@MyNameIsMena

advanced heart failure and critical care cardiologist @PMunkCardiacCtr @UHN | outreach @Weeneebayko | assistant professor @uoftmedicine 🫀

 Toronto
Joined June 2009
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🚨 Normal blood pressure ≠ adequate tissue perfusion! Ris et al. highlight key concepts in HF-related cardiogenic shock: 🔹 Venous congestion drives hypoperfusion 🔹 Lactate may remain normal 🔹 Microcirculatory dysfunction matters 🔹 Hemodynamic trends > isolated values Recognize shock before hypotension develops. 📖 Circ Heart Fail. 2026 🔗 doi.org/10.1161/CIRCHEARTFAI… — 🚨 ¡Presión arterial normal ≠ perfusión tisular adecuada! Ris et al. destacan aspectos clave del shock cardiogénico asociado a insuficiencia cardíaca: 🔹 La congestión venosa contribuye a la hipoperfusión. 🔹 El lactato puede permanecer normal. 🔹 La disfunción microcirculatoria es fundamental. 🔹 Las tendencias hemodinámicas importan más que los valores aislados. 🫀 ¡Reconocer el shock antes de que aparezca hipotensión! #HeartFailure #CardiogenicShock #CardioTwitter
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The hardest part of cardiology 🫀fellowship?? Holding the pager at night. I built the Cardiology Night Float Application 💻 7 PM: STEMI, shock, VT storm, a crashing Impella, and more. You can call your attending Work them up and Survive till 7 AM 🕖 cardsnightfloat.netlify.app

Night Float Cardiology

Night Float: a real-time, multi-patient cardiology on-call simulation for fellows.

cardsnightfloat.netlify.app
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These next few years are going to be full of bright cardiology fellows and early attendings just pumping out great teaching tools. Literally in the last 48 hours I've seen a coronary visualizer (learncoronary.com), an echo simulator (intro2echo.com), now a PVC localizer.
Abhiram Challa
@Challa1218Oct 18
PVC localization has been one of the harder things to learn and teach as a cardiology fellow interested in EP. So I built learnpvcs.com to help connect the 12-lead ECG with 3D cardiac anatomy. You can explore different PVC origins, rotate and look inside the heart, and work through practice cases. It's an early educational prototype, and I'd love feedback from fellows, electrophysiologists, and educators. Which PVC origin do you find hardest to localize? #CardioTwitter #EPeeps #MedEd @OpenAI @WvuCvFellows @wvudeptofmed

Learn PVCs — Anatomy to ECG

Explore 3D cardiac anatomy, ECG patterns, and practice cases for learning PVC localization.

learnpvcs.com
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Mena g retweeted
Heart_BMJ
@Heart_BMJOct 17
Cardiopulmonary exercise testing in contemporary cardiology: physiological insights, novel applications and evolving algorithms bit.ly/4c2zQIj
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In 100% agreement Exercise should be a prescribed New @JACCJournals @ACCinTouch scientific statement jacc.org/doi/10.1016/j.jacc.…
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I created LearnCoronary (learncoronary.com), an interactive tool designed to help general cardiology fellows and other early-career learners better understand coronary angiography and the spatial relationships between different angiographic views. #cardiotwitter @OpenAI
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After years in the ICU, I have a few controversial opinions: Here are a few of my most controversial ICU opinions: 1. Doing chest compressions on a frail 95 year old isn't "saving a life." It's just cruel.
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SWAN GANZ: se sigue recomendando (IIb) en shock cardiogénico secundario a IC. Su uso precoz <6 h., se asocia a menos mortalidad. Es útil para fenotipar, dar tratamiento y decidir escalamiento de soportes… jacc.org/doi/10.1016/j.jacad…
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Congratulations @KateHanneman!! Outstanding news and so richly deserved!
Kate Hanneman@KateHannemanSep 30
Special news to share! I’m incredibly honored to be named a candidate for an at-large director position on the @RSNA Board. RSNA has played such an important role in my professional journey, and I’m tremendously grateful for the opportunity to give back! rsna.org/news/2026/september…
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Guías 2026 de la AHA de manejo preoperatorio en cirugía no cardíaca (alias valoración preoperatoria). Recién salida del horno ayer. Puntos importantes: 🔴 Los iSGLT2 se suspenden 3 días antes por riesgo de cetoacidosis euglucémica (nota: la evidencia nueva apunta a que tal vez no se requiera). 🔴 Los aGLP-1 semanales se suspenden más de 1 semana antes (por broncoaspiración). Metformina: continuar. 🔴 Betabloqueador: continuar. Si apenas lo vas a iniciar: empezar 7 días antes. 🔴 IECA/ARA-II pueden omitirse 24 horas en hipertensión controlada + cirugía de alto riesgo, pero se continúan en insuficiencia cardíaca. 🔴 Prueba de estrés y angioTC coronaria: solo con riesgo alto (como <4 METs por DASI y otra indicación. CAC de 0 en los últimos 2 años: pasa a cirugía sin más. 🔴 El ECG en asintomáticos con cirugía de bajo riesgo: no aporta, no es necesario. 🔴 En cirugía de alto riesgo, >65 años, o sintomáticos: considera medir BNP o NT-proBNP). En general no se necesitan seriados. 🔴 Anticoagulación oral (con ACOD) sin puente en general, sin heparina. Puente solo si: AVK y riesgo trombótico muy alto: válvula mecánica mitral, EVC/AIT en los últimos 3 meses, trombofilia o CHA₂DS₂-VASc ≥7. 🔴 Tiempos e infarto. Después de un stent farmacoactivo: esperar 6-12 meses si cirugía electiva. Después de un EVC/AIT se esperan ≥3 meses.
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The 2026 AHA/ACC Multisociety Guideline for #Perioperative CV Management for Noncardiac Surgery reaffirms the 2024 guideline. The title reflects the reaffirmation, while recommendations & supporting content remain unchanged. jacc.org/doi/10.1016/j.jacc.… #JACC
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Dear cardiology fellows 🫀 I built a free TTE cheatsheet with @claudeai I keep open while reading echos: guideline cutoffs, 17-segment walls by view, valve grading and 15 built-in calculators (AVA, SV/CO). Check it out 👇 echoguide.netlify.app #EchoFirst #CardioTwitter
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#CardiogenicShock may begin before hypotension becomes obvious In acute HF, rising venous pressure, impaired microcirculation, inflammation, &progressive hypoperfusion can drive a gradual transition toward shock. Recognizing this continuum early may be critical 🫀 Read More⤵️
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📌Featured in the @CircHF Cardiogenic Shock Issue: A comprehensive review of phenotype-driven microaxial flow pump strategies for cardiogenic shock management 📝Article by @MorenoMDPhD @JasonKatzMD @AmitPawaleMD @wapplefeld 🔗ahajournals.org/doi/full/10.… @WashUCardiology
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PH in the ICU isn't the diagnosis. It's the clue. 🔍 On this episode of SoCCC Pre-Rounds, Dr. Manreet Kanwar breaks down how to actually approach pulmonary hypertension at the bedside: why elevated PA pressures are a sign of an underlying disease process (not a diagnosis in themselves), how to sort pre-capillary from post-capillary from combined PH, and why protecting the right ventricle is the real endgame in the CICU. 🎙️ Episode with host Dr. Anthony Carnicelli, out now. Link in bio. Listen now: open.spotify.com/show/0TFSW3… Made possible by unrestricted support from @zoll_cms @CCCEnthusiasts @JasonKatzMD @jameshorowitzmd @AnnGageMD @ElliottMillerMD @BalimSenmanMD #SoCCCPreRounds #CriticalCareCardiology #PulmonaryHypertension #CICU #MedEd #Cardiology
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We are incredibly grateful for the generosity of the anonymous donor that has contributed the single largest gift for cancer care and research in Canadian history. A truly inspirational launch for #CarryTheFire, our campaign to create a world free from the fear of cancer.
University Health Network
@UHNSep 23
Every major breakthrough at UHN's @pmcancercentre has been powered by philanthropy. Now, in this new "golden age" of cancer research, care and education, the Princess Margaret Cancer Foundation is launching Canada's largest cancer fundraising campaign: $2.5B to help create a world free from the fear of cancer. thestar.com/news/gta/princes…

It's the largest donation for cancer care in Canadian history. And that may not be the best part

Princess Margaret Cancer Centre’s $100 million donor is anonymous — and didn’t restrict how the money should be spent.

thestar.com
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Does a life-or-death ER tool work equally well for everyone? A new study led by Dr. Doug Lee tested EHMRG, a tool used to guide #heartfailure care decisions in the ED, for fairness across income, background, and location. 🔗bit.ly/4Ac3hlf #HealthEquity #Research #TRCHR
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🫀 Cardiogenic shock ≠ hypotension. A new 2026 European consensus proposes a 3-pillar definition of cardiogenic shock: 1️⃣ End-organ hypoperfusion at rest 2️⃣ Hemodynamic abnormality 3️⃣ Underlying cardiac dysfunction 🔑 All 3 must be present. Important implications: 📌SBP >90 mmHg does not exclude shock 📌Normotensive & euvolemic CS are real 📌Use a multiparametric assessment—not a single BP or lactate value 📌Resting hypoperfusion helps distinguish advanced HF from true HF-related CS A major step toward a potential Universal Definition of Cardiogenic Shock. doi.org/10.1093/ehjacc/zuag1… #CardiogenicShock #HeartFailure #Cardiology #CriticalCare #CICU #Hemodynamics
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Congratulations @alexanoop and colleagues!!! So proud of you!!! Extraordinary work by @UHNTransplant alum!!! 🫀
Anoop George Alex
@alexanoopAug 30
We are profoundly grateful to God for His guidance through this journey. Special thanks to our multidisciplinary team for their tireless dedication, to the donor's family for their selfless gift of life, and to the recipient and their family for the trust they placed in our care.
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🔥 Myocarditis is a moving target — and so is its arrhythmic risk. New 2026 consensus introduces a phase-based framework for arrhythmic myocarditis: 🔥 HOT: active inflammation → polymorphic VA 🔄 HOT-to-COLD: inflammation → evolving scar → key arrhythmogenic window ❄️ COLD: established scar → monomorphic, re-entrant VA 🧠 Key message: integrate CMR/EMB + rhythm phenotype + genetics + ventricular function to guide antiarrhythmics, ICD decisions, ablation and follow-up. Think phase. Treat cause. Control arrhythmias. Prevent SCD. academic.oup.com/europace/ar… #Myocarditis #Cardiology #Electrophysiology #Arrhythmia #SuddenCardiacDeath #CMR
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