Patients with #HF are at risk for thromboembolic events,even when in sinus rhythm

Low-dose #DAOC seem to reduce thromboembolic risk

OAC should be considered in patients with heart failure in sinus rhythm in some circumstances jacc.org/doi/10.1016/j.… @JACCJournals #cardiotwitter
Patients with heart failure should be evaluated for atrial fibrillation or subclinical atrial tachyarrhythmias. Decision to anticoagulate depends on the CHA2DS2-VASc score. #MedTwitter
Heart failure patients in sinus rhythm with a mechanical heart valve, active venous thromboembolism, or hypercoagulable disorder should be anticoagulated. #CardioTwitter @JACCJournals @JavedButler1 @MihaiTrofenciuc
Other conditions in patients with heart failure in sinus rhythm in which anticoagulation could be considered include LA enlargement, asymptomatic mural thrombus, anterior apical akinesis or dyskinesis, prior thromboembolic events, LV aneurysm, and severe LV dysfunction. #HF
Anticoagulants should also be considered in patients with recent ACS or stable coronary artery disease. The decision to initiate anticoagulation therapy is based on the balance between risk for thromboembolic events versus risk for bleeding. #HF #NOAC #MedTwitter @mmamas1973

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More from @HanCardiomd

29 Mar
Myocardial cooling

In animal models of STEMI, the application of hypothermia (32–34°C) is effective in reducing reperfusion injury. hypothermia attenuates different damaging components of reperfusion-injury and activates various cardioprotective signalling pathways @ESC_Journals Image
Pressure-controlled intermittent coronary sinus occlusion
This technology represents the ‘percutaneous’ evolution of the very old concept of perfusing the heart in a ‘backwards’ fashion via the coronary sinus (CS). @mmamas1973 @DFCapodanno @mirvatalasnag @CMichaelGibson @Hragyesc Image
Read 4 tweets
19 Feb
This fantastic review about Cardiac Involvement in Fabry Disease: JACC @ACCinTouch Review Topic of the Week by Maurizio Pieroni et al.

jacc.org/doi/10.1016/j.… @JACCJournals @iamritu @purviparwani @ShelleyZieroth @hvanspall @mmamas1973 @mswami001 @alessia_gimelli @WilliamZoghbi
📌The cardiomyopathy associated with FD manifests mainly as LVH.

📌In addition to glycosphingolipid accumulation, secondary mechanisms of cardiac damage in FD include inflammation and immune activation.
#CardioTwitter @JACCJournals @mmamas1973 @AllanLKleinMD1 @NadeenFaza
📌Cardiac imaging, particularly #whyCMR CMR imaging, is essential for diagnosis and staging of FD.

📌Early treatment can improve clinical outcomes in patients with FD and cardiomyopathy @purviparwani @chiarabd @mswami001 @onco_cardiology @alessia_gimelli @Cosyns @vass_vassiliou
Read 4 tweets
5 Feb
This is a good review article about the advent of novel #WhyCMR mapping techniques allows us to glimpse some of the pathophysiological mechanisms underpinning #HF cfrjournal.com/articles/tissu… @radcliffeCARDIO @chiarabd @Sarah_Moharem @JSabatino86 @vass_vassiliou @DrHaniMahmoud @Cosyns
The Prognostic Role Of Tissue Characterisation Using Cardiovascular Magnetic Resonance In Heart Failure #WhyCMR #MMI @EACVIPresident @alessia_gimelli @JSabatino86 @SCMRorg @HFA_President @ShelleyZieroth @radcliffeCARDIO @mmamas1973 @AndrewJSauer
The Prognostic Role Of Tissue Characterisation Using Cardiovascular Magnetic Resonance In Heart Failure #WhyCMR #HF #MMI @almallahmo @Jessica_B_ @acreanTGH @Cardiac_MRI @JenJordanPhD @ThomasTreibel @erik_schelbert @radcliffeCARDIO @EACVIPresident @mswami001 @iamritu @purviparwani
Read 5 tweets
16 Jan
Year In Review 2020 : Original Perspectives on the Year’s Most Important Clinical Topics in General Medicine from the NEJM Journal Watch
📌The ISCHEMIA Trial
📌Gout and Hyperuricemia Clinical Trial
📌EAST-AFNET 4 Trial :Rate or Rhythm Control in AF ?
@NEJM @JWatch #MedTwitter
Year In Review 2020 : Original Perspectives on the Year’s Most Important Clinical Topics in General Medicine from the NEJM Journal Watch
@NEJM @JWatch @DBelardoMD @DrJennHaythe
📌Drugs for COVID19
📌Rx for Knee OA and Meniscal Tears
📌Management of Persistent Sciatica
Year In Review 2020 : Original Perspectives on the Year’s Most Important Clinical Topics in General Medicine from the NEJM Journal Watch
📌Delabeling Penicillin Allergy
📌Antibiotic Treatment Vs Appendectomy for Appendicitis
@NEJM @JWatch @BethFratesMD @JJcolemanMD
Read 4 tweets
13 Dec 20
📝 Major Clinical Trials for the Management of Stable CHD in the Past 2 Decades

📌COURAGE (2007)
📌BARI-2D ( 2009)
📌STICH (2011)
📌FAME-2 (2012)
📌FREEDOM (2012)
📌ORBITA (2018)
📌ISCHEMIA (2020)
@mmamas1973 @mirvatalasnag @ErinMichos @DavidLBrownMD @DLBHATTMD @iamritu
*COURAGE* (n = 2,287)
PCI + OMT vs. OMT in stable CHD
• All had evidence of ischemia
• 31% triple-vessel CHD
• 4.6 years median follow-up
• HR death/MI 1.05 (95% CI: 0.87 to 1.27
Read 10 tweets
12 Dec 20
Multimodality imaging in takotsubo syndrome: a joint consensus document of the European Association of Cardiovascular Imaging (EACVI) and the Japanese Society of Echocardiography (JSE) #EACVIBestof2020
Full paper is here 👇🏻
academic.oup.com/ehjcimaging/ar…
#EACVIMMIesc
CMR can visualize the entire spectrum of functional and structural changes that occur in patients with TTS.
In the acute phase, CMR is recommended in doubtful TTS cases, especially if diagnosis of another type of MINOCA (e.g. myocarditis) requires a different therapeutic approach
Although the role of nuclear imaging in TTS has not yet been well established in clinical practice, myocardial perfusion and sympathetic nerve innervation can be assessed by SPECT and MIBG. #EACVIBestof2020 #EACVIMMI #WhyCMR
Read 4 tweets

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