimal oxygen supplementation strategy for a clinically stable patient in the ICU?
Follow me down this #tweetorial rabbit hole. #medtwitter #pulmcc #AIMW19
1/
Given that population health improvements often come from small benefits in large populations, and the fact that #oxygen is one of the most commonly prescribed interventions in the #ICU, there is potential for benefit if we can correctly titrate our oxygen titration.
2/
2/
I’m going to refer to hypoxia and hyperoxia in this #medthread, and I’d like to (somewhat arbitrarily) define these terms. I’ll call hypoxia anything below 90% and hyperoxia anything above 96%. This is based upon some of the literature I will discuss.
3/
3/
Study warns against combined use of oral #anticoagulants , #antiplatelet therapy for #AFib 1️⃣
#GARFIELD-AF registry
escardio.org/The-ESC/Press-…
#GARFIELD-AF registry
escardio.org/The-ESC/Press-…
Intro/10 #STEMI #tweetorial #FITSurvivalGuide for #ACCFIT. Organized by @dr_chirumamilla. @ACCCardioEd @ACCinTouch
1/10 #STEMI from ruptured plaque, less plaque erosion. @BraunwaldEugene pic demonstrates LDL oxidized, glycated➡️cytokines release express adhesion molecules➡️monocytes roll, diapedesis➡️ingest LDL, become foam cell➡️SMC migrate, proliferate➡️some apoptosis➡️plaque
