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Beyond basic echo anatomy #echofirst 🌟Elevating the way we see the interatrial septum in TEE 🥽 The interatrial septum is more than anatomy 🫀- it’s a procedural roadmap📍 TEE guidance for: 1️⃣ M-TEER (transseptal puncture) 2️⃣ PTC of ostium secundum ASD

Alexander Mladenow MD

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15,572 görüntüleme • 1 ay önce •via X (Twitter)

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Apical 4-chamber view: a single window that maps cardiac anatomy and relationships. How to obtain it: 🔵 Place the transducer at the point of maximal impulse (LV apex) 🔵 Keep the probe index marker directed toward the patient’s left side (≈3 o’clock) 🔵 Aim the beam toward the base of the heart (toward the right shoulder) 🔵 Fine-tune tilt/rotation until all four chambers are symmetric and the septum is vertical From the LV apex, you see all four chambers in one plane (LV, RV, LA, RA) with correct orientation (apex near the probe, atria deeper). Key structures: 🔵 LV: papillary muscles, chordae, anterior & posterior mitral leaflets 🔵 RV: moderator band, anterior & septal tricuspid leaflets 🔵 Interatrial septum and ventriculoatrial septum (LV–RA separation) 🔵 Right superior pulmonary vein entering the LA near the septum 🔵 Descending aorta seen posterior/lateral to the LA High-yield pearl: The tricuspid valve annulus is normally positioned more apically than the mitral, an important landmark in structural assessment.

Apical 4-chamber view: a single window that maps cardiac anatomy and relationships. How to obtain it: 🔵 Place the transducer at the point of maximal impulse (LV apex) 🔵 Keep the probe index marker directed toward the patient’s left side (≈3 o’clock) 🔵 Aim the beam toward the base of the heart (toward the right shoulder) 🔵 Fine-tune tilt/rotation until all four chambers are symmetric and the septum is vertical From the LV apex, you see all four chambers in one plane (LV, RV, LA, RA) with correct orientation (apex near the probe, atria deeper). Key structures: 🔵 LV: papillary muscles, chordae, anterior & posterior mitral leaflets 🔵 RV: moderator band, anterior & septal tricuspid leaflets 🔵 Interatrial septum and ventriculoatrial septum (LV–RA separation) 🔵 Right superior pulmonary vein entering the LA near the septum 🔵 Descending aorta seen posterior/lateral to the LA High-yield pearl: The tricuspid valve annulus is normally positioned more apically than the mitral, an important landmark in structural assessment.

CardiovascularCorner

12,333 görüntüleme • 4 ay önce

👇Transseptal Complication: Aortic Injury👇 The patient was transferred from another hospital due to an aortic injury. During the initial procedure, the clinician inadvertently punctured the aorta. In a moment of panic, the sheath was advanced—an action that should never be taken in such circumstances—before transferring the patient to our facility. Upon arrival, we carefully retracted the sheath under guidewire support, prepared for thoracotomy if needed. Subsequent angiography and TEE assessments revealed no evidence of a shunt or bleeding. Fortunately, this severe complication was resolved without the need for surgical intervention. Key Lessons: 👉 1. Always puncture posteriorly; the left atrium is located in the posterior aspect. 👉 2. Remain calm; never advance the sheath into the aorta. 👉 3. Do not retract the guidewire until ruling out any shunt or bleeding🚨🚨 👉 4. Transseptal puncture should be performed or supervised exclusively by experienced clinicians🚨🚨 👉 5. For challenging anatomical conditions, TEE or ICE guidance is highly recommended🚨🚨 Philipp Sommer Christian Sohns Martin Braun Moneeb Khalaph Vanessa Sciacca Maxim Didenko, MD PhD FESC FEHRA @AleSpoken AGEP Young DGK #EPeeps #CardioTwitter

👇Transseptal Complication: Aortic Injury👇 The patient was transferred from another hospital due to an aortic injury. During the initial procedure, the clinician inadvertently punctured the aorta. In a moment of panic, the sheath was advanced—an action that should never be taken in such circumstances—before transferring the patient to our facility. Upon arrival, we carefully retracted the sheath under guidewire support, prepared for thoracotomy if needed. Subsequent angiography and TEE assessments revealed no evidence of a shunt or bleeding. Fortunately, this severe complication was resolved without the need for surgical intervention. Key Lessons: 👉 1. Always puncture posteriorly; the left atrium is located in the posterior aspect. 👉 2. Remain calm; never advance the sheath into the aorta. 👉 3. Do not retract the guidewire until ruling out any shunt or bleeding🚨🚨 👉 4. Transseptal puncture should be performed or supervised exclusively by experienced clinicians🚨🚨 👉 5. For challenging anatomical conditions, TEE or ICE guidance is highly recommended🚨🚨 Philipp Sommer Christian Sohns Martin Braun Moneeb Khalaph Vanessa Sciacca Maxim Didenko, MD PhD FESC FEHRA @AleSpoken AGEP Young DGK #EPeeps #CardioTwitter

El Hamriti Mustapha

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The New Hash AI Roadmap is Here! We’re excited to unveil the future of Hash AI- it’s bigger, bolder and more ambitious than ever. Our vision for 2025 and beyond is clear: deliver more value to our holders and unlock powerful new utility for the $HASHAI token. This new roadmap is a statement of our commitment to innovation, real-world utility, and the long-term growth of the Hash AI ecosystem. Join us as we explore the limitless possibilities of AI and shape the future of crypto mining.

The New Hash AI Roadmap is Here! We’re excited to unveil the future of Hash AI- it’s bigger, bolder and more ambitious than ever. Our vision for 2025 and beyond is clear: deliver more value to our holders and unlock powerful new utility for the $HASHAI token. This new roadmap is a statement of our commitment to innovation, real-world utility, and the long-term growth of the Hash AI ecosystem. Join us as we explore the limitless possibilities of AI and shape the future of crypto mining.

Hash AI

87,927 görüntüleme • 1 yıl önce

Are you agile on the sagittals?? Sagittal T1 images are for anatomy, but only if you know how to use them! Here is how I remember the sagittal anatomy 1. Start lateral 2. Find the gyrus that looks like a triangle, that is the pars triangularis of the inferior frontal gyrus 3. In front of it is the pars orbitalis—easy it’s over the orbit 4. Behind it is the pars opercularis. Remember oper sounds like OVER so its OVER the sylvian fissure 5. Behind the pars opercularis is the precentral gyrus 6. Right behind the precentral is the post central—duh post follows pre! 7. Behind the post central is the supramarginal gyrus. Remember supra means above, so it’s above the sylvian fissure. Margin = at the posterior margin of the sylvian fissure 8. Behind the supramarginal gyrus is the inferior parietal lobule. Remember inferior is below supra, so inferior parietal lobule is below the supramarginal 9. More medial is the lateral orbital gyrus. It’s easy, it above the orbit! 10. Even more medial is the gyrus rectus. Rectus means straight, so if you see a gyrus that is straight like a line, that is the gyrus rectus! Hopefully this gives you a handle on the sagittal! Stay tuned for the midline sagittal anatomy!!

Are you agile on the sagittals?? Sagittal T1 images are for anatomy, but only if you know how to use them! Here is how I remember the sagittal anatomy 1. Start lateral 2. Find the gyrus that looks like a triangle, that is the pars triangularis of the inferior frontal gyrus 3. In front of it is the pars orbitalis—easy it’s over the orbit 4. Behind it is the pars opercularis. Remember oper sounds like OVER so its OVER the sylvian fissure 5. Behind the pars opercularis is the precentral gyrus 6. Right behind the precentral is the post central—duh post follows pre! 7. Behind the post central is the supramarginal gyrus. Remember supra means above, so it’s above the sylvian fissure. Margin = at the posterior margin of the sylvian fissure 8. Behind the supramarginal gyrus is the inferior parietal lobule. Remember inferior is below supra, so inferior parietal lobule is below the supramarginal 9. More medial is the lateral orbital gyrus. It’s easy, it above the orbit! 10. Even more medial is the gyrus rectus. Rectus means straight, so if you see a gyrus that is straight like a line, that is the gyrus rectus! Hopefully this gives you a handle on the sagittal! Stay tuned for the midline sagittal anatomy!!

Lea Alhilali, MD

22,853 görüntüleme • 7 ay önce

#TeamBestie from the red carpet of the NYC premiere! Queen of the Ring is more than just a movie—it’s a powerful tribute to the women who fought for their place in the ring. As two women who’ve lived that journey, it’s incredible to see their stories on the big screen, especially as we celebrate International Women’s Day. This film, the true story of Mildred Burke’s rise to pro wrestling superstardom is a must-see for every fan of women’s wrestling and beyond! In theatres nationwide TOMORROW! #QueenOfTheRing

#TeamBestie from the red carpet of the NYC premiere! Queen of the Ring is more than just a movie—it’s a powerful tribute to the women who fought for their place in the ring. As two women who’ve lived that journey, it’s incredible to see their stories on the big screen, especially as we celebrate International Women’s Day. This film, the true story of Mildred Burke’s rise to pro wrestling superstardom is a must-see for every fan of women’s wrestling and beyond! In theatres nationwide TOMORROW! #QueenOfTheRing

Trish Stratus

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Nickolay Mladenov, the Board of Peace High Representative for Gaza: If Gaza continues the way it is now or does not move into implementing the roadmap and the comprehensive plan, the two-state solution will become practically impossible. With everything that is happening in the West Bank and with more than 50% of Gaza now under the control of the Israeli army and less than 50% under the control of Hamas, there is no credible pathway forward to a political resolution of the conflict. The only way that we can build back to that is if we have transitional governance, if we have decommissioning of weapons, if we have withdrawal in Gaza, and that will get us back on track for the political discussions that will need to take place.

Nickolay Mladenov, the Board of Peace High Representative for Gaza: If Gaza continues the way it is now or does not move into implementing the roadmap and the comprehensive plan, the two-state solution will become practically impossible. With everything that is happening in the West Bank and with more than 50% of Gaza now under the control of the Israeli army and less than 50% under the control of Hamas, there is no credible pathway forward to a political resolution of the conflict. The only way that we can build back to that is if we have transitional governance, if we have decommissioning of weapons, if we have withdrawal in Gaza, and that will get us back on track for the political discussions that will need to take place.

Ariel Oseran أريئل أوسيران

11,455 görüntüleme • 4 gün önce

#Djibouti spoke; "Somali, We Are" This new song from should be seen as an anthem for the Somali people, resonating with the soul of every Somali from coast to coast and every frontier. In fact, it’s more than just song; its rhymes, content, traditional beat, and evolving melody echo the heartbeat of our people. A timeless declaration of unity that binds us all, wherever we are in the Horn of Africa and beyond. You don't need to understand the language to feel the beauty of this song. Soomaali weeyaanee, Soomaali weeyaan dheh!

#Djibouti spoke; "Somali, We Are" This new song from should be seen as an anthem for the Somali people, resonating with the soul of every Somali from coast to coast and every frontier. In fact, it’s more than just song; its rhymes, content, traditional beat, and evolving melody echo the heartbeat of our people. A timeless declaration of unity that binds us all, wherever we are in the Horn of Africa and beyond. You don't need to understand the language to feel the beauty of this song. Soomaali weeyaanee, Soomaali weeyaan dheh!

Abdirashid Hashi

32,179 görüntüleme • 2 yıl önce

Watch this interview and you'll see that Nafiu Bala Gombe's problem is deeper than we thought. He was asked the constitutional basis for calling for calling himself the ADC national chairman and who in the party supports him. Instead of answering the question, he reintroduced himself and then spoke in what sounded like a language only he understands. Why is he doing this to himself? Clearly, this young man needs more basic education than the chairmanship of a political party. ~Prof Kperogi

Watch this interview and you'll see that Nafiu Bala Gombe's problem is deeper than we thought. He was asked the constitutional basis for calling for calling himself the ADC national chairman and who in the party supports him. Instead of answering the question, he reintroduced himself and then spoke in what sounded like a language only he understands. Why is he doing this to himself? Clearly, this young man needs more basic education than the chairmanship of a political party. ~Prof Kperogi

Abubakar Yunusa

55,815 görüntüleme • 5 ay önce

The anatomy of a neo-colonial tourist economy. 🧵 In the thread below, we exposed the narrative attack. Now, look at the economic reality behind the scenes of this second video: 1️⃣ A foreign-owned Riad extracting the capital. 2️⃣ Underpaid sub-Saharan labor providing the service. 3️⃣ A binationale tourist extracting the "content." What exactly does the Moroccan citizen gain here? We finance the world-class infrastructure, the visa-free access, and security that enables this bubble, only to host visitors who act as digital proxies for a hostile neighboring agenda. They consume our resources, use our hospitality as a backdrop, and then wage cognitive warfare against our national brand. It is a one-way extractive model. Time to enforce true normative sovereignty. 🇲🇦 #Geopolitics #Morocco #Sovereignty #DigitalInfluence

Meryem

11,420 görüntüleme • 4 ay önce

It’s WAY bigger than just an RBI Somewhere around the country… a parent is walking to their child’s room with tears in their eyes… To show them a video of someone who looks like them… doing things that they never thought they could. But it’s not just about those other kids or families…. I think it’s easy for people to pull for PB because they always see his big smile, and positivity… The truth is… PB probably needed that win much more than we could ever know. We’re proud of you brother… and love you. Keep grinding baby. You have more people supporting you than you could ever imagine. We still have more steps to take. It’s WAY bigger than just an RBI 🤟🏴‍☠️

It’s WAY bigger than just an RBI Somewhere around the country… a parent is walking to their child’s room with tears in their eyes… To show them a video of someone who looks like them… doing things that they never thought they could. But it’s not just about those other kids or families…. I think it’s easy for people to pull for PB because they always see his big smile, and positivity… The truth is… PB probably needed that win much more than we could ever know. We’re proud of you brother… and love you. Keep grinding baby. You have more people supporting you than you could ever imagine. We still have more steps to take. It’s WAY bigger than just an RBI 🤟🏴‍☠️

#PackTheJungle🏴‍☠️💍

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Did Lily think life is all about look? “NO! it’s like the least fun part of life! the way you look is the least important part of yourself, the inside of you is the most important. The society have made it so important when it’s never been all that. People can be so much more than their looks, people ARE so much more than their looks… However it’s cute to have like playing with makeup, style, that’s just for your self gratification, it’s not for other people, but sure getting compliments on the way look is always a good time, but at the end of the day, those are for yourself, don’t ever do that for anyone else, it’s never gonna end well, tho in this world is pretty much impossible especially with my job, but we have to try.”

Did Lily think life is all about look? “NO! it’s like the least fun part of life! the way you look is the least important part of yourself, the inside of you is the most important. The society have made it so important when it’s never been all that. People can be so much more than their looks, people ARE so much more than their looks… However it’s cute to have like playing with makeup, style, that’s just for your self gratification, it’s not for other people, but sure getting compliments on the way look is always a good time, but at the end of the day, those are for yourself, don’t ever do that for anyone else, it’s never gonna end well, tho in this world is pretty much impossible especially with my job, but we have to try.”

nmixx pics

47,650 görüntüleme • 2 ay önce

Sam Altman: "Very soon an AI will just be running for you in the background all the time" That entire model is on its way out. But the vision isn't the tell. This is: He says everyone's going to want "so much more of this AI infrastructure than we think." That's not a roadmap. That's a man admitting he can't build chips and power fast enough. The always-on assistant is the headline. The infrastructure bottleneck underneath it is the trade almost nobody is pricing in. That gap is the whole edge.

Sam Altman: "Very soon an AI will just be running for you in the background all the time" That entire model is on its way out. But the vision isn't the tell. This is: He says everyone's going to want "so much more of this AI infrastructure than we think." That's not a roadmap. That's a man admitting he can't build chips and power fast enough. The always-on assistant is the headline. The infrastructure bottleneck underneath it is the trade almost nobody is pricing in. That gap is the whole edge.

plutos

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🚨MAJOR NEWS: Minneapolis Police Chief Brian O’Hara just raised a serious question about the ICE shooting. Confirming what we have all seen for ourselves. “I’ve seen the videos and it’s not clear to me why he appears to be in the path of the vehicle more than once… When you approach someone in a vehicle… There are very basic steps you take…” Translation: basic procedure wasn’t followed, and someone ended up dead. Ice is clearly out for blood.

🚨MAJOR NEWS: Minneapolis Police Chief Brian O’Hara just raised a serious question about the ICE shooting. Confirming what we have all seen for ourselves. “I’ve seen the videos and it’s not clear to me why he appears to be in the path of the vehicle more than once… When you approach someone in a vehicle… There are very basic steps you take…” Translation: basic procedure wasn’t followed, and someone ended up dead. Ice is clearly out for blood.

Brian Allen

2,008,168 görüntüleme • 7 ay önce

I’ve always respected Steve Kerr for his coaching and the way he uses his voice to speak to the moment. Here he is bringing us together, to inspire us, to move humanity forward about the current events in Minnesota. I wrote in M! this weekend about how we can become our higher selves, our better angels, and moving humanity forward… together. This moment transcends politics, sports, media. It’s bigger than who you voted for. It’s bigger than each of us. It’s a moment to reflect and come together. To recognize that there really is more that unites us than separates us.

I’ve always respected Steve Kerr for his coaching and the way he uses his voice to speak to the moment. Here he is bringing us together, to inspire us, to move humanity forward about the current events in Minnesota. I wrote in M! this weekend about how we can become our higher selves, our better angels, and moving humanity forward… together. This moment transcends politics, sports, media. It’s bigger than who you voted for. It’s bigger than each of us. It’s a moment to reflect and come together. To recognize that there really is more that unites us than separates us.

Maria Shriver

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“In âkharin nabarde, Pahlavi barmigarde!” 🦁☀️ This is more than just a song; it’s a cry for freedom. As the people of Iran stand on the frontlines of their final battle, let’s show the world that they are not alone. Join the movement, share this song, and let the message of hope and resilience echo across every border. Iran will win. Together, we are the voice of the voiceless. ✌️ Anglicization for Singing Along: 🎶 In âkharin nabarde, Pahlavi barmigarde! 🎶 (Translation: This is the final battle, Pahlavi will return!) Check out 4rsa1an for more and watch the full video here: #Iran #Freedom #Pahlavi #Solidarity #VoiceOfIran #SupportIran #HumanRights

“In âkharin nabarde, Pahlavi barmigarde!” 🦁☀️ This is more than just a song; it’s a cry for freedom. As the people of Iran stand on the frontlines of their final battle, let’s show the world that they are not alone. Join the movement, share this song, and let the message of hope and resilience echo across every border. Iran will win. Together, we are the voice of the voiceless. ✌️ Anglicization for Singing Along: 🎶 In âkharin nabarde, Pahlavi barmigarde! 🎶 (Translation: This is the final battle, Pahlavi will return!) Check out 4rsa1an for more and watch the full video here: #Iran #Freedom #Pahlavi #Solidarity #VoiceOfIran #SupportIran #HumanRights

Afshine Emrani MD FACC

40,058 görüntüleme • 8 ay önce

I think it’s more than just my vision; it’s the vision of the Indian people. What’s more important is understanding that and bringing it together. I see a huge opportunity for India in rethinking how we produce in the 21st century in a democratic environment. This will involve AI, robotics, drones, and much more. To achieve this, we need to build the necessary infrastructure. This will make India an alternative producer to the Chinese way of doing things. There is enormous energy locked and hidden within the social structure of India. India needs to respect the skills of its people and create a system that empowers them. If I could make India slightly fairer, I would consider that a success. We have already been successful in challenging the idea of anger and hatred. Introducing the message of love into the conversation, as we did during the Bharat Jodo Yatra, is a very powerful step. We saw the pressure building on the Prime Minister when he began saying he was 'non-biological.' At that moment, we realised we had defeated him. : Shri Rahul Gandhi 📍Washington DC

I think it’s more than just my vision; it’s the vision of the Indian people. What’s more important is understanding that and bringing it together. I see a huge opportunity for India in rethinking how we produce in the 21st century in a democratic environment. This will involve AI, robotics, drones, and much more. To achieve this, we need to build the necessary infrastructure. This will make India an alternative producer to the Chinese way of doing things. There is enormous energy locked and hidden within the social structure of India. India needs to respect the skills of its people and create a system that empowers them. If I could make India slightly fairer, I would consider that a success. We have already been successful in challenging the idea of anger and hatred. Introducing the message of love into the conversation, as we did during the Bharat Jodo Yatra, is a very powerful step. We saw the pressure building on the Prime Minister when he began saying he was 'non-biological.' At that moment, we realised we had defeated him. : Shri Rahul Gandhi 📍Washington DC

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🇨🇦 Universal health care is a fundamental Canadian value.⚕️ It's what makes Canada stronger. It makes our Canadian economy more competitive. And Canadians live longer than Americans. The case for investing in healthcare is clear. It’s at the core of why we love our country so much. 🍁 📍Premiers’ Meeting

🇨🇦 Universal health care is a fundamental Canadian value.⚕️ It's what makes Canada stronger. It makes our Canadian economy more competitive. And Canadians live longer than Americans. The case for investing in healthcare is clear. It’s at the core of why we love our country so much. 🍁 📍Premiers’ Meeting

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