Discover and read the best of Twitter Threads about #EchoFirst

Most recents (4)

Evaluation of Cardiac Masses:
A Tweetorial for #FITSurvivalGuide 🚨 #ACCImaging @ASE360 @SCMR @journalofCMR @ACCinTouch
Dedicated:@dr_chirumamilla & all #ACCFIT in #CardioTwitter
Main Ref:… Palaskas, et al. Curr Treat Options Cardio Med (2018) 20: 29.
Usually, it all starts with an abnormal finding in an echo suggestive of intracavitary mass. How can we tell one from the other? It can be confusing.
For artifacts, I did a Tweetorial already that describes the most common ones. Basic understanding of ultrasound physics is needed to be able to explain them:…
Read 24 tweets
#FITSurvivalGuide on Restrictive Cardiomyopathy (RCM) vs Constrictive Pericarditis (CP).

In both:

💠Diastolic RV & LV impaired; systolic function preserved
💠HFpEF phenotype, predominant “R sided” signs (­JVP, edema, ascites)

@dr_chirumamilla @Pooh_Velagapudi @bcostelloMD
🔑 to understanding different filling:
RCM = myocardial disorder
CP = pericardial disorder.

@majazayeri @fawazalenezi55 @SanChris999 @GuruKowlgi @Nidhi_Madan9 @sabeedak1 @noshreza @SaggerMawri @nsivcd @DrManiCardio @khandelwalMD @drjohnm @heartdoc45 @zainasadEP @docaward

💠Stiff myocardium➡️early diastolic ⏫­­LV and RV pressure w/small vol ∆
💠 Echo: early diastolic abnormalities
💠High initial flow (= E wave; so E/A >2); ends abruptly (⬇️E decel time)

⚠️Restrictive pattern also in stage 3 HFrEF w/abnl early diastole

Read 12 tweets
#FITSurvivalGuide: The Forgotten Valve-#TricuspidRegurgitation (#TR) #tweetorial for the new #ACCFIT!

1⃣ Anatomy
2⃣ Etiologies
3⃣ Classification
4⃣ Diagnosis
5⃣ Treatment

Resources: @ASE360 @JACCJournals @CircAHA @ACCCardioEd @UMNews @Medtronic

cc: @dr_chirumamilla
[2/10] Impt to understand #TricuspidValve 1⃣ Anatomy

3 leaflets ⬇️ + fibrous annulus + 2 papillary 💪🏽 + chordae tendinae + RA/RV ❤️

⬛️ Anterior 🍃 (largest)
▪️Septal (smallest)

(note: throughout #tweetorial, see image descriptions for more content) TV is largest and most apically displaced valve (normal TV area is between 7 and 9 cm^2).  Tricuspid annulus = complex nonplanar 3D structure w/low posteroseptal portion (towards the RV apex) & high anterolateral portion.TV has 2 distinct pap muscles (ant & post) + 3rd variable septal pap muscle. Largest pap = typically anterior w/chordae supporting ant & post leaflets. Posterior pap supports post + septal leaflets. Septal pap is variable: absent in up to 20% of normal patients or small, or multiple.Note attachments of leaflets/chordae to papillary muscles, RV free wall, moderator band.
[3/10] 2⃣ Etiologies = Structural (1º) vs. Functional (FTR)

Keep chart ⬇️ DDx in mind when reading #EchoFirst

~80% of significant TR = FTR/2º to TA dilatation + leaflet tethering ⬅️ RV remodeling ⬅️ volume and/or pressure overload

Structural (1º) cause = less common
Read 12 tweets
Today's #FiTSurvivalGuide for basic #EchoFirst views

Parasternal Long Axis:
Left lateral decubitus
3rd L intercostal space. Move⬆️or⬇️ to find window
👀descending aorta, coronary sinus, pericardium, LV, both leaflets of MV, LA, aortic valve & root, RV
RV Inflow View:
Medial angulation of scan plane

👀RA, Tricuspid valve, RV
Further angulate probe to remove portion of LV (seen in A, but not in B)
Parasternal short
👀annulus, 3 cusps of aortic valve (open in systole, close in diastole), coronary ostia (LM at 4 & RCA at 11), LA, IAS, RA, TV, RVOT, pulmonary valve, proximal pulmonary artery (slight superior angulation for R & L branches)

Read 12 tweets

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