Will Watson @DrWillWatson Twitter profile

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Will Watson

1 year

Delighted to have my PhD work published in @circAHA !

Retained Metabolic Flexibility of the Failing Human Heart

Background: The failing heart is traditionally described as metabolically inflexible and oxygen starved, causing energetic deficit and contractile dysfunction. Current metabolic modulator therapies a

www.ahajournals.org

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Last Seen Profiles

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Will Watson

@DrWillWatson

3 years

11 weeks ago, I was 92.5kg - and that horrible word, obese. Now I’ve lost 11kg and am feeling great. Come the new year I am aiming for a BMI under 25!

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Will Watson

@DrWillWatson

2 years

Has been successfully appointed clinical lecturer in cardiology at the University of Cambridge 🥳

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Will Watson

@DrWillWatson

2 years

I am a dual trainee in cardiology and intensive care medicine. I spent 9 months working in covid ICU. I am triply vaccinated. It reduces your chance of getting covid. It reduces your chance of being ill with covid. It reduces your chance of passing on covid. #GetVaccinated

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Will Watson

@DrWillWatson

6 years

Heart Failure with Preserved Ejection Fraction #HFPEF Tweetorial! Once thought as just diastolic dysfunction, it is much more than that! (picture credit @Medcomic ) #HeartFailure #CardioEd

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Will Watson

@DrWillWatson

2 years

Pretty casual but I graduated from my DPhil

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Will Watson

@DrWillWatson

8 months

I bet lots of you out there have given patients a slug of magnesium for pesky arrhythmias. I have never really known how it works, but here's a theory....

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Will Watson

@DrWillWatson

6 years

Tweetorial! Troponin, troponinaemia, troponinitis, troponin leaks - distinguishing type 1 MI from type 2 or nonischaemic myocardial injury. Increased demand for a limited supply of evidence...

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Will Watson

@DrWillWatson

4 years

No ties, a Littman Classic II and they CALL THEMSELVES CARDIOLOGISTS

Will Jenkins

@WillJenkins82

4 years

On Wednesdays we wear blue. #cardiotwitter #cardiofellows

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Will Watson

@DrWillWatson

3 years

New review of cardiac metabolism in heart failure in @JACCJournals .

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Will Watson

@DrWillWatson

5 years

Be honest, who else was worried this black hole had LAD territory ischaemia?

Medlife Crisis (Rohin)

@MedCrisis

5 years

Cardiologists like to think they're the centre of the universe. Turns out we're just the centre of the galaxy. Left: supermassive black hole at the centre of galaxy M87 Right: cardiac PET scan

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Will Watson

@DrWillWatson

2 years

An intensivist, just happening to be passing me in the corridor, stopped me and asked what a patient’s left ventricular function was. Clearly I have reached the stage of cardiology where I am expected to intuit all ejection fractions within a quarter mile radius. (It was 46%)

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Will Watson

@DrWillWatson

11 months

@DacreJane 1. Of course, pay for level of job stress is terrible. 2. Workload has increased with reducing resource (austerity has caused loss of facilities and colleagues with no prospect of their replacement). This creates feelings of helplessness.

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Will Watson

@DrWillWatson

11 months

love this. Direct link between mental stress (seen by Amygdala activation) and vulnerable coronary plaques. We all know stress causes MI but here's the links in the process visualised in a study!

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Will Watson

@DrWillWatson

3 years

Dear all hospitals. Please can you avoid having a lengthy (I.e. more than 30 seconds) message play before I can speak to a switchboard operator? It has made my day feel (or possibly be) twice as long

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Will Watson

@DrWillWatson

6 years

@DrAmalinaBakri Remember the first thing is the patient! ABC approach and call for help. Patients with adverse features (shock with SBP <90, collapse, or ischaemia) need a DC cardioversion (with sedation from a friend if necessary). If they are stable and maintaining output then amiodarone IV.

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Will Watson

@DrWillWatson

4 years

I knew if I got topless on social media I would increase my reach.

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Will Watson

@DrWillWatson

2 years

@iceman_ex “The science isn’t strong enough,” he said, giving another bolus of magnesium upon seeing a ventricular ectopic.

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Will Watson

@DrWillWatson

2 months

How many of you fluid restrict heart failure patients to 1.5L? Me too! But the evidence would suggest this has no benefit on decongestion and just makes patients more thirsty. Thanks @JJCuthbert for linking this

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Will Watson

@DrWillWatson

5 years

My research on pubmed this morning shows there has been exponential growth in the number of medically published paradigm shifts (following a paradigm shift in this phenomenon at some point in the 1990s). Gathering pace of research or over-use of lazy cliches?

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Will Watson

@DrWillWatson

8 months

Delighted to have won the early career investigator prize

British Society for Cardiovascular Research

@BSCResearch

8 months

First speaker in the BSCR Early Career Investigator Prize session is @DrWillWatson who describes the Metabolic Flexibility of the Failing Human Heart

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Will Watson

@DrWillWatson

2 years

@mevparekh They are tweeting exactly the same thing going 'table of doctors next to us, just talking about rotas and UTIs... he made some kind of rubbish joke that ended "and then I gave him tazocin" and everyone thought it was hilarious'

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Will Watson

@DrWillWatson

3 years

Update: 80kg 💪 - maybe I gained over Xmas but as it goes on, it feels the final kgs are getting harder to shed!

Will Watson

@DrWillWatson

3 years

11 weeks ago, I was 92.5kg - and that horrible word, obese. Now I’ve lost 11kg and am feeling great. Come the new year I am aiming for a BMI under 25!

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Will Watson

@DrWillWatson

2 years

I didn’t go to America and all I got was this stoopid plaque

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Will Watson

@DrWillWatson

3 years

@traumagasdoc Makes more sense when you think of it like this

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Will Watson

@DrWillWatson

4 years

Nitrates and pressure-volume loops - these patients were given a 200mcg IV bolus. Group 1 are healthy: they had a predominant preload reduction and stroke volume fell. Group 2 have HFrEF: they had a predominant afterload reduction and stroke volume rose.

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Will Watson

@DrWillWatson

2 years

@matthewbowker Not really a joke but calling an old lady “young lady” never fails.

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Will Watson

@DrWillWatson

6 months

Why do we need prizes, additional degrees, etc to prove we are worthy of applying to a speciality? How do these things prove you are a decent doctor?

Chelcie Jewitt

@ByChelcie

6 months

So i’ve just looked at the 2024 ICM ST3 Self-Assessment Matrix… Safe to say, I will not be getting an interview 😢 No prizes, no additional degrees, no nationally held leadership position (for 6/12). I work so hard, but nothing that ticks any boxes. Should I even bother?!

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Will Watson

@DrWillWatson

1 month

ACC round up: Beta blockers are out, impellas are in, you feel better if you lose weight. I will not be taking questions.

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Will Watson

@DrWillWatson

2 years

Excellent summary on evidence behind heart failure drugs in stages of renal failure.

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Will Watson

@DrWillWatson

4 years

Seeing many severely hypoxic patients with #COVID19 who seem to lack air hunger and look paradoxically comfortable. This seems to be a central effect from the virus's neurotropic properties as discussed in

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Will Watson

@DrWillWatson

6 years

In case anyone was wondering where I got these great images from, check out @medcomic

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Will Watson

@DrWillWatson

5 years

@drjustinzaman @jasaunders90 A better tweet would have been “our PA is so good they have been able to ameliorate the need for a clerking acute med doctor, freeing them up for educational roles” Push people up, don’t drag them down.

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Will Watson

@DrWillWatson

11 months

@DacreJane 8. A bizarre cultural ideology that seeks to mitigate risk with form filling and mandatory training. Both of these eat into staff time (probably an indirect creator of risk) rather than addressing underlying systemic inadequacies.

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Will Watson

@DrWillWatson

11 months

@DacreJane 12. Basics of human needs: you can’t park, there is nowhere to take a break, food is expensive. Often these things have been contracted out to profiteering external contractors.

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Will Watson

@DrWillWatson

3 years

Thanks to everyone who voted for me as a staff governor at @CUH_NHS - I am delighted to be representing front line medial staff over the next few years.

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Will Watson

@DrWillWatson

11 months

@DacreJane 4. Administration in the NHS has frequently become bullying and nagging management, a role that should be facilitatory of staff goals instead pushes them around to suit management goals.

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Will Watson

@DrWillWatson

2 years

Now published! The physiology of how altering conditions of preload and inotropy in the human heart can dramatically alter its energy consumption

Frontiers | Myocardial Energy Response to Glyceryl Trinitrate: Physiology Revisited

Objective: Although intravenous nitrates are commonly used in clinical medicine, they have been shown to increase myocardial oxygen consumption and inhibit c...

www.frontiersin.org

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Will Watson

@DrWillWatson

3 years

Back to it, I guess

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Will Watson

@DrWillWatson

11 months

@DacreJane 3. Feeling of exposure to personal risk and litigation (partly thanks to (2)) is greater than ever. Bawa Garba proved that a doctor can be held responsible for systemic issues beyond their control which impact their ability to provide good care.

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Will Watson

@DrWillWatson

11 months

@DacreJane 11. A special shout out to IT. IT is meant to make your job easier. So, so frequently it makes it harder in the NHS. Systems not fit for purpose. Ancient and slow infrastructure. Multiple systems that do not interact. Manual data entry where it should be automated.

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Will Watson

@DrWillWatson

4 years

ICU - closed circuit ventilators with filters Wards - patients coughing and sneezing out aerosols ICU - FFP3 mask, hat, visor, full gown, 2 pairs of gloves, added apron Ward - surgical mask, apron, gloves, hat, ? visor 🤷‍♂️

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Will Watson

@DrWillWatson

3 years

Hooray! #whycmr

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Will Watson

@DrWillWatson

3 years

University of Oxford #covid #vaccine up to 90% effective. Tremendous news @UniofOxford

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Will Watson

@DrWillWatson

3 years

Anyone who has done an ALS course will be familiar with the concept of giving a lipid emulsion such as intralipid to combat local anaesthetic toxicity

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Will Watson

@DrWillWatson

2 years

Has been awarded a postgraduate diploma in medical education 😎

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Will Watson

@DrWillWatson

11 months

@DacreJane 9. A move away from teaching towards service provision: few opportunities for informal teaching in the workplace due to pressure of work or for junior staff to attempt more skilled work due to concerns over litigation and/or a more fragmented team structure

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Will Watson

@DrWillWatson

2 years

Leaving another HF session I am left thinking that the phrase “heart failure” is not only needlessly alarming but poorly reflective of a wide spectrum of cardiac dysfunction, including subclinical disease.

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Will Watson

@DrWillWatson

11 months

@DacreJane 7. Patients are sicker, older, frailer and more co morbid but modern medicine has evolved to develop resource intensive (and often not risk free) treatments which has created a high expectation of this difficult work (in a resource poor and risk adverse environment)

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Will Watson

@DrWillWatson

3 years

Amazing @TheBachChoir concert at @southbankcentre with @annalapwood and @NHSChorus19 celebrating the work of @CUH_NHS intensive care heroes told through the eyes of a patient. Really moving occasion and a privilege to see professional musicians performing peerlessly.

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Will Watson

@DrWillWatson

11 months

@DacreJane 5. Work becomes inescapable. Email, phone calls and admin eat into personal time. Combined with the feeling of exposure and high levels of risk this leads to an “always on” feeling.

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Will Watson

@DrWillWatson

7 months

@Dr_Done_ @GSTTnhs @icabbs I hear the criticism of those saying 'remove trainees' but then the place goes "thank you very much" and it gives them licence to have a fully PA/consultant delivered service and trainees lose the opportunities in a major specialist centre. Remind people of their duty to train.

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Will Watson

@DrWillWatson

2 years

found this interesting: a simple, echocardiographically derived index (TAPSE/PASP) models the interaction betwen right ventricle and pulmonary artery and predicts outcomes post tricuspid valve intervention @JACCJournals

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Will Watson

@DrWillWatson

4 years

Published online! We used a hybrid approach of magnetic resonance imaging, Phosphorus magnetic resonance spectroscopy and dynamic nuclear polarisation to understand the myocardial contractility changes in vivo following nicotinic acid or acipimox

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Will Watson

@DrWillWatson

3 years

Reasons to be happy today

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Will Watson

@DrWillWatson

11 months

@zackferguson Oh man I worked there. It was crazy. They worked out it was cheaper to buy a Greggs sausage roll and use the wrapper as a tourniquet than buy actual tourniquets. I had to eat 192 sausage rolls a day to keep the department going.

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Will Watson

@DrWillWatson

5 years

Dapagiflozin in heart failure now published @NEJM - real reductions in death, cardiovascular death and hospitalisation - a new and exciting era in drugs that target the heart's metabolism? #cardioed #heartfailure

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Will Watson

@DrWillWatson

11 months

@DacreJane 6. Fragmented teams: staff moving around more frequently and shift based structures make forming a supportive network of colleagues harder.

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Will Watson

@DrWillWatson

2 years

@zackferguson Also these ologists: Thanks for urgently reviewing our patient, please admit under general medicine and never ever call us again.

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Will Watson

@DrWillWatson

6 years

@DrAmalinaBakri When your tweet about heart failure management gets 4 likes but a lame joke about a hemi gets 30 😬. Do the med students know what to do when that patient goes into broad complex tachycardia postop though?

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Will Watson

@DrWillWatson

10 months

Getting some bookcases done and almost beside myself with excitement about ladders

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Will Watson

@DrWillWatson

11 months

My response to why people feel badly treated by the NHS as an employer

Will Watson

@DrWillWatson

11 months

@DacreJane 1. Of course, pay for level of job stress is terrible. 2. Workload has increased with reducing resource (austerity has caused loss of facilities and colleagues with no prospect of their replacement). This creates feelings of helplessness.

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Will Watson

@DrWillWatson

3 years

type 1 and 2 MI share risk factors; a diagnostic dilemma. It makes sense as CAD will increase your vulnerability to type 2. Well done @chapdoc1

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Will Watson

@DrWillWatson

10 months

@Neuro_Matt @DrLindaDykes It's quite suprising that an Impella wasn't deployed

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Will Watson

@DrWillWatson

5 years

@MedCrisis “Amazingly, even harder to read than his clinic letters” - (Caldecott) Guardian

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Will Watson

@DrWillWatson

5 months

Chicken and egg issue of HFpEF and AF - this article emphasizes the importance of screening for #HFpEF in #AF groups. Also see the editorial here

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Will Watson

@DrWillWatson

1 year

Delighted to start as a postdoctoral by-fellow at Churchill college. My first experience of high table dining was a little surreal as there were only three of us…

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Will Watson

@DrWillWatson

4 years

@cjcjohnston @EdinSurg Not sure why a big cupboard of antibiotics is necessary when you have the cleansing ginger elixir at hand.

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Will Watson

@DrWillWatson

11 months

@DacreJane Actually 15. A management culture that has embraced ‘listening’ but it never generates ‘doing’. Countless surveys and focus groups - but we’re not actually listened to because little happens. So it’s wasteful and may add to feelings of helplessness to change.

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Will Watson

@DrWillWatson

11 months

@DacreJane 10. General helplessness to change any of these things listed above.

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Will Watson

@DrWillWatson

1 year

People think the NHS will suddenly collapse one day. It’s “on the brink of collapse.” It doesn’t though. It just gets progressively worse and worse. People wait longer, get worse care, die sooner. Things are bad now, they are worse than ever, they will just keep getting worse.

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Will Watson

@DrWillWatson

5 months

@sarahhudsonuk was not content with pre existing diagrams of heart failure trials so made her own.

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Will Watson

@DrWillWatson

11 months

@DacreJane 13. An austerity driven culture that sees cost rather than value. Services and roles of indirect value (from a community nurse to free coffee in the hospital) are cut, which have downstream effects creating less resource, more risk and probably more cost.

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Will Watson

@DrWillWatson

8 months

To those who said I’d never make it, I put it to you that signs are really easy to get made

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Will Watson

@DrWillWatson

4 years

Guys either stop putting it in all caps or tell us what E C H O stands for

BSEcho

@BSEcho

4 years

We're looking for examples of best practice to share in ECHO. What have you developed which could be used by others? How have you streamlined/improved your services? Send them to editor @bsecho .org

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Will Watson

@DrWillWatson

4 years

@MKIttlesonMD Working in Cambridge, we tend to expand this to college affiliation and current area of research. E.g. Prof Y is a fellow at Kings with a research area in ancient Greek history and was rumoured to have helped recruit for MI6 during the early 90s.

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Will Watson

@DrWillWatson

3 years

@drphiliplee1 You note your consultant has written as a management plan “turn half the population of the universe to dust” and has fashioned a gauntlet from infinity stones. Do you: A Suggest alternative management B Prescribe a mild sedative C Tell Captain America D Report to safeguarding

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Will Watson

@DrWillWatson

9 months

Proud recipient of an @acmedsci starter grant 🥳 Ten minutes after receiving this email a pipe burst so the universe likes to keep my on my toes!

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Will Watson

@DrWillWatson

4 years

Finally we can do away with warfarin in this group. NOAC superior for post infarct LV thrombus.

European Society of Cardiology Journals

@ESC_Journals

4 years

Improved thrombus resolution in post #ACS LV #thrombosis with #NOACs vs. #Warfarin @AgewallStefan @GianluSava #EHJPharmacotherapy #cardiotwitter #twittermed #antithrombotics

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Will Watson

@DrWillWatson

5 years

#bcs2019 restriction/constriction - the physiology you re-learn a million times

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Will Watson

@DrWillWatson

4 years

@DavidMayMD @CMichaelGibson @DrAsifQasim @SukhNijjer @chapdoc1 @LdnCardiology @rallamee @RicardoPetraco @HighSTEACS I think you mean this - hard to see but reference here:

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Will Watson

@DrWillWatson

2 months

Delighted to have this published in @TheJHLT by @ISHLT

Will Watson

@DrWillWatson

2 months

Very pleased to have our investigation of ventricular-secondary MR in our advanced heart failure population out in print We demonstrate the importance of RV-PA coupling and decongestion determining outcomes in this population

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Will Watson

@DrWillWatson

9 months

1: not sure what is wrong with this patient, can I have a full body CT please Radiology: get out 2: I just need the ejection fraction Echo: we’d better give you the lateral S prime and Doppler the descending aorta just in case But really why is there a echo minimum dataset?

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Will Watson

@DrWillWatson

5 years

Accumulating evidence that vaping isn’t as benign as we thought. Case series of over 50 vapers with symptoms and chest X-Ray changes

Pascal Meier,MD

@DrPascalMeier

5 years

How risky is vaping? Pulmonary Illness Related to E-Cigarette Use @NEJM #vaping #ecigarettes #ecigs #ecig

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Will Watson

@DrWillWatson

4 years

John Cleland proposes HFsnEF at #BSH2019 - you heard it here first @BSHeartFailure

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Will Watson

@DrWillWatson

4 years

Me doing an ICU

Charlotte Summers

@charlot_summers

4 years

Critical Care teams from @CUH_NHS @PapCriticalCare working collaboratively today to support the EoE Critical Care Network by transferring patients to our campus #teamwork @stephen_t_webb @simonlambden @stephenposeynhs @CUH_Roland @RoyalPapworth

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Will Watson

@DrWillWatson

2 years

@Baddiel Catspansion

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Will Watson

@DrWillWatson

5 years

Genuinely curious to see this with 150 likes. I would supplement K when it starts to fall rather than stop diuretics in someone who is overloaded. Anyone else do what Prof Kittleson does and is there any evidence in here?

Michelle Kittleson MD PhD

@MKIttlesonMD

5 years

#TipsForNewDocs If a HF patient is undergoing diuresis and K < 3.5, stop diuresis with loop/thiazide diuretic until K improves. I’m here to tell you that ICD shocks attributed to diuretic-induced hypokalemia is a form of iatrogenesis imperfecta best avoided. #kittlesonrules

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Will Watson

@DrWillWatson

5 years

Three papers on using CMR to detect cardiac #transplant rejection in this month's @JACCJournals Imaging - is it time we stopped snipping bits of heart out and did something noninvasive? #cardioed

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Will Watson

@DrWillWatson

2 years

Because it’s the university of Cambridge, I am being interviewed for a research job by a Lord.

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Will Watson

@DrWillWatson

4 years

Some impressive 8pm NHS love in Old Headington courtesy of @VicarHeadington ! #ClapForTheNHS @HeadingtonNews

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Will Watson

@DrWillWatson

1 year

@ShaunLintern @thetimes I cannot say more strongly than others - training more is a waste of money. We need to retain more. We do that by improving the job, which is multi factorial (quality, hours, training, pay, etc)

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Will Watson

@DrWillWatson

3 years

A colleague just said to me they found the massive number of educational resources, conferences and other things we are meant to absorb overwhelming and stressful. I am not sure I had seen it like that before but the more I think about it, the more I agree.

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Will Watson

@DrWillWatson

2 years

@RevRichardColes @Baddiel The potato scone, much under-appreciated yet a clear superiority over a hash brown.

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Will Watson

@DrWillWatson

6 months

Well this will be different

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Will Watson

@DrWillWatson

5 years

no benefit from early cardioversion in AF... no benefit from early angio post cardiac arrest... it's been a good week for the on-call SpR! Can someone do a study showing no benefit in echo for ? tamponade post CABG?

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Will Watson

@DrWillWatson

3 years

Now I’m making some hardcore thesis writing efforts, I’ve ditched the diet, eaten half a cake today and my productivity has reached godlike levels. I’ve literally written half a chapter in a day.

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Will Watson

@DrWillWatson

1 month

Huge. In MI with ejection fraction >50% having timely angiography, followed up for 5 years: Beta blockers DO NOT REDUCE MORTALITY.

NEJM

@NEJM

1 month

Presented at #ACC24 : Hospitalized patients with acute myocardial infarction & preserved EF were assigned to receive open-label long-term beta-blocker therapy or not. Beta-blockers did not lead to a lower risk of death or MI. Full REDUCE-AMI trial results:

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Will Watson

@DrWillWatson

3 years

@TharushaGunawa4 5 days a week of 800 calories and a 20 minute HIIT session, 2 rest days. But also trying to change my relationship with food and get out of the mindset that a snack will pick me up when I feel tired / grumpy / etc

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Will Watson

@DrWillWatson

2 months

Very pleased to have our investigation of ventricular-secondary MR in our advanced heart failure population out in print We demonstrate the importance of RV-PA coupling and decongestion determining outcomes in this population

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