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Not all anterior STEMIs are the same. Always be ready for the unexpected. How would you approach this case? #Cardiotwitter #ACCFIT ⁦Hady Lichaa, MD, FACC, FSCAI, FSVM, RPVI⁩ Douglas Drachman⁩ ⁦Eric Secemsky MD MSc⁩ ⁦Jay Mohan, D.O., FACC, FSCAI, FASE, RPVI⁩ ⁦⁦Jay Giri⁩ ⁦@SahilAgrawalMD⁩

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Vladimir Lakhter

2,088 subscribers

22,719 просмотров • 3 лет назад •via X (Twitter)

Здоровье и велнесНаука и технологии#Cardiotwitter#ACCFIT
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Комментарии: 11

Фото профиля Felix Valencia
Felix Valencia3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Thanks for sharing!

Фото профиля Jay Mohan, D.O., FACC, FSCAI, FASE, RPVI
Jay Mohan, D.O., FACC, FSCAI, FASE, RPVI3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @jaygirimd @SahilAgrawalMD Tricky tricky! Nice save! What guide did you use?

Фото профиля Vladimir Lakhter
Vladimir Lakhter3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @jaygirimd @SahilAgrawalMD JR4 guide as it seemed to favor the LAD. Wiring was fairly simple but afterwards had to use the 6Fr Telescope guide extension to get the rest of the equipment down. I think an AL guide would have done well too

Фото профиля Frank Arena
Frank Arena3 лет назад

@SVRaoMD @HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD You make a good point,but there is more to consider than just anatomy. So many don’t even look at the ventricle or check edp prior to engaging in a complex intervention. Then they act surprised when the patient decompensates. The state of the pump matters.

Фото профиля Umair Khalid
Umair Khalid3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Very tricky case. Only half of the LAD is anomalous that decided to be the culprit for STEMI 😳

Фото профиля Vladimir Lakhter
Vladimir Lakhter3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Not being able to see the occlusion stump of the LAD was very frustrating initially. I didn’t know if it was a flush occlusion due to later presentation. Thankfully the case solved itself during RCA

Фото профиля Eladio Galindo
Eladio Galindo3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Amazing case and better save! Congrats

Фото профиля Timir Paul, MD, PhD, FACC, FSCAI, FAHA
Timir Paul, MD, PhD, FACC, FSCAI, FAHA3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Nicely done

Фото профиля Vladimir Lakhter
Vladimir Lakhter3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Thank you! Don’t think that I would have been able to complete the case without guide extension

Фото профиля Jay Bagai
Jay Bagai3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD One disadvantage of going guide first- without seeing the rca one could waste a lot of time probing the “cap” of the occlusion

Фото профиля Vladimir Lakhter
Vladimir Lakhter3 лет назад

@HadyLichaaMD @DougDrachmanMD @EricSecemskyMD @DrJayMohan @jaygirimd @SahilAgrawalMD Definitely agree and especially in this case. I’m glad we had the universal radial diagnostic Catheter up first.

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Heart Attack Ethiopia, Inc.

12,620 просмотров • 1 год назад

"It's about honesty, the basis is to be honest, even if its not nice for patients....We will cope with this" Eva Schumacher-Wulf Dear Friends, It is with a heavy heart that we learned this weekend that one of our longtime faculty members and dear friends has passed away. Eva Schumacher-Wulf was an exceptional patient advocate, a patient scientist who always contributed to the field, never afraid to challenge the status quo, and a fierce fighter for what was right.I (Gil) first met Eva in San Antonio in 2021, I believe, and that was where I truly saw the impact she was making within the patient advocate community in Europe. She was someone who believed we all deserved to be part of the same Conversations. Fast forward three years, Eva became one of our faculty members for our first in-studio Breast Cancer discussion, produced together with Mirrors of Medicine and she flew to Belgium just to come and record. Alongside our other faculty, she thoughtfully and wisely represented the patient perspective, never making the conversation about herself or what she was personally going through. She believed in the science and in doing what was right for all patients.Eva was always happy to lend her voice to ensure the patient perspective was heard at oncology congresses. She reported live on behalf of OncoAlert at ESMO in 2024, continuing her unwavering commitment to the community.Above all, Eva was a wonderful person—selfless, kind, and deeply principled.I saw Eva one last time at ASCO, where we spoke briefly. As always, I left our conversation saying, "See you at ESMO, and don't forget—we still have to get together in San Antonio." Had I known that would be the last time we would speak, our conversation would have been very different.We will always miss Eva, and our hearts go out to her family, friends, and everyone whose lives she touched. Gil FabriceAndre Hope Rugo Javier Cortes MD PhD Roberta A Albany Jame Abraham, MD, FACP Matteo Lambertini, MD PhD Erika Hamilton, MD, FASCO Stephanie Graff, MD, FACP, FASCO Philippe Aftimos, MD  Giampaolo Bianchini Elisa Agostinetto G Curigliano MD PhD Icro Meattini Sara Tolaney Maryam Lustberg MD, MPH, FASCO Sherene Loi, MD Dr. Kelly Shanahan Elisabetta Bonzano MD, PhD Rebecca Dent Double Whammy Julia Maués Stacey Tinianov (she/her) MPH, BCPA Jose Fernando Moura, PhD Janice Cowden Tanja Spanic Christine Hodgdon Dr. Kelly Shanahan Nadia Harbeck,MD PhD Eva Schumacher-Wulf Evandro de Azambuja, MD, PhD
0:49

"It's about honesty, the basis is to be honest, even if its not nice for patients....We will cope with this" Eva Schumacher-Wulf Dear Friends, It is with a heavy heart that we learned this weekend that one of our longtime faculty members and dear friends has passed away. Eva Schumacher-Wulf was an exceptional patient advocate, a patient scientist who always contributed to the field, never afraid to challenge the status quo, and a fierce fighter for what was right.I (Gil) first met Eva in San Antonio in 2021, I believe, and that was where I truly saw the impact she was making within the patient advocate community in Europe. She was someone who believed we all deserved to be part of the same Conversations. Fast forward three years, Eva became one of our faculty members for our first in-studio Breast Cancer discussion, produced together with Mirrors of Medicine and she flew to Belgium just to come and record. Alongside our other faculty, she thoughtfully and wisely represented the patient perspective, never making the conversation about herself or what she was personally going through. She believed in the science and in doing what was right for all patients.Eva was always happy to lend her voice to ensure the patient perspective was heard at oncology congresses. She reported live on behalf of OncoAlert at ESMO in 2024, continuing her unwavering commitment to the community.Above all, Eva was a wonderful person—selfless, kind, and deeply principled.I saw Eva one last time at ASCO, where we spoke briefly. As always, I left our conversation saying, "See you at ESMO, and don't forget—we still have to get together in San Antonio." Had I known that would be the last time we would speak, our conversation would have been very different.We will always miss Eva, and our hearts go out to her family, friends, and everyone whose lives she touched. Gil FabriceAndre Hope Rugo Javier Cortes MD PhD Roberta A Albany Jame Abraham, MD, FACP Matteo Lambertini, MD PhD Erika Hamilton, MD, FASCO Stephanie Graff, MD, FACP, FASCO Philippe Aftimos, MD  Giampaolo Bianchini Elisa Agostinetto G Curigliano MD PhD Icro Meattini Sara Tolaney Maryam Lustberg MD, MPH, FASCO Sherene Loi, MD Dr. Kelly Shanahan Elisabetta Bonzano MD, PhD Rebecca Dent Double Whammy Julia Maués Stacey Tinianov (she/her) MPH, BCPA Jose Fernando Moura, PhD Janice Cowden Tanja Spanic Christine Hodgdon Dr. Kelly Shanahan Nadia Harbeck,MD PhD Eva Schumacher-Wulf Evandro de Azambuja, MD, PhD

OncoAlert

16,259 просмотров • 2 месяцев назад

Sunny Hostin now walks back her previous defense of the Cornell 7. She says that if this was in D.C. when she was still a federal prosecutor she would take the case, and blames New York's intoxication law for it not being tackled sooner: "I always look at this as a former sex crimes prosecutor. In D.C. this case would have gone to trial. I would have prosecuted this case like I prosecuted a lot of sex crimes. The problem is the New York law. And this is a morally repugnant case. It is grotesque when you read the details, Ana, you are right. I feel terrible about how this happened, why do these kids -- why do they have ketamine? Why are they -- why is there no upstanding -- an upstander. You know, you want that. The young man to go upstairs and say, 'shut this down. What is going on?' You want more people to do that. But New York makes it incredibly impossible to prosecute a case like this. You would have to be unconscious or involuntarily drugged like slipped a drug in order to charge this case and that is why it wasn't charged in 2024. And I will tell you there are 19 other states that have this same law. 19 other states."
1:09

Sunny Hostin now walks back her previous defense of the Cornell 7. She says that if this was in D.C. when she was still a federal prosecutor she would take the case, and blames New York's intoxication law for it not being tackled sooner: "I always look at this as a former sex crimes prosecutor. In D.C. this case would have gone to trial. I would have prosecuted this case like I prosecuted a lot of sex crimes. The problem is the New York law. And this is a morally repugnant case. It is grotesque when you read the details, Ana, you are right. I feel terrible about how this happened, why do these kids -- why do they have ketamine? Why are they -- why is there no upstanding -- an upstander. You know, you want that. The young man to go upstairs and say, 'shut this down. What is going on?' You want more people to do that. But New York makes it incredibly impossible to prosecute a case like this. You would have to be unconscious or involuntarily drugged like slipped a drug in order to charge this case and that is why it wasn't charged in 2024. And I will tell you there are 19 other states that have this same law. 19 other states."

Nicholas Fondacaro

140,423 просмотров • 1 день назад

Last night it all became too much for me seeing Damien O'Connor triggered all the pain from my son's injury and seeing him laugh about the facts being pointed out by Sue Grey , that this government knew people would be hurt and me knowing what so many are going through was all just too much for me, I could not stay in the same room . When I saw him laugh, someone I once called a friend, it triggered an immense outflowing of grief in me. I knew everyone in this gov really has no heart for the lives they have taken, via the vaccine and the gross injuries caused to our people . Sometimes you just can't be strong all the time! Peter A. McCullough, MD, MPH® Coronavirus Plushie NZ and the MRNA NZDSOS - NZ Doctors Speaking Out with Science Brian Tamaki Hannah Tamaki #novoteforthe5intheHive #vaccineinjury
3:17

Last night it all became too much for me seeing Damien O'Connor triggered all the pain from my son's injury and seeing him laugh about the facts being pointed out by Sue Grey , that this government knew people would be hurt and me knowing what so many are going through was all just too much for me, I could not stay in the same room . When I saw him laugh, someone I once called a friend, it triggered an immense outflowing of grief in me. I knew everyone in this gov really has no heart for the lives they have taken, via the vaccine and the gross injuries caused to our people . Sometimes you just can't be strong all the time! Peter A. McCullough, MD, MPH® Coronavirus Plushie NZ and the MRNA NZDSOS - NZ Doctors Speaking Out with Science Brian Tamaki Hannah Tamaki #novoteforthe5intheHive #vaccineinjury

Aly Cook

38,983 просмотров • 3 лет назад

A young couple throws a gender reveal party for the guy’s parents. They pop the cannon… blue AND pink confetti explodes everywhere. Mom immediately starts screaming “Oh my god, twins!!” thinking they’re having boy-girl twins. Then the man’s other girlfriend steps forward and calmly says… “I’m pregnant too.” The mom, completely stunned, looks at her son and blurts out: “You didn’t double dip, Toby?!” Turns out they’re a full throuple. Both women are pregnant by the same man at the same time. They all live together, sleep together, and do everything as a trio. You can hear the shock and unhappiness in her voice as it all sinks in 😭 She was NOT ready for that plot twist. Modern family announcements are something else. Be honest — how would YOU react if your son dropped this on you at a gender reveal?
1:38

A young couple throws a gender reveal party for the guy’s parents. They pop the cannon… blue AND pink confetti explodes everywhere. Mom immediately starts screaming “Oh my god, twins!!” thinking they’re having boy-girl twins. Then the man’s other girlfriend steps forward and calmly says… “I’m pregnant too.” The mom, completely stunned, looks at her son and blurts out: “You didn’t double dip, Toby?!” Turns out they’re a full throuple. Both women are pregnant by the same man at the same time. They all live together, sleep together, and do everything as a trio. You can hear the shock and unhappiness in her voice as it all sinks in 😭 She was NOT ready for that plot twist. Modern family announcements are something else. Be honest — how would YOU react if your son dropped this on you at a gender reveal?

End3of6Days9 (Helen) 🇺🇸

159,559 просмотров • 6 месяцев назад

Jon, Before we get to the math on the charge dimensions you just described, and how they are missing 12+% of the explosives you claim went off, we are going to talk about why you keep changing things up. 24 hours ago, you claimed the 0.5 gram "would be a 10mm x 15mm charge" (see first video)! 12 hours later, you claimed the charge was 7.0 mm x 7.34 mm (shocking, I know). Of course, this was after I pointed out how absurdly too large that would be for 0.5 grams of PETN. The problem you can not change Since you changed the charge size in your response, I figured I would point out the obvious gaslighting to the world. 1st, as previously noted, the optimum standoff distance is 1.5x the diameter of the cone. In the case of the last dimensions you provided, the standoff distance would be about 11 mm, which you factored into your devices overall size. So this is my question for you Jon (and all of your wisdom). With the expected penetration (EP) only 1/2 the diameter of the cone, why is it positioned so far back in the device in your diagram? Someone who built such a sophisticated charge would certainly be able to rearrange the internals to give it a snowballs chance in hell of actually working, right? Even with 3x the distance of the EP away from the end of the device dimension you provided, the theoretical jet would be extremely dissipated and STILL INSIDE THE MIC! By the time it leaves the device and hits the air outside, it would be almost totally, if not completely dissipated. So, why would you place it so far back if you ACTUALLY KNEW how this charge worked? Simply put, the explosive charge properly placed int he device wouldn't need a built in standoff. New Dimensions Are Still 12% Cubic Inches Short For 0.5 grams of PETN In your attempt to correct yourself before being further exposed, you forgot to take into account the empty space of the cone leaving you 12% worth of explosives short for a 0.05 gram charge. That is very significant, especially for a charge this size. See graph paper image with all the math. SUMMARY 1. You changed the charge dimensions in the same day 10mm x 15mm -> 7.34 mm x 7.0 mm 2. Second set of charge dimensions you gave yesterday are 12% shy for 0.5 grams of PETN. 3. At 3x max optimal distance for EP of 3.7 mm, you are still inside the mic and the jet would be worthless by the time it exited. 4. Charge placement and why you decided it needed an internal standoff to begin with. All of these point to one thing. You continue to pull this out your butt. Thank you for your attention on this matter.
0:28

Jon, Before we get to the math on the charge dimensions you just described, and how they are missing 12+% of the explosives you claim went off, we are going to talk about why you keep changing things up. 24 hours ago, you claimed the 0.5 gram "would be a 10mm x 15mm charge" (see first video)! 12 hours later, you claimed the charge was 7.0 mm x 7.34 mm (shocking, I know). Of course, this was after I pointed out how absurdly too large that would be for 0.5 grams of PETN. The problem you can not change Since you changed the charge size in your response, I figured I would point out the obvious gaslighting to the world. 1st, as previously noted, the optimum standoff distance is 1.5x the diameter of the cone. In the case of the last dimensions you provided, the standoff distance would be about 11 mm, which you factored into your devices overall size. So this is my question for you Jon (and all of your wisdom). With the expected penetration (EP) only 1/2 the diameter of the cone, why is it positioned so far back in the device in your diagram? Someone who built such a sophisticated charge would certainly be able to rearrange the internals to give it a snowballs chance in hell of actually working, right? Even with 3x the distance of the EP away from the end of the device dimension you provided, the theoretical jet would be extremely dissipated and STILL INSIDE THE MIC! By the time it leaves the device and hits the air outside, it would be almost totally, if not completely dissipated. So, why would you place it so far back if you ACTUALLY KNEW how this charge worked? Simply put, the explosive charge properly placed int he device wouldn't need a built in standoff. New Dimensions Are Still 12% Cubic Inches Short For 0.5 grams of PETN In your attempt to correct yourself before being further exposed, you forgot to take into account the empty space of the cone leaving you 12% worth of explosives short for a 0.05 gram charge. That is very significant, especially for a charge this size. See graph paper image with all the math. SUMMARY 1. You changed the charge dimensions in the same day 10mm x 15mm -> 7.34 mm x 7.0 mm 2. Second set of charge dimensions you gave yesterday are 12% shy for 0.5 grams of PETN. 3. At 3x max optimal distance for EP of 3.7 mm, you are still inside the mic and the jet would be worthless by the time it exited. 4. Charge placement and why you decided it needed an internal standoff to begin with. All of these point to one thing. You continue to pull this out your butt. Thank you for your attention on this matter.

Matt Tardio

35,788 просмотров • 3 месяцев назад

Nowadays, it is hard to surprise me with anything in real life, let alone on social media. But what still continues to surprise me, to one degree or another, are the comments on my posts where I show and describe the situation in the cities of my country. No matter how hard some try to insult Ukraine and my people, all these individuals are hiding behind their own cowardice and the realization that they themselves would lack the strength and mental fortitude to walk this path from beginning to end. Writing negative and aggressive comments is the 'ceiling' - the absolute limit for russians and their followers scattered across the globe. Spirit is tempered in battle: for soldiers, it happens on the battlefield; for the civilians of Ukraine, it happens in the struggle against cold and the hardships of daily life. You either become strong or this world devours you - these are the laws that will always be with us. The main thing to remember is that Ukrainians are ready for almost anything because we have vast experience in overcoming adversity. We will be happy to live a peaceful life, but we are always prepared for any challenges that may arise. But are those same people who spew their hatred here ready for such challenges? Of course NOT! If anything similar happened to them, they would tuck their tails and eat out of Putin’s hand.
0:54

Nowadays, it is hard to surprise me with anything in real life, let alone on social media. But what still continues to surprise me, to one degree or another, are the comments on my posts where I show and describe the situation in the cities of my country. No matter how hard some try to insult Ukraine and my people, all these individuals are hiding behind their own cowardice and the realization that they themselves would lack the strength and mental fortitude to walk this path from beginning to end. Writing negative and aggressive comments is the 'ceiling' - the absolute limit for russians and their followers scattered across the globe. Spirit is tempered in battle: for soldiers, it happens on the battlefield; for the civilians of Ukraine, it happens in the struggle against cold and the hardships of daily life. You either become strong or this world devours you - these are the laws that will always be with us. The main thing to remember is that Ukrainians are ready for almost anything because we have vast experience in overcoming adversity. We will be happy to live a peaceful life, but we are always prepared for any challenges that may arise. But are those same people who spew their hatred here ready for such challenges? Of course NOT! If anything similar happened to them, they would tuck their tails and eat out of Putin’s hand.

Katerina Horbunova

16,638 просмотров • 8 месяцев назад

Russian political analysts claim that Estonia and Latvia do not exist — that they are invented territories and that this is how children should be taught. He says that if you want Russians not to ask the question “Why did we attack Ukraine?”, then from childhood they must be taught that none of the countries Russia plans to attack actually exist. The existence of these countries is simply a historical misunderstanding. And only then will a generation grow up that will “return historical territories.” This is the kind of nonsense we have been listening to all this time. I always understood that there would be war. The only ones who did not understand this were politicians, who often even played along with this propaganda. And Russia’s policy has always been like this. It did not start in 2022, it did not start in 2014 — I saw similar videos when I was a student long before the war, and even when I was in school. Do you think they are saying this into empty space? This is how the opinion of Russians is shaped. And in the second part of the video you can see what ordinary Russians think — they wish for total destruction, for the killing of everyone, not only Ukrainians but also, for example, the German people, the British, and others. And it is not only ordinary Russians saying this, but also the Russian elite on state television channels. And then we see Russians at international sports competitions, at the UN, and on theater stages in the very same countries they dream of destroying — and often they are the very same Russians who made these statements. And only Ukraine pays attention to this, raises the issue, protests.
2:48

Russian political analysts claim that Estonia and Latvia do not exist — that they are invented territories and that this is how children should be taught. He says that if you want Russians not to ask the question “Why did we attack Ukraine?”, then from childhood they must be taught that none of the countries Russia plans to attack actually exist. The existence of these countries is simply a historical misunderstanding. And only then will a generation grow up that will “return historical territories.” This is the kind of nonsense we have been listening to all this time. I always understood that there would be war. The only ones who did not understand this were politicians, who often even played along with this propaganda. And Russia’s policy has always been like this. It did not start in 2022, it did not start in 2014 — I saw similar videos when I was a student long before the war, and even when I was in school. Do you think they are saying this into empty space? This is how the opinion of Russians is shaped. And in the second part of the video you can see what ordinary Russians think — they wish for total destruction, for the killing of everyone, not only Ukrainians but also, for example, the German people, the British, and others. And it is not only ordinary Russians saying this, but also the Russian elite on state television channels. And then we see Russians at international sports competitions, at the UN, and on theater stages in the very same countries they dream of destroying — and often they are the very same Russians who made these statements. And only Ukraine pays attention to this, raises the issue, protests.

Devana 🇺🇦

13,603 просмотров • 7 месяцев назад