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

Currently 5 meds FDA-approved for long term management of obesity ⤵️ 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

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

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 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?

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?

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

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

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 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

1/ #ASPC2021 Day 2 continues!

@DrMarthaGulati presents on Ischemic Heart Disease Without Obstructive Coronary Arteries (INOCA)

Follow this🧵on INOCA:
♦️Outcomes
♦️Mechanisms of ischemia and diagnosis
♦️Guidelines

@ASPCardio @CardioNerds 2/ Definition of INOCA: symptoms of ischemia in the absence of obstructive CAD or flow-limited disease

Check out this great infographic by @najahakhan, @CardioNerds Academy Fellow, on INOCA

#ASPC2021

1/ Great #ASPC2021 session by @dramitkhera on ACS in Patients with COVID-19

Follow this🧵on pts w/ COVID
🔷Prevention of ACS events
🔷Identification of ACS
🔷Management of ACS

@ASPCardio @CardioNerds 2/ 8 fold📈in AMI w/ COVID even in pts with no ASCVD/FH

Absolute risk for AMI📈in pts with ASCVD. Even higher for FH +ASCVD bit.ly/3eJ2csW

Based on NHANES, 75% of US pop has risk factors (CKD, obesity, smoking, T2DM) for severe COVID
bit.ly/3xYxpQn

#ASPC2021

Essentials of Stable Ischemic Heart Disease

♦️Plaque Characteristics & Progression
♦️Choosing From Imaging Toolbox
♦️Perils of Polypharmacy
♦️Who & When To Revascularize
♦️Overview of Guidelines

🧵on this great @ACCinTouch session from today #ACC21 #ACCMedStudent 1/Plaque Progression #ACC21

Non-atherosclerotic intimal lesions➡️progressive atheroscl. lesions (fibroatheroma)➡️lesions w/ acute thrombi

Plaque rupture = lesion growth
Lumen area maintained till 40% narrowing
Narrowing beyond 40% occurs w/ plaque rupture+intraplaque hemorrhage

💥The Ultimate Guide to Lipids💥
🟢Lipid biology
🟢Physical exam clues for lipid disorders
🟢Lipid tests & interpretation
🟢CV risk assessment
🟢Fundamentals of lipid management
🟢Review of guidelines

🧵on this great @ACCinTouch session from today #ACC21 #ACCMedStudent #ACCPrev 1/ Lipid Biology #ACC21 #ACCMedStudent
Lipoprotein-central core of cholesterol ester/TG surrounded by apolipoprotein

Dietary fat➡️chylomicrons➡️TG metabolized in muscle & adipose by lipoprotein lipase➡️chylomicron remnants liver uptake➡️VLDL➡️FFA & IDL ➡️LDL➡️LDL receptor uptake

#ACCMedStudent, it's Day 2 of #ACC21! Benefits of virtual meeting⏪old sessions available onDemand.

Great @ACCinTouch session yesterday on Advanced Heart Failure Therapies, ending w/ debate on Transplant vs. LVAD! #ACCHFT

🧵on some take-home points from the 6 presentations 1/ Moving Beyond NYHA Class #ACC21
Vague w/ wide inter & intra observer variability
Utility breaks down in advanced HF

🌟Reclassifying advanced HF: INTERMACS Profiles (lower score = sicker) helps prognosis/triage

🔑Assign profile after identifying features of advanced HF

🌟Future of Dyslipidemia Management🌟
🧵on this great session from #ACC21 #ACCMedStudent

1/ Team-based approach to improve CV outcomes
🔸pharmacist interventions reduce LDL-C
🔸sessions with dietitian improves lipids &📉costs
🔸Multi-D lipid clinic⬆️guideline-directed treatment 2/ Familial Hypercholesterolemia (FH)
♦️ Genetically inherited, autosomal dominant
♦️ LDL-C >190 mg/dL
♦️ Family hx of premature coronary disease

Presence of corneal arcus (ring of cholesterol precipitate) or tendon xanthoma (>8mm Achilles tendon) before age 45 highly suggestive

1/ Ready for a #Tweetorial on coronary artery calcium (CAC) score?

Keep reading to:
☢️Understand the pathophysiology of coronary artery calcium
☢ Identify the utility of the CAC score
☢️Recognize the limitations of CAC scoring 2/ How do you feel about the following statement:

I understand the utility of CAC score and can recognize its strengths and limitations.