#JACCCardioOnc#Tweetorial: Along the spectrum of cancer Tx, #YeSCCT has a lot to offer regarding identifying subclinical #ASCVD, excluding obstructive #cvCAD in cardiotoxicity when appropriate. #CardioOnc, as a field, can gain from incorporating CCT in practice.
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#YeSCCT may identify subclinical #ASCVD in cancer patients & survivors. Reviewing previous non-gated thoracic CT scans for CAC may help identify subclinical #cvCAD and start prompt preventive Tx.
Several clinical scenarios in the context of cardiotoxicity may require ruling out obstructive #cvCAD. Cancer pts tend to have ⬆️ risk of complications from invasive procedures➡️ thrombocytopenia & hypercoagulable states. #YeSCCT may derive significant benefit. #JACCCardioOnc
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Although #whyCMR has an established role in the assessment of cardiac masses, when not feasible #YeSCCT may be performed. This figure shows a pt case w/ #melanoma having episodes of VT. CCT was performed to assess for coronary anomaly or obstructive #cvCAD. #JACCCardioOnc
Shown is an example of flail leaflet of the #mitralvalve at the P2 segment.
Surgical #mitralvalve repair is the gold standard; due to prohibitive risk, the patient underwent successful percutaneous repair #TMVR, guided by 3D #EchoFirst.
New #Coronavirus Research For #EPeeps (1/10):
While the use of hydroxychloroquine and azithromycin in patients with #COVID19 remains controversial, many patients receive this therapy. The primary adverse effect is QT prolongation and torsades de pointes/polymorphic VT. #JACCCEP
(2/10): A topical #COVID19 research letter published in #JACCCEP from investigators at @HeartsInRhythm in Vancouver explore the use of a handheld #ECG device versus a standard 12-lead ECG for QT monitoring. bit.ly/34joL10
(3/10) The handheld #ECG would be ideal because it could minimize healthcare worker exposure. The study cohort included 22 patients referred to their center for a possible inherited arrhythmia syndrome. bit.ly/34joL10#JACCCEP
(1/10) #JACC#Tweetorial: T2MI is #cvMI due to alterations in either myocardial oxygen supply and/or demand in the absence of acute atherothrombosis. It can occur in pts w/ normal coronaries and in obstructive/non-obstructive stable #cvCAD. fal.cn/AGvR
(2/10) #JACC#Tweetorial: Frequency of T2MI varies widely due to differences in populations, comorbidities, adjudication processes, & cTN assays, w/ a major challenge being the absence of uniform definitions that can be useful w/ high reproducibility. fal.cn/AGvR
(3/10) #JACC#Tweetorial: How T2MI manifests depends on the pathobiology & clinical context, w/ T2MIs less likely to have chest pain, imaging/#ECG abnormalities & ⬇ cardiac troponin concentrations compared to T1MI. Many T2MIs are driven by other illness. fal.cn/AGvR