Gurleen Kaur, MD Profile picture
Aug 30, 2021 20 tweets 11 min read Read on X
1/ In the🥉@PaChapterACC & @CardioNerds Narratives in Cardiology episode @mirmerrill, @scfuentesr, and @NatashaCuk talk w/ @KTamirisaMD

Follow this #CardsNarratives🧵on the discussion about gender equity & women in Cardiology/Electrophysiology (EP)
2/ We'll cover these 3 questions:

🔸Why should we promote gender diversity in Cardiology/EP?
🔸How do we address barriers for women in Cardiology/EP?
🔸What are some opportunities for EP in private practice?
3/ I feel comfortable openly discussing or asking others about factors that make them different from myself like race, religion, ethnicity, gender, sexual orientation, immigration status, etc
4/ Women are🦄in procedural subspecialties of cardiology

Women only 7-10% of EPs in practice & limited visibility in leadership roles

Why is diversity important❓

♦️ Diversity drives innovation
♦️ Women more likely to provide patient centered communication➡️improve outcomes
5/ Addressing barriers to EP:

🔹⬆️Inclusivity by adjusting work & training environments
🔹Address sexual harassment & discrimination
🔹Advocate for work-life integration & flexible work schedules
🔹Acknowledge & respond to family planning concerns

bit.ly/3syVECS
6/ ACC survey of hostility, discrimination, harassment in cardiology workplace by @DrLaxmiMehta ⤵️

jacc.org/doi/abs/10.101…
7/ Other ways to address barriers of women in Cardiology/EP:

♦️ Consider reduced or flexible training schedules
♦️ Address underrepresentation in leadership
♦️ Address the unequal access to funding & resources, pay & compensation inequity

jacc.org/doi/10.1016/j.…
8/ Sex differences in pursuit of IC as subspecialty among FITs: jacc.org/doi/full/10.10…

🛑Similar barriers apply to EP🛑

Graph depicting barriers ⤵️
9/ Survey of FITs⤵️

14% FITs interested in EP
Among those interested, only 16% women

Women more likely to pursue career in EP if they had female mentor

Article: jacc.org/doi/10.1016/j.…
Editorial: jacc.org/doi/10.1016/j.…
10/ Mentorship from women & men is 🔑

✨Good listener
✨Empower mentees
✨Provide constructive criticism/feedback
✨Be honest, show vulnerability/imperfections

Role models also important – see what someone went through, learn from their journey

Figure by @RBP0612
11/ Other practical tips for Women in Cardiology/EP

💠Women have⬇️speaking invitations: step up & say I am interested
💠Put interests out there, be your own advocate
💠Sponsorship: asked to write paper/ give talk but don't have time➡️invite colleague

pubmed.ncbi.nlm.nih.gov/33587663/
12/ Addressing bias

🛑Microaggressions: pick your battles
🛑Negative encounter in workplace: have conversation, ask them "did you really mean it?"
🛑Repetitive & intentional: call it out, use allies

Silence communicates approval, so speak up

amjmed.com/article/S0002-…
13/ Addressing imposter syndrome

Everyone doubts their abilities, but not all talk about it

Plural view helps – you are not the only one
➕Positive feedback for yourself- think about great things you've done
✍️Journal positives & negatives

bit.ly/37ZHpxl
14/ Benefits of EP private practice

💮Certain level of independence and flexibility, can choose devices/tools, lab set-up, build new program
💮Leadership opportunities, can be part of decision-making
💮Close & longitudinal relationships w/ patients
15/ More on EP private practice:

💮Can engage w/ community initiatives in addition to procedures, patient care, & leadership opportunities

☠️Understanding finances is important – take time to learn about this from mentors
☠️May be harder to network when outside of academia
16/ Summary

🔹Women are underrepresented in EP
🔹Need to mentor & address barriers (culture, work conditions, underrepresentation in leadership)
🔹Private practice EP involves procedures, patient care, leadership, & community engagement opportunities

go.nature.com/3mnhecC
17/ I feel comfortable openly discussing or asking others about factors that make them different from myself like race, religion, ethnicity, gender, sexual orientation, immigration status, etc
18/ After reading this #CardsNarratives Tweetorial, I have a greater appreciation for diversity in cardiology.
19/ Please consider replying with a personal experience or reflection in relation to anything discussed in this Tweetorial
20/ Listen to the full discussion here w/ Dr. Tamirisa on "Empowerment and Growing Together as Women in EP"
cardionerds.com/141-narratives…

Thanks to @CardioNerds, @AmitGoyalMD, @Dr_DanMD, @ThomasMDas for guidance and feedback on this #CardsNarratives Tweetorial!

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More from @Gurleen_Kaur96

Jul 23, 2023
1/ Strategies for medical management of obesity, presentation by @BevTchangMD #ASPC2023

Currently 5 meds FDA-approved for long term management of obesity ⤵️ Image
2/ Who is eligible for anti-obesity medication❓

🫀 BMI >= 30, BMI>=27 with weight related comorbidity
🫀For Asians, BMI>=25-27, BMI>=25 with weight-related comorbidity

#ASPC2023 Image
3/ Efficacy‼️

Expectation of response rate: >5% weight loss over 1 year

Phen/top: 10% weight loss, 70% response rate

Semaglutide: 15% weight loss, 86% response rate

Tirzepatide: 20% weight loss, 90% response rate

#ASPC2023 Image
Read 6 tweets
Jan 19, 2023
1/ Cardiac Stress Testing @CardioNerds
🔶Indications
🔶Types - Exercise vs. Pharmacological
🔶Compare & Contrast Modalities

Thanks to @SimratKaurMD, @AmitGoyalMD, @jholtzman3 for feedback on this infographic!

Follow🧵for a breakdown of the graphic⤵️
2/ Indications

Evaluate:
🔺Stable chest pain in pts w/ intermediate-high risk of CAD
🔺New onset symptoms in pt w/ known CAD
🔺Valvular heart disease & provocative testing in HCM
🔺Microvascular disease & CAV in transplant pts
🔺Hibernating myocardium in pts w/ known CAD
3/ Types❓Exercise vs. Pharmacological

🏃‍♀️Exercise
What➡️Treadmill
Who➡️ Anyone who can exercise (achieve 4 METs) and get to 85% of max predicted HR (220-age)

When evaluating report, look for:
🌟Duration of exercise
🌟METs achieved
🌟% max HR
🌟HR/BP response
Read 12 tweets
Nov 16, 2022
1/ In Episode 234, @PaChapterACC & @CardioNerds featured a Narratives in Cardiology discussion on Structural Heart Disease & LatinX Representation in Cardiology w/ @MayraGuerreroMD, @TDonisan, @AdrianaCMares

Follow this #CardsNarratives 🧵 on Valvular Heart Disease in Women Image
2/ We’ll cover these 2 questions:

❓What are the disparities in valvular heart disease in women?
❓What changes need to be implemented to improve the care of women with valvular heart disease?
3/ I feel comfortable openly discussing or asking others about factors that make them different from myself like race, religion, ethnicity, gender, sexual orientation, immigration status, etc
Read 12 tweets
Jul 25, 2021
1/ Day 3 & last session of #ASPC2021 on special populations

Talk on MI & HF among people with HIV by Dr. Markella Zanni

Follow this🧵on:
🔹MI risk in people w/ HIV
🔹HF in PWH
🔹CVD preventive approaches tailored to people w/ HIV

@ASPCardio @CardioNerds
2/ Patients with HIV are now living longer ➡️increased risk of CVD

Global burden of atherosclerotic CVD in people living with HIV has tripled over past 2 decades

Relative risk of MI is 1.5-2 in high-income countries

pubmed.ncbi.nlm.nih.gov/23459863/

#ASPC2021
3/ From US Partners database study – adjusted relative risk for MI was around 3 for women & 1.5 for men – regionally specific

Type 1 vs. type 2 MI: both ~50%
Women – more type 2 MI

pubmed.ncbi.nlm.nih.gov/17456578/

#ASPC2021
Read 18 tweets
Jul 24, 2021
1/ #ASPC2021 talk for Honorary Fellowship Award by @NMHheartdoc on New Kind of Prevention – Reducing CV Health Disparities at Community and Individual Level

🧵from session

@ASPCardio @CardioNerds
2/ #ASPC2021
Covid-19 deaths by race and ethnicity in the US:
1 in 555 Black Americans has died

Populations w/ highest disease burden➡️ lowest vaccination rates
3/ Any discussion of prevention shouldn’t start at hypertension, dyslipidemia, but at the root cause of those inequities.

Need to address policy. All policy is health policy.

Stolen breaths nejm.org/doi/full/10.10…

#ASPC2021
Read 10 tweets
Jul 24, 2021
1/ Great #ASPC2021 session by @RonBlankstein on Chest Pain and Imaging

Follow this🧵for some takeaways on
🟣Stress Testing vs. Anatomical Testing
🟣Coronary CTA
🟣Guidelines

@ASPCardio @CardioNerds Image
2/ ‼️ Imaging tests alone do NOT change pt outcomes but how we act on them might

‼️ No one test is always the best test

‼️ Test selection influenced by multiple factors: local availability, prior training, guidelines, evidence

🔜AHA/ACC New Chest Pain Guidelines

#ASPC2021
3/ Stress testing vs. Anatomical

ETT: exercise capacity, not as great for ischemia

SPECT MPI: reversible perfusion deficits, underestimates extent of disease esp if multi-vessel

PET MPI: measure absolute blood flow, calculate myocardial blood flow reserve

#ASPC2021 ImageImage
Read 10 tweets

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