Siyab Panhwar, MD
@DrSiyabMD
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Interventional cardiologist. Country doc. Passionate abt heart disease prevention/education on social media (600k TikTok followers). Views own. 🇵🇰 🇶🇦 🇺🇸
Minnesota
Joined March 2018
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Pinned Tweet
My father’s visiting me from my home country, after 8 years (!!!) of not seeing him.
He’s also an interventional cardiologist, and I followed in his footsteps. I had the pleasure of showing him around my hospital, introducing him to my amazing colleagues, showing him the cath…
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Don't confuse looking jacked with being healthy.
As a cardiologist, I've seen plenty of body builder type "fit" men with big heart attacks and terrible coronary artery disease.
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Got a lot of grief for suggesting that we shld be aggressive in screening for and lowering cholesterol in young people in their 20s-30s.
Let me use a patient story to tell you why I believe that.
Long 🧵. Please read the whole thing before commenting.
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Just wear the damn mask man Jesus why is this such an issue
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The reason why the tech industry has consistently failed to “disrupt” medicine is because they actually have no clue how medicine actually works or have any insight whatsoever.
Full body MRIs will be $50 and everyone will be getting one at least annually.
This should not be controversial.
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I have lost count of “young and fit” with sky high LDLs who present with massive heart attacks and have been brainwashed into skipping a statin.
Tragic.
Coming from an MD? Even more tragic .
@MountainMaestro
My LDL is 200. I'm 52 and fit. No doubt in my mind that a cardiologist would try to feed me that poison.
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What this person is calling “Medical paternalism” is actually a very reasonable and well thought out take by a physician that most physicians, including myself agree with.
I’m not stopping anybody from paying $3500 to get a full body MRI if they want. It’s a free market. But…
Just a wild amount of medical paternalism from a physician via
@chrissyfarr
's latest piece.
Whatever this instinct is that suggests consumers can't be educated on their health, it needs to go away.
Also, lol - the person here clearly hasn't even seen how these services work.
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Lmao the back tracking here is insane. If our bodies are meant to “heal naturally” - why do you have to sell me essential oils and other garbage?
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I 100% know it wasn’t from the vaccine because:
1. I’m not a quack anti-vaxxer.
2. I’m a cardiologist who knows a little about cardiac arrest.
3. I don’t believe in conspiracy theories.
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Why? Underlying risk factors such as high blood pressure, steroid abuse, diabetes, genetics,
smoking etc.
Working out can help but you may not be able outrun your risk factors with exercise alone.
Again, being jacked does not necessarily mean you are healthy!
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Hot take: hospitals lifting masking requirements is a dumb, dumb idea. Don't @ me.
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“I stopped fearing polio”
Jesus take the wheel please. Humanity is doomed 😮💨😮💨😮💨
I stopped fearing polio when I learned these few things:
-- Poliovirus is an Enterovirus
-- There are over 100 Enteroviruses that infect humans
-- Every enterovirus can infect the nervous system and cause paralysis
-- Enterovirus infections typically present as a cold
-- We will…
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What kind of cardiologist would ignore an LDL of 130 in a 26 year old and just dismiss them?
Are they waiting for ~30 years of high LDL exposure, plaque accumulation, before finally doing something at 50?
Prevention has to start early. We keep missing this crucial point.
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Oh god.
#unvaccinated
is trending on Twitter. AV taking a victory lap - “CDC finally says no diff between vax and unvax!! We were right!!” Uh no, you remain at high risk if you are unvaccinated. That hasn’t changed. CDC what have you done..
#covid19
#cdc
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As
@theliverdr
and others have eloquently said, these folks choose to body shame doctors and other healthcare professionals because they have no other viable argument when medical professionals debunk their harmful and false claims.
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Dr. Vinay Prasad says if people continue to mask to avoid colds/flu we don’t know what would happen to auto immunity for cancer (????) . Also literally no one is “interfering” in the lives of others by wearing a mask. This guy is unhinged.
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British anti-vax cardiologist Aseem Malhotra is falsely claiming that the death from a heart attack of Australian cricketing legend Shane Warne was because of the COVID vaccine.
As a cardiologist let me tell you why this is wrong & fear mongering about life saving vaccines:
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Also, it is well established that the carnivore diet is actually **terrible** for you and can INCREASE the risk of heart disease - and substituting red meat for plant foods REDUCES your risk. Seed oils are not the enemy.
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@mimilyang
I am South Asian and was not born in the US, but when people ask me "Where are you *FROM* from??" I'm always tempted to mess with them and say Montana or something.
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I may not know much but what I know for sure as hell is if Vinay Prasad disagrees with you on COVID, you’re doing the right thing.
The likes of Prasad et al. are bewildered there are still people who choose to wear masks and do things to protect themselves.
#covid19
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Hey Michelle,
Can you tell me the risks of conducting cardiac catheterization on every single young athlete to diagnose those with anomalous origin of coronary arteries? Is it really a “simple” test?
- me, a cardiologist who does these routinely.
@stkirsch
So we’re expected to believe that this kid, whose father is filthy rich, has never had any of these simple tests that would have diagnosed this condition? He is going to be a pro basketball player and he’s never had these tests?
COME ON, WAKE UP!
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"Lab leak" is trending. So COVID is fake news, "just a cold", "you don't need a vaccine" etc AND at the same time it's a bioweapon purposely leaked in Wuhan to kill Americans?
Which one is it?
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As per esteemed psychiatrist Dr Vinay Prasad - if you have concerns about COVID you could have an anxiety disorder.
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There is no money to be made when cardiologists talk about statins. It would be more financially lucrative to convince people NOT to take a statin.
@MohammedAlo
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It’s a beautiful sight when they turn on each other.
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For the millionth time, funeral directors are NOT medical professionals.
EVERYONE DEVELOPS blood clots after death. If you didn't I would be worried.
Funeral director John O’looney shows blockages removed from blood vessels of a young man’s heart. Who died “suddenly”
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Complains about being asked to wear a mask in a PRIVATE facility.. When I say why not just honor their request, he turns it into the “but will you mask FOREVER?!??” argument. It’s a PRIVATE facility. Go somewhere else if you don’t like it. No one is forcing u to choose THAT vet.
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STUDY: Viral myocarditis (aka myocarditis from viral infection) vs COVID vaccine induced myocarditis.
- Viral myocarditis is FAR, FAR deadlier than vaccine induced myocarditis.
- 11% vs 1% mortality in this study.
- 12% vs 1% rate of heart failure
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Coward blocked me after sending me this nice message 😂
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This person actually tried to “both sides” cocaine here and claim the COVID vaccine is worse for the heart than cocaine.
I can’t believe this website is free 💀
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Earlier this week, this thread by NaturallyFTW went wild. She blocked me (snowflake LOL) but I was able to grab a screenshot before she did that.
As a cardiologist, myocarditis is in my wheelhouse. So let's talk about why this tweet is fear-mongering clickbait garbage. A🧵
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After Vinay’s invaluable insights and expertise on public health, COVID, infectious diseases, psychiatry, pediatrics and so many more specialties over the last few years, I am very excited to hear about his insights on preventive cardiology.
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Organs are incredibly scarce - hearts especially so. An unvaccinated person who is immunosuppressed after transplant is at great risk of severe COVID infection and if they die a preventable death, the organ dies with them.
Anti-vaxxer crocodile tears are pathetic!
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As a cardiologist I can categorically and confidently call this tweet bullshit. Myocarditis exists on a spectrum of severity, and mild myocarditis is absolutely a thing. Shame on this physician for spreading anti-vax fear and nonsense.
#myocarditis
#covid19
Please remove the term “mild myocarditis” from your vocabulary. Myocarditis is usually diagnosed in the hospital. If you have to go to the hospital with chest pain and get the diagnosis “myocarditis” it’s not mild.
RT and Share
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I asked him about his LDL. His wife told me it was checked 1 year ago (elsewhere) and it was 185. What was done for it? NOTHING. No advice, no follow up, no meds, nothing. 🤯
Read that again: A clinician saw an LDL of 185, and did nothing.
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A cancer doctor should know that viral infections are generally not a good thing for cancer patients
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Wife tells me: "I had no idea and no info given to me then. If I knew then what u are telling me now I would have pushed for answers/Rx".
These are educated, well-off people. Sure, they could have looked it up themselves, but that's not their job.
It's ours.
We are failing…
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Some other examples:
- Why are we still using fax machines like it's 1985?
- Finding a way to collect all medical info/reports without having to spend 5 hours on it yourself.
- Making documentation way more efficient so we can spend more time w/ patients and less on the computer
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Vinay Prasad is so upset that there still exist people that want to take COVID seriously.
Waaaaaah why don’t people accept my brilliance and JUST ACCEPT my sage advice and just like MOVE ON omfg waaah
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Anti-vaxxers already blaming what happened to
#DamarHamlin
on the vaccines. They have no shame.
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As a cardiologist, thank you for highlighting and reminding people that heart disease is the
#1
killer of men and women in this country.
However, indiscriminate CAC scans are not a good idea. Not everyone needs one, and the doctor who orders it needs to know what the CAC…
#1
- Coronary Calcium Scan
Heart disease is the leading cause of death for men and women, resulting in the death of 1 in 5 people (1).
A coronary calcium scan helps assess the risk of coronary artery disease (CAD) & future cardiovascular events.
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Based on the response I got yesterday, I can almost **guarantee** you that if this guy had his LDL screened at 30 and say it was 130 or 140, he would have been told to "fix diet, lose weight, exercise.. NEXT PATIENT!" Not even a cursory education on prevention.
Then he goes…
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You want to make a real difference in medicine?
Maybe focus on the things that ACTUALLY need innovation.. but they are not sexy/flashy enough for tech.
@mcuban
and
@costplusdrugs
is an excellent example of tech/biz intervention in medicine that has done wonders.
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Wowwwwww. Ladapo just unabashedly *lying* through his teeth.
Both Hannity and Joseph Ladapo are VACCINATED.
Unbelievable that these folks would rather put their politics over their people.
“It's an unsafe medication.”*
- Florida Surgeon General Joseph Ladapo on the most recent booster.
*The booster is FDA-approved.
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As an interventional cardiologist I treat heart blockages heart attacks for a living with stents.
Too many 40/50 y/o with NO prior medical care/screening coming to my ER with big heart attacks later, I am a true believer in CVD prevention >>> cure (or patch, rather). Here's the…
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Listen y'all, cardiovascular disease in young Americans is a crisis. CVD is already the king of cause of death-
#1
killer in the US.
As the young population grows older, we're going to have a complete public health disaster on our hands.
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Our cholesterol guidelines are not stringent enough for primary prevention.
There, I said it.
I mean I'm just an early career, lowly, country doctor and interventional cardiologist and not some esteemed guideline writing ivory tower academic who probably has forgotten more…
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If ur potential future PD is doing this shit to applicants you can be sure he’ll do the same for you if you do something he doesn’t like.
Absolutely despicable behavior from a supposed PD. He blocked me, now I know y!
He knows he can do this because applicants are desperate.
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Some of y'all got so mad at me for being "so aggressive" or not "following guidelines." Easy to criticize from the peanut gallery with comfy views and high horses. LOL.
Please. We're not even following the guidelines AS THEY CURRENTLY EXIST.
This guy fell through the…
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This kind of fearmongering bullshit is what those of us who educate on social media have to fight on a daily basis.
Dietitian (not a cardiologist or a lipidologist) fear mongers the risk of diabetes on statin therapy by MISREPRESENTING and cherry picking a study.
Her video…
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She made a video targeting me as well for calling her out. And his husband made a veiled threat.
How desperate 🤣Don’t make ridiculous and dangerous statements on social media and get upset when you get called out.
also “matrix trained md” 🤣
Update.
She thinks I’m a teenager (I’m almost 32, only 3 years younger than her), and I’ll apparently be hearing from her lawyers for commentary on a presentation she has given lifetime access to.
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It can take us less time to do the procedure to place the stent.
Fortunately it was slower that day and I had the time to do this counseling, and I'm not in an "in-and-out factory line" type of job. Not many places afford doctors that kind of time.
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People trust doctors to put them under, cut their chest open, put catheters in every large blood vessel they have, give them tons of medications in funny looking IV bags, and best of all give them a WHOLE STRANGER’s heart NO QUESTIONS ASKED.. but a vaccine is a problem? Chile pls
Australia just DENIED a mother from getting a lifesaving heart transplant because she isn't vaccinated.
This is what pure evil looks like😠
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It’s easy for physicians to tell their patients to just do “diet and exercise and lose weight” to bring down their LDL, A1c etc.
We think we do some big thing dishing out this advice. We’re not. Patients are not stupid. Everyone knows that.
Y’all think people don’t know a…
@DrSiyabMD
Thanks for this post. My teen went on statins at 17 after trying for two years to get it down with diet and exercise. But we would never have known they had high LDL except for blood work because of other medication. We should test people younger when there’s a family history!
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I did a community cardiology clinic today in Cleveland, OH today. CLE is the city I had my first job as a doc (
@CaseUHmed
); the city and people have a special place in my heart, so I was honored to do this.
It was an eye-opening & practice changing experience. 🧵
#heartdisease
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Obvs, no one knows for sure, but if this LDL level 1 year ago had been acted on aggressively, there is a chance his MI could have been prevented or at least delayed.
What if he was screened and managed in his 30s? Even lower chance. Definitely much less plaque accumulation.…
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Inertia is truly real in medicine. I refuse to participate in this preventable cycle.
I will continue to be aggressive in screening, and recommending aggressively managing HLD (among other RF), in people in their 20s and 30s, after shared decision making re the data, facts,…
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Last week had a 55 y/o man come in w/ MI. His LDL was **188** (not on meds). Oh boy. More below.
Stented his RCA then LAD arteries. As part of that, I put an ultrasound (IVUS) inside the arteries.
He had layers of plaque EVERYWHERE. All the way down his arteries.
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Good reminder for everyone to strongly consider CPR and AED training. You could save a life.
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Clearly, this is a problem. This guy is in trouble for his future. Young guy with young family and kids.
After the case, I went up talked to him and his family and educated them about heart disease, atherosclerosis, risk factors... just the basic stuff. Probably spent 45-60…
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@NYCCOBA1
This is blatant misinformation and not how fentanyl overdoses work. Will you block me too for pointing this out?
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Damar Hamlin: releases a video of himself.
Conspiracy theorists: no way that was him. It was a deep fake or CGI.
This country is getting dumber every day 🤦♂️
#DamarHamlin
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Ppl that scream bloody murder at abortion (“Oh I care about life!!”) are the same hypocrites that couldn’t be bothered to give a shit about a pandemic that killed over a million Americans in 2 years. Please, miss me with that bullshit. It’s always been about control.
#RoeVWade
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I think we can all agree that a guy like him at 55 with an LDL of 185 should raise alarm bells and prompt aggressive management, right?
Yet, nothing was done.
His next contact with healthcare was not for close outpt f/u for prevention.. it was his MI a year later.
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All I did was point out to this newly minted grifter that Damar Hamlin doesn't owe him any explanations re his cardiac arrest.
Did I hurt your feelingz Kevin?
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Absolutely wild speculation & disinfo spreading that the recent cases of
#malaria
in FL/TX are related to the "GMO mosquitoes" released by a Gates-funded org, and that *of course* Bill Gates has a malaria vaccine for it when HCQ works... one big conspiracy. Let's talk about this.
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And this is all mostly SOFT plaque, with very little calcified plaque.
If he had gotten a CAC score, it would probably have been lower than what you would expect given his amount of disease..
Clearly a false sense of security and he would have been undertreated for his CAD…
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@kevinnbass
He doesn’t owe you or anyone else anything. As a supposed med student you should know that
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Literally the only people fear mongering ‘lockdowns and mandates are coming!!’ are antivaxxers 🤷🏾♂️
Vaccinated folks are happy to get a booster and move on with their lives.
I know a lot of people vaccinated against covid, and a lot who declined the kind offer from our governments.
Uniformly, all the people who still fear covid are vaccinated.
None of the unvaccinated fear it.
According to government narrative on the "safe and effective"…
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But CLEARLY, he has a sh*t ton of plaque. I fixed the most severely blocked areas but you could just as well place stents in the entire artery (we don't do that, obviously).
I barely found a half-decent place to land my stent because there was so much plaque.
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Never thought I’d end up in the NY Post but here we are. Ft
@this_is_mallory
$11 masterclass to HoLisTicAllY and NaTurAllY cure your eyesight issues. Truly monumentally dumb.
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So many people not screened as they should be, *per the guidelines*.
So many eligible patients not on lipid lowering agents AND/OR not treated as they should be, *per the guidelines*.
Statins dropping off after PCI/CABG, and not being continued, *per the guidelines*.
People…
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I get it - guidelines are based on the available data. And data for <40 is lacking, etc etc.
Our guidelines will catch up in 10 years.
But I have eyes, and I can read the latest studies on cholesterol/CVD and the statistics on CVD risk factors in young people.
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TikTok fitness influencer/podcasters are saying that walking is not exercise. Y’all these fitness influencer/Podcasters are not OK. Someone please go check on them.
Just because somebody has a fancy podcast on TikTok or Twitter or Instagram doesn’t mean that they know what…
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A lot of the
#UrgencyofNormal
folks say "Oh, we need to LIVE again. If you get COVID you can easily get paxlovid and monoclonal antibodies, etc and probably be fine." Thread. 1/6
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Cumulative exposure to LDL over time determines a lot of ASCVD risk. The lower the LDL for as long as possible, the lower the risk of ASCVD. Tons of accumulating data on this.
Hyperlipidemia in young adulthood increases risk of CAD later in life.
Yet we wait decades to…
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ASCVD risk scores and all are great but they are not gospel. I'm not a monkey. I'm a clinician trained to use my brain and clinical judgment.
If I see a 30 y/o with an LDL of 130, I'm not telling them to come back in 10 years so I can calculate a nice little ASCVD score for…
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Damar Hamlin called me personally today on FaceTime and I can verify with 100% credibility that he indeed is alive and recovering well. Everyone can go home now!
#DamarHamlin
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The news article linked (seems to be deleted now?) claimed that a recent "cardiac testing" event in Washington found a 53% myocarditis rate.
🚩
#1
- you can't diagnose myocarditis at a random screening event set up at a convention center. That is not a thing.
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@AnilMakam
Anil, the 4000 or so people that died of COVID since the beginning of this month apparently didn’t get your memo that severe COVID is gone!
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Plenty of bullshit on social media demonizing these life saving vaccines, while completely overlooking the harms of viral infection. Sad to see many physicians also downplaying the risks of COVID-19 myocarditis.
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CV risk factors among the young are on the rise or not adequately controlled
From this study of 13,000 20-44 y/o from 2009-2020, prev of HLD decreased from 41% to 37%.
If you allow me to generalize this, 1/3rd of young adults in the US have high cholesterol. Many of them…
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Can any one point me to just ONE legitimate source that shows that sudden cardiac deaths in young athletes have increased since the roll out of vaccines? I don't want random poorly generated evidence-free graphs or bar charts - I want a valid source.
#cardiacarrest
#DiedSuddenly
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I just finished 24 hours of being on call as a doctor.
What a clown 🤡
@sgremminger
Doctors also seem to be the only 9-5 (many 9-4) profession left. I don’t know a singly lawyer who works the schedules doctors work.
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Another fear-mongering garbage clickbait tweet from
@NaturallyFTW
(I'm still blocked).
I'm a cardiologist, and let me tell you why this person doesn't know what they're talking about and why you should not listen to them when it comes to COVID vaccines and the heart. A 🧵
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Why did you not mention this little snippet in the study? Because it greatly attenuates your attempt at alarm?
"The majority of new diagnoses of diabetes occurring in people with baseline glycaemic markers that are close to the diagnostic threshold for diabetes."
Statin…
Add diabetes to the list of statin use risks.
A 36% increased risk of high-intensity statins for inducing new onset diabetes as seen from all randomized, placebo-controlled trials (absolute increase from 3.5% to 4.8%).
h/t
@EricTopol
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Reminder: this public health official and DOCTOR is pushing vaccine misinformation while being fully vaccinated himself and KNOWING that the vaccines are highly safe and effective.
What a shame!
While the Biden administration and Big Pharma continue to blindly push mRNA COVID-19 vaccines, Florida remains dedicated to responding to public health concerns guided by data and common sense.
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This study re-affirms what we know already. COVID-19 infection is far worse for you than the vaccine. When can we put this issue to rest?
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You all are welcome to step outside your bubble and step into the real world with me and you'll see the crisis of hyperlipidemia (and other RF) plaguing the young population in America.
I see it in my communities. And on social media where I have done basic CV prevention…
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1. There is NO evidence that COVID vaccines accelerate the development of coronary artery disease. This is a process that occurs over DECADES. Especially in people that have STRONG risk factors such as smoking.
Malhotra has no evidence for his claims.
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Since this took off a bit: hi everyone! I debunk COVID-19 disinformation and other general BS on here and on my IG/TikTok.
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GeNe ThEraPy 🫠😮💨
The shots are a gene therapy, NOT a vaccine. Are you going to argue now with the inventor of the mRNA technique? 🤨
#stoptheshots
#crimesagainsthumanity
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This is why a tiny bit of knowledge + extreme confidence can be so dangerous.
The first symptom of a congenital heart defect in a young athlete can be sudden cardiac arrest on the field. You can live decades without knowing until you have your event.
@IanCopeland5
@stkirsch
The likelihood of a congenital heart defect not being diagnosed until someone is 18 is slim to none, there would’ve been symptom presentation long beforehand.
And if you actually read the article, it says “likely” caused by, not conclusively.
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