Discover and read the best of Twitter Threads about #cardiology

@hmkyale

We have been doing a series of studies, led by @jeb1426, on sex differences in symptom complexity & phenotypes in acute myocardial infarction (AMI) and their impact on diagnosis & treatment. Some imp findings. #Cardiology #MedTwitter @YaleMed @YaleCardiology @yuan_lu1

@jeb1426 @YaleMed @YaleCardiology @yuan_lu1 In one study, we found 'Women had more variation in unique symptom phenotypes than men' greater symptom complexity & longer door-to-balloon times. Non-chest pain symptoms are more frequent in women, potentially delaying STEMI recognition. @CircOutcomes ahajournals.org/doi/full/10.11…

@jeb1426 @YaleMed @YaleCardiology @yuan_lu1 @CircOutcomes In another study, that focused on older patients... ' Women reported more symptoms and had significantly more symptom phenotypes than men.' @amjmed sciencedirect.com/science/articl… @YaleCardiology @YaleMed

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cardio-met

@cardiomet_CE

1) Welcome to Part 2 of a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. DOn't miss Part 1, still available for 🆓CE/#CME, at cardiometabolic-ce.com/hcm5a/.
Now you can learn more, and EARN MORE credit, by following this 🧵!

2) Our expert author is again Sergio Kaiser MD PhD FACC FESC 🇧🇷🇮🇱 @pabeda1, cardiologist 🫀, Professor 🎓 of #InternalMedicine, Rio de Janeiro State University. He brings the general cardiologist's perspective to our #HCM discussions. Read and learn!
#FOAMed #CardioTwitter

3) This program is supported by an unrestricted educational grant from Bristol Myers Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.

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SebCbien75

@sebforeverbose

Avec des vaccins à l'efficacité de plus en plus limitée (50% au mieux face à XBB 1.5 contre plus de 90% sur les premiers variants)
francais.medscape.com/voirarticle/36…

> face à l'échappement immunitaire, quelle logique de l'obligation vaccinale si d'ici l'été la protection tombe à 25/30% ?

https://twitter.com/franceinfo/status/1641842881211006998

On peut aussi noter le variant BQ.1.1 Cerberus...

À chaque mutation de + en + sélectionnée par la pression immunitaire et vaccinale, le virus mutant résistant est sélectionné et diminue l'efficacité vaccinale car la vitesse d'évolution et complexité du virus va + vite

De + chaque réinfection ⬆️ les risques de décès, d'hospitalisation, mais aussi de + en + kde séquelles, notamment pulmonaires, troubles cardiovasculaires, hématologiques, diabétiques, gastro-intestinaux, rénaux, de santé mentale, musculo-squelettiques et neurologiques.

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cardio-met

@cardiomet_CE

1) Welcome to a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. Previous programs, still available for 🆓CE/#CME, are at cardiometabolic-ce.com/category/hcm/.
Now you can earn another 0.75hr credit by following this 🧵!

2) Our expert author is JA Linderbaum MS, ARNP, FACC, FPCNA @jlinderbaum, Associate Professor of Medicine, @MayoClinic, CV #NursePractitioner, Assoc. Medical Editor #AskMayoExpert.
#FOAMed #MedEd @MedTweetorials #CardioTwitter @transformingHC @TNPJ_Journal #cardiology

3) This program is supported by an unrestricted educational grant from Bristol Myers-Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.

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Jay Mohan, D.O., FACC, FSCAI, FASE, RPVI

@DrJayMohan

1/ Had a great time writing this @EPLabDigest article with @DrCJBradley

tinyurl.com/mryk3cwe

2️⃣ different perspectives (IC And EP) using different devices (watchman/ amulet) for LAAC in the community center.

Let’s take a dive into two different LAAC programs #Tweetorial

2/ #LAAC has come a long way over the past few years and now we have two main players in the space

🔸 @bostonsci #watchman
🔸 @AbbottNews #Amulet

Both are very effective and each has pros/cons

My center focuses on Watchman FLX while @DrCJBradley center focuses on Amulet… twitter.com/i/web/status/1…

3/ Historically #EPeeps has taken the driver seat in this space (rightfully so) due to experience with the LA/transeptal. HOWEVER the new gen #IC/structuralist have become a vital part of the team.

#LAAC programs require:
📌Implanter
🔎Imager
🧑🏼‍⚕️Anesthesiologist/Cath lab team… twitter.com/i/web/status/1…

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Antonio Guerrero

@guerreroespejo

A 58-YO♂️, DM, fever & L lower quadrant abdominal pain 2 months prior: acute R-sided back pain, & 3/6 diastolic murmur at R upper sternal border.

CT: a R renal infarction & splenic embolism

MR: multiple infarctions
1/7

doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia

Transesophageal echocardiography: a vegetation and severe aortic regurgitation.

Blood 🧫: Cardiobacterium hominis

CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7

#IDtwitter #microbiology

The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications.
3/7

#infecciosas #MedTwitter #Doctor

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ʏᴀsʜ ʙʜᴀᴠsᴀʀ

@DoctorBhavsar

AV dissociation, capture beats and fusion beats are all hallmarks of ventricular tachycardia

A simple understanding 👇

#CardioTwitter #Cardiology #Medtwitter

What’s a “capture beat” ?

During ventricular tachycardia, sometimes the SA nodal firing takes control of independent ventricular depolarization for brief moment, as this happens, “CAPTURE BEATS” appear. They are nothing but a brief moment of normal looking P-QRS pattern

Whats a “fusion beat” ?

During ventricular tachycardia, sometimes the SA nodal impulse and the independent ventricular impulse combine together to create a mix looking P-QRS pattern called fusion beats.

#ECG @EPeeps_Bot #ecglearning #CardiacArrest

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Tan-Lucien Mohammed, MD, FACR

@TLHM_MD

Kicking off #BlackHistoryMonth w/ an appreciation thread of physicians:

1/ Charles R. Drew, MD

- American surgeon & researcher
- pioneer in the field of blood transfusions
- developed techniques for blood storage
- first African-American surgeon to examine for @AmCollSurgeons

2/ Vivien Thomas

- cardiac surgery pioneer & lab supervisor who developed procedure used to treat cyanotic heart disease
- supervised surgical labs at Johns Hopkins for 35 yrs
- awarded honorary doctorate & named an instructor of surgery @JohnsHopkins

#BlackHistoryMonth

3/ LaSalle D. LeFall, Jr. MD

- Surgeon, oncologist & medical educator
- first black physician to pursue training in surgical oncology @sloan_kettering
- first black president of @AmericanCancer (1978) & @AmCollSurgeons (1995)

#BlackHistoryMonth #equanimityunderduress

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Top Biomedical Science

@imedverse

Beautiful anatomy graphics from @medics_AbuSaif

#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #anatomy

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Kashif Pirzada, MD

@KashPrime

Seeing a lots of post-Covid cases like this: 30s-40s, pleuritic chest pain, mild shortness of breath, negative ecg and troponin, low positive or positive D-dimer. CT scans almost always (-) for pulmonary embolism. What to do? #medtwitter #Cardiology
frontiersin.org/articles/10.33…

This study shows Dimer can be elevated for 10 weeks after infection. Reminds me of what @BinitaKane saw last year, but these patients are not hypoxemic at rest or on a walk-test. I've been sending for cardiac consult/ echo/stress test, but is a V/Q scan or resp consult needed?

Forgot to attach the thread where this is discussed last year:

https://twitter.com/BinitaKane/status/1526623437313146882?s=20

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SONECOM

@SONECOM_AC

Afectación cardiaca en enfermedad de Fabry en 🧔🏻‍♂️de 52 años. EKG con PR corto + HVI. @VazyurVasquez @MDBeni @CuitlhuacArroy1 @ImagenCardiaca @LiliPosadaM @ASE360 @smexcardiologia @Cardiotweets83 @SISIACOficial @Enrique_Berrios #echofirst #Cardiology #Cardiotwitter

La enfermedad de Fabry es un desorden lisosomal de transmisión ligada al cromosoma X debido al déficit de la enzima alfa galactosidasa A, con acumulación multisistémica de globotriaosilceramida (GB3).

La afectación cardiovascular suele manifestarse en forma de HVI, fibrosis miocárdica, ICC y arritmias, que limitan la calidad de vida y constituyen las causas más frecuentes de muerte. En la imagen se observa los estadios de la afección cardiaca

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sandeep kamat

@kamsandy123

Patient with Inferior wall Myocardial infarction..guess the sign…? #MedTwitter #CardioTwitter #Cardiology #heartattack Clue:-The “crease” is a marker for “grease”

yess..indeed its FRANK’s sign..

pre and post successful thrombolysis ECG respectively of the same patient:-

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Antonio Guerrero

@guerreroespejo

82 años♂️, DM, dislipemia, y enfermedad arterial periférica: dolor torácico anginoso con semiología de insuficiencia cardiaca.
ECG:⬆️segmento ST en V2-V3 y DI-AVL.
PCR SARS-CoV-2:➕
Coronariografía: arterias coronarias sin lesiones
1/6

#cardiologia #urgencias #MedicinaInterna

Ventriculografía: fracción de eyección del ventrículo izquierdo muy reducida a expensas de acinesia apical extensa.

SÍNDROME DE TAKO-TSUBO ASOCIADO A LA INFECCIÓN POR #SARSCoV2
2/6

DOI: 10.1016/j.recesp.2020.06.022
#IDtwitter #Cardiology

El ecocardiograma confirmó los hallazgos de la ventriculografía

Rx de tórax: signos de insuficiencia cardiaca leve, sin evidencia de neumonía.

Buena evolución, con mejoría del cuadro de insuficiencia cardiaca.
3/6

#MedTwitter #Doctor

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Psychosocial #Stress increases the risk of #stroke

1. A longitudinal study (2007-2021) was conducted on 27,000 people from 32 countries belonging to various continents to assess the relation of self-reported stress and risk of various types of stroke
#MedTwitter #neurotwitter

2. Increased stress at home and at work (within the previous 12 months) increased the risk of stroke by 95% (1.95 times) and 170% (2.7 times) respectively, as compared to no self-reported stress. Recent stressful events increased the risk of stroke by 1.3 times.

3. This association was consistent for all stress domains, including work stress, home stress, and financial stress. The association was independent of socioeconomic status, occupation, and educational level & remained significant after adjustment for cardiovascular risk factors.

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Jaime A. Gómez Rosero

@medinternajg

Dato importante 🚨
Si tienes un paciente hospitalizado con falla cardíaca aguda y está cerca del egreso hospitalario, entonces INÍCIALE a la mitad de la dosis los medicamentos esenciales en falla cardíaca crónica (IECA/ARA2/ARNI + BB + ARM) y cítalo a mas tardar en 2 semanas🧵👇

Si bien las guías recomiendan un seguimiento ambulatorio temprano (2 a 4 semanas) luego del egreso por falla cardíaca aguda, el nivel de evidencia de esta recomendación es bajo y no aclaran cómo se debe iniciar y titular los medicamentos de falla cardíaca crónica.
Sin embargo…👇

El estudio STRONG-HF mostró que los pacientes asignados al grupo de cuidado de alta intensidad (iniciando la mitad de las dosis antes del egreso y titulando a la totalidad de la dosis a las 2 semanas) presentaban menos el desenlace primario.

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Cliff Reid

@cliffreid

Three #cardiology cases with diagnostic ECGs in our resus room today and some learning points for emergency clinicians

#ecg #ekg

1. Sudden onset palpitations

ECG shows regular narrow complex tachycardia with rate around 140

We suspected this was atrial flutter
Rather than subject a patient to the horror of iv adenosine (which only reveals flutter - it can’t convert it), we moved the ECG limb leads around to get a ‘Lewis lead’ which better shows atrial activity

(See litfl.com/lewis-lead-s5-… )

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Beverly G. Tchang, MD

@BevTchangMD

Empagliflozin is now my go-to SGLT2i for pts with #diabetes and #CKD or #CHF, over cana or dapa or ertu.

Why?

A: EMPA-KIDNEY: nejm.org/doi/full/10.10…
and EMPEROR-Reduced and EMPEROR-Preserved
1/

EMPA-KIDNEY is unique because it enrolled GFR 20-45 *without* proteinuria whereas others (DAPA CKD, CANVAS) enrolled pts with CKD+proteinuria, though DAPA-CKD conducted a subgroup analysis for UACR < and > 1000

The primary outcome was a composite of progression of #kidney disease (defined as #ESRD, a sustained decrease in eGFR to <10, a sustained decrease in eGFR of ≥40% from baseline, or death
from #renal causes) or death from #cardiovascular causes

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Jay Mohan, D.O., FACC, FSCAI, FASE, RPVI

@DrJayMohan

1/ For the fellows and #ACCEarlyCareer!

It’s a coronary thrombus! When to consider thrombectomy? What do you do? Let’s walk through this…#Tweetorial

#Cardiotwitter #Cardiology #STEMI

2/ Middle age patient with hx of CAD and PCI to LAD presents with significant SOB and elevated Hs-Trop. No chest pain. No ECG changes. Echo with inferior hypokinesis.

Here’s the diagnostic with a JR4.

Notice the filling defect in the RCA. This is thrombus. How do we know?

3/ Keys of #thrombus on angiogram

🔑 contrast staining
🔑 Lack of calcium on non con image
🔑 ovoid filling defect (complete lumen)

#Cardiotwitter #STEMI #TIMI

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Ikram Haq, MD

@IkramHaqMD

🧵 on the Algorithmic Localisation of Accessory Pathways from ECG

A concept I’m getting to grips with made easier by a beautiful review by #Crinion & @adribaran in Card Electrophysiol Clinic (PMID 33161996)

#EPeeps #MedEd #Cardiology

🫀Considerations of AP localising algorithms:

A. Only apply to manifest antegrade AP & not concealed AP which conduct retrograde

B. Algorithms focused on atrioventricular AP & not other rarer AP

C. Depend on the degree of preexcitation with

D. Cautions with multiple APs

🩻 Anatomic Nomenclature

- AP locations is described in the LAO view
- Older algorithms use anatomical descriptions derived from the Valentine heart position & not attitudinally correct nomenclature which can be confusing

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Top Biomedical Science

@imedverse

Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices.

1. Recommendations for MRI workflows in patients with cardiac implantable electronic devices.

#CardioEd #Cardiotwitter #CardioScience

2. Workflow for provision of MRI to patients with MR Conditional cardiac implantable electronic devices.

3. Suggested additional steps required prior to performing MRI for patients with CIEDs that are MR Unlabelled or do not fulfil MR conditions.

#CardioEd #Cardiology #Cardio

4. Suggested consent statement for implanting cardiologists when potentially implanting an MR Unlabelled device, or revising/upgrading a device that may then become MR Unlabelled.

#MedEd #MedTwitter #FOAMed #cardio #CardioEd #Cardiology #CardioScience #Cardiotwitter

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