Profe Andrés

🛬🐣𝑫𝒆𝒔𝒄𝒖𝒃𝒓𝒊𝒓,𝒄𝒓𝒆𝒂𝒓,𝒇𝒍𝒐𝒓𝒆𝒄𝒆𝒓 💐🌹

- Sociología

🇻🇪🇫🇲🇪🇺🇮🇱

[Profe Andrés @Tuprofeonline2]

De vez en cuando pónganse en el lugar del otro y entiendan que lo que para ustedes no tiene ninguna importancia al otro le puede doler un montón y eso no significa que esté exagerando... 🙌

[Dilo con dibujos @dilocondibujos_]

Amen sin tilde ❤️

[𝑀𝑂𝐿𝐻𝐴𝑀 @molham_q8]

لك حكاية ليس لها شبيه، ولك حنيه طاغية ❤️

[HeartRhythm @hrs_journal]

2026 HRS/EHRA scientific statement on pulsed field ablation for cardiac arrhythmias

https://t.co/N3Q8jG0aBz

[CardiovascularCorner @TrackYourHeart]

ECG From Scratch #33: Left Atrial Abnormality

If right atrial abnormality tends to make the P wave taller, left atrial abnormality tends to make it wider.

(Why)
Because the left atrium normally depolarizes after the right atrium. Delayed or prolonged left atrial activation can therefore increase the total duration of atrial depolarization.

The classic ECG clue
P-wave duration ≥0.12 s (120 ms)
That is at least 3 small boxes.

The P wave may also become:
Broad and notched or humped
The second hump reflects delayed left atrial activation.

This pattern was historically called P mitrale, particularly because it was associated with mitral valve disease. The broader term left atrial abnormality (LAA) is preferable because a broad P wave does not necessarily prove anatomical left atrial enlargement.

Look at V1
🔵Lead V1 can provide another important clue.
A normal P wave in V1 is often biphasic:
small positive component ➡️ negative component

With LAA, the terminal negative component may become:
≥1 mm deep
and/or
>40 ms wide

Why?
The right atrium lies more anteriorly, while the left atrium is positioned posteriorly.

So the initial positive component reflects right atrial activation, while the prominent terminal negative component reflects delayed left atrial activation directed posteriorly, away from V1.

Where can LAA appear?
Common settings include:
- Mitral stenosis or regurgitation
- Aortic stenosis or regurgitation
- Hypertensive heart disease
- Dilated, hypertrophic, or restrictive cardiomyopathy
- Coronary artery disease

An important caveat
A broad or notched P wave does not prove anatomical left atrial enlargement.

A patient may have a broad P wave because of delayed atrial conduction even when imaging does not show an enlarged left atrium.

[♡ ︎ @Ussonlyy]

Just the two of us, under the rain.🤍

[Daniela S. @missfbe]

Llega un momento en la vida en que aparece alguien que nos obliga a ponernos frente a Dios porque sabemos que esa persona merece un amor completo, y sabemos también que el nuestro no lo será: vendrá con errores, con torpezas, con egoísmo, con heridas que no queremos causar pero que sucederán. Y es ahí, en la conciencia de esa insuficiencia, donde nos vemos empujados hacia el único amor capaz de cubrir las faltas del amor humano, el que no brota de nosotros y de nuestros límites, sino de la fuente eterna.

[Alberto Esteban @doctorchecho]

Los objetivos secundarios solo pueden ser exploratorios. Sacar recomendaciones de ellos solo es manipular la evidencia. Luego que si la ivabradina y tal.

[CardiovascularCorner @TrackYourHeart]

Primary PCI: Opening the Artery Is Not the Whole Story

In STEMI, the angiogram may show a beautiful epicardial result after PCI.
But the myocardium can still be injured.

(Why)
An occluded coronary artery contains more than thrombus. It may contain atherosclerotic debris, thrombotic material and disrupted plaque. During PCI, some of this material can embolize downstream.

The result can be:
1️⃣ Distal embolization
2️⃣ Microvascular obstruction/no-reflow
3️⃣ Side-branch occlusion
4️⃣ Reperfusion-related injury

So the goal of primary PCI is not simply:
(Open the artery)

It is:
Restore epicardial flow while preserving myocardial perfusion.

How PCI evolved
Early STEMI intervention relied heavily on balloon angioplasty.

The problems were familiar:
Residual stenosis
⬇️
recoil
⬇️
reocclusion
⬇️
restenosis

Coronary stents changed this by providing a scaffold, reducing residual stenosis and recoil and improving acute vessel patency.

Modern primary PCI therefore generally uses stent implantation when appropriate, rather than balloon angioplasty alone.

But the 2016 figure needs an important modern update.

Some strategies shown in the original diagram are not routine contemporary STEMI practice:
Routine thrombus aspiration is not recommended. Large randomized trials failed to show clinical benefit, and routine aspiration may increase stroke risk. Selective/bailout aspiration can still be considered when substantial thrombus persists, particularly after other PCI maneuvers.

Likewise, strategies such as routine deferred stenting or distal protection have not become standard approaches for every STEMI patient.

Modern PCI has shifted toward:
Rapid reperfusion + appropriate stenting + meticulous lesion treatment + prevention/management of no-reflow + selective use of adjunctive technologies.

And for complex ACS lesions, contemporary guidelines recommend IVUS or OCT-guided PCI to improve procedural results and reduce ischemic events.

Don't stop at:
(Did I achieve TIMI 3 flow)

Also ask:
(Did I restore effective myocardial perfusion)

Because an open epicardial artery does not automatically mean that the myocardium is adequately reperfused.

Source: Ndrepepa G, Kastrati A. Mechanical strategies to enhance myocardial salvage during primary percutaneous coronary intervention in patients with STEMI. EuroIntervention. 2016;12:319–328.

Updated with the 2023 ESC ACS Guidelines and 2025 ACC/AHA ACS Guideline.

[Sección Cardiología Geriátrica @SECgeriatrica]

🚨La sección de cardiología geriátrica evoluciona a asociación dentro de la estructura de @secardiologia!!!

Excelentes noticias que destacan la importancia de la cardiogeriatria en nuestra práctica diaria

Carta de nuestra presidenta @Carol_RoblesG 👇

[Ana Viana Tejedor @Ana_Viana_T]

Ya disponible el Tratado de Cardiología! Un placer coordinar el bloque de patología crítica cardiovascular junto a @PolShepherd de la mano de grandes expertos. Seguro que servirá para mejorar la formación de nuestros residentes @secardiologia @cris_lozano @JovenesSec @CardioRed1

[AbdAllah Othman @CardioBeat_]

https://t.co/iUEoEHWtIZ
📉🌟 Main Characteristic ECG Changes in Electrolyte Imbalances: Potassium and Calcium Levels:

Hypokalemia (Low Potassium): Prominent U waves (best seen in the precordial leads V2-V3)📉

Hyperkalemia (High Potassium): Peaked T waves 📈

Hypocalcemia (Low Calcium): Prolonged QT interval 🔍

Hypercalcemia (High Calcium): Shortened QT interval 📏

#Hypokalemia #Hyperkalemia #Hypocalcemia #Hypercalcemia #ElectrolyteImbalance

[Paola Morejón Barragán @paomorejon]

📚 𝐋𝐥𝐞𝐧𝐚𝐝𝐨 𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐮𝐥𝐚𝐫 𝐢𝐳𝐪𝐮𝐢𝐞𝐫𝐝𝐨 𝐲 𝐜𝐢𝐜𝐥𝐨 𝐜𝐚𝐫𝐝𝐢𝐚𝐜𝐨

Infaltable

By Bernard Bulwer

[FOAMex @FOAMexico]

Ciclo Cardíaco 💓
#FOAMed #FOAMex 🇲🇽

[JUDITH ✨🖤 @_tackina]

POV: You finally found your person. 🥹❤️

[meri @jenerobelili]

Sevdiğin kişiyle birlikte ikinizin de parçalarını taşıyan bir İNSAN yaratmak.. Bu kavrama hâlâ inanamıyorum, inanılmaz.

[Save A Man @Save_A_Man]

Who you marry is very important