"CV considerations & #COVID19"
💥Viral cell entry using ACE2
💥ACEi/ARB - don't stop - no evidence of harm/benefit
#ACCFIT #MedEd #Medtwitter #HMHFellow @HMHCardioFellow @HMethodistCV #StayHomeSaveLives #FlattenTheCurveTogether
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💥ACC: Measure troponin & BNP if considering ACS / HF clinically
💥Based on studies, ?consider using troponin as prognostic marker
💥ACS: GDMT, consider cath lab staff exposure, ?fibrinolytics in low risk ACS
#COVID19
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💥Reports of new onset cardiomyopathy - may contribute to #COVID19 mortality
💥Steroids or no steroids?
💥Cautious volume resuscitation
💥Consider RV failure with ARDS
💥Define hemodynamics, imp if considering ECMO
💥Malignant tachy-arrhythmia + ⬆️troponin -> ?Myocarditis
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💥Hydroxychloroquine / Azithromycin - no strong evidence for benefit
💥Does ⬆️QTc
💥Can use Tisdale score to risk stratify
💥Repeat ECG 2-3 hours post dose on day 3
#COVID19
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💥ISHLT: Stratify OHTxp by #COVID19 severity
💥Mild -> #StayHome, continue immunosuppression
💥Mod -> Admit, avoid non-invasive vent, consider early intubation
💥Severe -> Consider interrupting antimetabolite, local ECMO guidelines
#echofirst #radialfirst #yesCCT #whyCMR
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