Dami Akinmolayemi, MD, MPH
@DAkinmolayemi
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Aspiring Interventional Cardiologist | Cardiovascular Disease Fellow @SinaiCards | Internal Medicine Residency @ColumbiaMed | MD @UTSWedu | MPH @UTHealthSPH
New York, NY
Joined August 2022
RT @dranulala: ‼️Important teaching case:. AMI cardiogenic shock ➡️ LAD culprit, low EF ➡️ IABP great idea, right? 🤔. Not necessarily…. Che….
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8. Full open-access case in JACC: Case Reports special issue of Celebrating Clinical Success Stories
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7. Take-home points:.- Consider LVOTO in LAD-AMI CS with paradoxical deterioration on standard therapy.- Echo early & continuous reassessment .- Tailor hemodynamic support to mechanics of shock.- Sometimes, less inotropy + more afterload saves lives.
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6. 1 month later:.- LVEF improved to 55–60%.- No LVOTO
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5. Management pivot:.- Weaned off inotropes.- Switched to pure vasoconstrictors (vasopressin).- Reduced IABP augmentation → removed.- Gentle fluids.- Hemodynamics improved, lactate normalized
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4. Problem: .Standard AMI-CS therapy (inotropes, afterload reduction, IABP) ↓ afterload & ↑ contractility → worsened LVOTO.
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3. Pathophysiology: .- Anterior MI with apical akinesis and basal hyperkinesis → LVOT narrowing. - Fast flow → Venturi effect on anterior MV leaflet → SAM of anterior MV leaflet → worsened obstruction
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2. Clues:.- New loud systolic murmur.- Echo: apical aneurysm + hyperdynamic basal segments —>SAM of anterior MV leaflet + dynamic LVOTO —> Peak LVOT gradient: 110 mmHg on IABP 1:1 and 40 mmHg on IABP standby
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1. 75F with LAD-AMI → PCI complicated by slow flow + VT. Managed with norepinephrine, epinephrine & intra-aortic balloon pump (IABP) for AMI-CS. But… shock worsened despite “doing all the right things.”
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We present a case where guideline-directed AMI-CS management paradoxically worsened patient’s hemodynamics — and how we turned it around. 🫀👇.@FBeerkens @jjfein @dr_sapurva @dranulala @SinaiCards @MountSinaiHeart @sunnygoelmd #JACC #JACCCaseReport
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RT @koetob: Our study on SSO₂ therapy in acute anterior STEMI is now published in @EuroInterventio with an editorial by @GreggWStone and @D….
eurointervention.pcronline.com
The study explores the potential benefits of using optimized supersaturated oxygen (SSO2) therapy in addition to percutaneous coronary intervention (PCI) for STEMI patients.
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RT @EuroInterventio: NEW ISSUE OUT! .📌 State-of-the-art review on the imaging of atherosclerotic plaques; .📌 Low-dose prasugrel monothera….
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🚨 STEMI care ≠ PPCI alone. Konig et al. In the current issue of @EuroInterventio show peri-procedural SSO₂ therapy ↓ infarct size & ↑ myocardial salvage in anterior STEMI (real-world data). Next step → large RCTs. Honored to co-author the editorial with @GreggWStone
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Big congrats to Vivian Hu, now a first-year fellow @MSHCardsCT, for leading this great Case Report in @JACCJournals! Highlights stellar care in the CICU for a patient with cardiogenic shock in the context of both ICI + 5-FU therapy — complex and expertly managed. 👏📄🫀
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Congratulations to the @Sinaicards class of 2025! It’s been both inspiring and educational to work alongside you these past two years. Wishing you continued success as you go on to shape the future of cardiovascular care — you will be deeply missed!.@DLBHATTMD @FBeerkens
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RT @MountSinaiHeart: Led by @DoctorKini, the @MountSinaiHeart Cardiac Cath Lab attendings, fellows, staff, and their families laced up for….
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