dr rakesh maurya

[Dr. Gilbert Tang @GilbertTangMD]

Welcome to our August 27 special issue of #JACCCaseReports @JACCJournals
https://t.co/HEW4oV37b4

Full PDF here:
https://t.co/Yq1O7LGX99

@MinnowWalsh
@DeeDeeWangMD
@hmkyale
@Justine_Turco

Coronary, Peripheral and Structural Interventions
Transjugular Access for Left Atrial Appendage Closure
https://t.co/YGyTNKljWk

Complete Myocardial Bridging
https://t.co/CcTOFxqn2g

Heart of the Rockies: STEMI With Thrombolytic Failure Complicated by Cardiogenic Shock in a Snowstorm
https://t.co/OmEzMudn1u

Inferior ST-Segment Elevation Myocardial Infarction Due to Extrinsic Compression Caused by an Aortic False Aneurysm
https://t.co/QugUf1vI7P

Severe Hand Ischemia Following Distal Transradial Coronary Intervention for Cardiac Arrest
https://t.co/4fzn0MuMxv

Managing Acute Myocardial Infarction in Shock and Anemia
https://t.co/xecvdaZlD5

Percutaneous Retrieval of a Mobile Catheter Fragment From the Left Atrium Using a Biliary Basket
https://t.co/uFCvPWpKNf

Intraprocedural Thrombus Formation During Left Atrial Appendage Closure: A Conservative Approach
https://t.co/wz4WmiY8y2

The Coronary Crown: Anomalous Left Anterior Descending and Circumflex From the Right Coronary Sinus
https://t.co/Lh9RteQ5th

Rhythm Disorders and Electrophysiology
Torsades de Pointes Following Massive Transfusion Protocol: Case Highlighting Electrolyte Disturbances After Blood Product Administration
https://t.co/C91eT05mH0

Acute Pericarditis After Pulsed Field Ablation for Atrial Fibrillation
https://t.co/3BmPOvPFwP

Safe Use of a Drill for Managing Frozen Leads During Pacemaker Replacement
https://t.co/IdxL30dYGx

Arrhythmogenic Right Ventricular Cardiomyopathy Presenting as Monomorphic Ventricular Tachycardia
https://t.co/JmfLjiE8tu

Imagenomics and Ventricular Arrhythmia
https://t.co/XfTxsvDeEc

Salvage of Infected Cardiac Implantable Electronic Device and Pregnancy Preservation Using CITA-MIS
https://t.co/RIhGLvj6Hh

Valvular Heart Disease
Rhodococcus equi Endocarditis in Prosthetic Valve of a Heart Transplant Recipient
https://t.co/WnzAP8m3aE

FLNA Mutations in Multisystem Disease: A Diagnostic Key for Unexplained Valvular and Connective Tissue Disorder
https://t.co/wlE0KhssmU

Imaging of Mobile Emboligenic Calcified Amorphous Tumor in Mitral Annular Caseous Calcification
https://t.co/sHZUdS7Zcb

Delayed Device Embolization After TEER of the Mitral Valve as a Rare but Dangerous Complication
https://t.co/Uc2MRsXuz6

Surgical Aortic Valve Replacement Combined With Coronary Artery Bypass Grafting in a Patient With Progeria
https://t.co/QIyPmcTD5d

Ischemic Heart Disease
Rotablator Burr Disconnection and a Gap Predictor
https://t.co/tbfx1evF4w

Rotablator Burr Disconnection: Can This Rare Complication Be Predicted and How to Manage?
https://t.co/Ic8mEscDFR

LIMA-LAD Steal Syndrome As a Cause of Post-CABG Angina
https://t.co/EoVRIfRPbw

Congenital Heart Disease
Right Sinus Valsalva Aneurysm Ruptured Into the Right Ventricular Outflow Tract
https://t.co/s2RWFvSnaA

Customized Pulmonary Artery Stent for Management of Complex Coronary Artery Fistula
https://t.co/J28G94jMpa

Tailored Therapies for Adult Congenital Heart Disease Patients: Time to Think Outside the Box
https://t.co/zrbhrijm4T

Cardio-Oncology
Left Atrial Papillary Fibroelastoma and Mediastinal Radiotherapy
https://t.co/zHZ2fvwgDH

Fluoropyrimidines: A Cardiotoxicity Case for Caution
https://t.co/PvReIM4A1J

Heart Failure and Cardiomyopathies
Right Ventricular Failure Secondary to Right Coronary Artery Dissection Complicated by Impella Malfunction
https://t.co/Vc0jYEzLZE

Fulminant Myocarditis After mRNA COVID-19 Vaccine Evolving to Giant Cell Myocarditis
https://t.co/aFwDquYWhD

Vascular Medicine
Severe Diffuse Takayasu Arteritis Manifestation in Childhood
https://t.co/w3wJS3uqBq

Acute Myocardial Infarction as the First Clinical Presentation of Takayasu Arteritis in a 20-Year-Old Woman
https://t.co/o57Bi8duCQ

Critical Care and Resuscitation
Pericardial Decompression Syndrome: A Rare Complication of Malignant Pericardial Effusion Drainage
https://t.co/vf2Os9smIZ

Ice Water Drowning Survival After 147-Minute Submersion and 7 ◦C Hypothermic Circulatory Arrest
https://t.co/ITHl90Y7Mg

Health Promotion and Preventive Cardiology
Familial Hypercholesterolemia: Still an Enigma
https://t.co/HRX2nu9Fhj

Imaging
Pulmonary Embolism With Serpentine Thrombus Straddling a Patent Foramen Ovale
https://t.co/JF9zWDlAYR

Cerebrovascular Disease and Stroke
Keeping Up With Carney Complex: A Case of Recurrent Cardiac Myxomas
https://t.co/SNgivjiZva

@NAkhterMD
@aroniskn
@MiChen__
@FontanDoc
@juliendreyfus1
@sarano_maurice
@Miho_Fukui_
@Nishaki1
@ACHDocTMoe
@AdityaParikhMD
@AmitPawaleMD
@M_Pompeu_Sa_MD
@jsaef1
@JTSaxon
@Kentso987
@m_taramasso
@SyedZaidMD

[Dr. Gilbert Tang @GilbertTangMD]

Welcome to our January 14 issue of #JACCCaseReports @JACCJournals.
https://t.co/HEW4oV37b4

Full PDF here:
https://t.co/fma3RoHRky

@MinnowWalsh
@hmkyale
@Justine_Turco

Coronary, Peripheral and Structural Interventions
Contrast-Induced Encephalopathy After Coronary Angiography With Low-Osmolar Contrast
https://t.co/Y2azsFWCtT

Coexisting Congenital Left and Right Coronary Artery Anomalies: A Rare Cause of Pediatric Cardiac Arrest
https://t.co/XXH4eE9z0k

ST-Segment Elevation Myocardial Infarction From Carney Complex Familial Myxoma Embolization
https://t.co/NNKnjE49m4

Transhepatic Access for Mitral Valve Replacement: Transhepatic Transseptal Mitral Valve-in-Valve
https://t.co/dpgVtp1tgY

Aorto-Right Atrial Fistula Complicating Transseptal Puncture: Integrating Contemporary Imaging and the Structuralist’s Toolbox
https://t.co/FlzWQDnBqI

Transseptal Transcatheter Balloon Expandable Valve-in-Valve-in-Ring Implantation in Mitral Position
https://t.co/aw08rHGJsS

ELASTACLIP and TMVR for Failed TEER With Leaflet Tear
https://t.co/1pGOtYuYDE

Successful Transcatheter Mitral Valve Repair for Iatrogenic Chordal Rupture in Cardiac Amyloidosis
https://t.co/P9Ydy5Odse

First-in-Human Use of a Novel Dual-Mechanism Transcatheter Tricuspid Repair Device
https://t.co/KMdCKbnPVF

Fibrinolysis for Apical Thrombus as a Bridge to Emergent Valve-in-Valve Transcatheter Aortic Valve Replacement
https://t.co/ZzDPCVNN5b

Coronary, Peripheral and Structural Interventions
Transjugular Transcatheter Tricuspid Valve Replacement With the Evoque System: A Case Series and Technical Considerations
https://t.co/fWVqwOuzlW

Intermittent Mechanical Mitral Regurgitation: How Dynamic Real-Time Echo Outperformed Other Imaging Modalities
https://t.co/IjFXeZViCo

Recurrent Rheumatic Carditis Presenting With Severe Biventricular Dysfunction Despite a Normally Functioning Mechanical Mitral Valve
https://t.co/zc5EBysr2z

Stepwise Annular Reconstruction for Redo Double-Valve Surgery in Severe Mitral Annular Calcification
https://t.co/eAsTKO0bXw

Frame Overlap Technique: Improving Coronary Ostial Visualization in Latest Generation Supra-Annular Self-Expandable Transcatheter Heart Valve
https://t.co/AwRj0mB89z

Acute Deoxygenation After Transcatheter Edge-to-Edge Repair of Mitral Regurgitation
https://t.co/hWKQlQkxiv

Surgery
Advanced Hybrid Coronary Revascularization With Bilateral Internal Mammary Arteries: Preventing and Managing Left-Sided Cardiac Luxation
https://t.co/ueDaAN1XwP

Mitral Jamming by Left Atrial Mobile Thrombus in Severe Rheumatic Mitral Stenosis
https://t.co/7fjL04u9R1

Pericardial-Esophageal Fistula After Ethanol and Radiofrequency Ablation of Atrial Fibrillation
https://t.co/fakgbv77dR

From Shots to Shocks: When Ethanol Isn’t RF’s Friend—Pericardial–Esophageal Fistula after Combined Ethanol and Radiofrequency Ablation
https://t.co/CECWOXG8AU

Large Left Ventricular Aneurysm Caused by Aortic Stenosis and Exacerbated by Prosthesis-Patient Mismatch
https://t.co/09YClSr4iS

The Domino Effect of Tragedy
https://t.co/gf9d7DMyB6

Congenital Heart Disease
Targeted Drugs, PADN, and Transcatheter Closure for Atrial Septal Defect-Associated Pulmonary Hypertension
https://t.co/AgJjL9iP3D

Microaxial Flow Pump-Protected Percutaneous Pulmonary Valve Replacement in High-Risk Patients With Severe Left Ventricular Dysfunction
https://t.co/Q9IPeKgNcs

Biventricular Surgical Approach in Noonan Syndrome With Hypertrophic Obstructive Cardiomyopathy
https://t.co/hXHQnf8H6L

Transcatheter Pulmonary Valve Replacement in an Extra-Large RVOT Using a Custom-Made Pulmonary Valve
https://t.co/TfGP02dvFr

Cardio-Oncology
A Discovery of Potentially Hereditary Cardiac Angiosarcoma
https://t.co/dyApsy70Jf

Cardiac Infiltration in Mycosis Fungoides Resulting in Recurrent Tamponade
https://t.co/4jT9QKi9BT

Immune Checkpoint Inhibitor-Associated Myocarditis Mimicking Takotsubo Cardiomyopathy
https://t.co/YUrEJ76HyG

Heart Failure and Cardiomyopathies
Epidermolysis Bullosa Related to KLHL24 Gene: A Rare Pediatric Manifestation of Arrhythmogenic Cardiomyopathy
https://t.co/QvLIn25QBn

Recurrent Takotsubo Cardiomyopathy Due to Benzodiazepine Withdrawal
https://t.co/6XnyB1UnvR

Left Atrial Venting With Extracorporeal Support as a Bridge to Durable Support With Extensive Intracardiac Thrombus
https://t.co/Cdzmo27fEx

Rhythm Disorders and Electrophysiology
Radiofrequency Ablation and Right Purkinje De-Networking for Moderator Band PVC-Induced VF: Broadening the Therapeutic Landscape
https://t.co/CYjS7sft5u

First Reported Case of Infection Involving a Leadless Atrial Pacemaker
https://t.co/gdvlPgS2fL

Imaging
Leadless Pacemaker Infections: When Silver Bullets Are No Longer Immune
https://t.co/hZFPRsoBc1

Posterior MAD, Fibrosis, and Bileaflet MVP: A High-Risk Imaging Phenotype for Sudden Cardiac Arrest
https://t.co/xbDra03H2P

Mitral Annular Disjunction and Fibrosis in Bileaflet MVP: High-Risk Phenotype for Sudden Cardiac Arrest
https://t.co/46Q8JFMpWK

Cerebrovascular Disease and Stroke
Thrombus on ASD Closure Device Reveals Underlying Thrombophilia
https://t.co/WCktFc9WLk

@aronisMD
@MiChen__
@sarano_maurice
@Miho_Fukui_
@Nishaki1
@ACHDocTMoe
@AdityaParikhMD
@M_Pompeu_Sa_MD
@jsaef1
@JTSaxon
@Kentso987
@TagliariPaula
@m_taramasso
@SyedZaidMD

Authors’ handles:
@AlturkMD
@drproshkina
@cmlawley
@XGalloo
@npfam1
@jgranadacrf
@realnickvalle
@SalarTooba
@Kipourou_Kon
@josenborges
@josenborges
@Dr_Tolah
@xanderjacquemyn
@XanderJacquemyn
@SzegediNandor
@AnaBaracCardio
@AndrewNguyen_DO
@ranleemd
@JGhobrialMD
@JLmaigrotMD
@DrEdoSanhueza
@hanson_matthew
@sarano_maurice
@EssayaghBen

[Radosław Lenarczyk @RLenarczyk]

#Decremental #evoked #potentials to facilitate isthmus detection and monomorphic #VT #ablation in ischemic CMP
Kudos @K_Letsas❗️❗️👇
@ftrae @EuropaceEiC
https://t.co/3PGkzWv4UL

[日本循環器学会 情報広報部会 @JCIRC_IPR]

📕#JCS has published its official journal "Circulation Reports" 8-6 today!

Access URL (Open Access):
https://t.co/tREsVsbipX

Original research papers in this issue are about the following research areas:

🔴Arrhythmia/Electrophysiology
🟠Cardiac Rehabilitation
🔴Cardiovascular Surgery
🟠Epidemiology
🔴Heart Failure
🟠Ischemic Heart Disease
🔴Myocardial Disease
🟠Peripheral Vascular Disease
🔴Pulmonary Circulation
🟠Valvular Heart Disease

Please check out the TOC attached👀

#circ_rep Editorial Office H

[Zain Khalpey, MD, PhD, FACS @ZainKhalpey]

Idiopathic PVCs can originate from multiple regions of the heart, and their morphology can provide important clues to the site of origin.

Understanding these patterns is key for diagnosis and procedural planning in electrophysiology.

@MattersoftheH14

#MedTwitter #Cardiology #Electrophysiology #Arrhythmia

[sikandar adwani @SikandarAdwani]

Postural hypotension is often mismanaged because we treat the BP number before identifying the mechanism.

A simple bedside discriminator:

BP fall + appropriate HR rise → non-neurogenic OH
BP fall + blunted HR rise → neurogenic OH

Then look for:
• culprit drugs
• volume depletion
• parkinsonism/MSA/DLB
• diabetic or amyloid autonomic neuropathy
• supine hypertension

#Neurotwitter #Medtwitter #PosturalHypotension

Treat the orthostatic syndrome, not just the standing BP.

[Dr. José Ángel Cabrera @jacabreracardio]

Fundamental Anatomy and its Impact on Clinical Practice: Bachmann's Bundle and Interatrial Conduction (Part I-III)
Complete video and an outstanding editorial by ⁦@JustinTretterMD⁩ and ⁦@OCanoPerez⁩ https://t.co/N0JlNZnvex

https://t.co/a5oGW9JN6I

[Journal of Electrocardiology @JElectrocardiol]

🔬Research Alert

🫀In patients with angina pectoris, the presence of fragmented QRS (fQRS) complexes was associated with ≥70% coronary stenosis on coronary computed tomography angiography (CCTA).
🔗: https://t.co/lDFu0VI2Kj

[dr rakesh maurya @rakon11]

@pvvnlmeerut @aksharmaBharat @isomendratomar @1912PVVNL @mduppcl @MdPvvnl @UPPCLLKO I don't use plateform frequently. So this news should have been given more weight .

[dr rakesh maurya @rakon11]

@UPPCLLKO @CMOfficeUP @EMofficeUP @aksharmaBharat @mduppcl You officials are too lazy to work .first teach them how to work smartly.

[Sarah Fairley @SarahFairley7]

RTIG ostial stenting tips and tricks

A nice case of IVUS positioning

Case: 54 M, nstemi with severe LAD disease on angiogram? proximal LZ. IVUS showed disease back to near ostial LAD. LMS / Cx not involved, B angle not acute so suitable for RTIG stent placement ostial LAD.

[CardiovascularCorner @TrackYourHeart]

Bundle Branch Reentrant Tachycardia (BBRT) – A Rare but Important Ventricular Tachycardia

Seen in patients with structural heart disease, especially dilated cardiomyopathy or post-surgical hearts.

What is BBRT?
A macroreentrant VT that utilizes the His-Purkinje system as part of the reentry circuit.
It’s a form of ventricular tachycardia that mimics supraventricular origin on ECG due to its relatively narrow QRS (compared to other VTs).

Mechanism:
- One bundle branch acts as the antegrade limb
- The other as the retrograde limb
- The circuit involves the interventricular septum
- Often associated with prolonged HV interval

ECG Findings (as in the image):
A. Type A BBRT with LBBB morphology → indicates antegrade conduction through the right bundle.
B. Type C BBRT with RBBB morphology + left axis deviation → indicates antegrade conduction through the left posterior fascicle.

Clinical Significance:
- Can present as sustained monomorphic VT
- Often inducible during EP study
- May cause syncope, presyncope, or palpitations
- Frequently seen in patients with baseline bundle branch block and cardiomyopathy

Treatment:
- Catheter ablation (typically of the RBB) is highly effective
- ICD may be considered if underlying cardiomyopathy is present
Reference:
Zipes & Jalife’s Cardiac Electrophysiology: From Cell to Bedside, 8th Edition.
#Cardiology #ECG #Electrophysiology #VT #EPStudy #MedTwitter #CardioTwitter

[dr rakesh maurya @rakon11]

Tachycardia wobble ??

[Jasmine Sethi @JasmineNephro]

🫘💊How to initiate ACEi or ARB and how to monitor hyperkalemia/Creatinine

@ISNkidneycare @goKDIGO

[dr rakesh maurya @rakon11]

@TheOfficialSBI @OfficialSBICare Worst bank ,even worst employee ,shifting to HDFC ,axis bank.

[Dr Rob 🫀🩺 🇦🇺 @drhungo]

Why do I prefer atorvastatin & rosuvastatin?

💊 Potent - 50% LDL ⤵️ at high dose
💊 Can be taken day or night 🌃
💊 Absorption not affected by food 🍲
💊 ESRD 👉🏼 atorvastatin*
💊 SAMS 👉🏼 rosuvastatin**

* Only 2% of Atorvastatin is renally excreted & thus is my 🥇choice in ESRD

** hydrophilic, thus ⬇️ extrahepatic tissue penetration

#MedTwitter #CardioTwitter #MedEd #FOAMed #statin #cholesterol

[Dr Rob 🫀🩺 🇦🇺 @drhungo]

How do I approach statin associated muscle symptoms (SAMS) ?

💪🏼 confirm SAMS with history & CK
💪🏼 🔄 to hydrophilic statin
💪🏼 ⬇️ statin + add ezetimibe
💪🏼 Add bempedoic acid
💪🏼 Add PCSK9i*
💪🏼 Rechallenge with statin at 12 months

🔑 Only stop statin ❌ if symptoms severe or conformation of causality required

👤 LDL goal (nmol/L)👇🏼

🥅 high risk < 1.8
🥅 very high risk < 1.4

* can use all or a combination of statin, EZE, BPa or PCSK9i at the same time

#MedTwitter #MedEd #CardioTwitter #FOAMed #cholesterol #statin

[Dr Rob 🫀🩺 🇦🇺 @drhungo]

How do lipid lowering 💊 💉 work ⁉️

🔹 ⬇️ absorption of cholesterol from the gut (ezetimibe)

🔸 ⬇️ the synthesis of cholesterol in the liver (statins, bempedoic acid)

🔹 ⬆️ liver clearance of LDL 👉🏼 by inhibiting the PCSK9 pathway (Inclisiran, evolocumab)

Whilst cholesterol isn’t the ONLY risk factor, in the appropriate 👤 LDL ⤵️ significantly ⬇️ the progression of plaque/ASCVD

#MedTwitter #CardioTwitter #MedEd #FOAMed #LDL #lipids #cholesterol

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/
Why can furosemide improve dyspnea/pulmonary edema from acute congestive heart failure within minutes of administration?

The answer does not involve diuresis.

#medtwitter #tweetorial

[JMC @narrowQRS]

What's the longest PR interval you've ever seen?
Can you beat this???

https://t.co/CfDXA30uCF