Ritika Tuli (@ritikatulimd) 's Twitter Profile
Ritika Tuli

@ritikatulimd

🫀 FIT @AHNCVFellows | ACC Editorial Fellowship 24-25 I Proud alum of @IMMWHC @kmc_manipal l Passion for MedEd- Watch out for #CardioNuggets ! Tweets are my own

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linkhttps://www.linkedin.com/in/ritikatuli/ calendar_today13-07-2021 19:08:32

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Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

🚨 #CardioNuggets: Decoding Coronary Physiology in the Cath Lab CFR (Coronary Flow Reserve) = Total flow capacity   CFR = Normal > 2.0 FFR (Fractional Flow Reserve) = Epicardial disease?   FFR = Pd/Pa → Normal ≥ 0.80 IMR (Index of Microcirculatory Resistance) =

🚨 #CardioNuggets: 

Decoding Coronary Physiology in the Cath Lab 

CFR (Coronary Flow Reserve) = Total flow capacity   CFR = Normal > 2.0

FFR (Fractional Flow Reserve) = Epicardial disease?
  FFR = Pd/Pa → Normal ≥ 0.80

 IMR (Index of Microcirculatory Resistance) =
Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets 🫀 Nuclear Pharmacological Stress Agents 101 💉 Adenosine, Regadenoson, Dipyridamole — all induce coronary steal by vasodilating healthy vessels → ↓ perfusion to stenotic areas. 🧠 Regadenoson = A2A selective → fewer side effects ⚡ Adenosine = short

#CardioNuggets 🫀

 Nuclear Pharmacological Stress Agents 101

💉 Adenosine, Regadenoson, Dipyridamole — all induce coronary steal by vasodilating healthy vessels → ↓ perfusion to stenotic areas.

🧠 Regadenoson = A2A selective → fewer side effects
⚡ Adenosine = short
Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets North-South Syndrome on VA-ECMO: 🧠💔 Brain & heart get hypoxic blood (native, poorly oxygenated). 🦵 Rest of body gets well-oxygenated ECMO blood. 🚨 Look for low right arm sats! 🔧 Solutions: Improve lungs, ↑ ECMO flow, axillary cannula, or VAV-ECMO.

#CardioNuggets

North-South Syndrome on VA-ECMO:

🧠💔 Brain & heart get hypoxic blood (native, poorly oxygenated).

🦵 Rest of body gets well-oxygenated ECMO blood.

🚨 Look for low right arm sats!

🔧 Solutions: Improve lungs, ↑ ECMO flow, axillary cannula, or VAV-ECMO.
Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets 🫀 Class IC Antiarrhythmics: Flecainide & Propafenone 🔹 Strong Na⁺ channel blockers → ↓ conduction velocity (Phase 0) 🔹 Great for AF in structurally normal hearts 🚫 Avoid in CAD or HF ➡️ Proarrhythmia risk in post-MI (CAST trial) ➡️ Negative inotropy 💔

#CardioNuggets

🫀 Class IC Antiarrhythmics: Flecainide & Propafenone

🔹 Strong Na⁺ channel blockers → ↓ conduction velocity (Phase 0)
🔹 Great for AF in structurally normal hearts

🚫 Avoid in CAD or HF
➡️ Proarrhythmia risk in post-MI (CAST trial)
➡️ Negative inotropy 💔
Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets Dofetilide (Tikosyn) Class III anti-arrhythmic that blocks IKr → prolongs repolarization (↑ QT, ↑ ERP) without slowing conduction. ✅ Safe in HFrEF (DIAMOND-HF) ⚠️ Key Considerations: -Must be initiated in hospital (≥3 days) due to risk of Torsades de

#CardioNuggets

Dofetilide (Tikosyn)

Class III anti-arrhythmic that blocks IKr → prolongs repolarization (↑ QT, ↑ ERP) without slowing conduction.

✅ Safe in HFrEF (DIAMOND-HF)

⚠️ Key Considerations:
-Must be initiated in hospital (≥3 days) due to risk of Torsades de
Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets 💡 Why are some antiarrhythmics better for acute rhythm control vs maintenance? 📈 Use dependence = ↑ drug binding at fast HRs (Na⁺ channels open more) 🔹Flecainide, Propafenone → great for acute rhythm control 📉 Reverse use dependence = ↑ effect at slow

Ritika Tuli (@ritikatulimd) 's Twitter Profile Photo

#CardioNuggets 💡 Why combine beta blockers with Class IC antiarrhythmics? 🧪 IC agents (flecainide, propafenone) show use dependence—great at high HRs, ideal for AF cardioversion. 🚨 But they don’t block AV node → risk of 1:1 flutter or rapid AF. 🛡️ Beta blockers prevent

Bradley Petek (@bradleypetek) 's Twitter Profile Photo

We are recruiting for a 1-year combined Sports Cardiology and Hypertrophy Cardiomyopathy Fellowship at OHSU in Portland, Oregon starting July 2026. See below for details!

We are recruiting for a 1-year combined Sports Cardiology and Hypertrophy Cardiomyopathy Fellowship at OHSU in Portland, Oregon starting July 2026. See below for details!
Women in Heart Transplantation and MCS (@womenintxp_mcs) 's Twitter Profile Photo

Why Are Women Still Being Left Behind in Heart Failure Care? Join us Monday, May 12th at 7:00 PM CST for the first session of the WiTMCS #AHF Therapies in Women Webinar Series Cindy M. Martin Eileen Hsich #SharonBethLarson Aditi Nayak

Why Are Women Still Being Left Behind in Heart Failure Care?

Join us Monday, May 12th at 7:00 PM CST 
for the first session of the WiTMCS #AHF Therapies in Women Webinar Series
<a href="/CindyMMartinMD/">Cindy M. Martin</a> <a href="/Dr_Eileen_Hsich/">Eileen Hsich</a> #SharonBethLarson <a href="/AditiNayakMD/">Aditi Nayak</a>
Jennifer Co-Vu, MD, FACC, FAAP, FASE (@drjenniferco_vu) 's Twitter Profile Photo

To all the mothers, especially women in cardiology—healing hearts 🫀at work, holding hearts❤️ at home🏡. You lead, you nurture, you persevere. ❤️ Today we celebrate your strength, your love, and the difference you make every single day! Happy Mother’s Day👩‍🍼👩‍⚕️! #ACCWIC

Narendra Modi (@narendramodi) 's Twitter Profile Photo

To those who feel slightly dejected at their scores, I want to tell them: one exam can never define you. Your journey is much bigger and your strengths go far beyond the mark sheet. Stay confident, stay curious because great things await. #ExamWarriors

Leen Dabbas (@leenhanidabbas) 's Twitter Profile Photo

Excited to share that I graduated as Chief of the Global Health Track. I am very honored to have presented our project during my visit to Jordan and I look forward to continuing our work on AMR and making a difference! Grateful to my mentors for their guidance and support.

Excited to share that I graduated as Chief of the Global Health Track. I am very honored to have presented our project during my visit to Jordan and I look forward to continuing our work on AMR and making a difference! Grateful to my mentors for their guidance and support.
Lucas Battel, MD (@battel_) 's Twitter Profile Photo

What an amazing week — from presenting AHN_CVI Grand Rounds on the impact of AI in Cardiology, with my co-chief fellow Nikos, to spending the day with the phenomenal #EP pioneer Dr. Mel Scheinman, MD. Very thankful to AHN Cardiology Fellowships and #DrAmitThosani for these unique

What an amazing week — from presenting <a href="/AHN_CVI/">AHN_CVI</a> Grand Rounds on the impact of AI in Cardiology, with my co-chief fellow <a href="/DrNikosPappan/">Nikos</a>, to spending the day with the phenomenal #EP pioneer Dr. <a href="/MelScheinman/">Mel Scheinman, MD</a>. Very thankful to <a href="/AHNCVFellows/">AHN Cardiology Fellowships</a> and #DrAmitThosani for these unique