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Former Dutch colleague informed me of first Dutch COVIDー19 case in “Noord-Brabant” tested positive around 21:30. Visited northern Italy 1 week ago apparently.
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Gezien de onwaarschijnlijk lange incubatietijd en het symptoomloze dragerschap heeft het COVIDー19 virus NL al geruime tijd bereikt. Gezien het ideale carnaval/(overdacht) feest zal de echte epidemie in NL pas over 2-3 weken plaatsvinden.
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Incredible how many different presentations I come across in daily practice.
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I had a male pt today, 38 y/o with a nonstop back pain with chest pressure for 6 months. Even while resting. Normal resting ECG, normal trops, normal Gxt without any ischemia. MPS: slightly abnormal. CAG: 90% blockage Rcx. 85% blockage Ramus Intermedius. radialfirst epeeps
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3 m ago I saw a 34 y/o male (RF: HTN + 🚬) complaining of CP (more on his ➡ side of sternum). CCTA: 50-70% lesion RCa. Pt on OMT. Now complaining of: same CP accompanied by new onset of back- both arm and stomach pain related to exertion. Cardiac related? radialfirst epeeps
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In the era of CCTA and MRI. Do you still use Gxt in your practice to determine ischemia in suspected CAD patients? radialfirst echofirst epeeps
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Hi Cardiotwitter, What’s the first presentation of CAD in patients > 30 - < 40 y/o in your practice? RadialFirst echofirst Epeeps
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Which type of Angina do most of your younger < 45 y/o CAD patients describe? I am curious. RadialFirst epeeps cardiotwitter FOAMed
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4/- Despite the (private) positive treadmill test, his cardiologist writes he has no evidence for significant cardiac pathology. Mainly due to the normal CCTA April 2019. What are you thoughts? Would you do any more testing? Reassurance? foamed cardiotwitter radialfirst
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3/4: Early quitting due to chest pain. Pt. has cardiac anxiety due to his arrhythmia’s with psychological help. Pt. Demanding a S/O. (...)
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2/3: - October 2018: normal ECG treadmill stresstest. No PVCs, nsvt and ST-⬇. - April 2019: normal CCTA w/ CaC = 0. - October 2019: pt ordered a private clinic Treadmill test. Result: 1.0 m ST-⬇ in lead I + V4-V6. PVCs and bigimeny. 50% of target wattage. (...)
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[THREAD + POLL] cardiotwitter, Back to work: on call. 31 y/🧑🦲. Radiating CP while 🚘. Then 🚑 ECG ST-⬇ inferior leads. CtN-T after 6/8 hours 16 ng/L (cut off 14 ng/L) ECG in 🏨 all normal. [1/2] RadialFirst echofirst FOAMed
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Hi Cardiotwitter, What’s the first presentation of CAD in patients > 30 - < 40 y/o in your practice? RadialFirst echofirst
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Maybe any experience with this kind of cases? DavidLBrownMD
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Pictures will follow.
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2/- Any experiences? RadialFirst cardiotwitter echofirst
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