Y

[Ritika Tuli @RitikaTuliMD]

🫀 CardioNugget™:

Vasovagal Syncope

During tilt-table testing, watch BP + HR together:

🩸 Vasodepressor
BP ↓↓↓ while HR relatively preserved
→ Loss of vascular tone/vasodilation dominates.

💓 Cardioinhibitory
HR ↓↓↓ / significant pauses or systole
→ Excess vagal cardioinhibition dominates.

🔀 Mixed = BOTH
BP ↓ + HR ↓ → both mechanisms contribute.

🥤 FIRST:
Fluids + salt + compression → fill the tank + ↓ venous pooling.

💊 Recurrent symptoms? Midodrine → α₁ vasoconstriction → supports the pipes.

⚡ Why not automatically pace?

A pacemaker fixes HR, not vasodilation. A cardioinhibitory response on tilt ≠ automatic pacemaker.

#CardioNuggets #Cardiology #EP #Syncope

[gracielly barros @gracybarros]

Mitral Regurgitation with Multiple Jets: An Integrated and
Hierarchical Approach
https://t.co/VVTEdMeTcK

[Y @r0tc0dyan]

@PensareBBall Maybe the short term C solution until trade scenarios present itself as the season goes along. Would be a nice story to see him get playing minutes.

[Y @r0tc0dyan]

@gogeta_black570 I wholeheartedly believe this. The contract timings line up perfectly

[Y @r0tc0dyan]

@PensareBBall Good time to miss games. Schedule gets a little tougher. All part of a long nba season.

[CardiovascularCorner @TrackYourHeart]

WIDE-COMPLEX TACHYCARDIA: VT OR SVT WITH ABERRANCY?

A regular wide-complex tachycardia is ventricular tachycardia (VT) until proven otherwise. Several ECG clues can help distinguish VT from supraventricular tachycardia (SVT) with aberrant conduction.

1. Look for AV dissociation
Atrial activity independent of ventricular activity strongly supports VT. Capture beats and fusion beats are particularly important clues.

2. Check precordial concordance (V1–V6)
All predominantly positive or all predominantly negative QRS complexes favor VT.

3. Examine lead aVR
A prominent initial R wave, an initial R or Q wave lasting more than 40 ms, or a notched initial QRS downstroke can support VT in the appropriate algorithm.

4. Assess QRS morphology
An atypical RBBB or LBBB pattern, unusual initial activation, or prolonged ventricular activation can favor VT over SVT with aberrancy.

5. Compare with the baseline ECG
A similar QRS morphology during sinus rhythm may support SVT with pre-existing bundle branch block, but it does not exclude VT.

Important limitations
No single ECG criterion is perfect. Fascicular and other Purkinje-system VTs may have relatively narrow QRS complexes and lack classic VT features. A 1:1 atrioventricular relationship also does not exclude VT because retrograde conduction may occur.

Clinical safety: If the patient is unstable, perform immediate synchronized cardioversion for a regular monomorphic wide-complex tachycardia. If the rhythm diagnosis is uncertain, manage it as VT and avoid empiric verapamil.

Reference: Brugada P et al. Circulation. 1991;83:1649–1659; 2022 ESC Guidelines for Ventricular Arrhythmias.

[Y @r0tc0dyan]

@muckledd Quite asinine to reach a conclusion based off 1 game. Believe that is the very definition or recency bias.

[Y @r0tc0dyan]

@chichi_m3 @Raptors @McDonaldsCanada Its game 3/82 against the Timberwolves. He'll be fine.

[Y @r0tc0dyan]

@GuruTwoey @ceejaytalksball He is, if your basing it off 1 game, that's quite narrow minded.

[Radiology Bits @Rad_Bits]

Pulmonary edema stages = the Rule of 6 🫁

6–12: normal
12–18: cephalization
18–24: Kerley B lines, cuffing
24: bat-wing alveolar edema
Save this for your next call shift.

#MedTwitter #radiology #MedicalEducation #Medical

[Y @r0tc0dyan]

@DoubleFFss @TotallyAllIn Ok. He's not going anywhere. He'll be fine. Team will be fine. This is game 3.

[Y @r0tc0dyan]

@CLambertmedia Anyone reacting to this one stinker game and ignoring his body of work prior to Kawhis signing has some serious recency bias. He'll be fine, team will be fine. Long season.

[Y @r0tc0dyan]

@PensareBBall Hopefully this is one of the few throwaway games this year. But this team has no chance to win if he's not impacting offensively and defensively every night. .especially on Kawhis load management days.

[CardiovascularCorner @TrackYourHeart]

DILATED CARDIOMYOPATHY (DCM): A 12-PAGE VISUAL MASTERCLASS

What causes the heart to enlarge and lose its pumping function?

Explore DCM from diagnosis to management, including:
🔴 Causes & genetic forms
🔴 Echo, ECG & cardiac MRI findings
🔴 Guideline-directed treatment
🔴 Arrhythmias, ICD/CRT & complications
🔴 Reversible causes & prognosis

[1-min ID consult @1min_IDconsult]

【Definition of Neutropenic Fever】

Level: Basic

#IDMedEd #IDFellow #IMResident #MedStudent #InternalMedicine #MedEd #TxID

[CardiovascularCorner @TrackYourHeart]

Mitral stenosis: why does the opening snap occur earlier when MS is severe?

The severity of mitral stenosis determines the diastolic pressure gradient between the left atrium and left ventricle.

As MS becomes more severe:

⭕ LA pressure rises
⭕ The LA-LV diastolic pressure gradient increases
⭕ The mitral valve opens earlier after aortic valve closure
⭕ Therefore, the A2-opening snap (OS) interval becomes shorter

A useful clinical rule:

Mild MS: A2–OS ≈ 100–120 ms
Severe MS: A2–OS ≈ 40–80 ms

Doppler also reflects the hemodynamic changes. Increasing LA pressure produces a more sustained mitral inflow pattern with a longer deceleration time and reduced atrial augmentation.

Key takeaway:
In severe MS, the higher LA pressure forces the stenotic mitral valve open sooner, producing an earlier opening snap.

[Y @r0tc0dyan]

@glaf37 I'm not sure if we're both watching the same team over the past 2 games. They're defense will be there. But if they're offense is flowing and 3s are falling, they will win on most nights by double digits.

[Y @r0tc0dyan]

@lucarosano3 Triple single !

[Y @r0tc0dyan]

@GETABUCKETSLIM Upgrading the starting guard position and center is a must if title contention is the goal.

[Y @r0tc0dyan]

@Uzi_304 @PeekABoo3170 @TheHoopCentral Absolutely as of today, he is the better player. Was matched up against him as well throughout the night.