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CORE IM Profile picture
@COREIMpodcast
Oct 19, 2022 • 6 tweets • 6 min read • Read on X
1/🚨New Episode🚨
Aspirin for Primary Prevention: #MindtheGap Segment

What do current ACC and USPSTF guidelines say about daily low-dose #aspirin for the primary prevention of #cardiovascular disease?

🎧: apple.co/3VPRCV4
Sponsor: bit.ly/TCChoZ Image
2/Throwback to medical school pathophysiology!

Remember how the #atherosclerotic process takes place in blood vessels? 🫀

Now, where does #aspirin exert its effect during this cascade? 🤔 Image
3/What do the most recent #RCTs inform us about the use of aspirin for primary prevention ⁉️

ASCEND, ARRIVE, ASPREE!

#CoreIMJournalClub 📕 Image
4/How should we use the #ASCVD 10-year risk calculator? 🧮

Are there any other important risk factors that we are not accounting for? 😮

Ultimately, how can we best tailor the decision of #aspirin for primary prevention for each and every patient? 👩‍🚒👩‍🎨👩‍⚖️ Image
5/Incredibly grateful for the #dreamteam behind this relaunch of #MindtheGap!

Host @gregorykatz @eucaryotic
Producers @ShreyaTrivediMD @YichiZzzzz
Peer Review: Kinjan Parikh
Graphics: @elizzieh08

We hope you enjoyed our discussion of #aspirin, stay tuned for more learning!
6/ Make sure to check out our Shownotes & link for ACP CME credit!

🗒️: bit.ly/3gk4O40
CME: bit.ly/CIMCME

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More from @COREIMpodcast

CORE IM Profile picture
Jun 25
1/ 🚨 NEW #BeyondJournalClub w/ @NEJMGroup: REDUCE-AMI

What is the long term benefit of beta blockers in patients with preserved EF following an MI? Image
2/ Guidelines:

2025 ACC/AHA: early initiation of oral beta-blocker therapy post-MI to ⬇️ the risk of arrhythmias & reinfarction for the management of patients (IA)

Long-term benefit from continued use after hospital discharge remains unclear in patients with preserved EF ‼️
3/

2023 ESC Guideline: prescribing beta-blockers after uncomplicated ACS in patients with LVEF >40% is less well established
Read 8 tweets
CORE IM Profile picture
May 21
1/ 🚨 NEW video: Wide Complex Tachycardia on EKG 💗

Differential for regular wide complex tachycardias:
💓 Ventricular tachycardias
💓 Supraventricular tachycardias with aberrancy.

🎥: youtube.com/watch?v=qYVLZ0…
🖥️: coreimpodcast.com/2025/05/21/how… Image
2/ AV dissociation is pathognomonic for ventricular tachycardia, but other clues include:
💓Fusion beats
💓Capture beats
💓Precordial concordance
💗Extreme axis deviation
💗A very wide QRS complex
3/ ‼️ Remember to look at prior EKG to look for clues for aberrancy, such as a bundle branch block

In SVT with aberrancy, the QRS morphology will likely look similar to their baseline
Read 5 tweets
CORE IM Profile picture
Sep 11, 2024
1/ 🚨 NEW #AtTheBedside: Moral Distress Part 1: Definitions, Causes & Consequences

Time to really name, talk about, and hopefully unpack some of the hidden weight we carry in the practice of medicine ⤵️

🖥️:
Sponsor: @Pan_Financial coreimpodcast.com/2024/09/11/mor…
Image
2/ Moral distress:

When clinicians are:
☀️ Stopped from taking what they believe to be ethically appropriate actions
☀️ Forced to take actions that are ethically inappropriate based on their professional obligations

Results in a sense of complicity & wrongdoing
3/ Moral distress occurs at:

☀️Patient or family level
☀️Unit or team level
☀️System level
Read 8 tweets
CORE IM Profile picture
Jun 5, 2024
1/ 🚨 NEW #5Pearls on HFpEF!

HFpEF is:
- Clinical syndrome of heart failure w/ EF 50%+
- ☂️ term | Heterogeneous disease 

HFpEF is NOT:
- Classic high BP, causing stiff ventricles

🖥️ :
ACP CME:
Sponsor:  coreimpodcast.com/2024/06/05/hfp…
bit.ly/CIMCME
coreimpodcast.com/Freed
Image
2/ Clinically, HFpEF is:

🫀Dyspnea on exertion
🫀PND
🫀Orthopnea
🫀Fatigue
🫀Exercise intolerance
🫀JVD
🫀Pulmonary rales
🫀LE edema
3/ On echo, HFpEF is NOT:
🫀Just diastolic dysfunction

**Diastolic dysfunction CAN be seen in HFpEF 

But, it was not observed on resting echocardiograms of ⅓ of HFpEF patients in the Paragon-HF trial ‼️
Read 7 tweets
CORE IM Profile picture
May 13, 2024
1/ 🚨 NEW #5Pearls episode on Cardiorenal Considerations 🫀🫘

So many diuretic options, so which to choose and why?

Use the toolkit ⤵️ for all your diuresis needs!

🖥️:
CME: 
Sponsor:  bit.ly/3wx8tnB
bit.ly/CIMCME
coreimpodcast.com/Freed
Image
2/ Not all AKI in heart failure is cardiorenal syndrome!

In pure cardiorenal, expect a “bland” UA with no:
🥩 Protein
🩸 Blood
🦠 Granular or other cell casts!

**Remember, keep a broad differential for AKI
3/ You suspect volume overload in a patient…what dose of diuretic do you start with?

2.5x their home dose of diuretic (in IV form)!

IV options include:
💉 Furosemide
💉 Bumetanide

**Bumetanide drip at higher doses is associated with myalgias
Read 9 tweets
CORE IM Profile picture
Jun 8, 2023
1/ Time for #12LeadThursday!

What’s the axis and do you notice anything about the precordial leads? Image
2/ What do you see on ECG to identify extreme axis deviation?

Negative deflection in lead I + negative deflection in aVF = extreme axis deviation Image
3/ What about the precordial leads?

Do you notice dominant R waves, S waves, or T-wave inversions? Image
Read 5 tweets

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