Most recents (6)

Consejo de Cardiología Clínica y Terapéutica SAC

@clinicasac

📌Parte III. INOCA. Nuevas perspectivas del tto
🔹Agresivo tto de factores de riesgo tradicionales.
🚭Dejar de fumar
🔸Rehabilitación cardiovascular❤️, actividad física aeróbica🏃(140-180m/sem)
#Cardiotwitter #MedTwitter #MINOCA #INOCA

💊Fármacos
✅Fasudil: iRho-Kinase en células musculares lisas y contrala el vasoespasmo (efecto aditivo a nitratos).
✅Denopamine: agonista adrenérgico β1 selectivo x VO:⬆️flujo coronario
✅Medicinas Kempo (hierbas🇯🇵) -reportes-
✅Simpatectomía
⛔️AAS

jstage.jst.go.jp/article/circj/…

Read 3 tweets

Aaysha Cader 🫀

@aayshacader

#ESCCongress When coronary angiography is not enough: @RaberLorenz turns on the light with #OCT –
🔦ACS-⬆️resolution of OCT -gold standard to ID thrombus, ID unclear culprit, ACS aetiology, rule-in & rule-out
🔦#MINOCA
🔦Stent thombosis
🔦Optimize PCI
@mirvatalasnag @Hragy

Phenomenal talk oy @MaeharaAkiko : SCenarios where #IVUSis gold-standard

#ESCCongress @sbrugaletta @ziadalinyc @SanjogKalra @NishithChandra @APSIC6 @w_jyg @DrAnkushG @care4urheart2 @ShrillaB @chadialraies @cardioPCImom @ANazmiCalik @GeminaDB @KVM83 @ShaziaTHussain1

#ESCCongress
@JEscaned on physiologic assessment in guiding PCI

@adityadoc1 @DrAllenJ @SukhNijjer @Pooh_Velagapudi @adityadoc1 @poojaotherwise @KardiologieHH @w_jyg @NishithChandra @sabeedak1 @SanChris999 @skilicmd @APSIC6 @chadialraies @dranulala @Ortega_Paz @sbrugaletta

Read 6 tweets

Erin D. Michos, M.D.

@ErinMichos

Patients with #MINOCA were more likely to be women and have fewer traditional CV risk factors. Heterogenous pathophysiology – etiology is of great importance to guide treatment. Inge van den Hoogen #SCCT2021

#MINOCA diagnosis. Overt non-cardiac disorders need to be excluded. Also need to rule out missed obstruction and non-ischemic causes of myocardial injury. Then after MINOCA diagnosed, need to workup etiology. Inge van den Hoogen #SCCT2021

Plaque disruption and plaque erosion cause some cases of #MINOCA – diagnose with OCT or IVUS, but not CCTA. Inge van den Hoogen #SCCT2021

Read 5 tweets

Parham Eshtehardi MD

@CoronaryDoc

#Tweetorial on #ASNC2020 session

⚡Selecting Between Different Functional Tests⚡

☢ vs 🧲 vs ⏺ ❓

🔘 Strengths/Limits of Lesion Specific vs Myocardial Ischemia
🔘 Comparing Dx Accuracy of Tests
🔘 Ischemia Testing in #INOCA
🔘 How to Select Best Noninvasive Test

1/9

https://twitter.com/coronarydoc/status/1309649449162092544

#ASNC2020 #cvNuc
2/9
Dr Di Carli

☢ Issues with proposed #FFR threshold 0.8
☢ Exercise MPI correlates well with FFR but not at 0.8
☢ Benefit of FFR-guided revasc dominantly occurs w/ thresholds <0.8
☢ Quantification of lesion-specific #ischemia insufficient for patient mgmt

#ASNC2020 #cvNuc
3/9
Dr Di Carli

Lesion-specific #ischemia measurements (FFR/#FFRCT)

☢ Strength
Validated against ETT/MPI
Strong outcome data
Guidelines supported

☢ Limit
Controversial threshold (0.80 vs MPI-validated 0.66)
⬆ microvasc resist causes FFR pseudonormalization

Read 11 tweets

Dr. Purvi Parwani

@purviparwani

Check out the #MINOCA section in updated NSTE-ACS guidelines at #ESCcongress
bit.ly/3bcrixp

Here is a tweetorial on #MINOCA
🧲Class I Recommendations🧲

-> Use of Diagnostic algorithm
-> Use of #whyCMR
-> Use of working dx & Rx according to the underlying Dx

MINOCA has MI in it-> DOES the definition allows for the inclusion of non-ischemic causes of troponin elevation?

Given this limitation of the troponin bioassay, the “Fourth 4th Universal of MI" defined Injury from infarction

INJURY IS NECROSIS WITHOUT ISCHEMIA!
#ESCCongress

The hallmark of myocardial injury ⬆️ troponin, However, these entities differ conceptually
▶️ myocardial injury = nonischemic mechanisms of myocyte injury (eg, myocarditis),
▶️MI = ischemic mechanisms (eg,
plaque disruption or supply-demand mismatch).

#ESCCongress

Read 10 tweets