Mohd Anas

@smithECGBlog @CardioBeat_ @willyhfrick Too many handles like this fishing for views and likes

@CardioBeat_ You stole this image from @willyhfrick. Posting someone else’s image is OK if you get permission and give attribution, but to put it forth as your own is deceitful.

@medcrux This is what happens when AI talks and types. Dang…

🧵 “The IV fluids didn’t save her. They erased her sodium.” Today, let me introduce you to Anita. Anita came to the ER with vomiting and mild dehydration. Vitals stable. Mentally alert. Labs: Na⁺ 134 mEq/L — almost normal. She was started on “routine IV fluids.” By morning, Anita was confused. By afternoon, she had a seizure. 📉 Na⁺ 118 mEq/L What went wrong? 👇

@esanum @IhabFathiSulima This is medical ai account? Dang u people are scary

🔴 Diagnosis: Erythema nodosum (septal panniculitis) 📍 Multiple tender, erythematous-to-violaceous subcutaneous nodules on the shins (“bruise-like” as they evolve) ⚡️ Non-ulcerating, deep nodules > superficial purpura 🔷 Hypersensitivity reaction in subcutaneous fat (septal panniculitis, no true vasculitis) 💡 Most common/most important trigger: recent streptococcal infection (pharyngitis) (also sarcoid, TB, IBD, OCPs)

What is the description and the most important cause?

VT or NOT VT. THAT IS THE QUESTION... @DrRazi4 @EcgsOnly #CardioTwitter #ECG

@QAlmulihi Never seen doses suggested this high. We sure?

Vasopressors and Inotropes - Summary Sheet 1️⃣ Norepinephrine (Levo) 💉 Action: α1 > β1 agonist → ↑↑ SVR, ↑ CO, reflex brady may negate ↑ HR 📌 Uses: Septic shock (1st), Cardiogenic shock (1st), Hypovolemic shock (1st) 2️⃣ Phenylephrine (Neo) 💉 Action: Pure α1 agonist → ↑↑ SVR 📌 Uses: Septic shock with ↑ HR or ↓ BP; AFRVR, HOCM, AS, RV failure 3️⃣ Vasopressin (Vaso) 💉 Action: V1 (↑ SVR), V2 (↑ renal H2O reabsorption) 📌 Uses: Septic shock (2nd line), Anaphylaxis (2nd line), RV failure 4️⃣ Epinephrine (Epi) 💉 Action: •Low dose: β1 > β2 > α1 → ↑ CO, neutral SVR •High dose: α1 > β1 > β2 → ↑ CO, ↑ SVR 📌 Uses: ACLS (1st), Anaphylaxis (1st), Symptomatic bradycardia (2nd), Septic shock, Bronchospasm 5️⃣ Dopamine (Dopa) 💉 Action: •Low: D1 > β1 → ↑ CO, ↑ UOP •Medium: β1 > D1 → ↑ CO, ↑ SVR •High: α1 > β1 > D1 → ↑ SVR 📌 Uses: Symptomatic bradycardia, Septic shock with bradycardia (↑ mortality vs. Levo in septic and cardiogenic shock) 6️⃣ Methylene Blue 💉 Action: ↓ NO and cGMP → ↑ smooth muscle tone, ↑ SVR 📌 Uses: Refractory sepsis/anaphylaxis, post-cardiopulmonary bypass, amlodipine overdose, methemoglobinemia 7️⃣ Dobutamine (Dobuta) 💉 Action: β1 > β2 > α1 agonist → ↑ CO, ↓ SVR 📌 Uses: Cardiogenic shock, Add to Levo in septic shock with ↓ LVEF 8️⃣ Milrinone 💉 Action: PDE inhibitor → ↑ cAMP → ↑ inotropy, vasodilation → ↑ CO, ↓ PVR/SVR 📌 Uses: Cardiogenic shock, RV failure (↓ PVR, ↓ LVEDV) 9️⃣ Isoproterenol (Isuprel) 💉 Action: β1 = β2 agonist → ↑ HR, ↓ SVR 📌 Uses: Symptomatic bradycardia, Mg-refractory Torsades

@EcgsOnly Ccf (ppor r wave progression) , pericardial effusion (small qrs complexes) with prolonged qt (hypok, hypoca, hypomg likely diuretic)

SOB Dx ?

@DrRazi4 @PMcardioApp @drharikrishrau @Eugene4463 short pr, broad qrs complex of rbbb pattern with qs complex at inferior leads. my money on wpw antidromic with underlying bbb

32 y.o man; no previous medical illness; history of palpitation and 3X history of admission for pre-syncopal attack; VS stable. What is the #ecg diagnosis? @PMcardioApp #CardioTwitter #EPeeps #CardioEd #MedTwitter #MedicalStudents

@Paulo_SanPedro hei dr paolo. nice vid. it was a good experience having you in msia. would love to see u in action again some time in the future

V-E technique is associated with better tidal volumes and reduced failure rates compared to C-E technique. Wet Clinic at Vicente Sotto Memorial Medical Center

@Doctors__squad Better throw GINA guideline into the dustbin now.

@911GlockDoc @Doctors__squad A lot of redundant and questionable components. Dont spread this

@Doctors__squad Manage DKA - FUCKING

@_Anesthesiology Maybe i am missing something, but how does choice of anaesthesia affects long term outcome as compared to patients frailty, mrs, surgical technique, rehab plan etc...?

Visual Abstract in #Anesthesiology - Long-term Outcomes with Spinal versus General Anesthesia for Hip Fracture Surgery 🖌️ ow.ly/gzmo50RT5BE

@EMBoardBombs 5-1-1 5 in the CNS (tumor, vascular malformation, recent ischaemic stroke, recent significant head trauma, spontaneous unprovoked ICH) 1 in the CVS (suspected/ proven aortic dissection 1 anywhere (active uncontrolled bleeding other than menses/ bleeding tendencies)

EM doc? You've got to know tpa contraindications like the back of your hand! Here's our simplified list

@DrRazi4 @The_Iron_grey @ecgandrhythmRoe @EcgsOnly @smithECGBlog @EcgOxford How do i know there is reperfusion at posterior leads? There seems to be combination of 1st degree hb and mobitz type 2. So would it qualify as high degree av block? If there are q waves at inferior leads, when can we say it to be lafb? Or we just dont?

@The_Iron_grey @ecgandrhythmRoe @EcgsOnly @smithECGBlog @EcgOxford Likely very late presentation inferior posterior MI; Q wave with TWI in Inferior Leads and possible reperfusion TWI in Posterior Leads; Complicated with Mobitz Type 1 AV block;

57 y/m farmer from Bangladesh presents with chest pain and syncope. Similar history 5 days back. Here's the ECG. Quantitative Trop T 2.09 What should be the next line of management? @ecgandrhythmRoe @EcgsOnly @smithECGBlog @EcgOxford @DrRazi4

@EMBoardBombs Agree. Usually anterior leads is enough. 2 problems though. A. When dealing with cardiologists, they are insistent on posterior ecg and B. Exam curriculum still stresses on this

The diagnostic EKG here for a posterior MI that will require activation of the cath lab is only 0.5mm in 2 or more contiguous posterior leads

@AbdullahAqiel @IsxzuddinMY Ni spesis ckp kurang berfikir. Hati2 berkata2. Kata2 awak is reflective of service of @KKMPutrajaya dan @OfficialIIUM

@The_Nanashi_O @DrRazi4 @EM_RESUS @smithECGBlog @EcgsOnly My thoughts exactly. Because the reperfusion t waves seems too deep as compared to what i usually encountered and it extends beyond d lv aneurysm ecg changes at v2 v3

@mohda_nas @DrRazi4 @EM_RESUS @smithECGBlog @EcgsOnly Wellens' syndrome, it seems. Note that inferior TWs are not hyperacute — they are really reciprocal to reperfusion changes in the high lateral territory. LAD occlusion with spontaneous reperfusion — needs urgent Cath.

Summoning great ecg minds. Middle age diabetic with chest pain for 2/7 currently pain free. Whats the course of action? @The_Nanashi_O @DrRazi4 @EM_RESUS @smithECGBlog @EcgsOnly #omi #ecg

@Rizwan66598174 My guess exactly seeing the territorial changes like that

@mohda_nas Nice ecg mate..cud thr be multiple culprits..hmmm Inf and lateral has significant changes indicating Inf wall omi..meanwhile v2/v3 shows a biphasic... Cud it be high lateral or wrap around LAD...

@DrRazi4 @PMcardioBot Why the r wave is so large at v1-v3? It kinda looks like rbbbish with clear ste. In facility without pci, how "fresh" would u say this omi is? Because we know q wave is not reliable to say it is old infarct

Case of silent ischaemia; old guy with poor Diabetic control; no chest pain at all; reduce effort tolerance for few days; stable VS; midzone crepitations; Trop T>2000ng/dL. #ecg @PMcardioBot