Cardiology-Dr.AsifUllah

07/01/2026

Finerenone 💊 seems to have better outcomes compared to spironolactone in patients with chronic kidney disease (CKD) and type 2 diabetes 🩺.

Key findings:
- 🔍 Finerenone reduces mortality risk by 69% (aHR, 0.31; 95% CI, 0.21–0.45)
- ❤️ Lower risk of major adverse cardiac events (MACE ⬇️) with finerenone (aHR, 0.74; 95% CI, 0.58–0.94)
- ⬇️ Reduced risk of major adverse kidney events (MAKE) with finerenone (aHR, 0.47; 95% CI, 0.33–0.67)
- ⬇️Lower incidence of hyperkalemia with finerenone (17.2% vs 26.4%, P < 0.001)

06/01/2026

😔 Heart Failure Study: VICTOR Trial
Vericiguat reduces mortality in HFrEF patients 💊
- Cardiovascular death ↓ 16% (HR 0.84)
- All-cause mortality ↓ 25% (HR 0.75)
- Sudden cardiac death ↓ 29% (HR 0.71)
- HF-related death ↓ (HR 0.83)

Key findings:
- Significant reductions in mortality with vericiguat vs placebo
- Benefits seen across subgroups and baseline therapies
- Median follow-up: 19.7 months
- Vericiguat target dose: 10mg QD

💡 Vericiguat shows promise in reducing cardiovascular and all-cause mortality in HFrEF patients. If you're looking for more information, you might find it helpful to search online for the latest research on vericiguat and heart failure treatment.

05/01/2026

🤒 Respiratory Infections & Your Heart ❤️
Protect your heart from COVID-19, flu, and RSV with these 5 tips:
1️⃣ VACCINATED! Get vaccinated:
- Flu shot (before October)
- RSV vaccine (75+ or 50-74 with heart disease)
- Latest COVID vaccine
2️⃣ Steer clear of germs 🦠:
- Cover coughs/sneezes
- Wash hands frequently
- Avoid sick contacts
- Wear a mask
3️⃣ Report symptoms 🤕:
- Tell your doctor ASAP if you have flu- or COVID-like symptoms
- Medicines can help if started early
4️⃣ Take heart meds as directed 💊:
- Let your care team know if you need help accessing/payments
5️⃣ Boost your immunity 💪:
- Stay active 🏋️‍♀️
- Get good nutrition 🥗
- Quality sleep 😴
- Lower stress 🙏

05/01/2026

Excited to share that I just got recognised as one of JAMA Cardiology's top fans! 🎉

31/12/2025

Excited to share that I just got recognised as one of JAMA Internal Medicine's top fans! 🎉

21/12/2025

KmU job fair 2025

18/12/2025

18/12/2025

🔍 Key Points:
- Prediabetes is a disease with systemic consequences, increasing risk of CVD, CKD, dementia, and certain cancers 💔🧠
- Staging helps detect progression early and personalize interventions 🔍

Clinical Pearls:
1️⃣ Stage 1 (Normal Glycaemia ≠ No Risk): FPG

15/12/2025

🚨 Cardiogenic Shock: Vasopressor Management 🚨

Target MAP: 60-65 mmHg 💡

*First-Line Agent:*
🔥 Norepinephrine 🔥
- Dose: 8mg in 42mL D5 or NS (50mL total)
- Start: 0.05mcg/kg/min (1-2mL/hr)
- Titrate: up to 20mL/hr
- 💔 Arrhythmias, tachycardia ⚠️

*Alternative/Adjunct Agents:*
🐈 Dopamine 🐈
- Dose: 2-5mcg/kg/min (2.5mL/hr)
- Titrate: up to 20mL/hr
- 💔 Arrhythmias, tachycardia ⚠️

💪 Dobutamine 💪
- Add to norepinephrine if BP 70mmHg
- Initial: 0.5-1mcg/kg/min (0.36-0.72mL/hr)
- Maintenance: 2-20mcg/kg/min (1.4-14.4mL/hr)
- 💔 Tachyarrhythmias ⚠️

🔥 Adrenaline 🔥
- Add-on for refractory hypotension/bradyarrhythmias
- Dose: 9mg in 41mL D/NS (50mL total)
- Start: 1-2mL/hr, titrate up to 20mL/hr
- 💔 Tachyarrhythmias, increased lactate ⚠️

💊 Levosimendan 💊
- Use when BP >90mmHg systolic
- Dilute 12.5mg in 50mL D5, add to 500mL D5
- Infuse at 2-10mL/hr
- 💔 Arrhythmias ⚠️

💧 Vasopressin 💧
- Next choice
- Dose: 0.03 units/min
- Dilution: 40 units in 39mL NS
- Start: 1.2mL/hr (0.02 units/min), increase to 2.4mL/hr (0.04 units/min)

🚨 Avoid Beta Blockers in Cardiogenic Shock 🚨

🫀 Cardiogenic Shock Pathophysiology:
↓ Cardiac Output
↑ PCWP
↑ CVP/RAP
↓ Blood Pressure
↑ Systemic Vascular Resistance

14/12/2025

📚 Platypnea-Orthodeoxia Syndrome (POS) 📚

🤔 Characterized by:
- Dyspnea & hypoxemia in upright position 🛋️
- Resolves when lying supine 🛏️

Causes of POS:
- Intracardiac shunt (PFO, ASD, Atrial septal aneurysm) ❤️
- Pulmonary conditions with V/Q mismatch:
- Interstitial lung disease 🫁
- Pulmonary AV malformation → Hepatopulmonary syndrome 🫀

🔍 Diagnosis:
- Agitated saline (bubble) study 💧
- Perform in supine & upright positions 🛋️➡️🚶‍♂️

💡 Next best step: Agitated saline Echo 💡
- Most cost-effective, non-invasive diagnostic study 💸

💊 Treatment:
- Closure of defect provides relief of symptoms 💉
- PFO closure in patients with POS due to interatrial shunt without pulmonary hypertension

11/12/2025

Cardiorenal Syndrome Decongestion Strategies 💉💧

1. Guideline-Directed Medical Therapy (GDMT) 🩺
- Check diuresis adequacy: urine sodium, output, and diuretic dose 🌊
- Assess renal function and adjust diuretics accordingly 🤝

2. Worsening Renal Function? 🤔
- Diuretic-sensitive: continue diuresis 📈
- Diuretic-resistant: reassess volume status, consider right heart catheterization 📊

3. Volume Status Assessment 📈
- Normal filling pressures: diuretic holiday, switch to oral diuretics 💊
- Elevated filling pressures: combination diuretic therapy, ultrafiltration 💉

4. Screen for Precipitating Factors 🔍
- Barriers to GDMT, dietary indiscretions, intercurrent illness

5. Imaging Modalics 🖼️
- POCUS, VEXUS, echocardiography to evaluate cardiac function and pressures

6. Improve Cardiac Output 💪
- Address ischemia, arrhythmias, valvopathy, and optimize heart rate
- Consider inotropes, mechanical support, and pulmonary vasodilators

11/12/2025

💡 High-output heart failure risk is a concern when Hb < 5 g/dL.
Severe anemia can lead to increased cardiac output, potentially causing heart failure ⚠️.
Transfusion may be necessary to reduce this risk 💉.