Luay sayed

interventional cardiology, Vascular interventions. Director cath lab at Troy Beaumont Hospital

[Luay sayed @LuaySayed]

@drjkahn @IDF 👎👎wow after over 30k dead it’s outrageous to see an article like this. I wonder what John Spencer was smoking when he wrote this.

[Luay sayed @LuaySayed]

@amin_mulji @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar @OliviaMAllenDO Moderate LAD stenosis. Medical tx despite the significant “ angiographic “ shunt his R heart data and echo do not suggest clinically significant shunting.

[Luay sayed @LuaySayed]

1/2 71M presents e UTI syncope fever EKG e Inf stemi but no cp hs trop 570. ST⬆️ resolves in ER cath day 3. #cardiotwitter @ekgpdx @RajTayal2
@heartdoc45 @DrAmirKaki
#ACCFIT @HadyLichaaMD @DrJayMohan
@chadialraies @BaoGTran @AKassier @raatassi @ShariqShamimMD @trivaxheartmd

[Luay sayed @LuaySayed]

@DrJayMohan It was checked twice so I’m hoping you can provide the answer 😊

[Luay sayed @LuaySayed]

@yasirjawaid888 @ekgpdx @RajTayal2 @heartdoc45 @DrAmirKaki @HadyLichaaMD @DrJayMohan @chadialraies @BaoGTran @AKassier @raatassi @ShariqShamimMD @trivaxheartmd It’s 5f JR4 at RA/ CS junction

[Luay sayed @LuaySayed]

@amrabbasmd @ramymandoMD @IvanHansonMD @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar So how do you explain the inferior ST elevation And troponin bump when he was dehydrated with relatively lower blood pressure? Just slower coronary flow in that huge artery ?

[Luay sayed @LuaySayed]

@amrabbasmd @ramymandoMD @IvanHansonMD @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar Oh that makes sense. The sampling was at the CS/ RA junction not exactly at the month of the fistula. What you’re saying about coronary flow makes sense but it’s just hard to imagine that that big of a fistula does not cause much shunting

[Luay sayed @LuaySayed]

@HoumanKhalili @Wisam_Alhumam @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar Mid RA was 61 SVC 62. Repeated and rechecked twice

[Luay sayed @LuaySayed]

@Wisam_Alhumam @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar It did not detect a shunt

[Luay sayed @LuaySayed]

@raatassi @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar

[Luay sayed @LuaySayed]

@raatassi @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar 1 hour later

[Luay sayed @LuaySayed]

@raatassi @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar 1st ekg

[Luay sayed @LuaySayed]

@raatassi @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar Planning CTA as OP to better understand. I’m still puzzled by the lack of high RA sat and significant RV dilation with the amount of “ contrast shunt”

[Luay sayed @LuaySayed]

@raatassi @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar Yes I put a swan from R Fem. When RA sat didn’t make sense to me I put a wire to prove the connection RCA- RA is real.
He was initially septic dehydrated which I think caused near syncope. That’s why I waited on cath 3 days. In addition has persistent A fib on warf INR > 9

[Luay sayed @LuaySayed]

@ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar @OliviaMAllenDO

[Luay sayed @LuaySayed]

2/2 large RCA-RA /CS fistula. AO 90/63 PA 53/15. O2% RA 61 PA 65 AO 96. How do you explain RA sat( I expected 80s) and normal RV size? @ramymandoMD @IvanHansonMD @amrabbasmd @BeaumontIC @BeaumontCards @Babar_Basir @CMichaelGibson @NalassaadNihad @ANbilolikar

[Luay sayed @LuaySayed]

@raatassi It’s interesting that even with ultrasound guided access they still had 6% accidental arterial access. That’s still very high number

[Luay sayed @LuaySayed]

@agtruesdell @ShariqShamimMD Good job and Thanks for sharing … I would be concerned about Balloon expandable stent in the brachial. I think high risk of external compression and deformity. Have you done this before ?

[Luay sayed @LuaySayed]

@raatassi @RajTayal2 @heartdoc45 @DrAmirKaki @HadyLichaaMD @DrJayMohan @chadialraies @BaoGTran @AKassier @dr_rothschild @ramymandoMD @ShariqShamimMD Yes will do both 👍

[Luay sayed @LuaySayed]

50 yo healthy TIA 3 month ago - WU no fever just had TEE looks like small myxoma. Anticoagulate vs OR? #cardiotwitter @RajTayal2
@heartdoc45 @DrAmirKaki
#ACCFIT @HadyLichaaMD @DrJayMohan
@chadialraies @BaoGTran @AKassier @dr_rothschild @raatassi @ramymandoMD @ShariqShamimMD

[Luay sayed @LuaySayed]

@raatassi @RajTayal2 @heartdoc45 @DrAmirKaki @HadyLichaaMD @DrJayMohan @chadialraies @BaoGTran @AKassier @dr_rothschild @ramymandoMD @ShariqShamimMD I like that idea . Clinically it’s very unlikely to be an infection. I started him on xarelto will see if it looks different on repeat TEE in few months