It’s official! Blessed to have matched into cardiology fellowship @MountSinaiMiami! Extremely grateful to everyone who believed in me and formed part of this journey. I’m so excited for this new chapter in such a beautiful and fascinating field! #CardiologyMatch#MatchDay#NRMP
graduating AHFTC and this 1 year along side learning higher end HF technology I kept publishing several manuscripts with my team @metaacademy_ofc and we made really good papers. DM me to know more#link to register https://t.co/y1saeaB81G
Excited to share our recently published article on device-based therapies in cardiorenal syndrome! A project in the works since THT 2025.
Link:
https://t.co/5ZSYRHo3Cd
#CardioTwitter#HeartFailure#Cardiology
The Right Approach- For Whom?
Check out my latest on NEJM Voices: A cardiologist learns that end-of-life care is an iterative process.
And please sign up for FREE email alerts (link below) so you're always aware when a new piece drops!
https://t.co/Cjccj9wd5y
What do heart failure, atrial fibrillation, rheumatic heart disease, and a purple flower have in common? One drug: digitalis. Used for centuries, dismissed by many, now being re-examined with modern trial data. Here's what you need to know. 🧵
Excited to share this exciting case of a sinus of Valsalva rupture which was just published on Cases of SCMR. Check it out below! Grateful for the support from my mentor @seth_uretsky@morristownheart 🙌🏻
#CardioTwitter#Cardiology
Answer Revealed! 🫀 — May 5 CMR Case
This is an example of a sinus of Valsalva rupture into the right atrium, creating a left-to-right shunt as well as aortic insufficiency.
👉 Read the full case here: https://t.co/BlelcP4LT1
New CMR Case Drop! 🫀
What is the diagnosis of a 66 year old female who presented with dyspnea based upon the CMR images provided?
👇 Drop your answer below!
Answer revealed soon…
#SCMRCases#WhyCMR
Can we improve #STEMI outcomes by changing when we intervene?
🎷STEMI-DTU evaluates LV unloading with Impella before reperfusion.
A physiology-driven shift in STEMI care?
➡️ Key results: There was no difference!
🎷 heart-muscle damage was not significantly different: 30.8% TV-mAFP vs. 31.9% control
🏥 55
💃🏻21%
Mean age 61y
47 minutes longer for Impella group in time to reperfusion (but no diff in heart muscle damage despite this delay)
@JACCJournals
#ACC26 #LBCT #STEMIDTU
📎 https://t.co/P2rdqyhAlb
🫀 SPORTS CARDIOLOGY: what every cardiologist should know
New review just out 👉
Exercise is medicine… but not always harmless.
⚠️ Key message:
Sudden cardiac death (SCD) in athletes is rare (~1:50,000) but often the first manifestation of underlying disease
🔍 What really matters in practice?
1. Screening works (but not perfectly)
✔️ ECG-based screening can reduce SCD by up to 90%
❗ Still misses ~20% of conditions (e.g. coronary disease, fibrosis)
2. Athlete’s heart ≠ cardiomyopathy
The biggest challenge is NOT finding disease…
👉 it’s not overcalling disease
Physiological adaptations can mimic:
HCM
DCM
ARVC
LV non-compaction
➡️ Requires multimodality approach (ECG + imaging + exercise + genetics)
3. Red flags you should never ignore 🚩
Exertional syncope
Chest pain
Family history of SCD
Abnormal ECG (TWI lateral, ST depression, Q waves)
4. CMR is your best friend
👉 Especially when ECG is abnormal
👉 Detects fibrosis and subtle cardiomyopathy
(Yes… this aligns perfectly with what we see in ACM/arrhythmogenic phenotypes 👀)
5. Exercise prescription is evolving
❌ Old approach: “stop sport”
✅ New approach: shared decision-making
Some key points:
ARVC / desmosomal variants → avoid high-intensity exercise
Low-risk HCM/DCM → may still participate
Myocarditis → no sport for ≥3 months
6. The new frontier: master athletes 🏃♂️
↑ atrial fibrillation (3–5x)
↑ coronary calcium
↑ myocardial fibrosis
👉 Long-term effects still unclear
🧠 Take-home message
Sports cardiology is not about restricting athletes.
It’s about:
✔️ Identifying risk
✔️ Avoiding misdiagnosis
✔️ Enabling safe exercise
💡 My reflection:
This is exactly where imaging + genetics + phenotype integration becomes critical — especially in early/arrhythmogenic cardiomyopathies.
https://t.co/bQFlrEKZnS
#acc26 Six reasons why CHAMPION AF should not change oral anticoagulation for AF
I will have a formal post up on @theheartorg but here is a short summary
1) Stroke and Ischemic Stroke went the wrong way.
All S -> 33 vs 50 [HR 1.46 95% CI, 0.94-2.27)]
IS -> 27 vs 45; [HR = 1.61; 95% CI, 1.00-2.59)]
Look at those upper-bounds.
2) NI would not have been met for efficacy had they used a margin with both rate ratio and risk difference, which is standard practice.
The margin of 4.8% is based on event rates at 12%, which is 1.4 in relative terms (40% higher). But when event rates come in lower, as they did: 4.8% vs 5.7%, the 4.8% margin is too lenient.
The 0.9% higher rate of the primary endpoint has a 95% CI of (-0.8-2.6%), so 2.6% is less than the margin of 4.8%. Now do it with relative risk.
It's in table 2. The relative risk is 1.20. The 95% confidence intervals were 0.87-1.66. Note that 1.66> 1.40 so LAAC is not noninferior based on rate ratio margins
3) The primary safety endpoint is flawed because it excludes periprocedural bleeding and uses nonmajor bleeds, such as gum bleeds and bruising. It's open label trial so who which group will complain of more nonmajor bleeding?
4) When counting all events, Watchman barely reduced major bleeds. Also in the main results table is that major bleeds were 83 vs 87 (5.5% vs 5.8%; HR 0.92 95% CI 0.68-1.24)
5) Net Clinical Benefit was also flawed because they used nonprocedural bleeding and nonmajor bleeds.
A normal patient would simply say, there were 17 more strokes and only 4 less bleeds. Hardly a good trade.
6) Bayes: trials don't give answers, they update priors. For Watchman, you have PREVAIL failing against warfarin, CLOSURE AF clearly failing against best med Rx (mostly DOACs) so priors are pessimistic. To go from pessimistic priors to enthusiastic posteriors you'd need hugely positive data. CHAMPION is not that.
Don't believe the stories that CLOSURE failed due to them using other LAAC devices. In the AMULET IDE trial, Watchman and Amulet were similar. Also, if you believe that German operators are worse than US authors, you need to travel more.
Conclusion: Oral anticoagulation for AF is one of the most evidence-based practices in all of medicine. To upend that would take much stronger data.
Don't be bamboozled by this trial, which was designed to be positive before the first patient was enrolled.
#ACC2026
🚨 Fellows. Residents. Early career cardiologists — listen up.
#ACC26 is NOT just a conference.
It’s a career accelerator 🚀
If you show up right, it can change your trajectory.
Here’s how to MAXIMIZE 🎯every minute 👇
@ACCinTouch@JACCJournals@ACCmediacenter
It’s official! Blessed to have matched into cardiology fellowship @MountSinaiMiami! Extremely grateful to everyone who believed in me and formed part of this journey. I’m so excited for this new chapter in such a beautiful and fascinating field! #CardiologyMatch#MatchDay#NRMP
This is the 1st of a series of posts on how to read and apply the results of a randomized trial. We provide a practical guide with examples from literature.
More to come next week..
W/ @AndrewFoy82 & @drjohnm
Truly one of the greatest lectures I’ve had the opportunity to attend! Knowing how to critically appraise the medical literature is key to becoming an excellent clinician @morristownheart#DrAnthonyDeMaria#JACC#Structural