Brian Wood Vladyslav Kavalerchyk 🇺🇦 BCM Cardiology American Society of Echocardiography Aga Khan University American College of Cardiology Texas Chapter - ACC Jing Liu, MD Ritu Thamman MD Echo for fellows Benoy Shah MD Jan Verwerft Roosha Parikh Timir Paul, MD, PhD, FACC, FSCAI, FAHA Shelley Hall Raj Janardhanan, MD, MRCP, FACC, FASE John Lee Misha Dagan I thought it was a gigantic ASD🫀 However, the shunt run🪡 had NO step up at any level (unremarkable Qp:Qs). Then reviewing #YesCCT (from earlier in ER to r/o PE🫁) showed the septal bulge, but NO mixing of contrast.👇 So, this seems like a prominent interatrial aneurysm 🎯

45👨 w HTN. Asymptomatic. 👁️#EchoFirst➡️ PV = 3 m/s (descending Ao) 🎯#YesCCT➡️CoA 🪡Invasive P-P gradient=10 mmHg ➰3 Qs 1. Why are Echo & Cath gradients discordant? 2. Post-stenotic dilation or just aortopathy? 3. Management (Ao appears infolded)? #CardioTwitter #ACCFIT

"Nailing" of ostial LAD gone wrong 😢 Patient had PCI to LAD somewhere, but sx never improved, now coming in for 2nd opinion. What would u do now? 📌Teaching point for #ACCFIT: PCI of true ostial LAD lesion 👉 cross over to LMCA, & use imaging. #CardioTwitter #Cardiology

Inferior STEMI 💔 Ectatic RCA. Filled with extensive clot. What would be ur strategy? 🪡 #CardioTwitter #ACCFIT #Cardiology #MedTwitter BCM Cardiology AKUCardiology Waleed Kayani Osama Bisht Jeffrey Wilson, MD SCAI American College of Cardiology Texas Chapter - ACC

Erwin Mulia BCM Cardiology AKUCardiology Waleed Kayani Osama Bisht Jeffrey Wilson, MD SCAI American College of Cardiology Texas Chapter - ACC Mamas A. Mamas Dr Shariq Shamim Hany Ragy Khalid Minhas, MD FACC Hooman Bakhshi Jing Liu, MD Nyal Borges Poonam Velagapudi Dr Imran Hanif Hashmi Dr. Krzysztof Pujdak Great discussion! Here’s what we did: 1. Upfront multiple slow runs of aspiration (penumbra) 2. Protected rPDA 3. IVUS-guided stenting We were ready with distal vasodilators in case there was no reflow, but did not need it. Triple therapy x 1 month. Then Plavix + Apixaban.

75 👱‍♂️➡️Completely Asymptomatic. Normal Echocardiogram 🫀 ⚡️CAC score = 3013! 💥 🔸Other than optimizing primary prevention, would you do anything else? #CardioTwitter #ACCFIT #Cardiology #MedTwitter #CVPrev BCM Cardiology Aga Khan University American College of Cardiology Texas Chapter - ACC #YesCCT

🧵How to use #yesCCT data to perform low contrast coronary angiogram 👇 📌Patient below w/ #CKD, unknown graft anatomy. Used prior CT data to perform cor angio + bypass graft angio with minimal dye🪡 Read 8 pointers below🧵1/4 #CardioTwitter #ACCFIT #Cardiology #MedTwitter

🔥Key considerations 👇 1. #RadialFirst >> #SafeFemoral, but if doing femoral, can avoid femoral angio by using ultrasound pre, during & post sheath placement 2. Review CT. Look at native coronaries, including origin (e.g. anterior take off), any ostial disease etc 🧵 2/4

3. Identify exact location of graft ostia in relation to sternal wires🍥 4. Use saline injections to confirm engagement (T wave changes) if normal pressure waveform💉 5. Print out CT info, and paste it on the screen so you could use it as a map during the case 🧵 3/4

6. Examine femoral anatomy (any disease, pattern of calcification, CFA bifurcation relative to femoral head). 7. Inject small volume of dye (e.g. 3 cc) and do long cine's to follow contrast (including collaterals) 👀 8. Stage any PCIs if possible. 🪡 🧵 4/4

Hady Lichaa, MD, FACC, FSCAI, FSVM, RPVI BCM Cardiology Mamas A. Mamas Timir Paul, MD, PhD, FACC, FSCAI, FAHA Khalid Minhas, MD FACC Jing Liu, MD Aditya Bharadwaj Hooman Bakhshi Hany Ragy Syed Ali Naqvi 💯 When performing cath on a patient with prior CABG, I look for ANY chest CT in the system. Even if it’s a non-gated, non-cardiac CT, it always helps

🔥Acute PE can present as ST Elevation! Great #CardioTwitter #ACCFIT #PERT teaching case by Syed Zaid, MD 👇 ♦️Presentation: Shock & "STEMI" 📈 ♦️Emergent cath ➡️ Normal coronaries ♦️RHC for shock: RAP 22, CI 1.2, MAP 50 💔 ♦️PA gram ➡️ b/l PE ➡️ Thrombectomy➡️ Normal PAP & MAP

⭐️Exploring the Tricuspid Valve: The Next Frontier? 🚀 Understanding Atrial vs. Ventricular Functional TR & its Impact on Outcomes. Tune in for my interview with Dr. Maria Korber, senior author of today's #JACCINT publication to delve deeper👇 📖 Full Text:

✴️Summary points✴️ 🧿Atrial Functional TR (A-FTR) vs Non-Atrial Functional TR (NA-FTR) 🧿Multicenter study examining 1-yr outcomes (165 consecutive patients undergoing Transcatheter Tricuspid Annuloplasty (TTVA)) 🧿62 A-FTR vs 103 NA-FTR patients. Latter had more RV remodeling

✴️Summary points✴️ 🧿 Leadless vs TV Pacemaker Post-TAVR: Medicare fee-for-service patients aged 65+ 📊👵 🧿 Patient Overview: 10,338 individuals (730 Leadless, 9,608 TV) 🧑‍⚕️👩‍⚕️ 🧿 Growth of Leadless PPM: Increased 3.5 times between 2017 and 2020 📈🚀 🧿 Leadless PPM Recipients:

⭐️ Curious about long-term outcomes after M-TEER for secondary mitral regurgitation? 🎙️ Catch my interview with 1st author Dr. Stocker on today’s #JACCINT publication! 📖 Full Text: jacc.org/doi/10.1016/j.… 🔍 Key takeaways in comments! #CardioTwitter #Cardiology #ACCFIT 1/2

✨ Key Takeaways ✨ 🔹 1,628 patients from the Euro-SMR registry 🔹 Mean age: 74 years, with 87% in NYHA Class ≥ III 🔹 5-year MR reduction: 86% 🔹 5-year functional improvement: 60% 🔹 5-year survival rate: 35% 🔹 Independent predictors of 5-year survival: age, renal function,

✨ Key Takeaways ✨ 🔹 First-in-Human Study of Magenta Elevate 🌟 (9F self-expanding, catheter-mounted MCS via 10F sheath) 🩺 — providing support up to normal CO 🔹 14 patients underwent high-risk PCI 💉 🔹 No major device-related adverse events 🚫 (primary safety endpoint met

Check out the #JACCINT State-of-the-Art Review on 🏥 Renal Denervation 💉 for #hypertension & chronic heart failure. Covers #physiology, evidence 📊, tech 🛠, & future directions incl. multiorgan denervation. jacc.org/doi/10.1016/j.… #CardioTwitter #Cardiology #RDN

How many times a day are you asked, “How are you?” For many Veterans, it’s easier to say “I’m fine” than open up on how you really feel inside. Don’t wait to hit rock bottom to take action. content.govdelivery.com/accounts/USVHA…