#ESCCongress THREAD on CVD PREVENTION. I need to start with this, seeing someone with an MI or heart failure or AF & treating them appropriately doesn’t make us great doctors. PREVENTING those does. These #ESCGuidelines help a lot to getting us there @ShrillaB @wordfinga …/3
#ESCCongress #ESCGuidelines on CVS PREVENTION. A 🧵. Who to assess? ANYONE AT RISK! Those with FHx, DM, HTN, high lipids AND OBESITY… don’t forget Obesity! I would also have included sedentary lifestyle! @bes502 @papathanasiou_ @MichaelPapadak2 @PMarquesVidal @DrTiberi …/4
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 It’s a lifetime risk… from birth to the end… BUT AGE & COMORBITIDY increase risk- hence the vigilance we should have to identify those at likely risk #epeeps @Abraham_RMI @cor_etc @MihaiTrofenciuc @AskDrShashank @SineadHughes19 …/5
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 The burden of CVD in Europe is high, globally might be even higher. Recommendation to assess using SCORE2 (<70 years) & SCORE-OP (>70yrs). I like these scores but remember age is a continuum risk @purviparwani @DBelardoMD …/6
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 The algorithms specify apparently ‘healthy’, those with known Heart disease and people with diabetes. They are easy & clear to follow! @AsherElad @DrMartensPhD @LoaiAlbarqouni @BudoffMd @olbaPnauJ2 @jairlevogiro @Umair2017 …/7
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 AND an acknowledgement of AIR POPULATION as a risk factor - suggestion to consider avoiding regions of high air population. I would have taken it a step further - Wear a MASK in those regions 😷 @MilenaAste @SeemaDesh2020 …/8
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 this is a specific section on AF … basically if we can assess and manage all risk factors AF will decrease & keep our EP friends less busy @dickytill @martinbahls @roxanacampisi @GeminaDB @chiarabd @cchinHEART @HEARTinMagnet …/9
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 And a table giving specific treatment goals for each category of individuals. @maksuddan @DrMartensPhD @roxanacampisi @FuEdouard @DocStrom @EM_RESUS …/10
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 A crucial recommendation for physical activity @bes502 @ErinMichos @EkateriniL @venkmurthy 150-300 mins moderate intensity or 75-150 aerobic. Clearly the more the better! & guidance on lipid management! @drdiegocosta …/11
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 And of course HYPERTENSION - first look for it and treat it - and seek expert help like that if @AnastasiaSMihai and @DrVikasKapil (and local equivalents!) and treat aggressively. And needles to say STOP SMOKING! …/12
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 and because hypertension is so important , a dedicated info gram on its management! …/13
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 and this is the final comments- worth a read that’s for sure! …/14
#ESCCongress #ESCGuidelines CVS PREVENTION 🧵 so my short summary for the guidelines? 1- assess risks, I would say even in ‘apparently’ healthy 2- treat aggressively 3- worth reading the full guideline! It is worth it! Great job from @escardio & the #EAPC @EAPCPresident …THE END

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More from @vass_vassiliou

28 Aug
Educational Thread (longish) on AORTIC STENOSIS on the new #ESCGuidelines #ESCCongress published at @escardio #EHJ academic.oup.com/eurheartj/adva… Another thread to follow on AR. So truly excited about these guidelines and here’s why @mirvatalasnag @mmamas1973 @DrMarthaGulati @Hragy …/2
First things first #ESCCongress - a patient centered approach recommended. 👏 but I thought we had long moved to a patient centred approach but nonetheless good to highlight #epeeps #cardio #echofirst #whycmr …/3
#ESCCongress valve guidelines - and the role of the Heart Team re- emphasized. This is crucial. But also defining who should be present to constitute a ‘Heart Team’ @milena_mate @MelissaLyleMD @drzgezdentok1 @AScatteia @RositaZakeri @pacman8it @dr_benoy_n_shah @tchaaban1 …/4
Read 11 tweets
27 Aug
#ESCCongress #ESCGuidelines This is a Long thread on Heart Failure Guidelines published @escardio #EHJ academic.oup.com/eurheartj/adva… LONG BUT EDUCATIONAL! Focus on CHRONIC HF #epeeps #CardioEd @AlexFrogoudaki @mmamas1973 @DrMarthaGulati @purviparwani @Filippatos @EkateriniL @Hragy …/2
#ESCCongress Firstly, no longer Mid Range, replace by MILDLY REDUCED LV EF. Makes a lot of sense - in fact for some time I thought the previous guidelines referred to ‘mildly reduced’ until @merinopoulos corrected me… otherwise no real change in the nomeculture …/3
#ESCCongress nice algorithm - assess risk factors… do BNPs (watch the caveats- AF ⬆️ , obesity ⬇️ value so bear this in mind. The #echofirst and classification into Reduced, mildly Reduced and Preserved. @SineadHughes19 @wordfinga @rahatheart1 @HEARTinMagnet @bp_halliday …/4
Read 12 tweets
1 Sep 20
#ESCCongress has ended. A unique conference! An unforgettable conference! These are my highlights!

Firstly, an amazing DIGITAL experience... Brining everyone together, breaking all barriers, diminishing borders.

@Barbara_Casadei @Steph_Achenbach @mmamas1973 @DrMarthaGulati
In an earlier (still ongoing) Poll from today... 77% wished to have a hybrid Digital and In Person conference... That would certainly have lots of attractions especially for those who wouldn't other be able to afford it #ESCCongress



@MarziaRigolli
...& now the science! In random order (depending on which I could find in my twitter thread most easily!)

No 1. #Covid and the HEART

HTN, Lipids, Diabetes, CAD, heart failure, ALL associated with worse prognosis (critical events & deaths)

Women have it less severely

#EPeeps
Read 16 tweets
30 Aug 20
An EXCITING NEW guideline from @escardio at #ESCCongress on Atrial Fibrillation. It’s a long read of 126 but enjoyable! Here are my top tips from this guideline…#epeeps Link: bit.ly/2YRdX8S @mmamas1973 @pash22 @Hragy @DrMarthaGulati @ErinMichos @AnastasiaSMihai /THEAD
FOCUS is on CONFIRMING AF (12 lead >30s) and CHARACTERISING it…
The 4S….

Stroke Risk…
Symptom Severity…
Severity Burden of AF
Substrate of AF

@KTamirisaMD @StavrosStavrak1 @StavrosDrakos @JonathanBehar @bogdienache @mencardio
#ESCCongress /3
AF ESC GUIDELINE Tweetorial

Stroke Risk – Simple – CHA2DS2-VASc Score
& HAS-BLED, to stratify bleeding
Symptom severity- Use the EHRA symptom scale
Burden- paroxysmal, persistent, permanent and if paroxysmal how frequently
Substrate of AF- comorbidities #ESCCongress /4
Read 15 tweets

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