Indeed which has been fascinating to see. A great example of how broadly applied dichotomous thresholds (Hgb<7 =transfuse) miss nuances.

Certainly if risk profile is lower argument more could benefit is reasonable. Unfortunately donor supply is decreasing www.bbc.com/news/article...

Definitely applies to HFrEF, but I haven’t seen reimbursement tied to HFpEF-specific GDMT. Here’s a summary of current therapies. With cost/access issues around GLP-1 RAs and SGLT2is, curious how implementation will go—most patients unlikely to get both.

Prevalence statistics inform pre-test probability. These numbers are staggering and reflect my anecdotal experience. When considering interventions, Kaiser's PHASE program implements an effective intervention but prevention efforts will be key. www.amjmed.com/article/S000...

6/8 Subscribing to journals like @annalsofim.bsky.social isn't just about accessing articles—it's investing in this entire ecosystem that maintains scientific integrity and advances medical knowledge for better patient care. #ProfessionalDevelopment

Such a privilege to welcome the best in the business, Editor-in-Chief @annalsofim.bsky.social , Dr. Christine Laine to @cuanschutz.bsky.social 🏔️. Looking forward to @cudeptofmedicine.bsky.social Grand Rounds tomorrow!
@marishaburden.bsky.social @cudivhospmed.bsky.social

4/4 My key takeaway and summary slide below: docs and patients stand to benefit from adopting AI. The more optimal results in a more significant percentage speaks to the power of this technology. The adopters will outpace the non-adopters, and it is similar to the steam engine vs hammer analogy.

2/4 Are some of you using AI in patient care? Curious about AI taking the wheel and outperforming physicians in clinical decision-making? is this our John Henry moment in medicine (credit His Hammer in Hand, Hayden 1944)?

8/10 Most CVD outcomes were acute MI and heart failure hospitalization with little difference in mortality (all-cause and CVD-related)

5/10 For those age>70 without CVD, the benefit may still be there to keep them on a statin, especially if tolerating.

3/10 Evidence is limited for effect of substitutes on outcomes but stronger for populations similar to those studied (Asian diets, older adults). Consider salt substitutes for high-risk patients, especially those with difficulty adhering to low-sodium diets

9/ Subcostal 4 + IVC views:
• Confirms A4C findings
• Better shows RA morphology
• IVC size/collapsibility (context clue for R-sided pressures)
• 360° pericardial view

8/ A4C view: McConnell's sign = RV free wall hypokinesis with preserved apical contractility. First reported in 41 pts (19 with acute PE) in 1996 by McConnell et al, of course. Check out the anatomical basis in Torrent-Guasp helical heart model which explains the anatomy behind this!

7/ PSAX: My favorite view in PE! At mid-ventricle level (ID those papillary muscles in the LV), look for:
• Septal flattening (RV pressure overload)
• RV:LV >1:1 (dilation)
• Paradoxical septal motion in systole

5/ 🔍 My systematic POCUS approach: PLAX → PSAX → A4C → Subcostal 4 → IVC (+/- uJVP) Remember: One view is NEVER enough! Even suboptimal images can help, and you will improve your skills with repeated practice.

4/ Diagnostic accuracy breakdown (Chornenki et al):
www.jthjournal.org/article/S153...

3/ CT Findings predictive of RV dysfunction:
Contrast reflux into IVC
RV:LV diameter ratio >1 (blue >red line)
Interventricular septum bowing (seen mid-ventricle)

Here is a reference from @nickmark. If you understand this well, you would have a solid foundation IMO