Natasha @nat_echo Twitter profile

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Natasha

2 years

How to obtain right parasternal view This is the resulting image: aortic valve, proximal ascending aorta wrapping over the pulmonary artery. Perfect alignment for aortic valve velocities making it an ESSENTIAL view for proper AS assessment.

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Natasha

@nat_echo

2 years

Someone DM’d me to tell me they’ve reported my pinned tweet for being offensive. Babe, it’s a heart 🙄

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Natasha

@nat_echo

2 years

Today is 1st day that masks are no longer mandatory in clinical areas. I joined this trust during the pandemic so no1 has seen my face I apologise now - I suffer with resting bitch face. I always look furious. Even when I’m only mildly inconvenienced. It’s not you. Probably

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Natasha

@nat_echo

2 years

At what point do we think all NHS staff will quit and locum - in their original roles but for the twice the pay. You’d think we’d just pay substantive staff better and save the hassle wouldn’t you?!

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Natasha

@nat_echo

1 year

Doctors, nurses, porters, healthcare scientists, allied health professionals - anyone who works in a clinical environment: 🚨 Drinking water is not a luxury 🚨 Do not be dictated to that you cannot drink water whilst on shift.

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Natasha

@nat_echo

2 years

Well didn’t expect this to be quite so popular! Im glad it’s made you all laugh!! And 👋🏼 to all my new followers - sorry to to disappoint you but I basically just post heart pictures. Not all of them are phallic 😘

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Natasha

@nat_echo

2 years

I sit in a dark room with a bare-chested stranger, covering them in lube and taking videos.

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Natasha

@nat_echo

1 year

Optimising your echo windows: Do you stop when you get something vaguely like what you think it should look like? Or do you try and find something better every time? I’m forever telling my trainees “have you tried a rib space lower?” In apical 4 chamber. Here’s why: 🧵

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Natasha

@nat_echo

2 years

Sometimes they do just look exactly like the textbook! What’s your diagnosis and what test do you want next? Female <30yrs history of collapse of unknown cause.

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Natasha

@nat_echo

2 years

Dear hospital Comms: instead of sending an email EVERY day saying we are at full capacity. How about you just tell us when we are not… We don’t read the email.

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Natasha

@nat_echo

2 years

Measuring TAPSE should be undertaken using an RV focused view. From A4C slide the face of the probe laterally away from the sternum in the same rob space. Your 4 chamber will now look like this:

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Natasha

@nat_echo

4 years

Plan: “Refer for ECHO” Echo is short for echocardiogram. So turn off caps lock for it is NOT an acronym. It just feels like you’re yelling at us. Thanks for coming to my TED talk.

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Natasha

@nat_echo

4 years

A trust I worked in the ward staff did their own ECGs. Ward called: “Hi, is that CardioRespiratory? Please could you come and do an ECG?” “We can. But you have your own machine, is it broken?” “No the Dr asked for a 12 lead ECG ... our machine only has 10 leads”

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Natasha

@nat_echo

1 year

Echo referral: URGENT there’s a moderate pericardial effusion on CT… The echo: 👀 🤷🏽‍♀️

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Natasha

@nat_echo

2 years

Threw my pre-accreditation echo trainee in at the deep end by making them do a video case. Despite their insistence that they can’t scan & they’re rubbish at echo. Can you please show them some love and tell them they can do this please. They don’t listen to a word I say!!

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Natasha

@nat_echo

3 years

Like why?! WHY?! I am dreading looking at the pictures produced by this….

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Natasha

@nat_echo

1 year

That’s mad! Mitral annular disjunction

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Natasha

@nat_echo

3 years

TOE with chest compressions Pause in compressions > VF Shock > SR! Amazing to see what’s happening from the inside during CPR - and demonstrates how important good quality chest compressions are!

Ritu Thamman MD

@iamritu

3 years

CPR in a Vfib arrest debrillated to NSR seen by TEE #echofirst via @DrECMO

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Natasha

@nat_echo

3 years

Mitral inflow pulsed-waved Doppler What is happening and what does it mean?

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Natasha

@nat_echo

2 years

Comes with off-street parking.

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Natasha

@nat_echo

2 years

I couldn’t get an adequate PEDOF signal. But instead I picked up the highest gradient from right parasternal using the imaging probe. Always search for the highest, complete signal!! This AS has been upgraded from severe to very severe which can change their treatment plan!

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Natasha

@nat_echo

2 years

A day in the life … I need an echo now. Why? Because they’re being discharged So we will do it as OP No I need it now? Why? Because if it’s clear… they can go home. What’s it for? Echo? 🤔 Ok, what’s the echo for? … erm. 😬

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Natasha

@nat_echo

2 years

Probably one of the best examples of right parasternal imaging of the aortic valve I’ve managed to capture. My PEDOF probe is broken - so I’m really having to work hard for my AS assessments today 👀 Does it get any better than this though?!

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Natasha

@nat_echo

1 month

Did you know: The height of the colour box does not drop the frame rate, it’s the WIDTH that affects the frame rate. I always teach people to lengthen colour box to look at the whole of the pulmonary artery not just the valve. You never know when you may pick up a PDA!

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Natasha

@nat_echo

3 years

Posterior mitral valve prolapse. In all the dimensions 👀

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Natasha

@nat_echo

2 years

They teach you how to do CPR in your hotel room now apparently!! Does this count as CPD? 😆

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Natasha

@nat_echo

2 years

Hey Siri - show me something that is both cute but also completely terrifying… Ok 👇🏽

Avraham Z. Cooper, MD

@AvrahamCooperMD

2 years

This cardiac thrombus jumping around would be cute if it wasn’t ABSOLUTELY TERRIFYING Via @theEMfellow #MedTwitter

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Natasha

@nat_echo

3 years

The year is 1995. The game is Windows pinball space cadet. 🤭

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Natasha

@nat_echo

2 years

With patient in right lateral position Find PLAX Slide up ⬆️ rib space to Ao focus view Cross to the ⬅️ right side of the sternum Rotate 🔁 clockwise with marker at around 12/1oclock

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Natasha

@nat_echo

4 years

Dear dr - when referring for echo it’s useful to put the fact your patient has dextrocardia, a repaired TgA and a replacement TV on your referral... *puts probe on chest* errrrr what’s going on?! 🤔😩🧐🙃😳

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Natasha

@nat_echo

1 year

The echo training room 🤩 Where our echo trainees can study. Have some private space for 1:1s with their mentor Use the simulator for TTE/TOE/3D BSE posters/guidelines and accreditation info is on the notice board. It’s small but turning into a brilliant little space!! 😍

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Natasha

@nat_echo

4 years

Lots of time to update our echo training and look what I stumbled across: What’s the echo window and what’s abnormal? #Interestingecho #uhoh

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Natasha

@nat_echo

1 month

So I blew a few people’s mind today 🤯 when I mentioned the “follow the septum” method to correct an apical 4Ch Have you heard of this before or did I make this up?! So if your septum (instead of being central) is pointing to the right corner of the screen …

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Natasha

@nat_echo

1 year

It’s new machine day!! Days before Christmas too - what a present!! I nearly kissed the med eng guy who delivered her - he was rather aghast! About to take her on her maiden voyage - SO excited!!! Yay I can 3D in this room now 🥰

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Natasha

@nat_echo

2 years

Have had several requests for my book recommendations for echo recently. There are tonnes out there - and most echo labs will have all the good ones! Here are 3 I consistently come back to because they suit my learning style

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Natasha

@nat_echo

3 years

When most segments are having the day off….! 👀

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Natasha

@nat_echo

2 years

The more you read on MedTwitter the more you think being a doctor is really just a Trauma bond you’re paid for. And not always on time. Or the right amount.

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Natasha

@nat_echo

4 years

Heart or pinball machine?! 👀 #ballthrombus

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Natasha

@nat_echo

3 years

My laptop autocorrects anaesthetist to “amateur” I have therefore just sent this email: “Hi, I have booked an amateur for the TOE under general anaesthetic.”** I cc’d the anaesthetist. Kill me. [*shortened and identifiable info redacted, my emails aren’t this curt!]

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Natasha

@nat_echo

3 years

A patient mansplained AF to me this week. Then said “don’t worry you probably don’t get it” As I was doing their echo. 🤣 ok, hun 👌🏽

Dr Emma Beckett

@DrEmmaBeckett

3 years

I don't tell my plumber how to fix pipes, I don't 'splain the law to my lawyer, I don't tell my hair dresser how to cut or colour hair... but yet every non-scientist seems to want to 'splain our own areas of study to us?

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Natasha

@nat_echo

2 years

Anyone else obsessed with neat cable loops? For anyone who drapes them across the machine, tangles them up or leaves them on the floor - I wish you a list of technically difficult imaging windows of COPD patients who can only lie in the right lateral position 🤣🤭

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Natasha

@nat_echo

3 years

When the tricuspid valve leaflets are socially distancing

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Natasha

@nat_echo

4 years

My very first TOE image - acquired as the operator! I’ve been dying to get my hands on that probe! 🥳

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Natasha

@nat_echo

3 years

Friday 4pm outpatient walks in for what you assume will be a “quick normal study” and … 🤯

German PerezAmador. FACC. NBE. Fellow SISIAC

@gperezamador

3 years

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Natasha

@nat_echo

1 year

So the moral of this story is: “have you tried a rib space lower?” Don’t accept your very first window. Experience has taught me that there’s always better if you’re prepared to work for it. Who knows what you’ll miss if you don’t!!

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Natasha

@nat_echo

1 year

Have I mentioned recently how important it is to ALWAYS use right parasternal imaging and PEDOF assessment in AS?

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Natasha

@nat_echo

2 years

I wish never ever to see this. This is terrifying!!!! Can you save this?

Vas Panoulas

@VPanoulas

2 years

😳😱😱😱😱 #CardioTwitter #cardiology #echofirst

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Natasha

@nat_echo

2 years

Hello 👋🏼 new followers. Sorry if you’ve started following me purely because of my viral tweet. But I literally just post about hearts … so sorry! Hears an atrial septal defect in 2D and 4D from a transoesophageal echo

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Natasha

@nat_echo

2 years

Random troll ghost accounts have moved away from insulting my appearance to threatening to report me to the GMC. Babes, I don’t have a GMC number lol. Are you ok? I’m worried about you! Whoever you are 🤷🏽‍♀️ But FYI my regulatory body is the RCCP 😉

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Natasha

@nat_echo

4 years

Friday night fun! What’s your favourite TOE view? #projectTOE

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Natasha

@nat_echo

2 years

For those who liked 90s PC games … #3Dpinballspacecadet 👀 🫢

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Natasha

@nat_echo

2 years

Using 3D in your transthoracic study to visualise whether a device lead is causing tricuspid valve impingement. All 3 leaflets visualised! Is 3D in your routine study?

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Natasha

@nat_echo

1 year

Guess what we did at @WHH_CR @WHHNHS ?! The echo department at Warrington and Halton hospitals is now @BSEcho accredited!!!! In all four areas we applied for: TTE, TOE, Stress and Echo training!! 🥰🫶🏼🫀

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Natasha

@nat_echo

8 months

This heart cycles 130miles a week. Can you believe that? Patient had a good point: “why do they call it heart failure when I can do everything I want without symptoms. I feel fine!” The human body is incredible 😍 Adapt and overcome!

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Natasha

@nat_echo

1 year

If you were seen cannulating with one hand and chugging a coffee with the other - understandable. You’re a fool and should be reprimanded. Staying hydrated at a workstation when not directly involved in patient contact is not an infection risk. Drink water. Look after yourself!

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Natasha

@nat_echo

9 months

Possibly one of my favourite things about my job is getting people excited about using 3D and them wanting to know more and more!! All set up and ready for a 3D training session with this echo lab 😍😍😍😍 #vivid #echofirst #ultraedition #csound #4Decho

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Natasha

@nat_echo

2 years

🍀 so pretty. Still yet to find one in the wild. Quadricuspid aortic valve.

Dr Sabe De

@drsabede

3 years

Seeing Quad! A real rarity (<0.05%) - quadricuspid aortic valve #echofirst @amerjohri @HeartDocSharon @RodrigoBagur @VLSorrellImages

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Natasha

@nat_echo

2 years

Echo referral: Stroke ?cardiac cause 🤔 hmmmm, perhaps.

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Natasha

@nat_echo

2 years

Don’t forget that flow is now directed towards the probe (top of screen) so your forward flow velocities are above the baseline. As we are directly inline in this example, the result is a crisp, dense Doppler signal with minimal transit time artefact (all chin and no beard!)

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Natasha

@nat_echo

3 years

👋🏼 hello tricuspid valve. Nice to see you in 3D at last.

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Natasha

@nat_echo

9 months

Another day of 3D training - hopefully inspiring more people to fall in love 😍 with the power of 3D transthoracic echo! It’s so useful in day-to-day practice and can even save you valuable time. It’s not just for advanced imaging lists - it’s for everyday! 🥰

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Natasha

@nat_echo

3 years

Parasternal RV inflow view. Notice anything unusual?

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Natasha

@nat_echo

2 years

There’s something strange… In the left atrium … Who you gonna call? 👻

Dr.Negar

@drnhassanpour

2 years

Amazing myxoma. A 33-year-old man complained of abdominal pain. A ghost is in his heart!

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Natasha

@nat_echo

2 years

👏🏼 referring a patient with valve replacement for echo? Please include size and type of the valve on the referral, and implant date is even better!! #BSECHO22

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Natasha

@nat_echo

3 years

Do you still need convincing about using the PEDOF probe?! 4m/s using imaging probe in apical views. 6.4m/s using PEDOF in right parasternal. #justsaying

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Natasha

@nat_echo

1 year

I look at new valve replacement technologies and my first thought is always: Great, but that looks like it will be a nightmare to echo 😆 Reverberation o,clock

The Echo Lady

@The_echo_lady

1 year

👉🏻👉🏻👉🏻More info here:

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Natasha

@nat_echo

4 years

When you’ve finished apical views and ask the patient to lie on their back again so you can do subcostals.... 🤦🏽‍♀️

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Natasha

@nat_echo

2 years

To whoever needs to hear this today: if there’s even a hint of foul play in your marriage. Leave. You deserve respect Don’t ignore the 🚩 Don’t waste 16 years of your life! Also if you drop unsolicited dick pics in my DMs I WILL find ur wife on socials and send the screenshot!

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Natasha

@nat_echo

3 years

Clot in transit across PFO 😮

Mohamad Alkhouli

@adnanalkhouli

3 years

Angiovac extraction of a clot-in-transit straddled in a PFO. #cardiotwitter #MedTwitter #MedEd #EchoFirst

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Natasha

@nat_echo

2 years

“Stroke work up” Is one of my big bear echo requests. It means nothing. Just say you want to rule out cardiac cause and we will look for thrombus and PFO. New one today: “sepsis work up” Stop writing nonsense on echo referrals. Thanks, k bye 😘

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Natasha

@nat_echo

2 years

Biggest aorta you’ve ever seen?! 😬😬 I once had a GP referred OP echo for hypertension have 7cm ascending aorta. The oncall cardiologist asked me to repeat the size several times over the phone! SEVEN?! As in 4,5,6….7?! 😳 This looks way bigger!

Ivan Stankovic

@Ivan_Echocardio

2 years

a ticking bomb #echofirst

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Natasha

@nat_echo

2 years

The funny thing about having a department that services two sites (same staff) is when a patient says how much better it is HERE and how it way more thorough than over THERE with THAT person who did the scan. They thanked me enormously… Readers. I did both scans.

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Natasha

@nat_echo

2 years

If you could recommend just one book for someone starting on their echo journey to TTE accreditation - what would it be?

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Natasha

@nat_echo

1 year

@Xeon4f145d96s1 No different to me - a cardiac physiologist - signing off a cardiology registrars echo report. I’m an expert in my field. Registrar is learning echo. What’s the issue?

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Natasha

@nat_echo

4 years

My research abstract only went and got accepted for ESC congress 2020 didn’t it!! 😱

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Natasha

@nat_echo

8 months

Basically all you need to know is: Take an LA focus view. This may forshorten your ventricle, but that’s ok. Then press the AFI LA button … and the tool walks you through it. The white paper is available on Vivid club if you want to read the validation.

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Natasha

@nat_echo

1 year

👏🏼 👏🏼 amazing news for Matt! Today he found out he passed his @BSEcho written exam and is well on his way to accreditation! Yay!!!

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Natasha

@nat_echo

1 year

In a self audit of my weekend patients. All of my Simpson’s EFs have measured within 1% of my 3D or auto EF measured from strain. Me vs AI = 👌🏽 (Video of triplane - just because I like it!)

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Natasha

@nat_echo

3 years

Common misconception is that an echo takes 5-10 minutes! We are not being difficult when we say we can’t squeeze in a “quick echo” It is very difficult to squeeze in an investigation that takes around an hour (scan/report). And the more complex the pathology -the longer it takes

Gillian Whalley, PhD FASE FCSANZ

@GWhalleyPhD

3 years

Despite increased machine automation, scan times are increasing. This makes sense as there are so many more measurements now to make our studies better. Great to document it in #sonographer led research #ASE2021 . Great work Ashlee Davis (member of @ASE360 Leadership Academy)

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Natasha

@nat_echo

3 years

Echo is simple. How big is it? How well does it squeeze? Does it open? Does it leak? That’s literally it. We just make it sound complicated so not everyone does it 😉

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Natasha

@nat_echo

4 years

Some of echo is just pattern recognition - just like learning to read ECGs. I’ll let you see the images later - but can you spot what might be going on from M-mode and Doppler alone?

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Natasha

@nat_echo

2 years

It may be Friday the 13th but sending good acoustic window vibes to all! (Don’t @ me about the ECG - it was a covid level 1 scan)

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@nat_echo

1 year

Guess the LA volume.

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Natasha

@nat_echo

2 years

It’s my birthdaaaaayyyyyyy 🎈

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Natasha

@nat_echo

1 year

A 🧵 of 3D mitral valve dysfunction seen on TOE: ⬆️ normal native mitral valve ⬇️prolapse of native mitral valve

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Natasha

@nat_echo

6 months

New machine day is the best day ever isn’t it?! One of my favourite parts of unwrapping a new machine 😍😍😍😍 🎄 Christmas has come early for this customer!! 🥳

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Natasha

@nat_echo

2 years

Sure. You try get echo teaching from your consultant. 👋🏼 I got plenty of other stuff to do.

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Natasha

@nat_echo

3 years

I don’t think the right ventricle is very happy RN 🤔

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Natasha

@nat_echo

3 years

During echo. What I say: take a small breath in and hold your breath... What patients hear: do you best to hyperventilate 🙄

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Natasha

@nat_echo

4 years

Do you routinely take an RV focussed view? Obtained simply from the A4C view tilting the tail of the transducer laterally. It Straightens up the RV for optimal 2D measurements, TAPSE and RV TDI. If not - why not?!

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Natasha

@nat_echo

2 years

TTE and TOE simulator has been initiated. Ready for our BRAND NEW echo training room!! (Or we will call it my office as I will live in there from now on!!) A dedicated room for sim practice, theory and small seminars. How exciting is that!! 🥰🥰🥰🥰

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Natasha

@nat_echo

3 years

Focused echos require greater skill and experience of the operator than a minimum dataset echo. That is the hill I will expire on today.

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Natasha

@nat_echo

7 months

Pick your weapon for weekend locum 👌🏽 E95 with 4D probe 🥳 #vividfangirl

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Natasha

@nat_echo

4 months

🫶🏼

Lola sanchez

@Lolasan07257061

4 months

Have a good Day!!

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Natasha

@nat_echo

4 years

Who needs a TOE when you can get a cheeky shot of the left atrial appendage on TTE. Did you spot the intruder? Or did the poor LV distract you from looking at the whole image?

LuciaFernandezG

@LuciaFGasso

4 years

Do you really need a transesophageal echocardiogram? @echo_stepbystep @LopezOpitz @wikimagen @GARCIAEDINSON95 @CarlosMorrMD @fazalabul @NYCNYC6 @c_jlopezguarch @onco_cardiology @doctor_roig @massbolo @SeguraCardio @danilorenzatti

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Natasha

@nat_echo

2 years

No one can be offended by 3D echo can they?! I’ll keep my opinions to myself and restore normal service with this lovely mitral valve. Enjoy 👌🏽

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Natasha

@nat_echo

3 years

Someone commented not to long ago on an abnormal 3D of the mitral valve and said they don’t know what a normal valve should look like so found it hard to interpret. Here you go: normal vs prolapse viewed from atrial side of the valve in surgeons view. Anterior ⬆️ posterior ⬇️

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Natasha

@nat_echo

4 years

I have a joke about echo that Bonnie Tyler told me but it’s just totally clips of the heart.

the locum ST3

@admit_medics

4 years

I have a bladder scanner joke but IT’S NOT LEAVING THE WARD UNLESS YOU GIVE ME YOUR HOME ADDRESS!

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Natasha

@nat_echo

3 months

Who needs a TOE when imaging is so good on an E95 with a 4VC probe?! Clip in mitral position 👀 Can you tell which scallops from this view? 🥰

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Natasha

@nat_echo

4 years

Does QA matter? Why should we be wasting time reviewing, re-reporting & peer review? What about auditing - pointless? What if I told you this was was the same patient scanned 3 months apart. On the left a brand new machine and on the right a 10+ year old machine...?

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