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jedicath աǟզǟʀ.ǟɦʍɛɖ

@jedicath

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To Learn & Educate | alum IM CV & #IC @BrighamWomens @bidmc |MS @HarvardChanSPH tweets=own opinion

A Grey Scale World
Joined July 2009
Don't wanna be here? Send us removal request.
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 years
#Cardiology emogies 🎈 balloon 💋🎈kissing balloon ⛓stent 🔦echo 🔞low EF 🔪CABG 💊OMT 🚰diuretics 🚱renal shutdown 💉 Thrombolysis 💔MI 🐲surgeon
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
A curriculum designed by people who have never taken care of patients to take of physician burnout. Another grand slam by @DGlaucomflecken
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
“Nothing prolongs a procedure like a short-cut” Applies to all surgeries & procedures
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Dope anatomy #ACCFIT #EAPCI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
@mmamas1973 Will the hospital management apologize to the doctors who were forced to formally apologize?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 years
Learning on #Twitter versus traditional conferences #FOAMed #CardioEd
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
Diabetic patient with ACS. LAD treated with 3.0 mm stent and postdilated with. 3.0 NC balloon. Good result? Looks good?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
I hate ostial circumflex Background: LM LAD LCX. Culotte stent with IVUS before and after and FKB POT. 4 months later Imaging next tweet 1/n
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Thousands of Interventional Cardiologists the worldwide want to fix the anterior ischemia #BlackHole
@CBCAlerts
CBC News Alerts
5 years
This is the 1st-ever photograph of a black hole, unveiled by scientists this morning. More @CBCNews :
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
The only intervention was heparin and aspiration. No stent / balloon #cardiotwitter #STEMI #IC life
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
𝕂𝕚𝕟𝕘 𝕠𝕗 𝕒𝕝𝕝 𝕋𝕙𝕣𝕠𝕞𝕓𝕦𝕤 95 year old patient with this EKG #ACCFIT #EAPCI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Calcified LAD lesion. In future this will be for lithotripsy #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Best of what we do Interventional Cardiology. Simple and saves lives
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Amazing new coronary angiography modality. #SundayMotivation #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
So you are a fresh July cardiology fellow: 70 year old found unresponsive easily rousable. First BP by EMT is 70/30. Taken to non-cath hospital. Activate cath lab? Where is the culprit? #ACCFIT #EAPCI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
Sad Truth. Placing an under expanded stent in a heavily calcified artery is worse than no stent (no procedure) even in a class 2-3 stable CCS. 😐
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
It is all in the history. Young lady 1week post partum. #SCAD #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Stents in stable disease don’t prevent MI (in an elderly post CABG) “But there is inferior ischemia on the nuclear study” Stents still don’t prevent MI “But there is inferior ischemia on the nuclear study” Not just patients but general cardiologists also need education
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
39 year old lady presents with chest pain. Received lysis at a peripheral hospital COVID negative and transferred. Pain improved. Angio at 3 hours #cardiotwitter #ACCIC #EAPCI Where to next? Wire - balloon - stent?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
When STEMI don’t go according to the script. Elderly Asian lady with anterior STEMI. Heavily calcified vessels. No clear clot. WH wires didn’t cross BMW/Sion. Fielder XT got the job done LAD & then the diagonal crossed separately #Cardiotwitter #CTO101 #RadialFirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Young patient with inferior MI. The left system appears to be long recanalized LAD and diagonal. Never seen that before #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
Number of solutions. A simple (free) is to use a stopper balloon just distal to the diagonal alley. Wire just sailed ✌🏽
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
Does prophylactic low dose DOAC prevent LV clots in pts with anterior STEMI @jaccjournals
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
Balloon non-dilatable. Successful @ShockwaveIVL lithotripsy. Two lithotripsy trains were followed by wide complex VT after the end of the shocks. Self terminated and stable #CardioTwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 years
Stents I see them everywhere. #CardioTwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
For fellows what’s happening here Patient referred for angiography for cardiomyopathy #ACCFIT #EAPCI @PCRonline @SCAI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
😞when the CNN reporter is better protected than the ICU doctor #COVID
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
9 months
First PCI post #TCT2023 . Should be an easy lesion to cross? #radialfirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 months
Anterior STEMI. Serious size discrepancy between the LAD and the Left Main. How would you treat?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
Imagers #imagefirst . LAD 4.0 stent and post dil with 4.0. ‘MSA 12.8. There is plaque in a large vessel. Any point going bigger?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Operating at another cath lab. Severe radial spasm, pt needs RCA PCI but 5F guides not available. 6F guide won’t pass. BAT 🦇 to rescue same guide passed #RadialFirst #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
If we don’t look like an astronaut 👩‍🚀 in a space suit we may not be protected when dealing with a suspected case. Learn from Wuhan
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
July IC Fellows. Basic Garden Variety STEMI. Bread 🍞 Butter of IC #ACCFIT #EAPCI . No reflow treated with distal infusion of adenosine via Export (no western music 🤠)
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
@erconwell Also make sure he stands in a long virtual line Overcharge for the food Keep him standing for a 1 hour session or close the door and tell him room is full he can watch the small satellite screen has to walk twice around the house between sessions to get to the “right” room
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
Love 🎢 roller coasters except in the coronaries. #radialfirst 🏒 guide. Wire crossed but couldn’t deliver equipment
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
#whyIVUS Despite 3.0 NC the stent was 2.5mm. Dilated with 3.5mm achieved 3mm in the stent. Finally dilated with a 4mm NC. #imagefirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
PSA request to balloon manufacturers. Can we please make the markings on the balloons bold and readable. Difficult to see in the dark cathlab after a 𝘤𝘦𝘳𝘵𝘢𝘪𝘯 age. @AbbottCardio @Medtronic @bostonsci #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
My first post EXCEL BBC story EXCEL patient. 54 year old angina no Troponin. SYNTAX score 10
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
The Twin-Pass Dual Lumen catheter Where is the side port exit in relation to the 2 markers. See bench test below #ACCFIT #EAPCI #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
9 months
“Patient refused surgery. It all depends on how it is presented 1️⃣do you want surgery or PCI? 2️⃣surgery is a better option and wouldn’t recommend PCI as the first option.” — Antonio Colombo at #TCT2023
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
Thoughts and prayers for Erickson but CPR was delayed. I was screaming start compressions. #Euro2021
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 months
@fascinatorfun @mmamas1973 It is time the word “junior” is removed from the British lexicon in describing doctors. There are no junior lawyers or junior accountants. This word implies that they can be underpaid or simply that they are not qualified to be paid.
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 years
How to TAP with @mirvatalasnag patient with Distal LM turned down by and Surgery not accepted by patient /1
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
young pt with I-STEMI Large clot, export 2b3a, stent with TIMI3 flow. Post dilation of 3.75 NC lead to slow flow Relooked with IVUS 🧿 in 2 days TIMI 3 flow but 🧿 showed 🫥good MSA >11 but Please comment @ajaykirtane @mmamas1973 @ziadalinyc @djc795 @agtruesdell @aspergian1
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
Patient waited at home with chest pain for 2 days before coming to the ER. Inferior STEMI l. Thrombus aspirated STEMI in Days of #COVID19
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 years
84 year old man large NSTEMI EF 30% Aneurysm/ectasia in LAD followed by a severe stenosis. Unlikely to be accepted by surgeon Lucky that wire crossed. Provisional stent with POT #Cardiotwitter #RadialFirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
intervention in heavily calcified chronic total occlusions: an expert review by @KambisMashayek1 for EuroCTO Calcium is bad High level of expertise in techniques and equipment is needed @EuroInterventio
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
STEMI 2015. Had a stroke recently and now recovered. What is the significance of a LV clot years after a MI? Now do you anticoagulate or not if so warfarin or DOAC see RT/poll please
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
A diabetic patient in clinic with class 3-4 angina. History of PCI 2 years ago at OSH. A 2.5 mm stent in PDA by report. Angiography has diffuse ISR. IVUS showed this 👇🏽🙃
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
Interventional cardiologist snaring an embolized device
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
56 year old patient from OSH with acute NSTEMI small elevation of Troponin. EF reported 35-40%. What would you do or want to know? @mirvatalasnag @drptca @GoranEBC @billgogas @BaoGTran @GreggWStone @mmamas1973 @DocSavageTJU @ShariqShamimMD @cardiojaydoc02 #ACCFIT #EAPCI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
😊An easy JCTO-0 thought FielderXT or Gladius will cross 🧐Mongo Gaia2 Gaia3Next didn’t cross Performed a Carlino with Finecross -> Gaia3Next > Gladius #CTO #CTO101
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
To protect or not to protect the septal. It is a large vessel supplying small septals @perc_surgeon @aspergian1 @evandrofilhobr @AntoniousAttall @davidbartov @mirvatalasnag
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
Even month old stents occluded can be difficult to cross. Non-compliance is the reason for occlusion. Very impressed with the Gladius wire and Corsair Pro XS #CTO @agtruesdell @AntoniousAttall @ShariqShamimMD @nyalborgesmd @MichaelMegalyMD @skat_ct @HadyLichaaMD
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
#ACCFIT #EAPCI #ACCIC ST elevation aVR. Severe LM stenosis. #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Someone few months ago (apologize can’t remember who) had asked if we ever use a 48 mm DES in the coronaries. Here you go #CardioTwitter #RadialFirst #CTO101
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 months
Fear of Failure and overcoming it #CTO2024 @JAG24851 @DrBillLombardi
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
There is no intimal hyperplasia. Very focal stent compression. After 3.75 high pressure NC there was moderate improvement Lessons 👁‍🗨Ostial LCX is a different animal 👁‍🗨Imaging alone is not enough to prevent restenosis 👁‍🗨Need solutions for compression
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
Today I looked at our Gaia wires. I waved at them from far. Days of #COVID19
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
Another classic. “Cardiology will destroy every organ to treat the heart and nephrology think they can avoid dialysis”
@DGlaucomflecken
Dr. Glaucomflecken
3 years
Showdown in dialysis
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Never routine. But sometimes needed #CardioTwitter #RadialFirst Thrombo-aspiration
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
One of the largest ASDs I have seen. Essentially a black hole 49 mm in other views @KFAFHCards @mirvatalasnag @dr_benoy_n_shah #echofirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
#radialfirst weak pulse. US guided access. Wire stops near the axillary artery. Stop and Look 👀 Cross and proceed vs switch access?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
𝕀𝕟 𝕙𝕠𝕟𝕠𝕣 𝕠𝕗 𝕁𝕦𝕝𝕪 𝕒𝕟𝕕 𝕟𝕖𝕨 𝕀ℂ 𝕗𝕖𝕝𝕝𝕠𝕨𝕤. #ℂ𝕋𝕆𝟙𝟘𝟙 𝕗𝕠𝕣 𝕒 𝕁ℂ𝕋𝕆-𝟘, 𝟙,𝟙,𝟙 𝕄𝕒𝕕𝕚𝕟𝕒 𝕓𝕚𝕗𝕦𝕣𝕔𝕒𝕥𝕚𝕠𝕟. 𝕋𝕣𝕖𝕒𝕥𝕖𝕕 𝕨𝕚𝕥𝕙 𝔸𝕎𝔼 𝕒𝕟𝕕 𝕡𝕣𝕠𝕧𝕚𝕤𝕚𝕠𝕟𝕒𝕝 𝕤𝕥𝕖𝕟𝕥 #RadialFirst #imagefirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
8 months
I don’t do guess the vessel but this case honestly was not clear. STEMI or not? Where is the culprit? Background healthy man in 30s into gym life and non-smoker
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
𝕋𝕚𝕡𝕤 𝕗𝕠𝕣 #𝔸ℂℂ𝔽𝕀𝕋 #𝔼𝔸ℙℂ𝕀 STEMI with a tortuous RCA wire wouldn’t cross due to poor support even when supported with a small ballon. Options: 📍Guideliner 📍microcatheter 📍Change the guide
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
@JannetBrownn @mmamas1973 In that graph, guess who have the best (strongest) unions?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 years
STEMI #RadialFirst How not to cross for reduced DBT. Kids (fellows) DON'T try this at home 😂
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
11 months
𝐖𝐡𝐚𝐭 𝐇𝐚𝐩𝐩𝐞𝐧𝐞𝐝? NSTEMI RCA. WH & Sion didn’t cross, brought a MC to prepare for Fielder XT but Sion crossed. No injections after the first picture This is what is seen in the next picture🫥! Why and what happened?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
Pre and post @ShockwaveIVL dilation #cardiotwitter ClearStent
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
This is physician burn out 👇🏽. No amount of yoga or mindfulness is going to change it
@DrBradHolland
Bradford Holland MD FACS
4 years
I’ve been on hold 55 minutes with @AnthemBCBS to get an appeal of a PET scan for a neck node SCCA & carcinoma of unknown primary (shouldn’t require a peer-to-peer anyway) Physicians should have the ability to file meaningful complaints about this Prior Auth BS. #txlege
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 months
Watching a CTO wire crossing is akin to watching paint dry 😴 🎨 Gladius - Corsair Pro
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
2013 BVS placed in the LAD (between the septals) Continued to smoke 2019 Inferior MI. Relook at the LAD: 6 years post BVS. Archeological signs of the BVS remain 🤓
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
1 year
3:30 am. Jumping through hoops for a STEMI #radialfirst
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 years
Not all mature collaterals may mean a CTO? #CTO101 #radialfirst #cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
@aspergian1 You are right. It does not matter how experienced one is. Anything can happen. Complications, perforations, dissection, shock, bleeds .... everyday is a humbling experience. Needs team to deal with the procedure. Later. Your friends and colleagues lift you back up.
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
General cardiology call, amid a plethora of troponins, walks in a Young man w no previous history at all described 9 episodes of syncope. EKG in the ED #cardiotwitter #cardioEd #MedEd #EPeeps #ACCFIT
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
“Nothing of note happened today” George III. Just a run of 3 anterior STEMIs #2 80 year old w no clear stump & CTO RCA + ostial LCX. BMW no go, Sion subintimal, thankfully Fielder XT true lumen. Can CTOs present as STEMIs?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
I wish the industry makes easily readable balloon labels. Hard to squint and see. @BSCCardiology is easier to see than @AbbottNews balloons
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
Unnecessary stress test ⬇️ CTA ⬇️ cath stent ⬇️ Restenosis #CardioTwitter
@IDdocAdi
Adi
2 years
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 months
The moment of truth. Confirmation of the passage of the Gaia 2 Next via contra injection. (Pilot 200 buckled) #CTO102
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 years
My teaching to rotating IM resident after seeing a STEMI in an ISR in a 2007 stent: Stents don’t prevent MI Stents don’t prevent MI Stents don’t prevent MI Stents don’t prevent MI Stents don’t prevent MI Stents don’t prevent MI Stents don’t prevent MI Repeat
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
How to use the Guide-Extension catheters via @ramonlopezpalop #ACCIC #EAPCI #ACCFIT
@ramonlopezpalop
Ramón López Palop
4 years
Simple but, very interesting
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Had to do a fast culotte (instead of a DK-crush) with kiss & POT. Ultimately a good result but how we get there is sometimes not how we plan it
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
Today I smelled coffee and soap. I could. That made me happy Days of #COVID19 #SARSCoV2
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
young pt STEMI. Before, after aspiration and final after 2b3a and IC tPA. There is a ball 🏀. Now what? #cardiotwitter #STEMI
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
4 years
#CTO stump at the diseased ostium of diagonal. Fills via diagonal collaterals and retrograde filling. Plans A then B probably bifurcation stenting needed IC Explains procedure & risks to pt. Patient had 1 question: what will I benefit IC pain relief Pt I am pain free Reply?
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
2 years
For those missing the CoPilot. This is the Merit PhD hemostasis valve (no COI). Just as good if not better @MeritMedical
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
3 years
I wish I have this 3d model to show patients that the epicardial coronary accounts for minority of blood supply system of the heart
@issywalker
Issy 🚶🏼‍♀️
3 years
1.5 months in the making. A heart full of love.
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
Pretreatment of STEMI patients with P2Y12 receptor antagonists was not associated with improved clinical outcomes #STEMI #cardiotwitter #MedEd @DLBHATTMD
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
6 years
60 year old man angina with STE during attempted stress test. EF 40% discussed next day in MDT offered surgery adamantly refused even to see the surgeons. Trifurcation? #Cardiotwitter
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
7 years
#radialfirst when the 0.035 wire doesn't pass, stop and LOOK 👀
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@jedicath
jedicath աǟզǟʀ.ǟɦʍɛɖ
5 years
This account has the most extreme echos I have seen #EchoFirst X-Echo
@fazalabul
kazi ferdous
5 years
This is prolapse
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