Steve Noyes B.S, ACS, RCCS, RCS

Father and Husband, Cardiac Sonographer Spokane Heart Institute (current) past exp. : Kaiser Permanente Portland, Or, University Colorado Anschutz

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@IhabFathiSulima I see clot formation in RV. If vfib is shockable, any decision to proceed is way above my pay grade.

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@OungSavly @iamritu @AEPCcongenital @WGACHDChair @CASivaram1 @alexsfelixecho @loomba_rohit @alex1708ander @SIwa23288585 @swatigar @WithAScalpel Gerbode defect?

[Dr Ihab Suliman @IhabFathiSulima]

What is the Imaging Modality and what is the diagnosis?

[Dr Ihab Suliman @IhabFathiSulima]

Why it is Scary ⁉️

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@VLSorrellImages @CASEfromASE @ASE360 Ok- Dr. Sorrell
Heres one🤣

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

Yep- its coming - likely more rural access

[Berci Meskó, MD, PhD @Berci]

A low-cost and expert-driven medical technology is being used in rural areas in Australia!

The machine is operated by a sonographer remotely (using a gaming controller) and helps perform an ultrasound examination.

Doctor shortages shouldn't mean that patients have to travel more (sometimes for no medical reason), but to use technologies that can extend the reach of medical care.

This is a perfect example of that!

[Heart_BMJ @Heart_BMJ]

Pearls and pitfalls in the diagnosis and management of mitral annular calcification https://t.co/NVGYoNnIlc

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

We know it’s coming… improved access to smaller/rural markets… but ultimately our roles will likely change.

[Oung Savly MD FACC FASE FESC FAAP FEACVI 🇰🇭 @OungSavly]

8-year-old boy, HFrEF. BP 150/100mmHg.
What reversible causes would you look for besides CoA & endocrine disorders such as hyperthyroidism or pheochromocytoma? @iamritu @CASivaram1 @WGACHDChair @AEPCcongenital @alexsfelixecho @loomba_rohit @swatigar @dkthekkoott @alex1708ander

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

Might be Aneurysmal SoV -RCA is also a concern - eager to see official answer

[NephroPOCUS @NephroP]

Interesting #echofirst images!
What’s happening?
#FOAMed #POCUS
Clinical: A middle-aged man with no relevant medical history presents with dyspnea, chest pain, and altered mental status. His symptoms had limited his daily activities for the past 6 months until they became incapacitating. HR 116 beats/min, BP 70/40 mm Hg.

🔗 to open access source article will be posted in a few hours.

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

!

[kazi ferdous @fazalabul]

Hydatid cysts

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

Answer is in comments.

[NephroPOCUS @NephroP]

What’s that weird structure in the LV❓
Obviously, not chiari network 🫣
See #TEE images in the thread as well as 🔗 to the source.
#POCUS #echofirst #FOAMed

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@josecaferca @NMerke @alex1708ander @alexsfelixecho @ImagenCardiaca @RyCImagenCardio @jaumeaguero @VerwerftJan @JRodriPalomares Yes- thats a great technique

[Chittur Sivaram MD MACP MACC @CASivaram1]

#echofirst
☑️ Well known right atrial vestigial structure- Eustachian valve
☑️ Located at the junction of IVC-RA
☑️ Long & mobile example ⬇️
☑️ Might be mistaken for thrombus or vegetation
☑️ Directs blood flow from IVC to IAS during fetal life
☑️ Might play a role in paradoxical embolism
@swatigar
@OungSavly
@alex1708ander
@DrRajeshG1
@HeartOTXHeartMD
@JohnHenryDean
@sudarshanballa
@iamritu
@NadeenFaza
@argulian
@ZainAsadCardOnc

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

Great example!

[NephroPOCUS @NephroP]

#POCUS #echofirst #FOAMed
Nice example: Trans-aortic CWD demonstrates two distinct spectral profiles across the AV - the gray, midpeaking, higher velocity (5.0 m/s) profile represents the valvular AS (blue arrow), and the whiter, “dagger-shaped,” lower velocity (2.6 m/s) profile represents the functional obstruction from HCM (green arrow).
Courtesy 🔗CASE (Phila). 2024;9(1):9-18. doi: 10.1016/j.case.2024.10.002. PMID: 40027907

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@OungSavly @iamritu @escardio @ACCinTouch @ASE360 @WGACHDChair @CASivaram1 @VDelgadoGarcia @echoleolopez @DavidWienerMD @alexsfelixecho @loomba_rohit @dkthekkoott @CardioNeo Always a great test question on registry/certification tests …(“Conversely, only about 7% of patients with BAV have a concomitant COA”) … can trip up folks depending how the question is worded.

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@HeartOTXHeartMD @CampLonghorn One of Texas finest that was up in my neck of the woods touring … aaron watson bluebonnets https://t.co/c3Bab531eA

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

Answer in chain - great example!

[Edgar Argulian @argulian]

A patient with shortness of breath. A zoomed parasternal long axis view is shown. What are the structures and abnormalities seen on this limited view?

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@dr_benoy_n_shah LVEF appears to be very vigorous? - this is out of my lane …but have seen hyper-viscosity type syndromes cause increase velocity with valve with decent mobility

[Steve Noyes B.S, ACS, RCCS, RCS @StevenNoyes]

@marklewismd Lol , tough crowd😆