Let’s talk about the Top 10 cardiology papers of 2024 that shook up the field!
Hard science, no BS, 🚀 and yes — some practices WILL change.
🫀 Let’s dive in: a tweetorial thread!
#CardioTwitter #MedEd #Cardiology 1/ REDUCE-AMI (NEJM)
🏥 Post-MI patients with preserved EF (≥50%)
🛑 Continuing beta-blockers? No benefit!
➡️ 7.9% vs 8.3% (death or MI)
✅ Safe to stop beta-blockers after uncomplicated MI.
#MI #Cardiology

1/
What is the 60/60 sign on echocardiogram?
It’s a specific finding suggesting acute pulmonary embolism (PE).
Key concept: sudden RV pressure overload.
Let’s break it down:
#Cardiology #Echo 2/
The 60/60 sign =
✅ Pulmonary valve acceleration time ≤ 60 ms
✅ Tricuspid regurgitation pressure gradient ≤ 60 mmHg
Both happening together points toward acute PE.
#POCUS #CriticalCare

1/ Nodal rhythm in athletes refers to heart rhythms originating from the AV node rather than the SA node. Common in endurance athletes, this occurs due to adaptations like increased vagal tone and structural remodeling. 🫀🏃‍♂️[1,2]

https://twitter.com/basalus/status/1341274217573171201

2/ Endurance athletes often show sinus bradycardia and AV conduction changes such as junctional escape rhythms and first-degree AV block. These are typically benign, physiological adaptations from prolonged training. 🏅⚡[1,2]

1/ Beta-blockers after MI with preserved EF (LVEF ≥50%) — do they help? A thread.
#CardioTwitter #MedTwitter #FOAMed 2/ Background
Beta-blockers have long been standard post-MI therapy.
But most data comes from the pre-reperfusion era & focused on patients with reduced EF.
What about preserved EF?

1/10
Adenosine: More than just for SVT! 🫀
Let’s deep-dive into the cardiovascular uses of adenosine — from tachycardia treatment to diagnostics and coronary interventions. A scientific thread with references 👇 #CardioTwitter #EP 2/10
1️⃣ Treatment of Paroxysmal Supraventricular Tachycardia (PSVT)
Adenosine is the first-line drug for terminating PSVT by transient AV nodal block.

Usual dose: 6 mg IV bolus, followed by 12 mg if needed.
📖 Faulds et al. Drugs. 1991;41(4):596-624.

Do you know when it’s safe to rule out pulmonary embolism (PE) without imaging? Let’s talk about D-dimer tests and the YEARS algorithm!

1️⃣ What is D-dimer?
It’s a blood test used to rule out clots (PE or DVT). A normal (low) D-dimer often means no clot. 2️⃣ Classic D-dimer Criteria (age-adjusted):
•≤50 years old: cutoff = 500 ng/mL
•50 years old: cutoff = Age × 10 ng/mL (e.g., age 70 = 700 ng/mL)

If below cutoff ➡️ PE unlikely ✅
If above cutoff ➡️ Consider imaging (CTPA, ultrasound) 🖥️

🧵 Amiodarone & Thyroid Dysfunction: What You Need to Know
Amiodarone is a life-saving antiarrhythmic, but it wreaks havoc on the thyroid. It can cause hypothyroidism (AIH) or thyrotoxicosis (AIT)—the latter classified into Type 1 and Type 2. Let’s break it down. 🔽 1/ Amiodarone-Induced Hypothyroidism (AIH) 📉
•Occurs in ~14–18% of patients
•More common in preexisting Hashimoto’s thyroiditis
•Caused by a failure to escape the Wolff-Chaikoff effect (iodine-induced suppression of thyroid function)

🔹 Treatment: Levothyroxine (L-T4) replacement while continuing amiodarone. If feasible, stopping amiodarone + a short potassium perchlorate course may accelerate recovery. [3-5]

1/ 🚭 Quitting smoking is one of the most powerful interventions for cardiovascular health. Whether young, old, or already diagnosed with heart disease, stopping smoking dramatically reduces heart attacks, strokes, heart failure, and death. Let’s dive into the evidence. 🧵 2/ Rapid Risk Reduction
Within months of quitting, blood pressure, vascular function, and clotting markers improve.
Within 1 year, coronary heart disease (CHD) risk is ~50% lower vs. continued smoking.
Within 5 years, CVD event risk drops ~39% in heavy smokers. (Duncan et al. JAMA 2019)