Internal medicine residency ✅ Onwards to Cardiology fellowship 🫀

RT @MujeebZubair: Replacement of aortic valve by cardiac surgeons 🫀 The aortic valve is a heart valve that controls blood flow from the he…

#CardioNugget 40/365: 🩺 #SENIORRITA Trial Insights: In adults 75+ with NSTEMI, an invasive strategy (angiography ± revascularization) didn’t significantly reduce death or nonfatal MI compared to medical therapy alone over 4.1 years. 🧠 Procedural complications <1% Interested to hear insights from Interventional trainees and cardiologists. #CardioTwitter #CardioNuggets #MedEd

#CardioNugget 39/365 🚨 New #AtrialFibrillation Classification 🚨 AF is now seen as a progressive disease, emphasizing early intervention & prevention: 🔹 At Risk: RFs (HTN, obesity) but no AF 🔹 Pre-AF: Atrial pathology on ECG/imaging, no AF 🔹 Paroxysmal: AF, terminates ≤7 days 🔹 Persistent: Continuous episode of AF lasts >7 days 🔹 Long-standing Persistent: AF >12 months 🔹 Permanent: Rhythm control no longer pursued 📌 Key updates: ✅ AF Burden (frequency & duration) matters! ✅ Holistic management: RF modification & lifestyle changes ✅ "Chronic AF" is outdated! #CardioTwitter #MedEd #CardioNuggets

#CardioNugget 38/365 2023 Atrial fibrillation guidelines: Anticoagulation in Typical AFL: Key Recommendations 1️⃣ Risk-based therapy: Anticoagulate based on the same risk profile as AF (e.g., CHA₂DS₂-VASc score). 2️⃣ Post-procedure care: After successful cardioversion/ablation, continue anticoagulation for ≥4 weeks. 3️⃣ Prior AF detected: Patients with prior AF should stay on anticoagulation post-CTI ablation. 4️⃣ No prior AF but high risk: Monitor for silent AF post-CTI ablation if not anticoagulated. #CardioTwitter #AtrialFlutter #CardioNuggets

#CardioNugget 37/365 🚨 Why avoid MitraClip if MVA <3 cm²? 🚨 MitraClip reduces mitral valve area, risking iatrogenic mitral stenosis if MVA is already small. This can ↑ transmitral gradients, ↑ LA pressure, & worsen pulm HTN. 🫁⚠️ 💡 Alternatives? Surgical repair/replacement TMVR (emerging option) 📌 Pre-procedural echo is 🔑 for proper patient selection! #CardioNuggets #MedEd #MitraClip

RT @AHNCVFellows: Our Leadership: The dedicated team leading our Fellowship: Program Director Craig Alpert, MD; Associate Program Directors…

RT @AHNCVFellows: Our Fellows: We're thrilled to have 18 incredible General Fellows in our program! 🥼⚕️We welcome 6 new fellows each year &…

#CardioNugget 36/365 📢 Echo tip: "Diastolic pattern c/w AFib" means a filling pattern seen on Doppler that suggests atrial fibrillation. Look for: 🔹 Loss of A-wave (no atrial kick) 🔹 Irregular E-wave variability #CardioNuggets #MedEd #CardioTwitter #FOAMed

RT @AHN_CVI: Pittsburgh’s Allegheny General Hospital Receives International Accolades for Excellence in Cardio-Oncology Care. @AHNtoday ht…

#CardioNugget 35/365 Measuring Mitral Valve Area (MVA) via Pressure Half-Time (PHT) on TTE! 📏💡 Steps on TTE: 1️⃣ Apical 4-Chamber → CW Doppler at MV leaflet tips 2️⃣ Measure PHT (time for E-wave velocity to ↓ to 0.707 of peak) 3️⃣ Apply Formula: 🏆 MVA = 220 / PHT (ms) 🔹 Severity: Mild MS: 1.5–2.5 cm² Mod MS: 1.0–1.5 cm² Severe MS: <1.0 cm² ⚠️ Limitations: Affected by LV compliance, MR, AI #CardioTwitter #Echofirst #FOAMed

#CardioNugget 34/365 Technetium (Tc-99m) vs. Rubidium (Rb-82): 🧪 Technetium-99m (Tc-99m) Used in SPECT imaging Lower energy gamma emissions (~140 keV) Longer half-life (~6 hrs) → allows for delayed imaging Cyclotron-produced 🧪 Rubidium-82 (Rb-82) Used in PET imaging Positron emitter → better spatial resolution Short half-life (~75 sec) → needs rapid imaging Generator-produced → no need for an onsite cyclotron 💡 Why the difference? PET (Rb-82) offers superior resolution, attenuation correction & absolute quantification (MBF). SPECT (Tc-99m) is more widely available & cost-effective. #CardioNuggets #MedEd #CardioTwitter

#CardioNugget 33/365 Flow convergence & PISA 101 🫀 As blood flows toward a regurgitant orifice, it accelerates, forming hemispheric isovelocity shells (flow convergence). The Proximal Isovelocity Surface Area (PISA) method uses this to estimate regurgitant volume & EROA in valvular disease. #CardioNuggets #CardioTwitter #MedEd

🚀 Happy to have posted a #CardioNugget every day in January! 🎉 learning so much daily and loving the journey! Always looking for feedback & new topics—what would you like to see next? Drop your suggestions! 💡💙 #CardioTwitter #MedEd #CardioNuggets

CardioNugget 32/365 Understanding Mitral Valve Prolapse vs. Flail! 🔑 Prolapse: Elongated, redundant leaflets & chordae, often from myxomatous degeneration. 🔑 Flail: Chordal rupture → free leaflet motion into LA. Severe MR is common. #MedEd #CardioNuggets #CardioTwitter

RT @VipsMDMEd: What’s a medication you use off-label more frequently than for the labeled indication?

RT @AHNCVFellows: Welcome to the AHN Cardio Fellowships official account! Located in the heart of Pittsburgh, we take pride in our well-rou…

#CardioNugget 31/365 Ever heard of the Ar-A ratio? It's a measure in echo that compares blood flow timing during atrial contraction: flow into the heart (A wave) vs. flow backward into veins (Ar wave). A wave is measured on mitral pulse wave doppler. Ar (atrial reversal) wave is measured on pulmonic vein doppler. If Ar is much slower, it hints at stiff heart chambers (diastolic dysfunction). i.e. Ar/A duration> 30 ms is consistent with elevated LVEDP. #CardioNuggets #CardioTwitter

RT @BarackObama: Our hearts break for the families who lost loved ones in the tragic plane and helicopter crash at DCA. Michelle and I send…

#CardioNugget 30/365 Spotted a B bump on TTE? 🫀 This late-diastolic notch on mitral valve M-mode signals elevated LVEDP & impaired LV compliance. Think diastolic dysfunction, LVH, volume overload. #CardioTwitter #CardioNuggets #MedEd #echofirst

CardioNugget 29/365 "Transcatheter Mitral Valve Replacement (TMVR) with Tendyne: 🫀 Approach: Transapical or transseptal 🛠️ Features: Self-expanding valve w/ tethered LV anchoring #Cardiology #TMVR #Tendyne #CardioNuggets