Cynthia Jackson

Lesion stratification with intracoronary imaging provides detailed morphological insights that may guide PCI, identify high-risk plaques, and support a shift towards integrated morphofunctional assessment in coronary artery disease. eurointervention.pcronline.com/article/lesion… @m_g_mcgarvey @K_DeSilva @DrKeeble @ziadalinyc @divaka_perera @drdworakowski @DrNileshPareek #CardioTwitter #InterventionalCardiology #CoronaryArteryDisease

Falla Ventricular Derecha Aguda🫀➡️ 🔰📚European Heart Journal 2025 doi.org/10.1093/eurhea… Enlace a Artículo Completo👇🏻✅🆓

Los B-bloqueadores SOLO deben ser usados como primera línea en: *IC de FEVI reducida *Post MI con disfunción de VI *Algunas arritmias Pero como antihipertensivos: *⬆️ 30% riesgo de EVC🧠 Y en mujeres: *⬆️riesgo de IC, muerte y recurrencia de IAM🫀 10.1161/HYPERTENSIONAHA.125.26

#ResistantHypertension affects approximately 10% of patients treated for #hypertension and is associated with increased #cardiovascular mortality compared with controlled blood pressure. 📄 Learn more in this Review: ja.ma/47kA8aG

🫀 Arterias, dominancia y vistas angiográficas explicadas de forma clara con ilustraciones vectoriales. Dentro hilo 👇#CardioEd

📸 Proyecciones angiográficas clave 🔴 Para coronaria derecha: 🔹LAO 45° → segmento proximal y medio 🔹RAO 30° → segmento medio 🔹LAO 20° + craneal 25° → crux 🔴Para coronaria izquierda: 🔹Craneal 40° → descendente anterior 🔹Caudal 40° → bifurcaciones 🔹LAO caudal (“spider view”) → visión global

How does Lp(a) drive atherosclerosis? 🫀Delivers cholesterol to the arterial wall 🫀Carries oxidized phospholipids → vascular inflammation 🫀Interferes with plasminogen → impaired fibrinolysis 🫀Promotes an atherothrombotic environment Understanding these mechanisms strengthens the case for targeted Lp(a) therapies 📎 shorturl.at/Uudsc @drmarthagulati @AnnalisaFiltz @CardioMDPhD 🙏🏽 @DrDerekConnolly for inviting this review #Lpa #CardioTwitter #CVprev

🫀 Manejo de la cardiopatía isquémica en pacientes con insuficiencia cardíaca 📘 JACC: Heart Failure – Position Statement 🔗 DOI: 10.1016/j.jchf.2025.102731

Hace dos días se publicaron las nuevas guías del tratamiento del TEP: ahajournals.org/doi/epub/10.11… ¿Qué cambia? 🧵

🫀 CardioNugget: Kounis Syndrome (Allergic ACS) Kounis syndrome = ACS triggered by an allergic or hypersensitivity reaction • Mechanism: mast cell activation → histamine, leukotrienes → coronary spasm ± plaque rupture • Common triggers (DRUGS): – Antibiotics: penicillins, cephalosporins – NSAIDs / aspirin • 3 Types: – Type I: vasospasm, normal coronaries – Type II: plaque rupture in underlying CAD – Type III: stent thrombosis • Risk factors: atopy, asthma, prior allergies, CAD, coronary stents • Management: treat ALLERGY + ACS #CardioNuggets #MedEd #CardioTwitter #KounisSyndrome

2026 ACC/AHA Guideline on Evaluation & Management of AcutePulmonaryEmbolism in Adults

Prevención Secundaria en Stroke Isquémico 🧠💉 🔰📚N Engl J Med 2026 DOI: 10.1056/NEJMcp2415601 Enlace a Artículo Completo👇🏼🆓✅ t.me/SoMELaguna

Rangos de referencia del Strain Longitudinal Global (SLG) por ecocardiografía. 🔗DOI: 10.1016/j.jcmg.2023.08.011

Meta-analysis of four randomized trials found β-blockers did not reduce mortality, recurrent #MyocardialInfarction (MI), heart failure, or revascularization in patients with preserved left ventricular ejection fraction after MI. ja.ma/4kqKcnN

🫀⚡ Spontaneous Coronary Artery Dissection (SCAD): what we know, what we don’t, and why it matters This 2024 JACC: Advances State-of-the-Art Review makes one thing clear: SCAD is no longer “rare and mysterious” — but it is still deeply misunderstood . 👩‍⚕️ Who is affected? SCAD disproportionately affects women, often young or middle-aged, and is a leading cause of myocardial infarction in women without traditional risk factors. Yet women remain underrepresented in cardiovascular research—slowing progress and perpetuating inequities. 🔬 Pathophysiology: the biggest gap Despite improved recognition, the primary mechanism of SCAD remains unresolved: The leading hypothesis is intramural hematoma (“outside-in”), likely from vasa vasorum bleeding An alternative intimal tear (“inside-out”) mechanism may coexist Sex hormones, arterial wall biology, genetics, fibromuscular dysplasia (FMD), and stress likely interact—but how is still unclear 📊 Management paradox Most SCAD lesions heal spontaneously → conservative management preferred PCI carries high complication and failure rates CABG has poor long-term graft patency Evidence-based medical therapy is limited: β-blockers may reduce recurrence Dual antiplatelet therapy may increase MACE in conservatively managed patients 🧠 Beyond the artery: the patient experience SCAD is often psychologically traumatic: High rates of anxiety, depression, PTSD Persistent chest pain frequently unrelated to recurrent SCAD Exercise and pregnancy counseling remain based on limited data, risking both over- and under-restriction 🌍 A new research model: iSCAD The review highlights the International SCAD Registry (iSCAD)—a patient-driven, multicenter, inclusive research framework designed to accelerate discovery, improve diversity, and create SCAD Centers of Excellence. 🔮 Bottom line SCAD is not just an MI subtype—it’s a distinct vascular disease. Progress now depends on mechanistic research, sex-specific science, patient partnership, and precision care. 📌 We can diagnose SCAD. The next challenge is understanding—and preventing—it.

New State-of-the-Art: lesion stratification with intracoronary imaging, from morphology-guided PCI to AI-enabled morphofunctional assessment, outlining the next paradigm shift in interventional cardiology. #InterventionalCardiology #IntracoronaryImaging eurointervention.pcronline.com/article/lesion… @m_g_mcgarvey @K_DeSilva @DrKeeble @DrPeterOKane @ziadalinyc @divaka_perera @DrJMHill @DrNileshPareek

New England Journal of Medicine 2026: Enfermedad arterial periférica de miembros infeiores DOI:10.1056/NEJMcp2501200 #MedEd #MedTwitter #MedX medicina-interna.org

Pseudoaneurisma ventricular y Ruptura de pared libre post-IAM. 🫀💥🩸 🔴La ruptura de la pared libre ventricular (VFWR) es una complicación rara pero catastrófica del IAM, con una incidencia actual cercana al 0.01–0.5%, pero responsable de hasta 30% de la mortalidad hospitalaria temprana post IAM-CEST. ⚠️🙀 🔴F. Riesgo: primer IAM (ausencia de circulación colateral), edad >70 a, ♀️, retraso en la reperfusión, IAM-CEST (transmural) de cara anterior o lateral. 🔴Fisiopatología: ocurre por necrosis transmural o lesión por reperfusión con hemorragia intramiocárdica. 💥🩸 Pico clásico 3-7 días post-IAM (era pre-reperfusión) y 24-48 hrs (era reperfusión). 🔴Clasificación de Becker: 🔺️Tipo I: ruptura aguda➡️ hemopericardio masivo, taponamiento, muerte súbita. 🔺️Tipo II: ruptura subaguda➡️ sangrado progresivo, choque cardiogénico. 🔺️Tipo III: ruptura contenida➡️ pseudoaneurisma ventricular. 🟡Pseudoaneurisma ventricular: resultado de una ruptura contenida por coágulos o adherencias pericárdicas. Suele tener cuello estrecho, pared sin capas miocárdicas, y localización posterior o lateral. Riesgo de ruptura fatal: 30–45%, aun en pacientes asintomáticos. 50% se diagnostica de forma incidental en estudios de imagen tardíos. 🛠️ Tratamiento: cirugía urgente = estándar de oro en VFWR. Mortalidad con manejo médico exclusivo hasta 90%☠️. Cierre percutáneo con dispositivos tipo Amplatzer es alternativa viable. 📄🆓️⤵️ @JACCJournals doi.org/10.1016/j.jacc… t.me/medicinaintern…

Falla Cardíaca Derecha en el SDRA🫀🫁 🔰📚Eur Respir Rev 2025 doi.org/10.1183/160006… Enlace a Artículo Completo👇🏼🆓✅ t.me/SoMELaguna

ANGINA POST-ANGIOPLASTIA CORONARIA 🔴Entidad frecuente en la era de DES 28% - 1 año 40% - 3 años 🔴Fisiopatología compleja, no sólo asociada a falla del stent: espasmo, disf microvascular, puente miocárdico, disección coronaria, progresión enf. coronaria Revisión @ESC_Journals 👌 @SIAC_cardio @jpcostabel @DrMarthaGulati @JoseJuanatey @JulianColla_ @mmamas1973 @FaustoHerediaDr