Ivan Bušić

ECG ❤️
ECHO beginner

[Milan Koštek @KostekMilan]

Let's repeat how the infranodal AV block improves upon slow-down of P waves. https://t.co/KKWIcUEioh

[Milan Koštek @KostekMilan]

Multifocal Ectopic Purkinje-related Premature Contractions (MEPPC) Syndrome
https://t.co/W3NXh4cAls

[Milan Koštek @KostekMilan]

What is DOT-CRT ❓
LOT-CRT patients were subclassified into “successful LOT-CRT” (LBBAP; presence of r’ in electrode electrocardiography [ECG] V1) and “deep septal optimized therapy” (DOT-CRT) (functional deep septal capture).

[Matters of the Heart 🫀 @MattersoftheH14]

.

[CardiovascularCorner @TrackYourHeart]

Understanding LV Diastolic Dysfunction via Mitral Inflow Doppler:

Mitral inflow Doppler patterns reflect LV diastolic function. Pulsed-wave Doppler at the mitral valve leaflets shows E (early filling) and A (atrial contraction) waves.

Here’s how the patterns change:

1️⃣ Normal Filling:
- E/A >1
- Deceleration Time (DT) <220 ms
- Normal relaxation and compliance.

2️⃣ Grade I – Mild Dysfunction (Impaired Relaxation):
- E/A <1
- DT >220 ms
- Relaxation is delayed, atrial kick becomes dominant.

3️⃣ Grade II – Moderate Dysfunction (Pseudonormal):
- E/A >1 (appears normal!)
- DT 150–200 ms
- LA pressure increases to "normalize" filling—requires Tissue Doppler to unmask.

4️⃣Grade III – Severe Dysfunction (Restrictive Pattern):

- E/A >1.5
- DT <150 ms
- Very high LA pressures, stiff LV—hallmark of poor prognosis.

⚠️Always correlate with tissue Doppler (E/e’), LA size, pulmonary vein flow, and clinical picture. A pseudonormal pattern can be misleading without these.

Ref:
Ho CY, Bulwer BE. In: Solomon SD, Bulwer BE. Essential Echocardiography. Humana Press, 2007:124.

#CardioTwitter #EchoFirst #MedX

[Dr. Andreas Roeschl @ecgandrhythmRoe]

@FibrilloFlutter @Frances98392343 @KostekMilan @koggelnoggel @LeonrMail @TheECGMedic @Vic_Sereda @MiguelP23970914 @TrackYourHeart @makkyecg Most likely AT 1:1 conduction with NSIVCD/atypical LBBB

[FLUTTER @FibrilloFlutter]

What do you think about this ECG ⁉️⁉️⁉️

[Dr. Andreas Roeschl @ecgandrhythmRoe]

PAC or PVC? Only the chest leads. A moment's thought should suffice to answer the question.

[Interventional Cardiology @Interve15538505]

#Sharing is learning

An interesting finding on the #Aortic #Valve in a patient with #Mitral #Stenosis. There are no #symptoms or #history of #infective #endocarditis.❗ F, 56 y.o @Irina67790690

[Dr. Andreas Roeschl @ecgandrhythmRoe]

Answer: SR, RBBB, 2nd degree AVB type 1 Wenckebach 👇

[Dr. Andreas Roeschl @ecgandrhythmRoe]

Many signs in this ECG indicate ventricular tachycardia. Name the signs that rule out supraventricular tachycardia with aberrant conduction.

[Ahmed Mohsen @drahmedmohsen85]

🎥 Apical Rocking
🔍 Classic echo finding in LBBB
🫀 Caused by septo-lateral dyssynchrony
💡 Key marker of mechanical dyssynchrony → may predict CRT response

👉 Always watch the apex carefully!

#Cardiology #Echocardiography

[Ahmed Ammar @Dr_Ahmed_Ammar]

Test your knowledge

ECG quiz

#ESCCongress

[Carlos M. Peñate, MD @Carlos_Penate6]

Amazing #ECG ✅
#ESCCongress2025 #ESCCongressVisuals 🇪🇸
👇
@ecgandrhythmRoe
@ECGEPSCADEVICE
@ecgrhythms
@OrlanditoCardio
@raico980724

[Ritika Tuli @RitikaTuliMD]

🫀 #CardioNugget
The “Lobster Claw” Sign 🦞 in HOCM

In HOCM, the LV outflow tract is narrowed mid-systole due to systolic anterior motion (SAM) of the mitral valve + septal hypertrophy.

📉 This leads to a bimodal LV ejection velocity pattern on Doppler—initial acceleration, followed by a mid-systolic drop (from dynamic obstruction), then a late rise.

🎯 The result? A “lobster claw” or “spike and dome” contour—diagnostic of dynamic obstruction!

🧠 Pro tip: Seen best with continuous wave Doppler across the LVOT. If you see a claw, think obstruction!

#CardioNuggets #MedEd #CardioTwitter

[Irina Akhmedova @Irina67790690]

Significant Pulmonary Regurgitation.

10, y.o.
Нas a history of open pulmonary valve valvuloplasty 5 years ago.

[Dr G Rajesh (Gopalan Nair Rajesh). @DrRajeshG1]

26 yr old boy with progressive effort dyspnoea

[El Hamriti Mustapha @melhamriti]

👉 Typical vs. Atypical AVNRT – Mechanistic Overview 👈

👉 Typical AVNRT (slow–fast):
Impulse conduction: Atrium → Slow Pathway → Ventricle → Fast Pathway (retrograde)
•This produces a short RP tachycardia, because the retrograde atrial activation from the ventricle back to the atrium occurs via the fast pathway.
•Consequently, the P wave is inscribed at the terminal part of the QRS complex on the ECG.

👉 Atypical AVNRT (fast–slow):
Impulse conduction: Atrium → Fast Pathway → Ventricle → Slow Pathway (retrograde)
•This produces a long RP tachycardia, because the retrograde atrial activation from the ventricle back to the atrium occurs via the slow pathway.
•Therefore, the P wave appears after the QRS complex on the ECG.

#EPeeps This post was created in collaboration @N_Trajkovska

@Phiso_de @chris_sohns @MBraunEP @MoneebKhalaph @Cardioschool @GNageler @ecgandrhythmRoe @Ecgloverr @ecgrhythms @KostekMilan @ALFIEEP1 @ECGEPSCADEVICE @nelsonpol @pjsm83 @ChristianHeeger @narrowQRS @MeldaYesilyurt @JNJNews @AbbottNews @BSCCardiology #CardioTwitter @TobiasReichlin @ArashArya_EP

[Alexander Mladenow MD @alex1708ander]

Doming PV in a pediatric patient with bicuspid pulmonary valve (BPV) 👉 UE Ao Arch SAX #echofirst

[Ahmed Mohsen @drahmedmohsen85]

🫀 M-Mode of the Mitral Valve
✅ Normal – smooth AMVL/PMVL movement in diastole
⚠️ SAM – anterior leaflet moves toward septum in systole (think HCM)
⚠️ Prolapse – leaflet bulges back into LA in systole
📍 S = Systole | D = Diastole
📍 AMVL = Ant. leaflet
| PMVL = Post. leaflet