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Sriram Sunil Kumar Profile picture
Sriram Sunil Kumar
@sriramsunilk
he/him. PGY2 @EinsteinMed / @Jacobihosp. Interested in #FOAM, #Cardiology, #CVImaging, #MedEd.
Jun 26, 2022 • 18 tweets • 12 min read
A patient with heart failure that you have been following for the last five years no longer has a low EF. What changed ? What medications do you add/stop ?

A #MedTwitter #Tweetorial on HFimpEF (HF with improved EF).

First let’s talk the nuances of calculating EF. 🧮

(1/14) EF = (EDV-ESV)/EDV or the percentage of EDV ejected by the LV. This volumetric analysis is performed by echocardiography. However in some cardiac diseases, the EF calculated can be falsely ⬆️/⬇️.
This can happen in which of the following conditions ?
2/n
May 17, 2022 • 17 tweets • 9 min read
ESR-CRP discordance,a #MedTwitter #tweetorial

First off, let’s talk about ESR physiology.
ESR is the rate at which RBCs settle in plasma of an anti coagulated blood sample.
(-) charged RBCs repel each other thus ⬇️ ESR.

(1/12) In the presence of (+) charged large asymmetric proteins, ⬆️ neutralization and RBC aggregation causes ⬆️ ESR. Which of the following physiological conditions would have an increased ESR ?
(2/12)