Aditya A Joshi

AHFTx Cardiologist at @URMed_AHF. Son, Husband to @AvanteeG, Dad, Physician. @FCBarcelona. Opinions own.

[Aditya A Joshi @AdiAJoshi]

After slowly coming down from cloud nine, extremely excited to announce that I’ll be joining @UW for my AHFTC fellowship starting July 2022. Truly believe that this endeavor wouldn’t be possible without support from many. Thank you to @AvanteeG @AnantJo23081958 @joshianjali1

[Edgar Argulian @argulian]

Why is there a number in the left atrium?

[Ritu Thamman MD @iamritu]

confusing LVOT Doppler signal w mitral regurgitation due to SAM in hypertrophic CM?

double check if it’s really the LVOT signal by estimating LVOT gradient with SBP/peak MR jet
& see if this matches measured LVOT (4v2) gradient

1.Peak MR signal(velocity) gives LVP-to–LAP gradient (4V2)

2.LVSP estimated by LV-LA gradient + LAP (~10-20mm Hg)

3.LVOT gradient estimated by LVSP – systolic BP #echofirst @echo_batman

[Edgar Argulian @argulian]

A patient with known heart failure admitted with another exacerbation. Why is it important to always pay attention?

[Edgar Argulian @argulian]

Exaggerated pre-systolic wave ('reflected' a wave) in a small, stiff ventricle. This should be differentiated from 'lobster claw' abnormality (systolic phenomenon) seen in dynamic LVOT obstruction, when PW is placed below the flow acceleration.

[Edgar Argulian @argulian]

A patient with small LV cavity, LVH and preserved LVEF. LVOT PW Doppler sampling shown. What are the signals and what are the implications?

[Dr. Rajesh J. MD DM @DrRajeshMAMC]

40-year-old gentleman with uncontrolled systemic hypertension, what are the DTA CW doppler findings ?

[Edgar Argulian @argulian]

It appears that diastolic venous return signals are seen below the baseline, while normally they are seen above the baseline. The subcostal view provides the clue, a hepatic vein draining directly into the lower right atrium: explains the signal directed away from the transducer in 4 chamber and RV inflow views and mixing with faint TR signal into a continuous flow.

[Edgar Argulian @argulian]

Attempted parasternal long axis view 1/2

[Edgar Argulian @argulian]

An intriguing spectral Doppler pattern. A patient with normal biventricular size and function. CW Doppler interrogation across the tricuspid valve in 4 chamber view is shown, consistently yields systolic diastolic flow. Whats are possible explanation?

[Varun C. MD, DM @drcheruvarun]

One of the rare reversible causes of cardiomyopathy.. spot diagnosis!

Unfortunately missed by UK cardiologists who were treating as garden variety non ischemic dilated cardiomyopathy..

[Edgar Argulian @argulian]

3D TEE with transillumination rendering highlighting large protruding atheroma and plaque ulceration in the aortic arch.

Bottom line: keep LDL low earlier in life!

[Michael H. Beasley, MD @MHBeasleyMD]

AHFTC training covers an enormous clinical landscape — MCS, transplant, shock, palliative care, etc. — often in a single fellowship year.

I created the Heart Failure Fellow Lecture Series to help close the education gap.

Free. No paywall. No sign-up. 🎓
https://t.co/0oOG9Ekrlx

[Howard Luks MD @hjluks]

I hear this every week in my office:

"Doc, my heart rate hits 150 during squats — that's cardio, right?"

No. And if your cardiologist hasn't explained why, keep reading. 🧵

[Sanjay Kaul @kaulcsmc]

1/
CHAMPION-AF: When is a 'win' not a win?
When noninferior efficacy isn’t established using stringent relative margin.

When superior safety is not established using unbiased procedural & nonprocedural bleeding patients care about.

Finally, when ischemic stroke risk is ⬆️ 61%.

[Venk Murthy MD PhD @venkmurthy]

@alex1708ander @Hragy @mmamas1973 @iamritu @CASivaram1 @argulian @ParrasJorge2 Unanswerable question which promotes over simplistic thinking about a complex biological system

https://t.co/H4owwobrYn

[Edgar Argulian @argulian]

A elderly patient with persistent atrial fibrillation presenting with dyspnea. Mitral inflow interrogation is shown. What are the findings suggestive of increased left ventricular filling pressures?

[Anish Koka, MD @anish_koka]

The origin story of organ transplant is brutal. (Link in reply)

The 3 precious kids pictured here with surgeon Carl Groth represented the longest anyone had survived with a liver transplant. All were dead within 2 years of this picture being taken.

[Edgar Argulian @argulian]

3D TEE with MPR focusing on the aortic valve 1/2

[Edgar Argulian @argulian]

What does this M mode thru the aortic valve demonstrate?

[Edgar Argulian @argulian]

A patient with dyspnea and lower extremity swelling. Hepatic venous flow was sampled using PW Doppler. 1/2