Dr Usama Fahad -Cardiologist

Dr Usama Fahad -Cardiologist Cardiologist, fixing rhythms , saving lives , spreading smiles �

Dr. Usama FahadMBBS (KMU) | MCPS (Medicine) | FCPS-II (Cardiology) | CHR (KMU)Ex-Junior Registrar, Cardiology – LRH | Go...
27/02/2026

Dr. Usama Fahad

MBBS (KMU) | MCPS (Medicine) | FCPS-II (Cardiology) | CHR (KMU)
Ex-Junior Registrar, Cardiology – LRH | Gold Medalist
Demonstrator Gajju khan medical college

🫀 Our Cardiology Services / ہماری خدمات

• ✅ Heart Attack – ہارٹ اٹیک کی فوری تشخیص اور علاج
• ✅ Coronary Artery Disease – دل کی رگوں کی بیماریاں
• ✅ Heart Failure Management – دل کی کمزوری / ہارٹ فیلیر
• ✅ Arrhythmia & ECG – دل کی دھڑکن کے مسائل
• ✅ Echocardiography with Doppler – ایکو کارڈیوگرافی اور ڈوپلر اسٹڈی
• ✅ Valvular Heart Diseases – دل کے والو کی بیماریاں
• ✅ Hypertension & Cholesterol Management – بلڈ پریشر اور کولیسٹرول کا علاج
• ✅ Diabetes & Heart Diseases – شوگر اور دل کی بیماریوں کا خصوصی علاج
• ✅ Congenital Heart Diseases – بچوں اور بڑوں میں پیدائشی دل کی بیماریاں
• ✅ Preventive Cardiology – پریوینٹو کارڈیالوجی (Diet, Lifestyle & Risk Control)

📅 Monday – Friday
🕑 02:00 PM – 05:00 PM
🏥 Jamal Medical Center swabi
📞 +92 323 5279388

📅 Saturday – Sunday
🕛 12:00 PM – 05:00 PM
🏥 Al Jannat Hospital and Infertility Center swabi
📞 +92 314 9299625

🫀 INOCA – Invasive TestingKey Tests:• Coronary Angiography – rule out obstructive CAD• Coronary Flow Reserve (CFR) – ass...
28/12/2025

🫀 INOCA – Invasive Testing

Key Tests:
• Coronary Angiography – rule out obstructive CAD
• Coronary Flow Reserve (CFR) – assess microvascular function
• Index of Microcirculatory Resistance (IMR) – quantify microvascular resistance
• Acetylcholine / Ergonovine Provocation – detect coronary spasm

Take-home:
Invasive testing is more comprehensive and can diagnose microvascular dysfunction or vasospasm in INOCA.

🫀 STEMI With Fibrinolytic Therapy – Timing of Angiography (AHA)⏱ **Immediate (Rescue PCI)** • Ongoing ischemic chest pa...
27/12/2025

🫀 STEMI With Fibrinolytic Therapy – Timing of Angiography (AHA)

⏱ **Immediate (Rescue PCI)**
• Ongoing ischemic chest pain
•

🫀 Prosthetic Valve Assessment TTE: Gradients, valve type, regurgitationTEE: Thrombus, pannus, paravalvular leakFluorosco...
26/12/2025

🫀 Prosthetic Valve Assessment

TTE: Gradients, valve type, regurgitation
TEE: Thrombus, pannus, paravalvular leak
Fluoroscopy: Mechanical valve motion
CT: Pannus, thrombosis, structure
CMR: Flow quantification (limited)

Tip: Rising gradient ≠ obstruction until proven

🫀 Role of ECG in LVH • Screening tool: Detects electrical changes caused by LVH • ECG Clues: High QRS voltages (Sokolow-...
25/12/2025

🫀 Role of ECG in LVH

• Screening tool: Detects electrical changes caused by LVH

• ECG Clues:
High QRS voltages (Sokolow-Lyon, Cornell)
ST-T strain pattern
Left axis deviation

Limitation: Specific but not very sensitive → echo is gold standard

💡 ECG helps suspect LVH, echo confirms structural hypertrophy

Primary ASCVD prevention focuses on lifestyle optimization and risk-based statin therapy to prevent the first cardiovasc...
25/12/2025

Primary ASCVD prevention focuses on lifestyle optimization and risk-based statin therapy to prevent the first cardiovascular event — AHA

❤️

STEMI (Non-IRA):• Complete revascularization is recommended for hemodynamically stable patients. • Timing: during index...
25/12/2025

STEMI (Non-IRA):
• Complete revascularization is recommended for hemodynamically stable patients.
• Timing: during index hospitalization or staged.
• Guidance: angiography ± FFR/iFR.

NSTEMI (Non-Culprit):
• Individualized approach.
• High-risk → consider complete revascularization.
• Low-risk → optimize medical therapy, staged PCI if needed.

Take-home:
STEMI: favor complete revascularization.
NSTEMI: guided by risk, ischemia, and anatomy.

SGLT2 inhibitors and ADHF When to Start: Once the patient is hemodynamically stable & euvolemic, ideally before discharg...
24/12/2025

SGLT2 inhibitors and ADHF


When to Start: Once the patient is hemodynamically stable & euvolemic, ideally before discharge.

Who: For both HFrEF & HFpEF, applicable to diabetic and non-diabetic patients.

Dose: Dapagliflozin 10 mg daily or Empagliflozin 10 mg daily.

Precautions: Avoid use if hypotensive, hypovolemic, or in shock; it's essential to monitor renal function & BP.

Benefit: Helps reduce rehospitalization rates and improve mortality.

🫀 Apical Rocking • Swaying motion of the LV apex during systole. • A key indicator of mechanical dyssynchrony. • Help...
23/12/2025

🫀 Apical Rocking
• Swaying motion of the LV apex during systole.
• A key indicator of mechanical dyssynchrony.
• Helps predict CRT response, especially in LBBB cases.
• Can be observed through echocardiography (apical views).

💡 Tip: Combining apical rocking with a septal flash may enhance CRT prediction.

🔥 ESC – HMOD (Hypertension-Mediated Organ Damage)🔹 What is HMOD?Organ damage caused by long-standing high BP — even befo...
15/12/2025

🔥 ESC – HMOD (Hypertension-Mediated Organ Damage)

🔹 What is HMOD?
Organ damage caused by long-standing high BP — even before symptoms.

✅ Major HMOD Targets (ESC):

❤️ Heart
• LVH
• LV diastolic dysfunction
• CAD / HF

🧠 Brain
• Stroke
• TIA
• Cognitive decline

🩸 Kidneys
• ↓ eGFR
• ↑ Creatinine
• Albuminuria

🩺 Vessels
• Carotid IMT ↑
• Plaques
• Aortic stiffness (↑ PWV)

👁️ Eyes (Retina)
• Hypertensive retinopathy
• Cotton wool spots, hemorrhages

⸻

🎯 Why HMOD Matters?

• Higher CV risk
• Stronger indication for intensive BP control
• Guides treatment decisions (ESC)

🩸 Acute Bleeding on DOACs | AHA Tips 🫀💊 Minor Bleeding: • Hold next DOAC dose • Local measures (pressure, ice, topical a...
14/12/2025

🩸 Acute Bleeding on DOACs | AHA Tips 🫀

💊 Minor Bleeding:
• Hold next DOAC dose
• Local measures (pressure, ice, topical agents)
• Monitor closely

🚨 Major/Life-Threatening Bleeding:
1. Stop DOAC immediately
2. Supportive care: IV fluids, transfusions if needed
3. Reversal agents:
• Dabigatran → Idarucizumab
• Apixaban/Rivaroxaban → Andexanet alfa
4. Consider activated charcoal if recent ingestion (

🎯 AHA Lifestyle & Stress Hacks to Lower Blood Pressure🔹 DASH Diet → More fruits/veggies, less salt & sugars🔹 Salt
14/12/2025

🎯 AHA Lifestyle & Stress Hacks to Lower Blood Pressure

🔹 DASH Diet → More fruits/veggies, less salt & sugars
🔹 Salt

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Al Jannat Medical Center
Panjpir
23340

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