Hopkins Advanced Heart Failure Transplant Faculty. #hopkinsheart. Osler residency alum. #washumed. Notre Dame obsessed. Tweets are my own (if there are tweets)
#TipsForNewAttendings
Trainees often ask questions like “Do you want increase Lasix today?”
My favorite response: “What do YOU want to do?”
Encourage them to make the decisions- prepare them for when you’re no longer their safety net!
#kittlesonrules
#TipsForNewDocs
Before ordering a test, have a plan for a normal, abnormal, or indeterminate result. If this thought experiment demonstrates the test won’t change management, or if you don’t know how to interpret/act upon all possible results, don’t order it.
#kittlesonrules
Kicking off the first wet lab of the academic year with a combined plastic surgery / cardiac surgery discussion on sternal / wound closure. Big shout out to Dr. Lily Mundy of plastics and Dr. Hamza Aziz of cardiac for lending their expertise. @HopkinsCTSurg
#TipsForNewDocs
You’re never too important to pre-round. Almost 20 years from training, I still review labs & notes from RNs & consultants before team rounds.
If you have an idea of the plan, rounding is more efficient and you can spend more time teaching.
#kittlesonrules
Excellent study (congrats @BrenerMickey et al) with and eloquent editorial summarizing such an important study. Much to be learned based on our prior results along with these and looking forward to more work in this field. @stevenhsu_md
And important editorial by @Brian_Houston12 & @JamesCFangMD
A lot of factors to consider. @stevenhsu_md@Js08Paul
Optimizing Hemodynamic Interventricular Interactions in LVAD Recipients: Is Speed Everything? | JACC: Heart Failure https://t.co/4s2QujgnUO
#TipsForNewDocs
Phrases to avoid on rounds:
Gentle diuresis (be specific!)
Soft blood pressure (can it be hard?)
Making good urine (what's bad urine?)
Specific assessments and goals/targets = better care.
#kittlesonrules
Fantastic experience being a faculty member with the incredible @NirUrielMD and @AlbertHicksMD at the @AbbottCardio Advanced MCS Topics course in NYC 🫀👩⚕️🌆
I always learn so much and am so inspired by my colleagues across the country!
Amazing work that will increase the donor pool for patients waiting on scarce organs ! Huge shoutout to @APolancoMD@cpasrij - absolute studs in the heart failure program for their dedication and tireless efforts !
Why does late RHF occur post LVAD?
LVAD unloading diminishes septal contraction, which weakens RV contractility. Coupled with persistent RV afterload, it leads to RV-PA uncoupling in the LVAD. @RyanTedfordMD @Brian_Houston12 @NavinKapur4@JonGrinsteinMD@MarkBelkinMD
Check it out! We loved doing this work and continue to do so. Many insights to be gained from PVL and correlation with clinical variables to try and bring to the broader LVAD patient community
Pressure-volume loops uncover occult RV dysfunction & ↓ reserve in LVAD, w/ PAPi as potential surrogate; ↓septal contraction 2/2 LV unloading a possible mechanism based on echo septal strain @Js08Paul, @stevenhsu_md, @hopkinsheart
🔗 https://t.co/p24p5RxThg
Pressure-volume loops uncover occult RV dysfunction & ↓ reserve in LVAD, w/ PAPi as potential surrogate; ↓septal contraction 2/2 LV unloading a possible mechanism based on echo septal strain @Js08Paul, @stevenhsu_md, @hopkinsheart
🔗 https://t.co/p24p5RxThg
Novel insights into the prevalence of intrinsic RVD and the importance of IVS and summed RV afterload in the RV-PA coupling during LVAD support.
https://t.co/Se8mgsj9HB
⬆️LVAD speed may impact RV function via septum
⬇️LVAD speed may impact RV function via afterload
🚨Excellent study of RV physiology using PV loops by @stevenhsu_md. PAPi as the best surrogate for RV-PA coupling?
@RyanTedfordMD@ISHLT@TheJHLT@MKIttlesonMD