1/🏥It's your first night alone in the CCU
😵💫You admit a patient with syncope due to complete heart block
🕡HR is 30 bpm with a wide ventricular escape rhythm
You wonder if it's time for your first
#TVP
, but
🔆is it indicated?
🔆& how are you going to set it up for success?
Beyond blessed to be the 1st recipient of the
#CaroleWarnesTravelScholarship
@MayoCVFellows
🫀🙏🏻
Went to learn ACHD, left with a clear vision for my future, the greatest mentors, & a very full ❤️
For those interested in
#ACHD
, I strongly recommend applying
It’s life changing✨
With everything from classic cardiogenic shock🫀, to necrotizing fasciitis 🦠, to Creutzfeldt-Jakob disease 🧠 and even Black Widow spider bites 🕷️
And with an all-female power team once again! 💪🏻
Welcome to Bayview CICU 🫀🔥
@hopkinsheart
@DrMSWilliams
@anjbhatla
@RawanAAmir
was awarded the Humanism Award this morning! 💙This annual award is given to a fellow who exhibits kindness, dedication, and collegiality in all aspects of their fellowship work.
#besthumanever
Elated I had the chance to attend
#ACC22
with my brilliant colleagues and mentors🫀
Incredible simulation center and exciting discussions that had us all sitting on the edge of our seats!🔥
Highlight: finally getting to meet the
@CardioNerds
family in person 🤓😍
So grateful ❤️
Honored to share our experience managing a complex congenital case at the FIT Forum: Stump the Professor segment at
#ACC24
🫀😍
Forever grateful to have the support & mentorship of the most amazing ACHD team
@heartsavermom
@AriCedars
✨
@hopkinsheart
#CHD
#WIC
So honored to be selected as the Maryland ACP winner for the second year running!
@AcpMaryland
🤩
Blessed to have phenomenal mentors
@UMInternalMed
😍
Also, was I making people read ECGs all day yesterday? You bet! 😂🫀
University of Maryland Internal Medicine Residency
Our residents had a great time yesterday with
@AcpMaryland
. Congrats to
@RawanAAmir
, 1st place in the clinical vignette abstract competition! And
@HananAAlharthy
, Profiles in Excellence Award!
First Half Marathon in the books! 🏃🏻♀️🤩
21K of uphills, downhills and second guessing some life choices 😂
With a busted knee and 2 weeks post-COVID, taking it as a win ✌🏻
Forever grateful ✨🙏🏻
#BaltRunFest
#RunHon
30 years young, and what a year it’s been 🎂🔥
Wishing I was closer to family to celebrate ❤️
What a blessed and beautiful life we live, forever grateful الحمدلله 🤍
So grateful for this phenomenal opportunity and for the endless support from our
@hopkinsheart
family ✨🫀
Of course, the biggest thank you goes to the greatest career and life mentor,
#ACHD
extraordinaire, Dr. Stacy Fisher
@heartsavermom
🤍
A huge thank you to the one and only Dr. Kimberly Manning
@gradydoctor
for another phenomenal
@CardioNerds
Academy Bootcamp session focused on medical humanities!
Incredibly inspirational.. My heart is so full❤️(& not in the worrisome dilated cardiomyopathy kind of way🫀)
Happy National Doctors Day! In honor of our wonderful residents who deliver compassionate care to our patients. Congratulations to Rawan Amir for receiving the Resident of the Year award for her fabulously creative wellness events. 🎉🏆
@UMInternalMed
@UMMC
So proud to represent
@UMInternalMed
and share our pre-operative 3D-print experience in complex congenital heart disease with DORV with the rest of
@UMMC
at our annual resident research grand rounds🫀😍
Publication to follow!
#Cardiology
#cardiotwitter
#wic
Happiest birthday to the absolute greatest
@karanpdesai
! 🫀👑
To many more years full of nothing but joy & success ✨
We’re so lucky to have the opportunity to work with and learn from the best!
@hopkinsheart
Join us Thursday 4/28 at 8:00 PM EST 🕗 to discuss TWO revolutionary trials in the world of HCM!🫀
🔵 VALOR-HCM & EXPLORER-HCM 🟡
Visual abstracts to help you prep for what will be an incredible JC below👇🏻🔥
#CardsJC
#HouseTaussig
“Behind every successful woman is a tribe of successful women who have her back”
Honored to be a part of the Hopkins Women in Cardiology tribe 🫀🙏🏻
To many more phenomenal nights with these inspirational visionaries ✨
#WIC
#Cardiotwitter
Get behind the scenes with me in this one-on-one interview with VALOR-HCM principal investigator
@DesaiMilindY
answering some 🔥 questions & sharing exciting news on what’s next in HCM!🫀
Honored to conduct this as a
@CardioNerds
fellow🤓❤️
@mydocwire
So excited for
#ACC24
this weekend! 🫀
If you’re interested in
#ACHD
and want a behind the scenes glimpse of what goes into our most complex patients’ care, come check out my talk at the FIT Stump The Professor segment! 🤓
Details below 👇🏻
@hopkinsheart
@CardioNerds
#WIC
Haven’t heard of BRASH syndrome before? 🫀🤔
Well take a look at this phenomenal infographic by
#HouseTaussig
‘s very own
@catweneboah
that walks you through every step, from diagnosis all the way to management 🤩 👏🏻
What is B.R.A.S.H? How can this underrecognized condition potentially lead to cardiovascular collapse and multi-system organ failure ?😖Check out further details ⬇️
🎉Biggest thank you's to
@RawanAAmir
@jholtzman3
@AmitGoyalMD
@Dr_DanMD
for their guidance with this infographic!
Honored and privileged to be a part of the phenomenal
@CardioNerds
community that is truly changing cardiovascular medicine one day at a time🫀✨
Congrats to all the 2021 grads 🎉🎓
So excited to start this incredible journey 😍
#CardioTwitter
With honor, privilege, and tremendous gratitude we are so excited to be celebrating the
@CardioNerds
Academy Graduation (Class of 2021) and Welcome to the Class of 2022.
#CardsAcademy
Congratulation to all Graduates & Newly Minted Nerds!
JHAH congratulates Dr. Salwa Sheikh on her appointment as an Adjunct Assistant Professor in Pathology at the Johns Hopkins University School of Medicine. Dr. Sheikh is the first Saudi female to take on this role.
🫀 What is pericardial decompression syndrome?🤔
🫀What causes it?
🫀& most importantly, how can I try to avoid it?
Check out this absolutely phenomenal infographic by
#HouseTaussig
‘s one and only
@catweneboah
👏🏻🤩
#Cardiotwitter
@CardioNerds
🫀What happens when you have a cardiac tamponade and you choose to drain it? What if it goes awry?
🫀What are some risk factors in performing pericardial drainage in pts with pericardial effusions/cardiac tamponade physiology?
Want answers? Check out my new infographic below ⬇️
What’s the latest in HCM?🤔
@DesaiMilindY
shared riveting results of VALOR-HCM at
#ACC22
⭕️Does Mavacamten reduce need for invasive SRT?💊
⭕️How do results compare to EXPLORER-HCM?🫀
Check out my article to get all the exciting details!👇🏻
@CardioNerds
@mydocwire
6/ What are the most common indications for TVP? 🤔
🔆Bradyarrhythmia à symptoms😵💫or hemodynamic compromise 🏥(eg. sinus bradycardia, 2nd or 3rd degree AV block)
🔆Overdrive pacing (eg. VT, TdP)
🔆Digoxin toxicity💊
🔆PPM Failure
So sad the one and only
@bootcampbrittpt
is leaving us 💔
But so blessed to have had the honor of working with and learning from the best physical therapist in the DMV area✨ can’t wait to see the phenomenal things you’ll do next!🫀💪🏻
#WalkAllMCSPatients
#NoActivityRestriction
My last day in the CCU with
@RawanAAmir
😭 I’m going to miss our collaboration to progress our complex cardiac patients, your awesome teaching skills and sense of humor. Thanks for the cupcakes!
To treat or not to treat mild chronic HTN during pregnancy..💊🤰🏻
Now that is the real question 🤔
Join
#HouseTaussig
led by
@a_h_ghoneem
and a phenomenal panel of experts tomorrow at 8:00 PM for a 🔥 discussion of the CHAP trial
See you all then! 🤓
#CardsJC
An absolute pleasure interviewing Dr. Paul Kalra to get an in depth view of
#IRONMAN
& what the future holds for our HF patients🩸
Bonus: interesting insight on the impact of COVID on ongoing trials 🦠
Full interview 👇🏻
@CardioNerds
#Cardiotwitter
#IRONMAN
#HeartFailure
🎙️Dr Paul Kalra &
@CardioNerds
' Dr
@RawanAAmir
discuss
#IRONMAN
data & implication for practice
📺👉
📊In
#HeartFailure
pts with a reduced LVEF and iron deficiency, IV FDI was associated with a lower risk of recurrent
#HF
hospitalisations🏥 and CV death
Great weekend at the DC-MD-VA Walk for 1 in 100 in support of those with
#CHD
Phenomenal to see how far we’ve come, inspiring to keep moving forward ✨
Big thank you to the greatest mentor and ACHD extraordinaire, Dr. Stacy Fisher 🤍
@hopkinsheart
#ACHD_heart
#HopkinsHeartHeroes
Not able to make it to
#ASPC23
in person? Experiencing serious
#FOMO
? 😕
Have no fear.. the
@CardioNerds
conference scholars are here!! 🦸🏻♀️🫀
Follow their live coverage of the 🔥 event and stay up to date with all the latest in🫀prevention👇🏻
🚨Curious to know how we used theophylline to treat painful left bundle branch block refractory to standard therapies? 🤔
Check out our case below 👇🏻🫀
#CardioTwitter
#LBBB
11/ To make sure we really understand the concept of sensitivity ⚠️
Let’s look at our favorite sensitivity analogy where you’re the pacer trying to see the QRS complex from behind a fence 👇🏻
Fence = mV
7/ So let’s get to know our TVP settings better🤓
For our case, our TVP mode will be VVI
V=Ventricle sensed
V=Ventricle paced
I=pacing Inhibited if native beat is sensed
Vs the other common mode of VOO
V=Ventricle paced
O=not sensed
O=no inhibition of pacing
Potential causes of underrepresentation of women in clinical trials 🤔
⭕️ Difference in care: less referrals to cardiologists —> less women treated for CVD
⭕️ Exclusion of pregnant women/women of “childbearing-potential” (vulnerable population) from most trials
#CardsJC
Let’s talk baseline characteristics. 23% of participants in each group are women, how may this impact generalizability of these results to the overall population?
#CardsJC
How can we promote representation of women in trials?
9/ Next, let’s look at the Output ⚡️which is the current🔌produced by the generator during every beat (measured in milliAmpers, mA)
The⬆️the mA, the⬆️the output
(obvious right? wait until you see what's coming next though😉)
Not just an Academy, but truly a loving family of nerds supporting each other in building the future of their dreams✨
Please consider joining us if you have an interest in
#MedEd
and
#SoMe
! 🤓🫀
Application link👇🏻 (extended to Nov. 20)
#CardioTwitter
🚨ATTN CardioNerds!
Applications are open for the CardioNerds Academy!
If you are a current trainee interested in the intersection of medical education &
#SoMe
, we encourage you to apply!
📜Applications EXTENDED to November 20th! 🔗
8/ Although there are different types of generators, they all have the same 3 variables that you can control:
🕑Rate
⚡️Output
⚠️Sensitivity
Let’s start with Rate🕑meaning the number of impulses generated by your TVP/minute
Random fact:
PCSK9-inhibitors are monoclonal antibodies used to lower LDL in patients with hyperlipidemia
They’re extremely powerful (lowering LDL by 60%) but can only be given SQ
It’s amazing how even in the simplest topics in medicine there is always something new to learn
10/ Finally, let’s talk about Sensitivity ⚠️which is the minimum current 🔌needed to detect native cardiac activity and inhibit pacing 🫀(measured in millivolts, mV)
🚨Don’t be fooled!
The⬇️the mV, the ⬇️ current is needed to be detected by the TVP so the⬆️the sensitivity!
27/ Congratulations on making it to the end of this thread and for keeping your patient alive in the CCU! 🥳
Thank you so much for listening and hope you learned something new from this little tweetorial 📚
#Cardiotwitter
#TVP
It’s finally out! 🎉
Wondering what do with a post-heart transplant patient coming in with DOE? 🤔
Learn more in our case discussion with the great
@CardioNerds
!! ❤️
Biggest differences in populations studied:
🟡 EXPLORER-HCM:
- NYHA class II-III 🌬
- excluded pts on disopyramide 💊❌
- excluded pts with syncope 😵💫❌
🔵 VALOR-HCM:
- NYHA class III-IV 🌬🌬
- included pts on disopyramide 💊
- included pts with syncope 😵💫
#CardsJC
What do we know already about AC in AF & ischemic stroke? 📚
🔸 AREST ➡️ early Apixiban vs Warfarin ➡️ ⬇️ ischemic stroke/TIA with DOAC, but ❌ statistically significant
🔸 TIMING ➡️ early vs late DOAC ➡️ early start non-inferior to late start
#CardsJC
Now for
#ELAN
trial!
🔹 Multicenter open label randomized trial
🔹 2013 participants
🔹 Aim ➡️ to evaluate the safety & efficacy of early vs late initiation of DOACs in patients with acute ischemic stroke 🧠 who have atrial fibrillation 🫀
#CardsJC
Current practice:
Treat those with severe HTN >160/105 💊
what we do with mild cHTN 130-159/80-105 is very debatable.. case by case 🤔
CHAP definitely encourages us to treat cHTN in pregnancy more aggressively
Particularly in women without comorbidities❗️
#CardsJC
Let’s get into it! Question 1 here we go!
#CardsJC
Societies have different recs based on mixed trial results regarding the benefits/risks of treating mild chronic HTN in pregnancy🤰.
What is your practice, and how does CHAP fit into these guidelines ❓
Highlights the importance of teamwork and multidisciplinary approach in medicine! ✨
Especially with such vulnerable populations that shift care between different specialties 🤰🏻
#TeamWorkMakesTheDreamWork
#CardsJC
#CardioObstetrics
@drladyheart
@CardioNerdsJC
@CardioOb
The problem is we are not usually the ones treating HTN in 🤰
It is our OB colleagues who are VERY GOOD at treating
#bloodpressure
but now we can all have new goals of therapy
Most patients just see an OB- women say their OB is their PCP & those visits are covered
#CardsJC
Ever wonder what to do with AC 💊 in your patients with ischemic stroke 🧠 & atrial fibrillation🫀?
Well look no further, the
@CardioNerds
are at it again with another
#CardsJC
!🤓
Set your ⏰ to join
#HouseTaussig
tomorrow at 8:00 PM EST for a 🔥 discussion on the
#ELAN
trial
The
@CardioNerds
are back again with a new
#CardsJC
Journal Club!! 🤩🎉
Join us on twitter Thursday🗓️, 7/27/23, 8:00 PM EST🕗in our🔥discussion on the
#ELAN
trial🫀
Get the inside scoop from our experts to help you decide when to start AC💊in your patients with stroke🧠and AF🫀
Interested in learning about catheter directed thrombolysis vs AC in intermediate-high risk PE?🩸
Join the
@CardioNerds
for an amazing discussion on the CANARY Trial 🦜
8:00 PM EST tonight! 🕗
Don’t be concerned with what others are doing
Focus your energy on yourself
On working hard and achieving your goal
You will never get things done if you get distracted by everyone and everything passing by
Quite interesting that patients on AC 💊 prior to randomization 👥 were excluded from this trial.. any thoughts on why that may be? And could this have an impact on trial outcomes? 🤔
#CardsJC
🔑Inclusion/exclusion criteria:
🔹 IV thrombolysis & thrombectomy before randomization were allowed
🔹 patients with petechial hemorrhage in infarcted brain region were included
🔹patients already receiving AC at time of stroke were excluded
#CardsJC
اللهم اني أسألك أن تريح قلبي و فكري و أن تصرف عني شتات العقل و التفكير
ربي إن في قلبي أمور لا يعرفها سواك فحققها لي يا رحيم
ربي كن معي في أصعب الظروف و أرني عجائب قدرتك في أصعب الأيام
#CHD
Awareness week is here 😍
Lets share these incredible
#CardioSmart
resources to help our patients stay on top of their🫀care! ❤️
Hint 👀: go to the clinician’s section, tons of infographics on common🫀conditions & in so many languages! Definitely using them in my clinic👏🏻
This week is Congenital Heart Defect Awareness Week ❤️
#CHD
is the most common type of birth defect. Nearly 1 out of 100 babies are born with some sort of structural heart defect. Share these
#CardioSmart
resources with your patients:
#CHDAwareness
Interested in
#MedEd
and social media?📱
Looking for a group of cardiology-enthusiast who lub nothing more than that dub?🫀
Then look no further! 👀🔍
CardioNerds is looking to expand it’s family once again! 🤩
Link to application below👇🏻
🚨ATTN CardioNerds!
Applications are open for the CardioNerds Academy!
If you are a current trainee interested in the intersection of medical education &
#SoMe
, we encourage you to apply!
📜Applications are due November 15th! 🔗
White coat hypertension. No big deal, even in pregnancy, right? NOPE! It's asociated with a 5.4-fold risk of developing
#preeclampsia
and a 2-3 fold increased risk of preterm delivery and small for gestational age infant.
#CardsJC
#CardioObstetrics
@BoydDamp
@CardioNerdsJC
Important that CHAP enrolled significant % of Black women & lower SES, as they are the groups most vulnerable. In abstract led by
@SalmanZahidMD
presented at
#ACC22
, we found even high income Black women w/
#preeclamspia
had worse CV outcomes than low income White women.
#CardsJC
What a revolutionary trial! 🤩
Great opportunity for cardiology and endocrinology to tag team once again!! 🙌🏻
What do you think is coming next? 👀
#CardsJC
JHAH congratulates Dr. Abdulrazack Amir on his appointment as an Adjunct Assistant Professor in the Department of Medicine at the Johns Hopkins University School of Medicine.
الأخوين براء وعمار.. اخترعا كمامة مطبوعة بطابعة ثلاثية الابعاد لدعم المجتمع في مواجهة #كورونا
برنامج #سوالف_رمضان
#رمضان_كريم
#عيشوا_معنا_رمضان
@baraa_amir
Piece of advise for med students:
ENJOY YOUR FREAKING VACATION!
Go ahead and take a summer course or work on your research that’s great but make sure you spend at least one month relaxing, re-energizing and enjoying life ☀️
Even superman needs to rest
The 🌎 is not ⚫️&⚪️, grey zones exist & we often live in them! 🔘
So wouldn’t say ➕ or ➖trial
But safe to say results are encouraging for early DOAC 💊 initiation given numerically ⬇️ event rates 📉 in early vs late treatment group with no ⬆️ in safety outcomes 📈
#CardsJC
To the Results!
The primary composite endpoint occurred in 2.9% in early treatment group versus 4.1% in the late treatment group. Risk difference was -1.18 (CI -2.84 to 0.47).
❓With no p-values available, how do you interpret such findings? Is this a ‘positive’ study?
#CardsJC
💊 vs PCI in ischemic LV systolic dysfunction 🤔
Will we see a similar mortality benefit with PCI as seen with CABG in STICH extension study? Or will 💊 reign supreme? 👀
Join the phenomenal House Einthoven tomorrow at 8:00 PM 🕗 for a discussion of epic proportions🔥
#CardsJC
Team
#CardsJC
@CardioNerdsJC
- House Einthoven presents!
Gear up for this really important discussion about the REVIVED-BCIS2 TRIAL
🗓️9/29/22 at 8P EST 📚
Reminder that applications for the next class of the
@CardioNerds
Academy are due TONIGHT at midnight, EST! Looking forward to reading everyone's application!