🥕Devesh Rai, MD🥕 Profile picture
Jul 23, 2021 14 tweets 10 min read Read on X
#ASPC2021

Evolution of ABCs of Primary Prevention by Cardiac disease

How the guidelines have changed over the last two decade

@rickferraro getting plugged at #ASPC2021
ABCDEF of prevention is important!!

A: Assess risk
B: BP
C: Cholesterol/Cigarette
D: Diabetes/Diet/Weight
E: Exercise/Education
F: Failure

Shared decision making is the key to the prevention

#ASPC2021
@CardioNerds @DrMarthaGulati @ErinMichos @khurramn1 Identifying and providing help with social determinants of health is the first aspect of prevention.

Risk stratification by ASCVD risk is the next step to guide the optimal therapy.

#ASPC2021
ASCVD is the first step.

But, never forget the risk-enhancing factors as they can change the paradigm. South Asian descent is a strong risk factor.

Pregnancy is nature's stress test! #CardioObs

#ASPC2021
ASCVD risk tells about CVA in addition to MI and CHD as well

CAC is another key factor that provides additional information about risk factors on top of ASCVD.

#ASPC2021

@Gurleen_Kaur96 @RichardAFerraro
@Gurleen_Kaur96 @RichardAFerraro When can be aspirin be used?

Choose wisely, when used in the right setting it can prevent major adverse cardiovascular events.

#ASPC2021

@ErinMichos
@Gurleen_Kaur96 @RichardAFerraro @ErinMichos B for Blood pressure control:

Measure the BP in the appropriate settings.

Focus on diet and exercise prior to initiating medications.

Practicing mindfulness can help in decreasing BP as well.

#ASPC2021
C for cholesterol:

Statins are the first line.

Target LDL < 70 in very high-risk ASCVD as per ACC
Target LDL < 55 in very high-risk ASCVD as per ESC

Zetia is the next step.

PCSK9i is the next one to achieve target LDL

#ASPC2021
C for cholesterol:

Statins are the first line.

Target LDL < 70 in very high-risk ASCVD as per ACC
Target LDL < 55 in very high-risk ASCVD as per ESC

Zetia is the next step.

PCSK9i is the next one to achieve target LDL
D: Diet

Mediterranean diet has shown to have a preventive effect

Smoking cessation is the key to prevention.

#ASPC2021
D: Diabetes

More than 150 minutes of exercise per week is vital to the prevention

DM: Exercise, SGLT-2i, and GLP-1 have shown preventive benefits in HF and coronary events.
E: Exercise

The more you exercise, more protected you are from major adverse cardiovascular events

#ASPC2021
F: Failure

Many medications have been shown to prevent new episodes of HF

@NMHheartdoc
In Summary

#ABCDEF of prevention

#ASPC2021

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More from @DeveshRaiMD

Jul 24, 2021
1/ The great debate begins with an intro by @DrMarthaGulati!!

What an incredible program with unique guests.

4/5 debaters are WIC!!

#ASPC2021

Let the debate begin.

Vote in the last.
2/43 Year/M with pre-DM and obesity with a recent gain of 19 lb during pandemic seeks a diet opinion from various experts:

EKG: NSR
Chol: 240, LDL: 140
Apo B: 120
CAC=0
HbA1c: 5.8%

Which diet is right??

#ASPC2021
Mediterranean diet:
@TracySeversonRD

Rich is legumes, Grains
Olive oil is the key
Low in fish, milk, and dairy products

#ASPC2021
Read 13 tweets
Apr 23, 2021
#CardioTwitter #CardioNerds #GITwitter How do you approach GI Bleed in patients with LVAD, we'll follow a patient from presentation to discharge

72 Y/F s/p LVAD 1 year ago presented with 🩸🩸in 💩 Image
Learning objectives😎☑️☑️

☑️Identification GIB in a patient with LVAD

☑️Predictive factors for LVAD and GIB

☑️Diagnosis and management approach of GIB & LVAD🩸🩸🆎🅰️🅱️🅾️

☑️Primary and Secondary prevention of recurrent GIB
I feel comfortable in diagnosing, treating, and preventing #GIB in patients with #LVAD.
Read 21 tweets
Feb 23, 2021
When do you typically discharge your patients post-TAVR?

Check out the 🧵 below for a #tweetorial about same-day discharge following #TAVR!

@tavrkapadia @Edwards_TAVR @TAVRBot @cardioPCImom @SripalBangalore @SrihariNaiduMD @Pooh_Velagapudi @ehj_ed @DLBHATTMD @JPDeptaMD
After this thread 🧵, you'll:

✅Recognize common complications🩺 after TAVR

✅Understand the feasibility of Same-Day Discharge (#SDD) and predictors of Next Day Discharge (NDD) after TAVR.

@CCIJournal #TAVR @WaqasTahir
I feel comfortable🙂 identifying patients who can be discharged🚑 on the same-day after TAVR?
Read 17 tweets

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