Anurag Sahu

When measuring the aorta in a repaired dissection measure the true and false lumen individually and together. The critical number for risk assessment is measured in a line including both lumens perpendicular to blood flow (5.5 cm being the general intervention cutoff) #ACHD ❤️‍🩹

One of my favorite ECG tricks: flip an inferior STEMI tracing upside down/backwards. V1–V3 become posterior leads (V7–V9), and that “ST depression” reveals true posterior ST elevation → inferoposterior MI. #CCU ❤️‍🩹

At first glance, this appears to be a large mid-muscular VSD. Look closer: an angled VSD patch incorporates part of the RV cavity into the systemic ventricle, surgical anatomy redefining physiology. #ACHD ❤️‍🩹

Anytime I see a small PDA , to me it looks like a small flame 🔥 and I instantly start thinking about the song “like a moth to flame burned by desire…” . I have no idea why I do this. #achd ❤️‍🩹🎶🎤

The IABP isn’t perfect. It’s not Impella. It’s not ECMO. But it still helps a lot of patients when used thoughtfully. Timing, positioning, augmentation, weaning. There is art to IABP management. And that skill still matters, even in the era of shiny mechanical support devices.

Imaging today has been busy - adult with uncorrected sinus venosus ASD. Adults with dilated right ventricles without explanation should nealry always undergo evaluation for an intracardiac shunt #ACHD ❤️‍🩹

#CCT imaging for #singleVentricle anatomy always brings challenges. Here js a nicely timed contrast study showing layered thrombus in the #Fontan ❤️‍🩹

Nice example of “Himalayan” p waves on ecg in a pt with Ebstein’s anomaly. P waves were tall enough that the ecg double counted as qrs and claimed ventricular rate was 120 bpm! #ACHD ❤️‍🩹

The #ACHD work force remains a major issue. #ACHD fellowship training, with concomitant issues like physician reimbursement and the job market are in some ways intertwined. Not an easy conundrum to solve where the pipeline is limited and stems from both @ABIMcert @ABP @WGACHDChair @ISACHD @ACCinTouch

Perspective by K. Panthagani et al.: Training Health Communicators — The Need for a New Approach nej.md/3H7Bwn1 #PublicHealth

Great piece by @wesyin on the impact of the One Big Beautful Bill (OBBA) on the health care market and small business. OBBBA allows Marketplace premium subsidies to lapse resulting in major premium increases for small business and their employees. briefingbook.info/p/how-cuts-to-…

My #ACHD patients often ask about ways to reduce triglycerides. A meta-analysis of 13 randomized controlled trials found that protein supplementation significantly reduced triglyceride levels #NIH - pubmed.ncbi.nlm.nih.gov/27026427/ I prefer my protein shake with a banana 🍌

In #ACHD , we’ve focused so long on who needs valve surgery, a Fontan revision, or transplant—we’ve missed the bigger picture: Cardiometabolic health matters. Obesity, insulin resistance, hypertension, inflammation—they drive outcomes, not just anatomy.

I get to do cool stuff. The LUPV, rupv, and rmpv are all anomalous LUPV to innominate vein. Rupv and rmpv go to svc. #ACHD never ceases to amaze. #whyCMR ❤️‍🩹

If you ever want to know how difficult access to care is, try and get a primary care appointment

“Education is not the filling of a pail, but the lighting of a fire.” Teaching isn’t just about guidelines; it’s about sparking curiosity and being part of their growth. Appreciate the @ISHVnews fellows I’ve had the chance to work with and thank you for keeping me learning too.

Great session moderating today’s @SCMR education series on aortic valve disease. A nice tidbit: assessment has moved beyond just LV size/function. T1 mapping & LGE let us assess myocardial health in valve disease and with prognostic value earlier—before dysfunction sets in.

Whether you are a cardiac imager or not , If you treat aortic valve disease this session will be high yield!!

Transitioning in early adulthood from great pediatric cardiology care to #ACHD care is as important as the initial surgeries themselves.

My @Briefing_Book piece on danger the bill’s poses to US economic and fiscal resilience The impact of Trump's Big Beautiful Bill on national debt would be larger than debt increases following all but the largest recessions briefingbook.info/p/comparing-th… @kevinrinz @ipogadog Jeff Zhang