viveyanne
@nurseviveyanneAdvanced HF NP🫀⚙️| broadway enthusiast | NYC explorer
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@nptala
To junior trainees that manage patients with MCS: whenever you have difficulty understanding what the MCS does, break it down to its basics: where does it draw blood from, where does it pump the blood to. It will simplify the physiology
“MRSA NARES NEGATIVE CAN WE D/C”
🚨BREAKING NEWS 🚨 PPIs will not prevent a bleed in a location without proton pumps
Low dose furosemide in congestive heart failure #heartfaliure #diuretics #medicaleducation
CC: Found down HPI: 40ish year old male with no known PMH presents via EMS after being found down. Here’s a bunch of labs and vitals cause we gotta write something here.
New data just presented at ESC, 5 year outcomes from MOMENTUM-3. The HeartMate 3 is an excellent long-term therapy for patients living with end-stage HF with ~ 60% survival at 5 years @MRMehraMD @shelleyhallmd @preventfailure
I now routinely work to start SGLT2i and MRA simultaneously for patients with heart failure. Ejection fraction independent. These are complementary therapies with solid evidence for all patients with heart failure. Using them together helps mitigate hyperkalemia risk.
There is rarely as good a feeling as starting an SGLT2 inhibitor in a patient with advanced cardiomyopathy and seeing their dyspnea resolve, edema improve, and plans to move into an assisted living facility cancelled. #GDMTworks
As much as I enjoyed pharmacists being referenced several times in this HF update, principle 3 is my favorite by far: "Start GDMT immediately. Delayed initiation of GDMT is associated with never initiating GDMT." Fantastic verbiage. #GDMTworks
The following are 16 key points to remember from the 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: bit.ly/39oYpxo #HFrEF
The prettiest summary of HF clinical trials 🫀😍 #GDMTworks #CardioTwitter @accpcardprn jacc.org/doi/epdf/10.10…
#TipsForNewDocs Volume status and ejection fraction are independent. A pt can have an EF 20% and still be dry requiring IVF. Examine and treat the patient, not the EF. #kittlesonrules
Me: “Hi Sir, what brings you to the ER?” Patient: “I feel fine, but my wife made me come in.” Me: … Patient: … Me: *places defibrillator pads on his chest*
When I was a fellow training in the ICU to care for critically ill patients with heart failure, LVAD, transolant… …there was this nurse named “Sue” (pseudonym) who knew how to get the patients through the night… Most units have a “Sue”… Find him/her and pull up a chair.
Heart failure cardiologist watching people stop spironolactone for… K of 4.5 twitter.com/FredSchultz35/…
If a comfort care patient is not comfortable, that is medical emergency.
Impostor syndrome: “I don't know what I'm doing. It's only a matter of time until everyone finds out." Growth mindset: "I don't know what I'm doing yet. It's only a matter of time until I figure it out." The highest form of self-confidence is believing in your ability to learn.
Pleased to share our paper looking at the impact of transitioning patients to oral diuretics for >/=24h prior to d/c, published this week @IJCardio It did not improve outcomes! Thanks to Barry Greenberg for the opportunity & mentorship! #cardiology #heartfailure #Cardiotwitter
In a family meeting, I'm trying to be direct/honest in answering questions. Sometimes this may sound blunt/harsh and upsets the family. Not trying to be mean, but I still think it's better to be direct/honest (rather than indirect/vague), and I will teach so to my trainees.
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