Shreyas Raghavan Nandyal
@shreyas_rn
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Internal Medicine @CookCountyIMR | @CPSolvers Academy | 🇮🇳
Chicago, IL
Joined April 2013
I am an interventional cardiologist who treats heart disease for a living, including by putting stents. This is my opinion on my tweet above. This is aimed at the general public. Long but worth the read: First, some basics: Atherosclerosis (plaque formation) is a NATURAL
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1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣ AKI + portal HTN 🟰hepatorenal syndrome 🖥️: https://t.co/cNg901ck5g
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🚨AGA guideline alert🚨 New Clinical Practice Guideline on the Management of Gastroparesis https://t.co/9rWkalDCjF
@AmerGastroAssn @AGA_Gastro @drkylestaller @margaretzhou @GreerKatar8819 @shailsingh A summary and some reflections to follow👇
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Great to speak with India PM @narendramodi @OfficialINDIAai to share our plans for the first-ever Google AI hub in Visakhapatnam, a landmark development. This hub combines gigawatt-scale compute capacity, a new international subsea gateway, and large-scale energy infrastructure.
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New episode of Channel Your Enthusiasm, part 2 of 3 on metabolic acidosis. Episode with chapters, chapter art, and fully it is referenced (as usual) https://t.co/9AVNCtc3wH
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💯
5/6 So, I’ve updated the diagram. Under “Immune hemolysis,” I’ve added a side branch: “Cell-mediated (T/NK-cell cytotoxicity, DAT-negative)” It’s a footnote in clinical reality but makes the schema more complete for those who enjoy a good hematologic deep dive.
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β-blockers safe pre-discharge in #HFrEF
#COPERNICUS ☠️ benefit in recent decomp https://t.co/RPAODKmbNj
#STRONGHF rapid uptritration ⬇️ events https://t.co/2EGk0obyDg
#IMPACTHF ⬆️ Rx persistence https://t.co/pc0wJkfY7U
#BCONVINCED stopping not helpful https://t.co/GdMoEu5qr8
Heart failure colleagues. I would propose a new focus of emphasis Re the acute Rx of newly decompensated systolic failure. We should favor afterload reduction FIRST. Seminal Beta-blocker trials were in ambulatory outpts. Giving BB to decompensated failure is a mistake. IMO.
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Wow! The @NEJM CPC now has a differential diagnosis provided by AI, Dr. CaBot, created by @arjunmanrai lab @HarvardDBMI, alongside the human expert. Times they are a changing!
I’ve been obsessed with the @NEJM CPCs since I was in grad school. Now, with @tabuckley_, it’s surreal to see @NEJM publish the first AI differential diagnosis in the 100+ year history of the series, generated by our AI system Dr. CaBot, alongside the human expert’s.
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On our latest episode, 'Ammonia Rising', @tony_breu asks a question straight from the hospital wards: Why does valproic acid cause elevated ammonia? https://t.co/QzhdKZlPN3
https://t.co/CFy77lwPOa
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🐅 Tiger Stripes Sign on Doppler = the echo twin of the Seagull murmur 🕊️ 🎧 Musical, high-frequency murmur caused by vibrating mitral leaflet or chordae. On Doppler: fine parallel lines — harmonic “tiger stripes.” Seen in MR, flail leaflet, or HOCM. Hear seagull, see stripes
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2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease Key Change: 🔹In patients with low-flow, low-gradient (LFLG) AS with reduced EF, the 2025 guidelines now place CT aortic valve calcium scoring (AVCS) on equal footing with dobutamine stress echocardiography
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Check out our summary for ESC 2025 trials! Especially before @txchapteracc meeting! #ACCFIT #ACC #CardioX Always a great pleasure to work with @AndreeFrans, future EP ⭐️
Check out our infographic summarizing trials presented at ESC2025 Read more about our section, collaboration, and leadership below https://t.co/WWaZk6BR0u
#MedEd @txchapteracc @utswheart @KTamirisaMD @DrHaloot
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#CardioNugget: Brugada Syndrome: Why that "coved" ST elevation in V1–V3? ✅ Normal heart: Epicardium shows a small phase 1 notch (from transient outward K⁺ current, Ito), but Na⁺ current (INa) dominates, so the notch is shallow. No major voltage gradient → normal ECG. ⚡️
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In patients with provoked venous thromboembolism and ongoing risk factors, extended treatment with low-dose apixaban for 12 months resulted in a lower risk of recurrent VTE than placebo, with a low risk of major bleeding. Full HI-PRO trial results and Research Summary:
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A product of the collaboration with my exceptional colleagues from residency on one of the many remarkable cases we’ve had the privilege to solve together. Happy to see our work published in one of the most recognized journals of medicine. @KirtanPatolia @CookCountyIMR
𝗠𝗼𝗿𝗻𝗶𝗻𝗴 𝗥𝗲𝗽𝗼𝗿𝘁 A 40-Year-Old Woman with Pain in the Chest, Hands, and Feet
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🚨Calling all #MedTwitter #Cardiology enthusiasts🫀 Make sure to join @stephenpanmd and @sukritibanthiya for this exciting Cardiology VMR! ❤️ Monday, September 22nd @ 2PM PST/5PM EST
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In the OASIS 4 phase 3 trial, once-daily oral semaglutide at a dose of 25 mg resulted in a greater mean reduction in body weight than placebo in participants with overweight or obesity. Full trial results: https://t.co/ZCoptDYr8U
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Tumor lysis syndrome has evolved and become less predictable with the introduction of new cancer therapies. A new review explores risk factors and causes of the syndrome, as well as strategies for treatment and prevention. Learn more in the Review Article “Tumor Lysis Syndrome”
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Mineralocorticoid Receptor Antagonists in Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Trials In post-MI patients, MRAs decrease the risk of all-cause mortality and new or worsening HF regardless of HF status @DrMarthaGulati @hvanspall
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📣Announcing Scientific Sessions 2025 Late-Breaking Science 📣 Join us in November to experience the highest tier of scientific discovery and practice-changing educational content. Scientific Sessions 2025 Chairs: @JoChikweMD @bnallamo 📍#AHA25, New Orleans, Nov 7-10
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