Brian Hsi, MD

Often we get a consult for RHC on AHF pt and elevated HCO3 + diuretic resistance with believe pt must be intravasc dry, but we find MAP, RAP, PCWP well elevated. Not intravascular dry but proximal nephron NaHCO3 retention is the cause of the diuretic resistance @RyanTedfordMD

@HFSA Make sure @RanLeeMD and @AndrewHigginsMD are involved if the intersection of critical care and AHFTC is on the table! They are leaders in these fields and they speak for many of us!

Check it out!!! We just published international donor heart selection guidelines. Special thanks to Dr Shelley Hall and Dr Hannah Copeland.

"Unable to get MRI due to AICD" MRI can be safely performed even in pts w/ legacy MRI-nonconditional CIEDs. There's even data on MRI in pts w/ abandoned leads👇 CIEDs ≠ MRI contraindication. Spread the word and narrow the gap! @HeartToProve @HMH_IMres #MedEd #CardioTwitter

Details into the life of an advanced HF patient @jilliannec! Sharing so hopefully more colleagues can get a glimpse of what our patients really go through. Thankful for our patients, their #hardtokill willpower💪, and allowing us to work with them. @dranulala

@dranulala @AKBhatiaMD @MountSinaiHeart @DOMSinaiNYC Great perspective👆 Trainees can often name a few VAD pt names and know at least one is currently admitted. Experience VAD clinic (hopefully earlier than 2 months before graduation like I did) and see the 8-yr post-implant w/0⃣complications!

@AKBhatiaMD @MountSinaiHeart @DOMSinaiNYC I think that’s well stated @AKBhatiaMD - really important to have the outpatient experience with “well visits” allowing us to appreciate the tremendous good that this technology also affords!

Every #LVAD clinic I try to make it point to ask, “Knowing what you know now, would you do it all over again?” Clinic today with all the feels as all reported “glad to have a VAD” 🙏🏽 #HeartFunctionNotFailure #HeartSuccess @MountSinaiHeart @DOMSinaiNYC

Dr. Guha's key tips for pulmonary HTN: ▶️PH = mPAP > 20 mmHg (new definition!) ▶️RHC is key in diagnosis! ▶️Initiate dual therapy for PAH up front! ▶️Always think about CTEPH (potentially curable!) Learn more👉 bit.ly/CNC2021-LS #cardiotwitter #MedEd #MedTwitter

A great overview of device therapies in HF by my favorite big sis @mahwash_kassi! For each therapy, patient selection is key! Come learn more👉 bit.ly/CNC2021-LS #cardiotwitter #MedEd #MedTwitter

Tips from @RayanYousefzai on HFrEF Rx at #CNC2021: ▶️Do not need to trial ACEi/ARB first before using ARNI ▶️SGLT2i improves mortality and HF hospitalization and protects kidney fxn! ▶️Updated 2021 Rx guidelines 👇 Learn more👉 bit.ly/CNC2021-LS #cardiotwitter #MedEd

The Great N. Kleiman on antiplatelet Rx: ▶️ASA✅2° prevention, ⏫CACS;❌1° prevention. ▶️Prematurely d/c DAPT highest risk factor for stent thrombosis! ▶️Shortened ASA duration may be helpful after PCI. Learn more👉 bit.ly/CNC2021-LS #cardiotwitter #MedEd #MedTwitter

Dr. Ross Reul giving a great overview of CABG ▶️In appropriately selected patients, CABG can provide complete revascularization and is safe ▶️Appropriate Rx before procedure👉improved outcomes Learn more👉 bit.ly/CNC2021-LS #cardiotwitter #MedEd #MedTwitter

Going on now! Come watch @athakkarMD teach radiation safety to save yourselves from one of the many possible reasons for midcareer headaches! And while in the cath lab anyway, listen to @IceTeaMD so you don't miss RV failure... #Cardiotwitter #MedEd #ACCFIT #AHAFIT @HMethodistCV

@CardioNerds @DrMarthaGulati @DBelardoMD @AnkurKalraMD @gina_lundberg @Gurleen_Kaur96 @ThomasMDas @EvelynSongMD @EuniceDuganMD @CBlumenthal2 @RichardAFerraro @dinubalanescu @a_h_ghoneem @DeveshRaiMD @najahakhan @jholtzman3 🙌@CardioNerds🥂 1. Brian Hsi #ACCFIT 2. @HMHCardioFellow👉@CCFcards for HF/Transplant (can't wait to start!) 3. #MedEd, device innovation, asking questions and looking for answers Keep democratizing education!

🎉 @CardioNerds Hit 15k #MedTwitter Followers! Let's build the #CardioTwitter community here at #ACC21🌎 Retweet & Follow one another. 1. Who are you 2. Where are you 3. What're your interests? Tag 5⃣. @DrMarthaGulati @DBelardoMD @AnkurKalraMD @gina_lundberg @Gurleen_Kaur96

Check out our combined @HMethodistCV & @ClevelandClinic amyloid cardiogenic shock experience - IABP viable bridging strategy for CA to OHT or VAD @VarinderKaurRa1 @JerryEstepMD @bhtrachtenberg @HMHCardioFellow #ACC21

New #ACC21 SimPub in @JACCJournals from #TRANSLATEHF collab led by @RBPatelMD Strong risk-treatment paradox in HF & kidney disease, such that pts with the highest mortality are treated with ↓ disease-modifying Rx Supported by @AHAScience & @AstraZeneca jacc.org/doi/10.1016/j.…

ELI5: Previously, high dose ASA🩸> low dose. ADAPTABLE, ~40% crossover from high to low dose, conclusion = no difference in🩸... Now even some experts are saying "choose whatever dose you'd like"🤔Wrong message? Would love to hear opinions (and🙏explain)! #ACC21 #CardioTwitter

@WilliamZoghbi @DrMarthaGulati @NEJM @AnumSaeedMD @CBallantyneMD @ErinMichos @ASPCardio @DrHeatherJohn @PamTaubMD @AnnMarieNavar @AmitGoyalMD @dramitkhera @DrMichaelShapir How should we interpret this trial in the setting of prior data suggesting higher bleeding risk with high-dose aspirin?

@DrMarthaGulati @NEJM @AnumSaeedMD @CBallantyneMD @ErinMichos @ASPCardio @DrHeatherJohn @PamTaubMD @AnnMarieNavar @AmitGoyalMD @dramitkhera @DrMichaelShapir Wonderful trial—was much needed—with pragmatic implications on daily practice management for most CV patients.

Amazing pragmatic #ADAPTABLE trial presented #acc21 #ACCPrev 💥 No difference in effectiveness of 81 mg vs 325 mg of ASA Published now @NEJM

👀Ready for that board question on arrhythmias in Chagas disease?👀 Come listen @ 10 CST to TX ACC @MiguelVldrbno, @scfuentesr, @aalahmadmd, @KTamirisaMD, @JavierSanchezMD and get that extra point in Oct! 👉bit.ly/3eTGBi9 #ACCFIT #AHAFIT #CardioTwitter @HMethodistCV

Blood supply of a human hand

1/ Ready for a #Tweetorial on coronary artery calcium (CAC) score? Keep reading to: ☢️Understand the pathophysiology of coronary artery calcium ☢ Identify the utility of the CAC score ☢️Recognize the limitations of CAC scoring