Pooja S. Jagadish, MD
@PoojaJagadishMD
To be a good cardiologist, one must be a great internist.
Cardiologist & Clinical Educator
🫀@UAZHeart | IM @UTHSC | MD @ETSU
≠ medical advice | ≠ employer's
ID:1508537645017747474
https://www.doximity.com/cv/poojasjagadish-md 28-03-2022 20:13:41
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Neurally Mediated Syncope:
😵Response to Noxious Stimuli, Baroreceptor Activation, Vagal Reflex
🫀Leads to ⬇️HR +/- ⬇️BP
🧠Usually quick reorientation. If prolonged recovery, consider head injury!
🍔Post-Exercise/Postprandial: vascular bed vasodilation
#CVBoardPearl #MedTwitter
There are many causes/classifications of syncope:
🫀Neurally Mediated (Vasovagal, Carotid Sinus, Situational)
🫀Neurogenic Orthostatic (Meds, Dehydration)
🫀Arrhythmic (VT, LQTS)
🫀Structural Cardiac (HCM, Ischemia)
🫀Dire (PE, Ao Dissection)
#CVBoardPearl #MedTwitter
Ref: ACCSAP
An upright systolic blood pressure of 50-60 mmHg at the level of the heart🫀is approximately equal to 30-45 mmHg in the brain 🧠.
This will lead to syncope.
Cerebral hypoperfusion leads to syncope after 6-8 sec.
#CVBoardPearl #MedX #MedTwitter
Ref: ACCSAP
This week's #CVBoardPearl will be on syncope. I post a board-relevant pearl every weekday at 11 AM ET/8 AM PT. Please read along to learn important caveats that can't be squeezed into a post.
#MedTwitter #MedX
Congratulations to all graduating Med Students! Remember to take the next month for yourself. Get rest, exercise, and a plan for your mental health. Intern year will be a new gauntlet. I'll try to help out with a weekday #CVBoardPearl .
#MedTwitter #MedX
The strongest determinant of recurrent peripartum cardiomyopathy is an LVEF < 50% before the subsequent pregnancy.
🤰 Residual LVEF < 50% is associated with a higher risk of recurrent HF, worsening of LVEF, mortality, worse fetal outcomes.
#CVBoardPearl #CardioTwitter #CardioOB
Peripartum Cardiomyopathy is defined as:
🤰NEW onset LVEF<45%
🤰± ventricular dilation
🤰NO reversible causes (dx of exclusion)
🤰Occurs towards the end of pregnancy up to the months following delivery (no longer a specific time before/after delivery)
#CVBoardPearl #CardioTwitter
Updated USPSTF guidelines for #BreastCancer screening.
For most: start biennial screening at age 40. Unclear benefits after 75.
#MedEd #PrimaryCare Primary Care Chat
jamanetwork.com/journals/jama/…
Guys. I’m published! 🥹I’m feeling proud for having pushed thru in unfamiliar waters, and hoping I’ve moved #SouthAsian healthcare forward a bit. American Journal of Medicine SouthAsianHealth South Asian Wellness #SAWAHS #PrimaryCare #DesiTwitter
More work to be done!
amjmed.com/article/S0002-…
Class I Pre-Pregnancy Surgical Indications:
🤰Marfan or nsHTAD + Aortic Root >4.5 cm
🤰Turner + Aortic Size Index ≥2.5 cm/m2
🤰BAV (w/o HTAD) + Aortic Diameter ≥5.0 cm
🤰Sporadic Aortic Root Aneurysm +/- Ascending Aortic Aneurysm + Diameter ≥5.0 cm
#CVBoardPearl #MedTwitter
So proud of my Daughter
✅ Winner of the AHA Teen of Impact
✅She is going to 8 years direct medical school at Tulane AHA Science # AHA
Continue beta-blockers during pregnancy and in the post-partum period in those with syndromic aortophathies (e.g. Marfan, vascular EDS) or nsHTAD (Class I).
- Risk of fetal growth impairment
- Labetalol is preferred
- Avoid CCB, ACEI, ARB
#CVBoardPearl #MedTwitter #CardioOB
Calling all #cardiologists ! ABMS has launched a 90-day open comment period for the proposed new #CVBoard . How will a new pathway to continuous certification improve your #cardiology practice? Submit your comments today! Learn more at CVBoard.org/get-involved/
Starting week #2 of #CardioOB for the #CVBoardPearl .
Join at 11 AM ET/8 AM PT. As always, please read independently to review important caveats! References are in the picture descriptions.
#MedTwitter #MedX #CardioTwitter #CardioX
There are 3 main strategies for anticoagulation in pregnant patients with mechanical valves:
1. Continue warfarin if low-dose (<5 mg/day)
2. Dose-Adjusted LMWH
3. Combination of Warfarin/LMWH
[Ref: Fig 18 from 2020 Valve Guideline]
#CVBoardPearl #MedTwitter #CardioOB