Omid Kiamanesh, MD, FRCPC

📄 Wisdom vs groupthink in transplant listing. Led by @leaharperMD. American Journal of Transplantation · doi.org/10.1016/j.ajt.… @leaharperMD @AJTransplant @broderickheart #CardioTwitter #MedTwitter #MedEd #Transplantation #DecisionMaking

Listing committees decide who gets a transplant and who does not. The substance of how they make those decisions gets far less attention than the data they use. This one is worth reading whether or not you work in transplant.

Why do we form committees for the hardest decisions in medicine? Pooled judgment is supposed to beat any single expert. Sometimes it does. Sometimes the committee makes a call no one in the room would have made alone. How do you tell the difference? 🧵

📄 DSP cardiomyopathy: novel variant, two sisters, one treatment algorithm. JACC: Case Reports · doi.org/10.1016/j.jacc… @JACCJournals @broderickheart @jawhiteMD @BBallantyneMD @NathanLeader22 @JacobAbdaem @j32_shaw #CardioTwitter #MedTwitter #CardioGenetics #Cardiomyopathy #DSP

DSP cardiomyopathy is a great masquerader. Recurrent myocarditis without a genetic workup is an incomplete diagnosis. The gene defines the disease. The disease defines the treatment. The treatment changes outcomes for the family, not just the patient.

A 42-year-old woman. Palmoplantar keratoderma. Recurrent myocarditis on MRI. Intense inflammation on cardiac PET. Was it autoimmune? Idiopathic? Neither. The genes told the story. The treatment changed. And then we tested her sister. 🧵

📄 One FKRP genotype, two siblings, two different hearts. Track the scar, not just the EF. JACC: Case Reports · doi.org/10.1016/j.jacc… @JACCJournals @broderickheart #CardioTwitter #MedTwitter #CardioGenetics #Cardiomyopathy #whyCMR #MedEd

LGMD R9 is autosomal recessive, so siblings of an affected patient should be offered cascade genetic testing. But this family marks the limit of genotype: a sibling's cardiac phenotype cannot be predicted from the proband's course.

Genetic cardiomyopathy tweetorial: Two siblings. The same gene. The same homozygous variant. One developed a dilated, scarred heart. The other's heart stayed nearly normal. Identical genotype does not mean identical heart. 🧵