Aref Obagi, MD 🇺🇲

Interventional Cardiologist

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@turilrh Either left subclavian or ostial LIMA. Left main doesnt look bad and mid lad lesion easy to fix. But needs to eval left subclavian

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@BrentAWilliams2 If they are at a point where they are needing to see a cardiologist, then likely yes. You dont see cardiologist just because (not like pcp). Most patients at this point have blood pressure, cholesterol or blockages issues that primary care couldn't treat.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@SriniTummala @Vascular_India @SIRspecialists @SIR_ECS @farkomd @JayMathewsMD @hmpVDM @CraigMWalkerMD @EndovascularNy @CAIRweb @AnahitaDua @BSIR_News @TraineesBSIR @SIRRFS @kmadass Good case for Esprit

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@MdBreathe As a cardiologist, I have seen increased numbers of patients presenting with massive cardiac arrest from heart attacks at a relatively young age (40s and 50s) despite not having significant risk factors.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@TCTMD Few hundreds$*

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@jbspadoni @uicfellows @KhalilIbrahimMD @spiritus_bah @AdhirShroff @evandrofilhobr @Babar_Basir Lad will likely end up in fmj (all the way to prox) and given young age, if don't intervene which is good option(instead of fmj), his collaterals will become robust with exercise program.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@jbspadoni @uicfellows @KhalilIbrahimMD @spiritus_bah @AdhirShroff @evandrofilhobr @Babar_Basir Lima is not an option here with a horrible distal target.
If symptomatic or asymptomatic and viable, then attempt pci(likely gonna need long stents). If asymptomatic and non viable, medical management.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@allinwithchris @chrislhayes So sad and heartbreaking. Rip Shaban.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@Obisht Theoretically yes but I don't have cardiac probe in our lab

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@Obisht I do it only in stemi when need to know ef right away esp if in middle of night

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@DrAlsaiediAB Good case! Thanks for sharing.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@AviBittMD and the images of dead kids made them so furious that no money in the world can change their views

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@Steph_Achenbach @escardio @ziadalinyc @Drroxmehran @JEscaned @mirvatalasnag @M_Marwan_ @HolgerNef @thiele_holger @tommasoggori Lesion looks severe to begin with. Would've fixed right away unless you doing hemodynamics for educational purposes. But yes I hav noticed ifr I useless and never go by it if normal.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@DerekNieberMD Good job man!

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@mornei2011 @BotPci @PCRonline @APSIC6 @GruentzigG @mirvatalasnag @mmamas1973 @dimitri_zappi @jedicath @ANazmiCalik @LAzzaliniMD @sbrugaletta @KardiologieHH @MGtberg @SVRaoMD @Tesslagra @uziyahya46 @jl35wilsonMD @w_jyg @AlkashkariWail @AJuradoRoman @foroepic @LCathlab No ... I would try to wire with workhorse wires, i have seen many fresh stemis with collaterals

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@Dr_JorgePadilla @PCRonline @hect2701 @MauroEchavPinto @mmamas1973 @ziadalinyc @MortonKern @ColletCarlos @DrAllenJ @ESHLOF @mirvatalasnag Stent it. Looks severe and pending plaque rupture.

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@johaniMD Provisional and stent into rpla

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@ShariqShamimMD @mandeep_mayo @AntoniousAttall @evandrofilhobr @DrJayMohan @drandrewsharp @BaoGTran @HadyLichaaMD @mmamas1973 @rajivxgulati @ziadalinyc No reflow, id give bunch of nipride/cardene with dual lumen mc and reassess

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@A_ChaarMD @john_damianosMD @rabiarizwanMD @h_alnahhas @PrabinSharmaMD Good job @A_ChaarMD

[Aref Obagi, MD 🇺🇲 @ObagiAref]

@JACCJournals Thrombectomy all the down to distal lad .... Give IC 2b3a and continue with systemic drip for 8-12 hrs along with systemic heparin for 2-3 days. Bring back and assess with ivus. Rule out pfo/intracardiac thrombus.