We had the first Essex ICC (Inherited Cardiac Conditions) clinic today ๐๐ฅณ Managing patients with confirmed or suspected ICC, and screening relatives at risk of serious โค๏ธ disease including cardiomyopathy. Huge thanks to
@AHardyWallace
for her excellent work as new ICC nurse ๐๐พ
We just got this letter from the junior doctors at our Trust thanking consultants and SAS doctors for supporting the strike. I trust they donโt mind it being shared, the tone is perfect. As stated, we are one profession and need to challenge the government to act urgently.
Heart transplant patient came in specifically to record some images of his heart to show the donor family when they meet, and for that reason it's the most beautiful scan we've done all week โบ๏ธ
Loving telephone consultations ๐คช
Patient: I was expecting Dr Dungu
Me: I am Dr Dungu
Patient: I was expecting an African fella
Me: ๐
I am Dr Dungu. I am of African origin, Uganda to be precise, but I was born in the UK.
Patient: You donโt sound African
Me: ๐ก
Anyway...
Nice example of persistent left superior vena cava draining into dilated coronary sinus. Images courtesy of our excellent imaging trainee
@Ritesh21S
๐๐พ
Patient referred for cardiac MRI to assess severe right ventricular hypertrophy on echo, actually severe case of epicardial fat ๐
#WhyCMR
#CardioTwitter
A patient was crying in clinic because he canโt afford his tablets. Works hard, just below average salary, not claiming benefits. Each month he has to choose between feeding his kids, heating the house and paying for life saving medications. What kind of world are we living in?
Dear admitting docs. If a patient has โrippingโ (his words) chest pain, known dilated aorta and a new very loud diastolic murmur, it is not a good idea to give 3 blood thinners (ASA & clopidogrel loading + Fondoparinux). Type A dissection, alive post op but bled
#notthefirsttime
Nice example of severe DCM with functional MR. Regurgitant volume only 33ml but regurgitant fraction 52%. So severe, over half his blood is going backwards
Take your blood pressure tablets if prescribed! Regression in LV mass by 23% in 1 year. First cardiac MRI scan reported as ?HCM ?Fabryโs. In fact, just hypertension thickening the heart.
#WhyCMR
Collateral damage from the COVID era. Patients at risk of untreatable heart damage if they will not (or cannot) come to hospital early with cardiac symptoms. Huge pseudoaneurysm, EF 7%
Made an unexpected debut on BBC News today. Very glad the presenter mentioned I FULLY SUPPORT the
#DoctorsStrike
. I trust that message is not lost by the media focusing on consultants needing to cover acute care, rather than the reason for doctors needing to strike ๐ค๐พ
Miracles do happen! Patient with cardiac AL amyloidosis. Always very serious but a severe case and basically condemned. Was as close to death as humanly possible but survived and got a heart transplant. Came in to say thanks today ๐ Thanks to the team
@qehbham
๐๐พ
An Essex ICC success story ๐
Emma-Jayne came to one of our first clinics earlier this year and, after urgent referral, received a heart transplant 15 weeks later!! Doing really well and has kindly agreed to share her story at a charity event next week โค๏ธ Posted with permission
Back to the day job...Aortic and mitral stenosis secondary to radiotherapy (for lymphoma). Seen a few cases before. No symptoms but aortic peak velocity 5m/s so likely double valve replacement.
Dungu in NEJM ๐ My dadโs very impressed, he even told my mum who doesnโt know what a NEJM is. I told him middle author is the new first/last author ๐
Presented at
#AHA23
:
ORBITA-2 trial: In patients with stable angina who were receiving little or no antianginal medication and had documented ischemia, PCI resulted in a better health status with respect to angina than placebo at 12 weeks. Full results:
You know those emails starting โI read with interest your paper titled...โ? Theyโre not always spam. This one ended up in an invite to give a talk in Jamaica ๐ฏ๐ฒโ๏ธ๐๐พ Coffee plantation trip today, Masters of Medicine 2020 starts tmrw
#HeartMoMents
Very happy to be appointed Honorary Senior Clinical Lecturer
@AngliaRuskin
๐ Expect lots of research output from our ICED-HF group over the next few years, with
@savodoc
๐ค
Gasps when REVIVED results shown, no benefit in PCI for severe ischaemic cardiomyopathy. Is there a role for stenting in anything other than acute STEMI ๐ค๐
#ESCCongress2022
Interesting cardiac tumour seen on coronary angiogram, 2D and 3D echo. Likely atrial myxoma but unusual stalk prolapsing across mitral valve. Presented with mini-strokes, surgeons will tell us what it is for definite when removed later this week
#CardioTwitter
#echofirst
#TOE
This is him, Darren. My friend, not my patient anymore because he has a normal heart and takes lots of drugs I canโt pronounce! He came to say hi to me and sister Jackie, and update about the meeting with the donor family that went as well as expected. Merry Christmas all!! ๐๐
Heart transplant patient came in specifically to record some images of his heart to show the donor family when they meet, and for that reason it's the most beautiful scan we've done all week โบ๏ธ
We welcomed our CEO
@M_J_Hopkins
at the Essex Cardiothoracic Centre to showcase our specialist cardiac services including heart failure, arrhythmia and of course ICC. Great to have the executive teams engaged in our vision for the department ๐๐พ
Very exciting times in the ATTR amyloid world! An effective and safe treatment with mortality benefit. Interesting to see curves separate at 18 months, proving disease modification
#ATTR
-ACT
#tafamadis
#ESCCongress
Happy 60th birthday to the incomparable Jackie Smith. Ward manager, my boss, everybodyโs boss ๐ A pleasure to work with, donโt even think about retiring Jac ๐
@BasildonHosp
Nice opening talk by Prof Elliott on HCM LVOTO services at
#AICC23
. Essex ICC on the map (top right)! We didnโt exist this time last year, now recognised and specialist commissioned by NHSE ๐
NHS IT at its finestโฆ.weโve moved to electronic prescribing in clinic. Took about 5 mins to complete the form online (handwriting takes approx 30s). Then what do you do? Print off the form for patient to take to Pharmacy! Couldnโt make it up!
Finally got fit tested for full PPE. Thanks to the team for working extremely hard through the weekend ๐๐พ Ready for the
#coronavirus
fight with my NHS colleagues ๐๐พ
My other favourite
Patient: Are you Jason?
Me: Dr Dungu
Patient: Jason Doogan?
Me: Yes (close enough)
Patient: Can I call you Jason? Itโs easier
Me: Not really
Patient: ๐
Me: ๐
Patient: Jason it is then
In Philadelphia for
#AHA23
! Presenting our TriageHF data on device prediction of HF decompensation. Pleased to also witness the Orbita-2 presentation in a couple of hours ๐
Truly practice changing paper. Asked โcan I stop my meds now my heart has recoveredโ at least twice per month and the answer was always โwe donโt know if itโs safeโ. Now we know the answer is โNOโ. Fantastic work by
@BPHlondon
, Sanjay Prasad and team
So this is quite topical after the very recent STRONG-HF trialโฆOur paper on drug sequencing in heart failure management, published today in
@Heart_BMJ
When it comes to heart failure management in the modern era itโs time to Go Hard or Go Home ๐ช๐พ
Spearheaded by
@savodoc
๐๐พ
You can try and avoid congenital scans but they find you somehow! Routine list. Persistent left SVC draining into left atrium rather than coronary sinus (only 8% of cases according to Radiopedia ๐ค)
#WhyCMR
#cardiotwitter
Course complete โ I do a quiz at the end with quite difficult CMR cases. One guy punched the air with joy when he got a question right, I think itโs been a success ๐
Team Essex ICC ๐ FY Dr Luis Avellano-Khan doing a great job presenting our abstract on the first 6-month data. 236 pts seen, 26% hit rate with genetic testing
#AICC2023
Fantastic work
@rallamee
,
@rajkumar_chris
for the perfect presentation and the whole ORBITA-2 team ๐๐พ An amazing achievement, reward for unbelievable hard work ๐๐พ
#Orbita2
#AHA23
Itโs an honour to talk about my research in Afro-Caribbean heart failure at Master of Medicine 2020 in Kingston, Jamaica. Caught up with the man who helped make it happen (and sent that non-spam email) Dr Edwin Tulloch-Reid
#HeartMoMents
Interesting list! Different cardiomyopathy, different mechanism of MR. Hypertrophic cardiomyopathy with systolic anterior motion of mitral valve and MR directed posteriorly.
Happy retirement to Paula who has been booking CMR/CT scans since before I started
@MSEHospitals
A real character, the swear jar will be in credit for many decades ๐
Sarah brining some Christmas joy to the National โElfโ Service office ๐ Yes they are stuck on Christmas tassels ๐ซฃ Christmas jumper day tomorrow, have to try and top thisโฉ ๐๐๐
As โฆ
@LCC_DrMalik
โฉ always taught me as a youngling, give nitrates during diagnostic coronary angiograms! Patient had bypass after study in 2011 (left), now arteries look quite normal and grafts occluded (right)
#spasm
#CardioTwitter
A short video about the importance of organ donation, particularly in the black community. Featuring a patient and now good friend of mine Darren, with his friend and activist Patrick Hutchinson from that iconic BLM photo
@NHSOrganDonor
Thank you so much for the support. It was a privilege to present to senior board members and meet our new CEO! Onwards and upwards for Essex ICC ๐๐พ
@AHardyWallace
and
@drjasondungu
flying the flag for the
@EssexCTC
inherited cardiac conditions service at the MSE AGM. An amazing, truly life saving service, for our Essex patients.
Great evening at the Bob Marley museum, including a tour and rounded off with a speaker prize from CEO of Heart Institute of the Caribbean (HIC) Dr Ernest Madu. Weโve been well looked after!
The reddest of red flags - carpal tunnel syndrome and future cardiac amyloidosis (ATTR)
Association of Carpal Tunnel Syndrome With Amyloidosis, Heartย Failure, and Adverse Cardiovascular Outcomes
The study I always wanted to do, screening for ATTR amyloidosis in black populations. Credit to the authors ๐
#ATTR
#amyloidosis
Design and Rationale the SCANโMP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study
Thrilled to be invited to talk at the
@Cardiomyopathy
UK study day in Leicester today. Currently hearing Gerry McCann explain the role of CMR in cardiomyopathies
#teamcardio
Recently reminded by
@johnbaksi
of my favourite MRI image, my legacy from the 2013 RBH CMR course! Enough to get Prof Raad to run and grab his glasses in anticipation (he was underwhelmed after the build up tbh๐)
"Magnet in a magnet" (lateral wall infarct)
#WhyCMR
#CardioTwitter
Tafamidis appears to work in ATTR cardiac amyloidosis. Need to start before heart failure progresses to NYHA 3. Before that, need to make diagnosis! DPD better than CMR but less available so get all your โLVHโ patients in the magnet
Normalisation of moderate LV impairment in DCM pt. Only change after 2 years of decent HF therapy (ACE-I, BB, MRA) was
#Entresto
, started 3 months ago.
Fantastic โฆ
@Cardiomyopathy
โฉ meeting, congrats to โฆ
@wbradlow1
โฉ & all of the organisers. Highlight for me, as always, was the patient perspective - focusing on psychological support. How many of us ask โhow are you copingโ instead of โhow are your symptoms?โ
#teamcardio
Sadly I have reached the 3rd of 4 โpatient describing doctorโ stages:
1. โYou donโt look old enough to be a doctorโ ๐
2. โYou donโt look old enough to be a consultantโ ๐ค
3. โI assumed you were the consultantโ ๐ซค
4. โI assumed you were a patientโ ๐ชฆ
Pleased to present our paper on clinical CMR, the first publication from the ICED-HF research group. What we see and how accurate we are. Hopefully of interest to anyone performing cardiac MRI, or thinking of setting up a service
#WhyCMR
#cardiotwitter
End of an era ๐ช my leopard skin leads - chosen as part joke, part to stop people using and damaging them - have been condemned! Ironically because people used them and damaged them ๐ก What next?
Calling all BSH members, please vote for Chair-Elect of the BSH Dr Lisa Anderson: Current Deputy Chair of the BSH, board member since 2015.
You should have unique link in your email, Lisaโs bio in next post. A wonderful doctor, just doesnโt do social media so Iโm posting for her!
FAO CMR trainees, no.1 rule of reporting - the differential diagnosis list should be shorter after the scan!
Patient went in:
?hypertensive
?HCM
Came out:
?Fabryโs
?myocarditis
?sarcoid
?โatypicalโ HCM
Mass had reduced by 40% on BP meds
๐คฏ
(rant over)
Full paper for DAPA-HF study in
@NEJM
. Very interesting data and seems Dapagliflozin has similar benefit in HF patients already on Entresto, in subgroup analysis.
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction | NEJM
Itโs great that
@Tesco
open their doors 1hr early for NHS staff. They even gave all the mums flowers ๐๐พ But then you realise packing hundreds of people with the highest probability of being silent carriers in one room is the exact opposite of social distancing ๐ฉ
Awesome to catch up with
@rtgerber
who is in town, all the way over from New Zealand for a CT course then birthday celebrations. Reminiscing about the old Hammersmith days, he hasnโt changed a bit! ๐๐ป
I just had an end of attachment meeting with a very bright, dedicated and enthusiastic final year medical student. With all the doom and gloom of strikes and corridor care of patients, it has restored my faith (hope) that the NHS has a promising future
Leaving party for the lovely Molcy, our Cath lab manager who is moving to Radiology. Extremely sad to see her go but we all wish her well. Julie held it together for a kind speech ๐ฅฒ