DARPAN_KOTHIA

MD Internal Medicine, Sacred Heart Hospital, Pensacola, FSU, USA ||

MBBS, MD Medicine. MP Shah Medical college, INDIA

[JAMA @JAMA_current]

#POCUS, or point-of-care ultrasound, can assess the internal jugular vein to estimate #JugularVenousPressure as an approximation of right atrial pressure. Jugular venous pressure can help identify volume overload using ultrasound assessment of the neck vessels.

To assess #JugularVenousPressure with #POCUS, the patient is positioned with the head of bed elevated and the linear probe is placed above the clavicle between the bellies of the sternocleidomastoid muscle. The vertical height from the sternal angle to the point where the internal jugular vein tapers is measured to calculate jugular venous pressure.

📌 Learn more: https://t.co/A3J2gpRbUl

[DARPAN_KOTHIA @DARPANkothia]

@m__kamareddine @stefankmil 🔪 Surgery
Touch Surgery, LapBot Safe Chole, UpSurgeOn, MyATLS, GlobalSurgBox and more

Every tool is credited to its creator and links straight to the tool.
A simulator that belongs on this list? Reply here — the library keeps growing.
#SurgEd #MedEd #FOAMed

[DARPAN_KOTHIA @DARPANkothia]

Every good medical simulator, in one place.

32 interactive tools, one searchable library: echo & cath sims, ventilator & ABG trainers, surgical apps.

Updated weekly. Search, tap, learn 👇
https://t.co/f1KZCT3q7w
#MedTwitter #CardioTwitter #MedEd #FOAMed #MedSim

[DARPAN_KOTHIA @DARPANkothia]

@m__kamareddine @stefankmil 🩺 Medicine
NephSIM, VentCoach and Dr Singh's Vent Sim for ventilation and kidneys
CGMSIM for diabetes, LearnHaem for blood films, an ABG trainer
+ AI virtual patients and clinical reasoning simulators
#MedEd #FOAMed #InternalMedicine

[DARPAN_KOTHIA @DARPANkothia]

@TedOLearyMD @JACCJournals @R_Amin78 Thank you so much for this, Dr O'Leary — this is the teaching point of the case, stated better than we managed. A patch that stops short of an annulus leaves an isthmus; one anchored to the annulus doesn't. Grateful for the diagram too — it makes the anatomy click.

[DARPAN_KOTHIA @DARPANkothia]

Grateful for the opportunity to have our case report published in JACC: Case Reports : "Sustained Monomorphic Ventricular Tachycardia Decades After Ventricular Septal Defect Repair."
https://t.co/8ux0JLnbkg
@JACCJournals @R_Amin78 #JACC

[DARPAN_KOTHIA @DARPANkothia]

@PriyankC05 The breakdown from PUSH-AHF itself (n=310): 43% were diuretic-naïve. The other 57% were already on home loop diuretics — 21% on ≤1 mg bumetanide equivalents, 36% on >1 mg. So the 2-hour urine Na rule was tested mostly in chronic users, not naïve patients.

[DARPAN_KOTHIA @DARPANkothia]

78-year-old with acute decompensated HF gets his first IV furosemide dose in the ED. Two hours later, do you wait for tomorrow's weight and creatinine — or check one number now? Spot urine sodium. 🧵 #CardioTwitter

[Mohammed Kamareddine, MD @m__kamareddine]

Apple is taking its sweet time reviewing EchoSuite, so rather than keep waiting, I’ve decided to launch it on the web! The upside is that It is available to everyone.

🌐 https://t.co/lxl7TTjJUy

EchoSuite brings together a real-time, anatomically labeled TTE simulator with interactive coaching and a fully adjustable 3D scene to make things more intuitive. It also includes echo calculators, and illustrations to guide you through image acquisition and measurements.

[Stefan Milutinovic @stefankmil]

I created LearnCoronary (https://t.co/VtlXhrUHJv), an interactive tool designed to help general cardiology fellows and other early-career learners better understand coronary angiography and the spatial relationships between different angiographic views.

#cardiotwitter @OpenAI

[Claude @claudeai]

A cardiology fellow built a 3D tool to help trainees learn to read coronary angiograms.

[DARPAN_KOTHIA @DARPANkothia]

Reference: Ter Maaten JM et al. Natriuresis-guided diuretic therapy in acute heart failure: a pragmatic randomized trial (PUSH-AHF). Nat Med. 2023;29:1020–1028.

[DARPAN_KOTHIA @DARPANkothia]

Caveats: the 2-hour value guides the next dose — it doesn't replace urine output, exam, and daily weights. Hard-outcomes benefit is unproven; it's a decongestion tool, not a mortality tool.

[DARPAN_KOTHIA @DARPANkothia]

@JACCJournals @R_Amin78 4/4
The lesson: ECG plus multimodality imaging can point to a plausible postoperative substrate — but don't claim patch-dependent reentry until electroanatomic mapping proves it. And arrange lifelong ACHD surveillance — he had none as an adult.
#CardioTwitter #EPeeps

[DARPAN_KOTHIA @DARPANkothia]

@JACCJournals @R_Amin78 3/4
IV amiodarone and lidocaine both failed. 200 J synchronised cardioversion restored sinus rhythm. He left on sotalol with a secondary-prevention dual-chamber ICD. Ablation deferred — no recurrence, and mapping a congenital substrate needs congenital EP expertise.

[Emmanuel Daniel @eodanielmd]

🫀 Suicide LV after TAVR

•Afterload drops → small, hyperdynamic LV obliterates its cavity → dynamic obstruction + shock.

•At risk: women, small LV, septal LVH, high EF/gradient.

•Treat: fluids, phenylephrine, β-blocker. STOP inotropes.