Steven Napierkowski, MD, FACC, FSCAI

Interventional cardiologist, Tomball, Texas

[Juanita Broaddrick @atensnut]

AMEN!!

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@aceddeca1 @drdanchoi @mcuban Great point!

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@Rick_Pescatore This is the right attitude!

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@BBGreatMoments Jeff Bagwell

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@panagis21 Love it! Also, nice office!

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@drjohnm Anatomic info > risk score.

[Angioplasty.Org @angioplastyorg]

@Tesslagra @ctayg @DrRajeshG1 @HeartOTXHeartMD @iamritu @mmamas1973 @Hragy @ShariqShamimMD @abadkhan2002 @georgetolisjr @GianTorre610 Rich - Judkins developed the femoral approach in mid-60s; wanted Sones to visit. Favalaro, who studied Sones' films, did his 1st CABG in 1967. So I assume by the mid-to-late-60s selective angiography was standard, esp. after Judkins made the technique much simpler. #AngioHistory

[Martin Picard @MitoPsychoBio]

Beautiful animation of metabolic flux in the mitochondrial Kreb (TCA) cycle

The three "CO2" coming off the cycle is how you lose weight: carbon from your material body coming off as gas you end up breathing out

By @janetiwasa

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

Would energy balance improve stress tests? PET scans already track blood flow to the heart muscle. Add oxygen saturation + hemoglobin, and you’ve got calories delivered. Then estimate or preferably measure calories burned. Match supply to demand to guide revascularization

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

Ever see a large language model multidimensional dataset splashed down on a 2D graph? Looks just like the scatter plots we have in our research trials. Scary to think how rudimentary our current tools are. #AI #medicine #research

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@DiscardedJ0ker @Paul_Wischmeyer @HeidiEngel4 @TantamKate @KatarzynaKotfis @nickmmark @DaytonICU @IvensGiacomassi @fisioprecoce @icurehab @Manu_Malbrain @IM_Crit_ @TomVargheseJr Yeah not sure this makes sense to me. Usually trach before ambulating them if vent dependent like this. Seems like less risk to the oropharynx to me.

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@DrBIqbal If I recall correctly it was Grantham that described this several years ago about bival in cto PCI. He said that it tends to clot if there’s not a good flow of blood unlike heparin. I think he said this used to happen during brachytherapy cases performed with bival.

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@YuvalBibiMDArt Well said!

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@praneet_manekar Himalayan p-waves. Afib. Ebsteins.

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@anish_koka This is such a great take.

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@DutchRojas Agree 100%

[Dutch Rojas @DutchRojas]

The independent practice of medicine is about more than business, it’s about better outcomes.

Health systems prioritize profits over patients.
They impose quotas, cut visit times, and dictate care based on contracts, not clinical judgment.

Independent physicians?
They don’t receive special funds from the federal government.
They also don’t receive special bond raises from municipalities.
They answer to patients, not corporate executives.

That’s why outcomes are better, prices are lower, and trust is higher.

That’s #healthcare

[Steven Napierkowski, MD, FACC, FSCAI @SCNapierkowski]

@JeffryGerberMD @sweatystartup I agree with this take. I will usually order a reasonable test for a patient if it’s requested. I guess our job as physicians is to decide what is reasonable. I don’t see why something like a CBC should be a big deal.