Verghese Mathew

@rajivxgulati @Tesslagra Always assume not occluded and usually will be correct

Occluded vs Not #RadialFirst

@DineshKalra @SVRaoMD @UofLCardiology @nyulangone @UofLHealth @ACCinTouch @American_Heart Looking good, making the rounds, doing the rounds- see you next week!

@UofLCardiology was honored to host @SVRaoMD @nyulangone for visiting grand rounds @UofLHealth today to unpack the #ACS 2025 guidelines @ACCinTouch @American_Heart. A terrific masterclass on the evidence, a peek behind the curtain on how guidelines get constructed/evidence gets re-analyzed meticulously, and most importantly, how to best implement these at the bedside for our patients. A must-see lecture that we will post on @VuMedi soon! @SripalBangalore @glennfishman @YChowdhuryMD @JasonKatzMD @DrM_ODonoghue @HollandTamis @ubcardio

@HeartOTXHeartMD Never my forte so I went into cardiology. I think it turned out alright…

My Ortho Bros (and sis’) will appreciate. Gave my HS Jersey to my Bio (and Chem) HS Teacher, Mrs Buxkemper. I’ve known origin and insertion of every skeletal muscle since a sophomore in HS because of her rigorous classes.

@DrMarthaGulati Yes, yet there are daily cardiology and specifically interventional cardiology consults for cor cal. agree that this is largely driven by misunderstanding of the application/implication of result by referrings and pts. Do we really think that the genie goes back in the bottle?

#CAC was NEVER intended guide downstream testing in asymptomatic people. The CAC score and even the location should not influence testing. The use of #CAC to help identify people who need more intensive preventive strategies is the intention. I also think the opportunistic identification of CAC is one that we need far more of

@CMichaelGibson @HeartOTXHeartMD Sobering proportion of us face severe issues. Yet ask hospital administrators about physicians and you’ll hear about need for RVUs, charts closed, modules completed, patient satisfaction surveys/ willingness to recommend. Two entirely different universes of priorities

Anonymous poll: If you are a physician, which of the following have you experienced (I understand that there may be two choices, but pick the worst one) :

@SPuro88 Just the beginnings of the cool parts… so much more 😁

Cool part about being a physician is that you get accused of being a pharma shill & forcing pills down peoples’ throats and get yelled at for not prescribing antibiotics for asymptomatic bacteriuria both in the same day.

@jonathankirk Onwards! All the best

At the end of February was my last day at Loyola after 10 years. It's impossible to overstate the support I've received here. I looked forward to coming to work every day because of the faculty, staff, and students I had the privilege to call colleagues.

@SahilBloom From personal experience, these are the exact moments you wish to have back when they’ve gone. You have it exactly right.

I got home at 2am from a work trip. At 6:30am, my son woke me up. “Dada, I have a question.” “I’m sleeping, what’s up buddy?” He looked at me intensely and said: “Can a T-Rex eat 600 velociraptors?” Honestly, give me this over a perfect 12-step sleep routine all day.

@JAMACardio Extra extra read all about it! The reliance on troponin for eval and treatment above all else- surely not the intended consequence but clearly the result - has been an impairment to cardiac diagnosis/risk stratification/treatment. Huge resources misdirected as a result

Changing from high-sensitivity cardiac troponin I to T assay doubled myocardial injury detection and admissions, without improving 1-year cardiovascular outcomes in suspected #AcuteCoronarySyndrome. ja.ma/4a8IbI3

@HeartOTXHeartMD Happy Birthday Suzi!

Struck gold with this lovely lady😊🙏🏼❤️

@SVRaoMD @SIFCardiology @nyulangone @glennfishman @LouaiRazzouk Looking great guys- congrats!

Another great live complex case for #SIF2026 @SIFCardiology! Thanks to Dave Rizik MD and his team for the opportunity.

🚨📢Calling Interventional Cardiology Fellows @MayoClinicCV has an opening for our Structural Heart Disease Fellowship for 2026-27 in Rochester, MN. Please complete application via mccms.elluciancrmrecruit.com/Apply/Account/… Any questions can be forwarded to Ellie Fate at fate.ellie@mayo.edu

@readswithravi Responsibility and accountability. It’s not usually someone else’s fault.

@SharpFootball Masterclass in accountability and responsibility. As opposed to what has become societally acceptable to explain away lesser performance in all walks of life- not just professional sports- failure is not usually someone else’s fault.

Tom Brady on feeling the PAIN of LOSSES: absolutely loved how Brady shared his experience here 🔥 “I always felt like you should sit with that pain. The flight home should be painful. It should be disappointing. You shouldn’t try to escape it. You shouldn’t make excuses for it. You need to feel it… and then you need to have some actionable items to GO DO SOMETHING ABOUT IT. I think naturally the human nature part about all of us is to say ‘oh it’s just one game or one season’ and make excuses. And then when you live in those excuses, you don’t live in the solutions. And those solutions are to get back to work, let’s care more, have more discipline & better practice habits.”

@adnanalkhouli Receive the best possible outcomes of advanced therapies, vs no therapy at all. competing priorities. We’ve lived with this difficult juxtaposition with numerous therapies- technology has been a great equalizer, yet delivery of ‘best care’ is akin to accepting non-inferiority.

When well-intended policies create unintended harm — a lesson in system dynamics. Rating systems are designed to help patients choose better care, increase transparency, and incentivize hospitals to improve. But when you change one part of a complex system, the ripple effects can be profound — especially when reputation and reimbursement are on the line. A new analysis in @JACCJournals reveals that after U.S. News & World Report began rating TAVR programs in 2020, lower-rated hospitals became significantly more risk-averse — performing 44% fewer high-risk TAVR procedures, with no compensatory increase at higher-rated centers. This is the paradox of public ratings: a tool meant to improve care may instead discourage hospitals from treating the sickest patients, simply to protect a score. It is a reminder that: 1. Metrics shape behavior. 2. Imperfect risk adjustment means patients — not systems — absorb the cost. 3. Those “too sick” for surgery must not become invisible casualties of policy design. This is an opportunity to rethink and redesign — rather than to blame. Perhaps the question should be: How do we build systems that reward treating the hardest cases — instead of penalizing them? jacc.org/doi/10.1016/j.…

Not sure who the original attribution of this piece is, but I both endorse and would posit that I realized it, to my benefit, well shy of 50. Christmas feels different after fifty. Not because it loses its magic, but because it finally reveals what the magic really was all along. When I was younger, I thought Christmas was found in the noise. In the wrapping paper everywhere, the late-night putting-things-together, the crowded house, and the early mornings that came far too soon. Back then, I believed the wonder was loud. But now I know the wonder is quiet. It lives in the soft glow of the tree before the day has even started. It lives in the memories that show up without asking — some joyful, some tender, some carrying faces and names I still ache for. After fifty, Christmas becomes something reflective. Every ornament tells a story. Every recipe remembers a pair of loving hands. Every carol opens a doorway to who we used to be, before we understood how quickly time would carry everything forward. I did not realize then how fast children would grow, how parents would age, how soon “next year” would become “years ago.” But now I stand here — older, a little slower, and so much more thankful. Because Christmas after fifty is not about rushing anymore. It is about the peace that settles in when you finally understand that time itself is the blessing. It is holding the people you love just a little longer. It is letting go of what never really mattered. It is thanking God for one more December — for breath, for life, for another chance to love well. It is sitting in the stillness and realizing the greatest gifts were never wrapped or placed beneath the tree. They were the ones gathered around it — every child, every answered prayer, every ordinary moment that turned out to be holy. Maybe that is the gift of aging — you stop chasing wonder and start recognizing it. So here is to Christmas after fifty — where joy is softer, gratitude runs deeper, love stretches wider, and the meaning shines clearer than ever. And if you are reading this, may you rest in this truth: even as the years change us, God’s love remains the same. It was faithful before. It is faithful now. And it will be faithful in every Christmas yet to come.

In Interventional Cardiology, the Cath lab is identity. But the arc of every career demands a transition, and our current systems are poorly designed for it. While procedural stamina may wane, late-career physicians gain the most critical assets: foresight, profound nuance, and lasting judgment. These are the very traits medicine needs now more than ever, yet our metrics (RVUs, case volume) measure activity, not wisdom. We prioritize quantitative output over qualitative impact. The erosion of relevance is, however, not inevitable. We must dismantle the false binary between "active" and "retired" and replace it with a model that values evolution over exit. The late-career phase must be deliberately designed. My new piece in @JACCJournals features powerful essays by Drs. Klein, Holmes, Wijns, and Park, transforming this transition from an ending into medicine's most enduring act of renewal. Read the full article: jacc.org/doi/10.1016/j.…

@HeartOTXHeartMD @CheapSeats411 Even cheese fries would work

Hoping @CheapSeats411 gets his free Italian Beef this week!

@SrihariNaiduMD @SCAI Do we know how many programs are taking fellows outside of match, how many fellows that constitutes, and how are these numbers confounded by that- if at all

@SCAI preliminary evaluation of the IC 2026 Match results ⬇️ press release

@BKRBusinessMin Sounds about right

Morgan Housel and The Art of Spending Money. Morgan Housel previously wrote a book called the Psychology of Money. His most recent book deals more fully with how people spend money and what it means. In a sense he largely says that most of us really want things that money itself can't buy. Being respected, liked, internal happiness and a sense of community. We may get dopamine fixes or short status binges from buying cool things but these buys don't likely long term change your happiness. @morganhousel