Most recents (8)

@dysclinic

Participated in a very interesting multidisciplinary POTS conference at @HopkinsMedicine on the topic of #FND, #syncope and #POTS where we discussed and debated the numerous issues surrounding FND diagnosis in our patient population. 1/🧵
#MedTwitter #NeuroTwitter

@HopkinsMedicine After conference, saw a patient who highlighted the issues discussed at conference.
👩‍🦽30 yo woman with POTS/MCAS/EDS triad with one TTT positive for POTS, but a 2nd TTT negative
❌ A neurologist diagnosed her with FND
💉 She is on allergy shots & many H1/H2 blockers.
2/🧵

@HopkinsMedicine 🚫 Neurologist didn't take into consideration neurologic and psychiatric manifestations of SYSTEMIC DISEASE (MCAS)
❌ This is not FND because there is underlying systemic disorder driving symptoms and signs.
🧠 Patient needs to be treated for the SYSTEMIC DISORDER first.
3/🧵

Read 6 tweets

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.

Read 70 tweets

Hany Ragy

@Hragy

The father of syncope in Europe #ESCCongress

Read 23 tweets

James Sheppard

@jamessheppard48

Can #bloodpressure treatment be harmful? Our new meta-analysis suggests it is NOT linked to #falls or #fractures but may increase the risk of syncope & acute kidney injury bmj.com/content/372/bm… – see thread @RichardJMcManus @Richard_D_Riley @ebhcmedstats @JulietU_S @drandyclegg

1/ No meta-analyses of randomised controlled trials to date have quantified the association between blood pressure lowering treatment and specific adverse events such as #falls, #fractures, #syncope (fainting) or acute kidney injury #AKI

2/ In a meta-analysis of 58 randomised controlled trials, including 280,638 participants and an average of 3 years follow-up, there was no evidence of an association between antihypertensive treatment and #falls (primary outcome) or #fractures.

Read 7 tweets

UCSD Internal Medicine

@ucsdim

Our #residents got to learn about #syncope & #adrenalinsufficiency today from Rising Chief @LizzyHastie, Chief @photon_ick, & Endo-enthusiast @tsantoscavaiola!!

Check out some highlights below we wanted to make sure we shared with our #MedEd peeps on #MedTwitter!!

Don’t forget about adrenal insufficiency!! For patients with things like #syncope or #hypotension, it’s easy to forget about cortisol as a cause! While things like dehydration, infection, & other things may be more common overall… AI is #treatable, so make sure you catch it!!

Primary AI = #adrenal glands themselves are the problem. This means #cortisol AND #aldosterone will be low, while #ACTH AND #Renin will be very elevated in attempt to remedy this!

Read 5 tweets

Prof Chris P Gale

@cpgale3

Patients with mitral annular disjunction present with frequent premature ventricular contractions; in this study, one-third had ventricular arrhythmias & one-tenth had severe arrhythmic events. @JACCJournals onlinejacc.org/content/72/14/…

A total of 82 (71%) patients reported #palpitations, 47 (41%) patients reported previous pre-syncope, 40 (34%) had ventricular arrhythmia, 15 (13%) had experienced #syncope, & 14 (12%) patients had experienced a severe arrhythmic event prior to inclusion

Mitral valve prolapse was present in 90 (78%) patients

Read 10 tweets

Laurence Badgley

@BadgleyLaurence

Patient symptoms difficult? I stand them front me w. min. clothes & relaxed stance. NOTE: unequal shoulders, head tilt, asymmetry of Superior traps., scoliosis, pelvic girdle asymmetry as each leg lifted up, palpable muscle spasms, Genu v/v & stigmata of joint hypermobility....

https://twitter.com/DianeOLeary/status/1156391312645603329

MECHANISM OF INJURY if pained & examine 18 #fibromyalgia points. REVIEW OF SYMPTOMS: with emphasis on organ dysfunctions=dysautonomias. Count time sleep duration & #awakenings (abbreviated = fatigue/depression). PANIC ATTACKS: consider POTS before psych. & ? lifetime #syncope.

In many patients with seeming “somatic” disorders you will find many with body tower asymmetries & asymmetric muscle spasms. Joints that sublux due to ligament laxity (genetic or injured) affect contiguous autonomic nerve tracts, arousing dysautonomias.

Read 5 tweets