First subject enrolled in our 5th (!!) clinical trial with
@WHOOP
. Will be analyzing sleep patterns and executive in cardiology fellows taking 24 hour call. Very excited for this.
@TJHeartFellows
NCT page: . More details belowโฆ
First clinical trial as PI is officially in the books. What an amazing experience it has been: exploring the use of remote physiologic monitoring of resident wellness and burnout using
@whoop
at
@PennStHershey
. Many thanks to the support of an amazing team and group of mentors.
Do you โค๏ธ hemodynamics? How about PV loops?
Here is Part I of our journey to to help YOU better understand PV loops and make them a little less daunting. Couldn't have done this without โญ
@TJUHospital
resident
@jayamj94
, and edits from
@PSullivan000
. Stay tuned for Part 2!
Itโs official - will be moving to San Diego in July for Advanced Heart Failure & Transplant Cardiology Fellowship. Couldnโt be more excited. West Coast here we come ๐๐๐
Me on nights, literally every night: ok donโt eat all the junk food tonight.
Me, 6 uncrustables, 3 puddings, 2 jellos, 5 mini snickers and a sleeve of Oreos later: tomorrow is a new day
Very excited to be joining the cardiology fellowship program at
@TJUHospital
!! Cannot wait to see what the future holds in Philadelphia. Thank you so much for everyoneโs support and kind words. Now off to finish residency strong :)
Shed a tear in clinic today seeing my favorite patient for the last time ๐ข. She brought me this card, and candy. We counted the visits together - 16 in-person visits in 3 years โค๏ธโค๏ธโค๏ธ
Hand up if this you ๐๐๐ (๐๐ผโโ๏ธ)
Cc
@DrNasrien
et al from the convo on this the other day (which I tried to locate but couldnโt find) ๐
A common question on rounds: โso what diuretic do we discharge this HF patient on?โ
@robmentz
sheds light on this with an AMAZING presentation of TRANSFORM-HF (furosemide vs torsemide in HF).
โซ๏ธ2859 pts randomized
โซ๏ธ12-month f/up
โซ๏ธNo difference in all-cause mortality/hosp
Might be one of the most frightening texts Iโve ever received. Please
#GetVaccinated
.
There is absolutely no need to risk being young and healthy and requiring ECMO.
[shared with permission]
Staffing the ๐บ๐ฆ๐ต๐ฑ border with these two ED physicians (from Boston and Toronto). Such a selfless group of people out here. ๐๐
@pitcher_dr
@SauveteursSSF
Part II of the Basics of PV loops: preload, coupling, afterload, ventricular dysfunction, and valvular disorders.
Big thanks to the team who helped put this together:
@jayamj94
&
@PSullivan000
, with guest editor
@RyanTedfordMD
.
If you missed Part I, check it out โฌ๏ธ
Do you โค๏ธ hemodynamics? How about PV loops?
Here is Part I of our journey to to help YOU better understand PV loops and make them a little less daunting. Couldn't have done this without โญ
@TJUHospital
resident
@jayamj94
, and edits from
@PSullivan000
. Stay tuned for Part 2!
Met someone yesterday whoโs done a nephrology and cardiology fellowship (now an interventional cardiologist). First off - wow.
Second, trying to wrap my head around what they would do about continuing diuretics in a HF patient. Like, what would their volume assessment be ?!?
This Tue AM, I host the epic discussion btw
@AaronGoodman33
and
@RichardBaron17
on the MOC of the ABIM exclusively on
#HealthcareUnfiltered
podcast.
This is a clip from the pod that U will NOT want to miss. It all started with a petition, now with >11k signatures. watch it all
Back in February, we had this idea of using remote physiologic monitoring (with the
@whoop
device) to track resident wellness and burnout. Study will officially start July 1st. Couldnโt be more excited to kick this off
@PennStHershey
For more info:
Received this email back in 2014 from my med school advisory dean. Cannot believe we are back in this nightmare of a time.
I have no words.
#PrayForUkraine
๐๐บ๐ฆ๐
Q: Why do we use a stethoscope?
A: For many reasons, and hereโs one of them that I will argue is undervalued. And is still at the heart (hint hint) of some ongoing researchโฆ
โI have no wordsโ - Iโve said this seemingly a million times since the conflict in Ukraine began. Here I share my thoughts on
@TCTMD
about what it means to be Ukrainian and how it has influenced me as a person. ๐บ๐ฆ๐
I continue to pray for peace in Ukraine
First clinical trial as PI is officially in the books. What an amazing experience it has been: exploring the use of remote physiologic monitoring of resident wellness and burnout using
@whoop
at
@PennStHershey
. Many thanks to the support of an amazing team and group of mentors.
Back in February, we had this idea of using remote physiologic monitoring (with the
@whoop
device) to track resident wellness and burnout. Study will officially start July 1st. Couldnโt be more excited to kick this off
@PennStHershey
For more info:
Just wanted to say thank you for all the love and support of the people of Ukraine โค๏ธ.
All the text, calls, messages, and comments are encouraging that there is so much good in the world, even in the darkest times.
#PrayForUkraine
๐บ๐ฆ๐๐บ๐ฆ
You perform a bedside echo and see thisโฆ
1. What do we see here that confirmed the diagnosis from tele
2. What do we do next?
(Please answer in comments)
@joshmcgoo
@JJcolemanMD
Not a bad question. Here the heart was fine - so only needed to bypass the lungs with VV. Bypassing the heart unnecessarily with VA would likely lead to additional problems (north south syndrome, risk of compartment syndrome/limb loss if you compromise the arterial system, etc).
Going home for thanksgiving was a no-go this year, for obvious reasons. Day was made when I got a text from a gym friend saying โsorry you couldnโt spend time with your family, weโll drop over dinner later, what kind of pie do you like?โ ๐๐๐
Iโm speechless, and thankful :)
Question for the day: if something is FDA-approved. And covered by Medicare, why is it not mandatory that every insurance company covers that med/therapy?
But distended neck veins coupled with cold extremities and hypotension should confirm the diagnosis (effusion with tamponade). These cannot be missed. Checking for a pulsus paradoxus (>10mmHg drop in BP with inspiration) can also help.
3 months of fellowship โ . Finished off a good work week and solid training week with a 405x3 back squat and 225 snatch. Couldnโt ask for much more.
Now taking a week vacation, setting up an email โout of officeโ message (first time ever), and going off the grid ๐. Cannot wait.
@SVRaoMD
@alextatem
Emphasis on the โitโs terribleโ part. But after a few weeks itโs not as bad. The tough part is the discipline to go to bed at a decent hour.
Last night at the Polish-Ukrainian border. What a ride it has been. One thing is certain - I donโt want to leave.
A quick rundown of our final nightโฆ
The last few nights we treated a ton of dehydration and hypothermia. Tonight, after our shift, we went across the border with a ton of hot chocolate/chai/coffee to hand out while people stood in line to cross the border from Ukraine to Poland (1/3)
And just like that
#AHA23
in Philly is a wrap!!
Great seeing everyone and catching up and making new friends. Canโt wait till next year.
@AHAScience
โค๏ธโค๏ธ
๐ฅ๐ฅ๐ฅ
@JACCJournals
State of the Art Review: Acute Decompensated Heart Failure in the Setting of Acute Coronary Syndrome ๐ฅ๐ฅ๐ฅ
A great update on the pathophysiology, epidemiology, risk factors, and outcomes for patients with ACS-HF.
@JLHarrington_MD
These girls cross the border from ะฃะบัะฐัะฝะฐ ๐บ๐ฆ (Lviv) every day to help translate and bring refugees food/water. They are absolute angels ๐ผ๐โค๏ธ.
We shared so many genuine laughs tonight, mainly when they corrected my Ukrainian ๐ณ. I will cherish this moment for a lifetime.
First time I did a right heart cath I read this (excellent) paper beforehand. Couldnโt have been more helpful. Great talk by
@RyanTedfordMD
. And I agree with
@AndrewJSauer
about recommending this paper for RHC tips and tricks.
Excited to share this story about a very long night in the ICU...and everything that came of it. All the work that we have done with
@whoop
wouldnโt have happened without this experience.
Andddd just like that - we are done we overnight call in fellowship.
@TJHeartFellows
What a ride itโs been. A lot of learning. And enough consults, stat echos, CCU evals, device interrogations, outpatient calls, floor admits, and RRTs to hold me over for a bit โค๏ธ
Did this interview with
@MensHealthMag
about how I occupied my time in the first month of the pandemic.
The physiologic changes I noted helped inspire two clinical trials we are doing with
@whoop
- HF and resident wellness.
@PennStHershey
Cannot stress enough the importance of obtaining a thorough history/physical yourself. Paying close attention to tele shows clear electrical alternans (which doesnโt necessarily equate to tamponade, only that the heart is swinging in the chest).
Have you ever wondered why we say that BNP or NT-proBNP levels are lower in obesity? Is this just an association or do lower BNP levels contribute to HF ??
Hereโs a nice review on physiology of BNP/NT-proBNP and their use in the clinical setting:
Excited to have Dr. Nasrien Ibrahim (
@DrNasrien
) join us on Clubhouse this Friday night at 9pm EST, for our first "Trainee Night" - we will be discussing all things cardiology training, early career development and more. We look forward to hearing her AMAZING story!
#CardioTech
This is an underutilized slide
@JavedButler1
- it should be emphasized HF talks.
Would like to underscore the misnomer of โstableโ HF patients when referring to those that are compensated.
Because look at that event rate! (EXTREMELY HIGH RISK)
@SJGreene_md
@gcfmd
Almost cried today. Thank you
@IRajapreyar
for being the best part of cardiology fellowship at
@TJUHospital
โค๏ธโค๏ธ
Over the past 3 years youโve been an amazing mentor, treated me like a colleague, and have become a best friend. I will miss you. Enjoy Boston and
@TuftsMedicalCtr
โผ๏ธ