Internal medicine residency ✅.Onwards to Cardiology fellowship 🫀

RT @AHNCVFellows: A huge welcome to our incoming Cardiovascular Disease Fellows! We're thrilled to welcome such an impressive group to the….

#CardioNuggets. ASD Secundum.Why does ASD secundum show RBBB + RAD on ECG?. ✅ Left-to-right shunt → volume overload of RA & RV. ✅ RV dilation → conduction delay = RBBB. ✅ RV dominance → Right Axis Deviation. 📍 Located at the fossa ovalis (mid septum). 🚫 No valve

#CardioNuggets. 🫀July tips for new interns!.Recognize Cardiogenic Shock Early!. Key signs:.💥 Narrow pulse pressure, elevated diastolic BP.❤️‍🩹 Often tachycardic, but not always.🫁 Crackles/JVD/S3.🧠 AMS.🧊 Cold, clammy skin.🚫 Low urine output.🧪 Lactate ↑, LFTs ↑, Cr ↑,.

#CardioNuggets. 🫀 Septal Flattening on Echo? Think RV overload!. Best seen in PSAX at papillary muscle level. 🔸 Pressure overload (PE, PH):.➡️ D-shaped LV in systole. 🔸 Volume overload (TR, ASD):.➡️ D-shaped LV in diastole. #CardioNuggets #EchoNerds #FellowsFirst #POCUS

#CardioNuggets. 🧠 The CAHP Score (Cardiac Arrest Hospital Prognosis) helps predict neurological outcomes after OHCA with ROSC. ➡️ Score >200: poor prognosis, but NEVER a reason to withdraw ICU care. ➡️ Score <150: .Patient with active ischemic EKG or high risk EKG changes,

#CardioNuggets. 🧐 Trying to measure LVOT gradient with CW Doppler (HCM, aortic stenosis)?. Be careful—you might be measuring mitral regurgitation (MR) instead! Here's how to tell:. 🗡️ LVOT.— Forward flow.— “Dagger-shaped,” late-peaking jet.— Mid-to-late systole.— Sign of dynamic

#CardioNuggets. 🧠 Q: My patient is complaining of fatigue on beta-blockers. What should I do?. A:.-Check for bradycardia/hypotension.-Avoid highly lipophilic agents e.g., propranolol (they cross the blood-brain barrier).-Consider nebivolol or bisoprolol (better tolerated).

#CardioNuggets. 🫀HALT = Hypo-Attenuated Leaflet Thickening.Seen on CT in bioprosthetic valves (TAVR/SAVR). 🔍 Subclinical leaflet thrombus → thickening ± motion restriction.✅ Reversible with anticoagulation. ⚠️ Not seen on echo; may affect durability & stroke risk. #TAVR

Apologies for the recent inconsistency with #CardioNuggets — I’m on an exciting journey to becoming a mom soon 🧿, and life’s been a little busier than usual! . Still learning and growing every day, and I’ll keep sharing nuggets as often as I can. Thanks for sticking around ❤️.

RT @AHNCVFellows: One last shoutout to our amazing fellowship grads! We're incredibly proud and excited to see all of your future achieveme….

RT @AHNtoday: We were honored to once again support hometown hero, heart health advocate and NFL player Damar Hamlin's @chasingMs_ All-Star….

Finishing up my 1st year in #Cardiology fellowship! 💓.Last July, I asked #CardioTwitter for the best resources for new fellows (👇). Grateful for all the advice I received — paying it forward with the list that got me through year 1 📚👇.@ACCinTouch #MedEd.

#CardioNuggets. Acceleration time and Ejection time in prosthetic aortic valve assessment:.🔹 AT = time to peak velocity.🔹 ET = total systolic ejection time. Why AT/ET is useful in prosthetic aortic valves:.-Gradients can be misleading—affected by flow, valve size & design.-AVA

5️⃣ Midventricular + Apical Aneurysm. ▫️Hypertrophy narrows mid-LV, aneurysm at apex. ➡️No LVOT obstruction but 🚨 high SCD risk due to VT. MRI for scar & ICD may be indicated.

4️⃣ Apical. ▫️Hypertrophy isolated to apex (“spade-like” LV).▫️Giant T waves on ECG. ➡️Low obstruction risk but ⚠️ arrhythmogenic & can form apical aneurysms.

3️⃣ Neutral (Concentric). ▫️Symmetric thickening without septal curvature.▫️May mimic HTN heart or athlete’s heart.➡️Less obstructive but still needs SCD risk stratification.

2️⃣ Sigmoid (Basal Septal). ▫️Prominent basal septal thickening, curved into LV.▫️Seen in elderly & hypertensive pts. ➡️May cause obstruction; often responds to meds.

1️⃣ Reverse Curve (Classic HOCM). ▫️Mid-to-basal septal hypertrophy with reversed curvature. ▫️⏫ Obstruction, SAM, MR. ➡️Most common, often requires septal reduction.

A #CardioNuggets 🧵👇. 🫀Not all HOCM hearts are shaped the same. There are 5 distinct LV cavity phenotypes, each with unique implications for obstruction, arrhythmia risk & management.