Ledo

Dr. J. Fernando Vargas Ledo / Cardiólogo Clínico / Cardiólogo Intervencionista

[SCAI @SCAI]

SCAI Bifurcation Club | Step-by-Step Approach to Treating Complications https://t.co/DzhTG9spHw

[Ledo @drledo91]

🤌🏻

[Ledo @drledo91]

@TrackYourHeart

[Dr Akhil Sharma @Drakhil_cardio]

#Sharing for learning
Your diagnosis? Cause? Treatment?Follow-up? and most importantly Prevention?
Rare complications may be infrequent, but they deserve greater attention. Every case is an opportunity to learn and highlights the need for standardized SOPs or a consensus statement to guide diagnosis, management, prevention, and follow-up.
What would you do?

[Zille Huma @Zill_cardio]

#EuroPCR

Complications during LMPCI: how to manage and how to avoid‼️

Unintended Stent Deformation

👉 Common in LMPCI
👉 ⬆️ risk of MACE if left untreated
👉Most common culprits: Abluminal rewiring & GC collision
👉Use IVI to identify the mech
👉Final IVI is a must

#1/2

[CardioNova @AppCardioNova]

🧵 ¿Te bloqueas al interpretar un ECG con marcapasos? 🫀

No eres el único.

Si no estás habituado, distinguir un funcionamiento normal de una disfunción puede ser complicado.

Hay una regla sencilla que puede ayudarte en segundos: el algoritmo TBC 👇

[Dr. FEVI🫀🩺 @javier20ch]

EKG: patrones de sobrecarga sistólica & diastólica. ⚡️🫀💢
🔵La sobrecarga sistólica se pone de manifiesto en el VD por presencia de onda R alta en V1 con onda T negativa asimétrica, mientras que la sobrecarga diastólica se presenta como patrón rsR' con T negativa asimétrica en V1.
🔵En el caso del VI, la sobrecarga sistólica se registra como una onda R alta con onda T negativa y asimétrica en V5-V6, y la sobrecarga diastólica como presencia de qR de gran voltaje con T positiva alta y picuda en V5-V6.
🔹️Actualmente se considera que independientemente de la cardiopatía de base la imagen electrocardiográfica de sobrecarga diastólica suele corresponder a fases ligeras o moderadas de crecimiento ventricular y la imagen de sobrecarga sistólica suele aparecer en fases más avanzadas de crecimiento ventricular.

[Zille Huma @Zill_cardio]

#TCTAP2026
#BifurcationPCI
❤️‍🔥 Practical Tips for LM Bif PCI:

👉LM PCI Saves Lives‼️

👉LCx Is Usually Big Enough To Rx

👉Upfront 2️⃣ Stent is Better For True Bifurcation w Large LCX (>2.5mm)

👉Post-PCI MSA Is the ONLY Predictor for Clinical Outcomes

👉Don’t Touch Small SB❗️

[Pedro Salmerón Sanginés @LectorHistoria]

¿Había sacrificios humanos y canibalismo ritual en Mesoamérica? Sí.
Justo en la misma época en que los europeos caminaban entre la mierda y las ratas para aplaudir que se descuartizara, quemara o empalara a la gente, y que en sus guerras destruían e incendiaban ciudades y violaban a todas las mujeres.
Lo que pasa es que unos eran el diablo y los otros lo hacían en nombre de Dios, lo que pasa es que uno eran salvajes y los otros, pues "así son las guerras" (como las guerras mundiales de los muy civilizados europeos del siglo XX).
Ese es el eurocéntrico doble rasero.
Y a ni unos ni a otros hay que juzgarlos desde el siglo XXI, el de Gaza, el imperialismo yanqui, Sudán, los terroristas desalmados armados y financiados desde EEUU...

[CardiovascularCorner @TrackYourHeart]

Brugada syndrome: more than just an ECG finding. A quick thread.

1/ Many associate Brugada syndrome with a characteristic ECG pattern. But the disease is far more complex than a simple tracing abnormality.
🧵🧵🧵

[Ahmed Bennis MD 🫀 @drbennisahmed]

💊 Practical algorithm for diuretic resistance in acute HF from #HeartFailure26— this is the slide to save!
Start: Furosemide 120-160 mg
↓ Still congested?
Add Chlortalidone 12.5-50 mg/24h
↓ Still congested?
Tailor to the problem:
• Metabolic alkalosis → Acetazolamide 120-500 mg/24h
• Hyponatremia → Tolvaptan 15-50 mg/24h
• rLVEF + hypopotassemia → MRA 25-100 mg/24h
And running through the whole algorithm:
➕ Add iSGLT2 throughout
➕ Add sacubitril/valsartan if LVEF <49%
➕ Consider parenteral route if oral absorption is the issue
Clean. Practical. Evidence-based. 💯
(Adapted from de la Espriella R et al. Nefrologia 2021)
#CardioTwitter #HeartFailure #Cardiology #Diuretics #HFrEF

[Ledo @drledo91]

🤯

https://t.co/jLYaiRBD6F

[Ahmed @AB_drmd]

🚨🚨🚨طفل عمره خمس سنوات عنده ارتفاع حرارة من خمس ايام. ايش التشخيص المحتمل؟؟؟

[EuroIntervention @EuroInterventio]

Despite successful primary PCI in STEMI, impaired myocardial reperfusion (“no-reflow”) may occur due to microvascular obstruction.
This state-of-the-art review provides a comprehensive overview of the underlying pathophysiological mechanisms, as well as invasive and non-invasive diagnostic tools, and pharmacological and interventional treatment strategies, highlighting current gaps in the field.

🔗https://t.co/UaXeekKr5i

#STEMI #InterventionalCardiology #NoReflow #cardiotwitter

@sbrugaletta @Ortega_Paz @josepgomezlara @LaudaniClaudio

[Abbott Cardiovascular @AbbottCardio]

See the power of Pullback Pressure Gradient (PPG) in action!

In this case, Dr. @yadersandoval seamlessly integrated our #CoroFlow Pullback Pressure Gradient (PPG) Software into his Fractional Flow Reserve (FFR) workflow with no added steps.

👀 Watch the case: https://t.co/I5Qsu49C4s

Safety Info:
CoroFlow Cardiovascular System: https://t.co/lBbPxfjNMa
PressureWire X Guidewire: https://t.co/Jr8lkF0IuG

#CoronaryPhysiology

[Zille Huma @Zill_cardio]

#TCTAP2026

Is there any role of CTA in the assessment &amp; Rx planning for Calcified Lesions ⁉️

⚡️CTA allows better characterization of Ca

⚡️Ca density is a novel predictor of Stent Under-exp &amp; need of Rotablation

⚡️CT for PCI planning may become ESSENTIAL for Ca management

[EHJ-IMP Editor-in-Chief @EHJIMPEiC]

📄 CTO-PCI: is ischaemia still the key for patient selection?
🔗 DOI: https://t.co/1OtXRpQLiq

🫀 Chronic total occlusion (CTO) PCI has evolved significantly, with high success rates—but patient selection remains the real challenge.

This editorial questions a long-standing paradigm:
👉 Is ischaemia enough to guide revascularization?
✨ Key insights:
🔹 CTO-PCI is associated with:
✔ improved symptoms and quality of life
❗ but no clear reduction in mortality or major events
🔹 Randomized trials show:
➡️ similar hard outcomes vs optimal medical therapy
➡️ benefit mainly in angina relief

📊 Role of ischaemia:
👉 Imaging confirms ischaemia—but:
❗ baseline ischaemic burden does NOT predict outcomes after CTO-PCI
🔹 Even patients with ≥10% ischaemia:
➡️ no difference in mortality or MACCE
➡️ but fewer angina hospitalisations

⚠️ Why ischaemia alone is insufficient:
👉 CTO physiology is complex:
collateral circulation
multivessel disease
microvascular dysfunction
👉 SPECT may underestimate disease
👉 PET provides better quantification (MBF, MFR)
💡 Clinical paradigm shift:
👉 From “ischaemia-driven” → “symptom-driven” selection
✔ Revascularize when:
refractory angina
significant functional limitation
👉 Imaging role:
➡️ confirm viable, ischaemic myocardium
➡️ support—not dictate—the decision
🧠 Future directions:
🔹 PET-based quantification (MBF/MFR)
🔹 Territory-specific ischaemia assessment
🔹 Integration of patient-reported outcomes

🚨 Bottom line:
CTO-PCI is a tool to improve symptoms—not to change prognosis.
👉 Treat the patient, not just the ischaemia.

#Cardiology #CTO #PCI #Ischaemia #CardiacImaging #PET #CoronaryArteryDisease #InterventionalCardiology #PrecisionMedicine 🫀📊

[Giuseppe Biondi-Zoccai @gbiondizoccai]

In patients with non–LM bifurcation lesions a conservative strategy without systematic side branch intervention is associated with very rare procedural complications and is noninferior to a systematic side branch intervention regarding MI https://t.co/o6A8Evt7P9

[PCRonline 🫀 @PCRonline]

Main vessel stenting in DK-Crush: lessons from stepwise provisional strategy
Episode 3⃣ of this series on "How to perform DK-Crush for left main bifurcation stenting" is now online!

https://t.co/yufu0WQTP1

In this episode, learn about:
🟣Optimisation of side branch stenting
🟣How to optimally deploy the second stent

Includes an additional analysis by @GoranEBC & William Wijns.

@twj1974 @NievesGonzalo1 @BURZOTTA_F @M_Lesiak
@gabor_gt @RhianEDavies1 @esbrilakis @VisibleHeartLab

#interventionalcardiology #CardioEd #EuroPCR

[野良医 @rising_sun2017]

えぇ…