Mandant: "Würden Sie mir für 200 Euro zwei Fragen beantworten?" Anwalt: "Natürlich. Und wie lautet Ihre zweite Frage?"

Presented at #ASCO26: Among patients with previously treated metastatic pancreatic ductal adenocarcinoma, the RAS(ON) inhibitor daraxonrasib led to significantly longer overall survival and progression-free survival than chemotherapy. Full phase 3 RASolute 302 trial results: nej.md/4nWaxvM @ASCO

The interesting aspect of stress cardiomyopathy is often 'non-physiologic' symmetry. In this case of biventricular involvement, it appears as if someone drew a line between functional basal segment and non-functional mid/apical segments for both ventricles

67F - Syncope and Chest Pain We know the diagnosis, but what else do you see? #ECG #ECGChallenge

Schon @jensspahn hat einer Ärztin ins Gesicht gesagt: „Niemand hat Sie gezwungen, Kassenarzt zu werden!“ Die Menschen sollten froh sein, dass es überhaupt noch Ärzte gibt, die sich das antun. Die Alternative sind von Investoren betriebene MVZ mit optimierter Abrechnung.

Wie man eine 95-jährige Patientin bei Asystolie und unbeobachtetem Kollaps 20 min reanimieren kann erschließt sich mir nicht…

🏃‍♂️ Elevated troponin after exercise… should we worry? 💥 Cardiac troponin = gold standard for myocardial injury. 👉 But what happens after intense exercise? 📊 A large meta-analysis (129 studies, >7,000 athletes) shows: ➡️ 36% of athletes have troponin levels above the normal limit after exercise ⚠️ That’s more than 1 in 3. 🔬 Key determinants (see Graphical Abstract, page 3): ✔️ High-sensitivity assays → detect more elevations ✔️ cTnT > cTnI ✔️ Peak in endurance sports (running, cycling, triathlon) ✔️ Highest after 3–6 hours of exercise 📈 The curve on Figure 4 (page 29) shows a clear peak around 4–5 hours of effort. 👀 What DOESN’T matter (as much as we thought): ❌ Sex ❌ Training status 👉 It’s not about who you are… 👉 It’s about what and how long you do. 🧠 Clinical dilemma: Troponin ↑ = myocardial injury BUT Exercise alone can cause it 👉 So… how do we interpret it in the ER after a marathon? 💡 Take-home message: 🩺 Context is everything 👉 Consider exercise type, duration, and assay used 👉 Not every troponin rise = pathology 🚀 This is a perfect example of why biomarkers need clinical interpretation, not just thresholds. #Cardiology #SportsCardiology #Troponin #Biomarkers #Endurance #ExercisePhysiology #CardioImaging #PrecisionMedicine #Athletes #Research 🏃‍♂️🧬

Die letzten Wochen von Timmy haben mich mit schrecken daran erinnert, dass ich dringend eine Patientenverfügung brauche!🥹

🏆 Dümmster Tweet des Jahres

Reading transmitral Doppler The transmitral inflow pattern is one of the most fundamental windows into left ventricular diastolic function, filling pressures, and relaxation physiology. After aortic valve closure, the LV begins to relax, but both valves remain closed during the isovolumic relaxation time (IVRT). During this phase, LV pressure falls rapidly without any change in ventricular volume. Once LV pressure drops below left atrial (LA) pressure, the mitral valve opens and ventricular filling begins. The first peak is the E wave (early diastolic filling). This represents passive LV filling, driven by the pressure gradient between the LA and the relaxing LV. In healthy young adults, E velocity is typically dominant because ventricular relaxation is efficient and suction is preserved. After the E-wave peak, flow slows as the LA-LV pressure gradient declines. This creates the deceleration slope, and the time from peak E to baseline is the deceleration time (DT), an important marker of LV compliance and filling pressure. A brief phase of minimal flow may follow: diastasis, where LA and LV pressures nearly equalize. The second peak is the A wave, generated by atrial contraction (atrial kick), which contributes to late ventricular filling. Key quantitative parameters from transmitral Doppler: 🛑E velocity: peak early filling velocity 🛑A velocity: peak atrial filling velocity 🛑E/A ratio: quick assessment of diastolic filling pattern 🛑IVRT: time from aortic valve closure to mitral valve opening; reflects LV relaxation 🛑DT (deceleration time): reflects LV compliance and filling pressure 🛑VTI (velocity-time integral): total blood flow contribution during filling 🛑DFP (diastolic filling period): duration of ventricular filling Clinical interpretation: - A reduced E wave with dominant A wave (E/A <1) often suggests impaired relaxation. - A very tall E wave with short DT may indicate elevated LV filling pressures and restrictive physiology. - A seemingly normal E/A ratio can be deceptive (pseudonormal pattern), this is why tissue Doppler and LA assessment matter. Transmitral Doppler is not just a waveform, it is a hemodynamic conversation between the left atrium and left ventricle. Ref: Otto Catherine clinical textbook

A middle aged woman in ER with chest pain and hypotension. Poor acoustic windows, but contrast echo obtained. 1/2

Na was denkt ihr

Was ich heute im Echolabor gefunden habe:

Kein Mensch braucht Capri-Sun. Der Softdrink besteht aus Wasser, 10% Fruchtsaft, z. T. zugesetzten Vitaminen und Zucker. Dazu kommt unnötiger Verpackungsmüll. Der Strohhalm ist hier das geringste Problem.

Dieser Unfug mit „Arzt ist kein Beruf sondern eine Berufung“ wurde nur erfunden, um eine gaga 24/7 Erreichbarkeit zu erzielen. Damit ist es vorbei. Die jetzige Generation macht das nicht mehr. Die kauft auch keine Praxen mehr für mehrere 100k€. 8-16 Uhr, danach Feierabend oder extremst gut bezahlte Stunden. Wartet mal noch 5 J ab und versucht mal, nach 16 Uhr einen Arzttermin zu bekommen. Und es ist gut, dass diese Selbstverarschung aufhört

⚠️ Wendepunkt für Klasse-Ic-Antiarrhythmika bei KHK? Die FLECA-ED-Studie vom #EHRA2026 zeigt: Bei KHK ohne Ischämie ist Flecainid zur VHF-Kardioversion so sicher wie Amiodaron. Prof. @C. Meyer kommentiert: ➡️ herzmedizin.de/fuer-aerzte-u… #Herzmedizinde #DGK #Kardiologie #CardioSky

Patient with shock, what is driving their hemodynamic collapse more, the RV or the pericardial effusion? 👇

Endlich wieder gleich qualifiziert wie @andreaskardio FA Innere Medizin✅️

ICU/ED/OR Airway "Secrets": #foamed #foamcc #meded #medtwitter #airways While you attempt direct laryngoscopy in a hypoxemic patient, you get this view:

Intraop TEE for fellows #echofirst Patient with type A dissection - which is most likely the true lumen 🆎?