Matt Villanyi

EM/CCM | CHS Ping Pong Champion

[Matt Villanyi @MatthewVillanyi]

@LeivaOrly Agree completely. Sometimes get pushback along the lines of "well they're sick and might get a fistula at some point so you shouldn't do anything that could lead to subclavian vein stenosis." Even for a flimsy little triple lumen CVC. Different for a big HD line, obviously

[Matt Villanyi @MatthewVillanyi]

@NicoGagelmann Fluids + po bicarb + lasix = poor man's dialysis

[Matt Villanyi @MatthewVillanyi]

@MDtheDO Doctor, can you send us some pen recommendations

[Matt Villanyi @MatthewVillanyi]

@MDtheDO My parents

[Matt Villanyi @MatthewVillanyi]

@MDtheDO @NYEmergency Low chloride can be a sign of contraction alkalosis which can hide a metabolic acidosis and falsely raise your bicarb

[Matt Villanyi @MatthewVillanyi]

@andxro For our assay normal is <40
Hers were 700 ➡️ 800 ➡️ 1000 ➡️ 3000 before she finally went to cath

[Matt Villanyi @MatthewVillanyi]

Late 30s female. Few months of chest pain acutely worsened prior to arrival. Pleuritic and worse with supine position but also exertional and alleviated with rest. 2nd ECG has posterior leads and was done 2hr later. Answer in thread #ECG #EKG #medtwitter #cardiotwitter #FOAMEd

[Matt Villanyi @MatthewVillanyi]

@safwanmsnr @RipDStar Typical anatomy is a posterior descending artery (PDA) that is usually supplied by RCA yes, but some patients (~5-10%) get it from the LCx. This is the idea of right vs left heart dominance. Smaller group are codominant (PDA comes from both sides)

https://t.co/nhkYvjRdfc

[Matt Villanyi @MatthewVillanyi]

@EcgOxford @DidlakeDW @Vadeboncoeur_Al @The_Nanashi_O @PendellM @BrooksWalsh @smithECGBlog @SergioPinski @UlhasDr @syamkumarmd @ekgpress @Fenerist63 @EM_RESUS @adribaran @PPodrid @ecgrhythms @EcgsOnly @ECGWeekly @JasonWinterECG @ECGcases @ECGfan @RobertHermanMD @FloydECGs TTE “inferolateral wall is moderately hypokinetic. The inferior wall is moderately hypokinetic. All other wall segments are normal in function”

[Matt Villanyi @MatthewVillanyi]

@PendellM Peaked at 2,965 about an hour before cath (normal for us is <40)
TTE “inferolateral wall is moderately hypokinetic. The inferior wall is moderately hypokinetic. All other wall segments are normal in function”

[Matt Villanyi @MatthewVillanyi]

@MDtheDO I also think we under-utilize Mg. Works well especially when combined with amio. I also just found this trial in the works, will be interesting to see how it goes: https://t.co/erjLzE7k6L Mg+dig vs amio

[Matt Villanyi @MatthewVillanyi]

@PharmERToxGuy I can definitely remember a few shifts where our pharmacists saved more lives than the physicians! We love our EM pharmacists

[Matt Villanyi @MatthewVillanyi]

@RobertHermanMD @EcgOxford @MaruanCarlos @The_Nanashi_O @ShariqShamimMD @UlhasDr @DidlakeDW @ecgrhythms @syamkumarmd @DrRajeshG1 @AslangerE @Vadeboncoeur_Al @amalmattu @EF_Cardiaca @smithECGBlog @EM_RESUS @FloydECGs @EMS12Lead @martinfd78 @EPeeps_Bot Sent you a message!

[Matt Villanyi @MatthewVillanyi]

60s F, CP @EcgOxford @MaruanCarlos
@The_Nanashi_O @ShariqShamimMD
@UlhasDr @DidlakeDW @ecgrhythms
@syamkumarmd @DrRajeshG1 @AslangerE
@Vadeboncoeur_Al @amalmattu
@EF_Cardiaca @smithECGBlog
@EM_RESUS @FloydECGs @EMS12Lead
@martinfd78 @EPeeps_Bot
#ECG #EKG #CardioTwitter
#FOAMed

[Matt Villanyi @MatthewVillanyi]

@EcgOxford @ecgrhythms @MaruanCarlos @The_Nanashi_O @ShariqShamimMD @UlhasDr @DidlakeDW @syamkumarmd @DrRajeshG1 @AslangerE @Vadeboncoeur_Al @amalmattu @EF_Cardiaca @smithECGBlog @EM_RESUS @FloydECGs @EMS12Lead @martinfd78 @EPeeps_Bot Upon review of the rest of her admission, she did report several more episodes of chest pain and eventually got her RI stented about a week after presentation

[Matt Villanyi @MatthewVillanyi]

@VivPaps @JSinghDO 2/2 They'll work two weeks of 5-6 shifts (the number goes down if the shifts are 12hr) and then will have multiple weeks off in a row every month to travel or spend time with family. It's very job dependent but things like that do exist out there and they allow full happy lives

[Matt Villanyi @MatthewVillanyi]

@VivPaps @JSinghDO 1/2 Tbh I disagree with the original poster, in a lot of ways it is very much a lifestyle specialty. Yes you may have to pick up some extra holidays or weekends but I have friends who recently graduated who now have more time than ever