Dr. Priya Ramcharan

Doctor - Internal Medicine | MBBS, MRCP | EACVI Certified Adult Echocardiography | ACC Certified in Cardiovascular Knowledge Exam (CCKE)

[Dr. Priya Ramcharan @priya451]

This morning it really sank in... I am going to be a Cardiology Fellow. 🫀
Grateful and excited for the journey ahead.
#Cardiology #CardiologyFellow #uwi

[Priscilla Wessly @PWesslyMD]

Congratulations to @SNagueh and the writing group on the much-awaited ASE diastolic function guidelines—an outstanding contribution. 👏 A must-read! #echofirst
@ASE360 @JournalASEcho

[Dr. Priya Ramcharan @priya451]

@DewdropsX_ Bake potato bake potahto bake potayto bake putato

[American College of Cardiology @ACCinTouch]

The ACC’s 🆕 “HF in a Box” toolkit supports clinicians in managing #HeartFailure, offering resources to integrate #SGLT2 inhibitors into therapy alongside established treatment options.

Explore lectures, guides, infographics & more: https://t.co/XCiF6pkP3d

[Drew @DMcIntyreWWE]

You won Spurs. Enjoy the Europa League I hope it makes you very happy. Dear Lord, what a sad little life Ange. You ruined my tweet completely so you could have a trophy.

Now take your trophy and get out of my mentions.

[Dr. Priya Ramcharan @priya451]

Thrilled to be selected as a #ASE2025 Social Media Champion!

I will be joining virtually to share key takeaways, expert pearls, and a Caribbean perspective on echocardiography.

Follow along as we celebrate #ASE50th and connect across borders!
#SeeYouInNashville @ASE360

[Dr. Priya Ramcharan @priya451]

@NadeenFaza @JournalASEcho @pattypellikka @Vidhu_anand @PWesslyMD @iamritu @purviparwani This was fun learning experience. Thank you all for sharing your expert knowledge. Looking forward to the next one #ASEchoJC

[Priscilla Wessly @PWesslyMD]

🛑 Physical exam may miss acute AR:
• Murmur often soft or inaudible
• Classic wide pulse pressure findings may be absent
⚠️ High index of suspicion is key
📸 TTE first → assess AR severity, LV size & function
🧠 If dissection suspected → CTA or TEE
#EchoFirst #Cardiotwitter #ASEchoJC @ASE360 @NadeenFaza @pattypellikka

[Nadeen N. Faza, M.D. @NadeenFaza]

#ASEchoJC
🚨 Echo Clues to Acute AR 🚨

1️⃣ Short pressure half-time on CW Doppler AR jet
2️⃣ Early diastolic closure of the mitral valve
3️⃣ Diastolic mitral regurgitation (MR)
4️⃣ Early systolic MR
5️⃣ L waves in mitral inflow (mid-diastolic flow)
6️⃣ Undilated LV with elevated LVEDP
7️⃣ Low cardiac output with rapid pressure equalization 📉
🎯 Diagnosis is tricky—physical signs may be subtle or absent.
Keep a high index of suspicion and act fast!
#EchoFirst #ASEchoJC

[Ritu Thamman MD @iamritu]

@Prasannasimha @puravmody @NadeenFaza @pattypellikka @Vidhu_anand #ASEchoJC h/t @JJahanyarMDPhD "broken leaflet" in aortic valve prolapse w AR

[Nadeen N. Faza, M.D. @NadeenFaza]

🧲 CMR in AR Assessment
Cardiac MRI = 🔍 gold standard for AR quantification when echo is inconclusive!
✅ Accurate regurgitant volume & fraction
✅ LV size & function (volumetrics, GLS)
✅ Myocardial fibrosis (LGE, ECV)
🌟 Especially useful in eccentric/multiple jets & pre-surgical risk stratification
#ASEchoJC #EchoFirst #WhyCMR @MaanMalahfji @pattypellikka @Vidhu_anand @PWesslyMD

[Dr. Priya Ramcharan @priya451]

@Vidhu_anand @NadeenFaza @ASE360 @JournalASEcho @PWesslyMD @pattypellikka @iamritu @purviparwani @EGarciaSayan @DavidWienerMD @MaanMalahfji @CASivaram1 @rajdoc2005 We seem to be heading toward earlier surgery in asymptomatic severe AR based on GLS and indexed LV size. Is this so? #ASEchoJC

[Dr. Priya Ramcharan @priya451]

@PWesslyMD @NadeenFaza @ASE360 @JournalASEcho @pattypellikka @Vidhu_anand @purviparwani @iamritu @EGarciaSayan @rajdoc2005 @CASivaram1 @DavidWienerMD @SIwa23288585 @MaanMalahfji @ShadenKhalaf In asymptomatic patient with severe AR and preserved EF normal LV size, is there a threshold on reduced GLS to consider intervention?

[Priscilla Wessly @PWesslyMD]

Sex Differences in AR – Key Findings (Li-Tan et al., Mayo Clin Proc 2021)
👩 Women presented later with:
• More symptoms
• Smaller LV, but ↑ LVEDDi, LVESDi, RVol/SV
• More LVESDi >20 mm/m² despite no symptoms
⚠️ Total mortality women > men
🔧 Post-AVR: Equal survival, strong LV reverse remodeling
🚫 Female sex not a risk—late referral was
📉 Women had less AVS & higher mortality vs. general population #EchoFirst #ASEchoJC @ASE360

[Dr. Priya Ramcharan @priya451]

@NadeenFaza @ASE360 @JournalASEcho @PWesslyMD @pattypellikka @Vidhu_anand @iamritu @purviparwani @rajdoc2005 @CASivaram1 @EGarciaSayan @MaanMalahfji @DavidWienerMD @SIwa23288585 @renujain19 Women usually have smaller LV volumes than men. How does this affect the cut off time for intervention?

[Dr. Priya Ramcharan @priya451]

@pattypellikka @NadeenFaza @ASE360 @JournalASEcho @PWesslyMD @Vidhu_anand @iamritu @EGarciaSayan @CASivaram1 @renujain19 @DavidWienerMD @boegel_kelly @nishath_quader @MaanMalahfji @rajdoc2005 So even if you have a small VC but there is Holodiastolic flow reversal then likely the AR is severe?

[Dr.Patricia Pellikka @pattypellikka]

@NadeenFaza @ASE360 @JournalASEcho @PWesslyMD @Vidhu_anand @iamritu @EGarciaSayan @CASivaram1 @renujain19 @DavidWienerMD @boegel_kelly @nishath_quader @MaanMalahfji @rajdoc2005 Holodiastolic flow reversals assessed
by pulsed-wave Doppler in the abdominal aorta usually suggest severe AR; it is a qualitative sign and usually quite specific. #ASEchoJC

[Dr. Priya Ramcharan @priya451]

@NadeenFaza How do you weigh the parameters in cases of discordant findings when grading severity?

[Priscilla Wessly @PWesslyMD]

Qualitative AR Assessment – CW Jet Density
🎯 Align beam with regurgitant jet & Adjust overall gain
📊 Density ∝ number of RBCs
🟡 Faint/incomplete jet = mild or trace AR
📍 Apical = best window for CWD
📍 Parasternal/RSB = better alignment for eccentric jets
#EchoFirst #ASEchoJC @ASE360 @NadeenFaza @iamritu @purviparwani

[Dr. Priya Ramcharan @priya451]

@NadeenFaza @JournalASEcho @ASE360 @PWesslyMD @pattypellikka @Vidhu_anand @iamritu @EGarciaSayan @renujain19 @SIwa23288585 @rajdoc2005 @purviparwani @MaanMalahfji @LucySafi @DrDeepa1020 @DavidWienerMD Lv dilation as well

[Dr. Priya Ramcharan @priya451]

@NadeenFaza @JournalASEcho @ASE360 @PWesslyMD @pattypellikka @Vidhu_anand @iamritu @EGarciaSayan @renujain19 @SIwa23288585 @rajdoc2005 @purviparwani @MaanMalahfji @LucySafi @DrDeepa1020 @DavidWienerMD Vena contracta >6 mm

Jet width/LVOT >65%

Holodiastolic flow reversal in aorta

PHT <200 ms

Eccentric jets