Liam Ring

Cardiologist | Lover of Echo, valves, and all things heart-y | Co-chair of education for the BSE @BSEcho

[Liam Ring @LiamHeartChap]

Boooooom!!!!

Thanks to everyone who made it possible. What an awesome couple of days. Now for next years programme…🙄

[Prof Dan Augustine @DanXAugustine]

#BSEcho2023 What a great 2 days for our amazing echo community.
💥1247 attendees!! 💥
Look forward to seeing everyone in Edinburgh for #BSEcho2024 🏴󠁧󠁢󠁳󠁣󠁴󠁿 👍🏾

[Prof Dan Augustine @DanXAugustine]

#BSEcho2023 What a great 2 days for our amazing echo community.
💥1247 attendees!! 💥
Look forward to seeing everyone in Edinburgh for #BSEcho2024 🏴󠁧󠁢󠁳󠁣󠁴󠁿 👍🏾

[Liam Ring @LiamHeartChap]

@cardiochar How did the presentation go lass?

[Liam Ring @LiamHeartChap]

@echo_batman @iamritu @StellEkaterina @alexsfelixecho @strain_rate @echo_stepbystep @dr_benoy_n_shah @alessia_gimelli @JGrapsa @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica @ottoecho Ok so 2 questions:

Why not then use an AVA of 1.1cm or 1.2cm2 if you are simply using it for screening?

And if 30% of patients within that quadrant won’t have severe AS…what echo tool do you use to differentiate the severe from the non severe…?

[Liam Ring @LiamHeartChap]

@cardiochar Booom!

[Liam Ring @LiamHeartChap]

@cardiochar Let’s have some serious ones now please Charlotte…

[Liam Ring @LiamHeartChap]

@Doctor_Darshan @echo_batman @lynne_w12 @JGrapsa @alexsfelixecho @strain_rate @echo_stepbystep @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica 🤔…CTC..?

[Liam Ring @LiamHeartChap]

@echo_batman @echo_stepbystep @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica Well…having abused my ears through years of listening to either 1. The Foo Fighters or 2. Early 90s indie music I can inform you that the sensitivity and specificity of my listening skills is probably close to 0% 😂

[Liam Ring @LiamHeartChap]

@SusilPallikada1 Nope - the apex beat.

[Liam Ring @LiamHeartChap]

Ok on this note…what are the best examination features of severe AS? I’ll go first…

I was once taught my someone ‘old school’ to feel for apical-carotid delay. I’d recommend it. If you can feel maximal apical pulsation BEFORE the carotid it’s always severe AS. Simples

[Vladyslav Kavalerchyk 🇺🇦 🇩🇪 @echo_stepbystep]

@LiamHeartChap @echo_batman @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica #Auscultation and interpretation must be learned carefully, and unfortunately many colleagues, especially in Western countries, no longer master this method 🦻

[Liam Ring @LiamHeartChap]

@echo_batman @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @echo_stepbystep @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica Love this discussion though. I think this is exactly the sort of thing that we should talk about in echo circles. Maybe you could come to @BSEcho conference next year Mr Batman and we could have a debate..(or an ‘argument’ as it is sometimes known 🙄😂)

[Liam Ring @LiamHeartChap]

@echo_batman @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @echo_stepbystep @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica Mean gradient

[Liam Ring @LiamHeartChap]

@echo_stepbystep @echo_batman @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica Yep. A good listen speaks volumes.

[Liam Ring @LiamHeartChap]

@echo_batman @lynne_w12 @Doctor_Darshan @JGrapsa @alexsfelixecho @strain_rate @echo_stepbystep @iamritu @dr_benoy_n_shah @alessia_gimelli @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica Ok I love a debate. I WOULDN’T choose AVA. You say AVA is the most ‘sensitive’ and that is true. But what you need when making a interventional decision is specificity: we can identify AS by simply listening to the heart; when to operate is the the only question that matters.

[Liam Ring @LiamHeartChap]

@StellEkaterina That’s very kind! 🙏🏻🙏🏻🙏🏻

[Liam Ring @LiamHeartChap]

RE the AS discussion (and to toot my flute)…this took A LOT of time to write…it was shredded several times by reviewers…but after much blood sweat and help from coauthors I’m very proud of it. Even though only about 10 ppl have read it 🙄😂 https://t.co/yZQ4UY5g3R

[Liam Ring @LiamHeartChap]

@dr_benoy_n_shah @StellEkaterina @echo_batman @alexsfelixecho @strain_rate @echo_stepbystep @iamritu @alessia_gimelli @JGrapsa @EchoBielefeld @NMerke @PatrizioLancel2 @MAecocardio @fpmorcerf @alcantaramonica 🙌🏻😂

[Liam Ring @LiamHeartChap]

And shout out to those whose help was invaluable when writing it…
@shaunrobinson02
@DanXAugustine
@dr_benoy_n_shah
@Echo_Imaging
@oxborough77

[Liam Ring @LiamHeartChap]

RE the AS discussion (and to toot my flute)…this took A LOT of time to write…it was shredded several times by reviewers…but after much blood sweat and help from coauthors I’m very proud of it. Even though only about 10 ppl have read it 🙄😂 https://t.co/yZQ4UY5g3R