Discover and read the best of Twitter Threads about #whyCMR

Most recents (10)

With all the discussion about viability in the past few days, I would like to share how I interpret and report viability on CMR. I first look for LGE. Rarely, there’s no LGE and it’s all viable or more likely, a non-ischemic cardiomyopathy. #WhyCMR 1/18
When I see LGE, I confirm it’s in an ischemic pattern – subendocardial or transmural, and limited to a coronary territory, i.e., an MI. If not, it's again a non-ischemic cardiomyopathy and not a viability issue anymore. 2/18
Next, I try to identify how many and where the MIs are. For this, I look at the extent and locations of ischemic LGE and decide which of the 17 LV segments are likely to be supplied by each of the coronary arteries. 3/18
Read 18 tweets
Hypertrophic Obstructive Cardiomyopathy #HOCM🚧

#Symptoms
Profound exertional dyspnea

#Imaging
▪️SAM/LVOT obstruction #whyCMR
▪️Classic #Doppler🗡#echofirst

#Hemodynamics
▪️Brockenbrough-Braunwald-Morrow sign, explained

#Treatment
▪️Alcohol🍷septal ablation #RadialFirst
Question:
Why wouldn’t more filling time⏱ prior to post PVC beat lead to less obstruction, less gradient, & ↑ arterial pressure?

After all, doesn’t ↑LV volume in #HCM ↓gradient and improve symptoms?

Cornerstone tx is hydration/💊s that ↑ diastolic filling time ...
Read 6 tweets
For all those unable to make my 7 AM presentation on Speckle Science yesterday, here's the requested #Tweetorial on Strain basics #ASE2019 @ASE2019 as promised.
Read 27 tweets
I will share my #SCAI2019 talk.
This was the suggested workflow from our group in 2014. #whyCMR was considered a downstream test due to a lack of understanding on what it has to offer. Now it has become the to-go test in our center to assess for cardiac Amyloidosis.
Congo red from biopsy, no longer needed for cardiac Amyloidosis, I’ll show you why
Read 21 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
Do you use #whyCMR in your patients undergoing #TAVR. More slides in the thread #CVimaging #ACCImaging #ACC19
Annular assessment by #whyCMR accuracy similar to #YesCCT

data from @JACCJournals
#ACCimaging #ACC19 #Cvimaging
Peripheral calcification is the limitation for #whyCMR use in #TAVR #ACCimaging #CVimaging #ACC19
Read 7 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

onlinejacc.org/content/73/9/1…

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 onlinejacc.org/content/73/9/1…
@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 onlinejacc.org/content/73/9/1…
Read 13 tweets
16/
Sorry @venkmurthy @onco_cardiology @IbrahimMSaeed1 and others but #WhyCMR is not on this algorithm. Though, it is used frequently as a “catch all” diagnostic test for various cardiomyopathies.
17/
I use cardiac MRI frequently for non-invasive evaluation in AL. Still, you will need biopsy proof of amyloid somewhere in the body before most hematologists will treat.

Amazing summary image by NAC group in London: ncbi.nlm.nih.gov/pubmed/29929616
18/
SPECIAL POPULATIONS

Aortic stenosis: ATTR and AS coexist in the elderly. Common cause of LFLG AS. We have described this @maz_hanna @ClevelandClinic as well as @JoaoLCavalcante, NAC, Columbia, +more. 16% of TAVRs and 30% of LFLG AS with EF<50% may have ATTR.
Read 9 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: 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

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