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
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
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.
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.
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?
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..
3D TEE with transillumination rendering highlighting large protruding atheroma and plaque ulceration in the aortic arch.
Bottom line: keep LDL low earlier in life!
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
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. 🧵
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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%.
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?
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.