Moiz Ehtesham, MD

Doctors on their day off. #MedTwitter #graduate2023

Hot off the press! My Editorial in JACC on Atrial functional MR. Among 72 definitions of AfMR (!!) in the literature, Koschatko et al demonstrated that the one provided by JACC CV Imaging Expert Panel in 2022 was the most powerful in predicting outcome. pubmed.ncbi.nlm.nih.gov/41949521/

VT or something else? @ecgrhythms @ecgandrhythmRoe

What a wonderful session on PVCs at #ACC26 ⚡🫀 ❓Should every patient with frequent PVCs get a cardiac MRI? ❓What to do with Asymptomatic PVCs? Key insights below 👇 #CardioTwitter #EPeeps #ACCEP

So basically…its inferior.

Among patients with atrial fibrillation at high risk for stroke and bleeding, left atrial appendage closure was not noninferior to medical therapy in reducing the risk of stroke, embolism, major bleeding, or death at 3 years. Full CLOSURE-AF trial results: nejm.org/doi/full/10.10… Editorial: Left Atrial Appendage Closure — Another Overused Method in Cardiology? nejm.org/doi/full/10.10…

2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines 1.Treat dyslipidemia earlier to reduce lifetime exposure to atherogenic lipoproteins; start lifestyle counseling in youth and consider early pharmacotherapy in high-risk individuals (e.g., familial hypercholesterolemia or LDL-C ≥160 mg/dL). 2.Use the PREVENT™ risk equations instead of older models to estimate 10- and 30-year ASCVD risk in adults aged 30–79, applying the CPR approach: Calculate risk, Personalize assessment, and Reclassify if needed (e.g., with CAC). 3.Consider LDL-lowering therapy in primary prevention starting at a 10-year risk of 3–5%, and recommend it more strongly at 5–10%, after clinician–patient discussion. 4.LDL-C and non-HDL-C targets are reintroduced, while maintaining focus on percentage LDL reduction based on ASCVD risk. 5.Apolipoprotein B (ApoB) measurement can help detect residual lipoprotein-related risk, especially in patients with high triglycerides, diabetes, or low LDL-C. 6.Measure Lipoprotein(a) at least once; elevated levels significantly increase ASCVD risk and warrant more intensive LDL-lowering strategies. 7.Coronary artery calcium (CAC) scoring can refine risk assessment and treatment decisions, particularly in men ≥40 and women ≥45 years. 8.LDL-lowering therapy is recommended for adults aged 40–75 with diabetes, CKD stage 3–4, or HIV regardless of LDL-C level. 9.In secondary prevention, stricter targets are recommended: LDL-C <55 mg/dL and non-HDL-C <85 mg/dL for very high-risk patients. 10.Statins remain the foundation of therapy, particularly in patients with elevated triglycerides; additional therapies may be needed for severe hypertriglyceridemia to prevent pancreatitis. #Cardiology #MedTwitter #CardioTwitter #HeartHealth #Healthcare @JACCJournals @ACCinTouch @DLBHATTMD @CMichaelGibson @DrMarthaGulati @hvanspall @AndrewJSauer @ESC_Journals @escardio jacc.org/doi/10.1016/j.…

🆕 ACC/AHA Guideline on the Management of Dyslipidemia offers a comprehensive “one-stop shop” for addressing the evaluation, management & monitoring of individuals w/ dyslipidemias. Read the full guideline in #JACC: bit.ly/4cLB0J0 #cvLipids #ClinicalGuidelines

ECG tools I use teaching cardiology fellows: 1. Cardiac axis simulator → cardiac-axis-training.netlify.app 2. Ladder diagram generator → lewisladder.netlify.app 3. Rhythm simulator → ecg-rhythm-simulator.netlify.app 4. ECG trainer with AI feedback → ekgcases.com Bookmark this.

Heart dissection lab with us! 💔

🌏 South Asia has the highest #IschemicHeartDisease burden 🫀. Men have higher mortality overall, but in Pakistan, women face greater risk. Key drivers for women: high blood pressure & low veg/fiber intake 🥦📉. Get the details in #JACCAsia: jacc.org/doi/10.1016/j.… #ACCIntl

@khurramn1 Its not even fun anymore unfortunately

Agree

Chatgpt thinks I wear belt on my scrubs.

➡️ ICD decisions should not rely on EF alone. Insight from the DERIVATE NICM study 1,384 NICM patients (with chronic heart failure and LVEF < 50%) from 21 centres in the US and Europe ✅ The DERIVATE 2.0 score performs better than the current criteria A multimodal score combining: Sex LVEF LGE presence LGE location showed substantially improved prediction of major arrhythmic events compared to traditional EF-based models. #whyCMR

Please describe the rhythm. Can you identify P waves?

What is the importance of the PROCTOR trial? Many younger operators were groomed to the idea that once they see a diseased SVG,they should go for native CTO PCI. This was based on a fake assumption, it made those older operators who are experienced in SVG PCI feel like Pariah’s!

Crowdsourcing this ECG that a colleague sent me. I don't know much history other than there has been no heart surgery and no dig use RR intervals are stable (I have never seen such a thing.)

Not at LDL-C Goal? Here’s Where the New Agents Fit in 2025.

If anyone looking for an interventional cardiology position in new England area send me a message. My old group is hiring. All visas welcome. #ACCFIT

@nandananavekar @SrihariNaiduMD @EllauziRama @MayoCVFellows @WMCCardsFellows Can we register with personal email or it has to be via fellowship?

@SrihariNaiduMD @EllauziRama @MayoCVFellows @WMCCardsFellows It is available for any learner. We have made it the primary curriculum for Mayo fellows.

💬 One of the most helpful tools during my fellowship learning! Currently on my echo rotation, and the videos and notes have been incredibly valuable for reinforcing concepts and day-to-day cases. @nandananavekar @MayoCVFellows 🫀

New in #JACCINT: Study validates #IVUS-defined stent expansion 🎯 Achieving minimal stent area >5.5mm² 🧩 after #PCI led to better 1-year outcomes 🫀📈 with lower target vessel failure and fewer adverse events ⚡ jacc.org/doi/10.1016/j.…