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Sam Ghali, M.D.
ER Doctor | Resuscitation | Airway | Cardiovascular Emergencies | ECGs | Emergency Ultrasound | Trauma | Critical Care | | Patient Advocate
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Sam Ghali, M.D. retweeted
Sam Ghali, M.D. Feb 23
People often ask “why teach on Twitter”? This is why.
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Sam Ghali, M.D. 2h
Replying to @jimbollen
Impossible to know but I’ll say this: If all it took to dislodge that thing was a PVC it was merely a matter of time.
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Sam Ghali, M.D. 3h
Echo
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Sam Ghali, M.D. 3h
Replying to @JerryTawanda @Xetanix
One in a trillion plus or minus
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Sam Ghali, M.D. 3h
Replying to @yrlilbr
First they will have risk factors. Symptoms will be of those conditions that lead up to the thrombus. In this case Heart Failure. But otherwise that’s the power of Echo.
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Sam Ghali, M.D. 3h
Replying to @andyrew_choi
☝️
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Sam Ghali, M.D. 3h
Replying to @AirplanesAndEMS
No worries at all my friend that’s exactly why I post these threads
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Sam Ghali, M.D. 3h
Replying to @kats3rdtime
Do it
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Sam Ghali, M.D. 3h
Replying to @cathy_deloach
And these “doctor” threads love you. ♥️
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Sam Ghali, M.D. 3h
Replying to @KardiologieHH
Yes there is Biventricular failure leading to Biventricular Apical Thrombi! Very nice catch.
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Sam Ghali, M.D. 3h
Replying to @jimbollen
Great question. It happens from loss of LV squeeze, which causes stagnant blood flow. Look closely and you will notice significant ↓ in contractility. This stasis leads to the formation of thrombus and it’s a classic mechanism.
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Sam Ghali, M.D. 4h
Replying to @AirplanesAndEMS
Good question. So this is an LV Apical thrombus that’s dislodged, so it will embolize out the Aorta and enter the systemic circulation. No telling where it will go. So heparanize, closely monitor, and expectantly manage the embolus.
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Sam Ghali, M.D. 4h
Replying to @AlexShehataMD
Keep in mind it could embolize anywhere
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Sam Ghali, M.D. 4h
Replying to @plasticje
It will travel systemically. It won’t just automatically travel to the brain, it could go anywhere in the body. So start a blood thinner and wait and see what happens. Then treat accordingly.
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Sam Ghali, M.D. 4h
Watch this INCREDIBLE 5 second clip. That’s a Cardiac Thrombus caught embolizing in action. This is the amazing shot you never want to see!
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Sam Ghali, M.D. 7h
Replying to @Jopo_dr @medicalaxioms
Whoa
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Sam Ghali, M.D. retweeted
Sam Ghali, M.D. 22h
Here’s your AMAZING reminder of the classic changes of ↑K+ Your ability to recognize these will save lives!
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Sam Ghali, M.D. 18h
Hi, ER Doc here. If you think wearing a mask “cuts off your oxygen”, then trust me you do NOT want COVID-19.
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Sam Ghali, M.D. 19h
Replying to @MOM_MD_ @Drtulsijose
I would gently disagree. If there are truly no ECG changes, HyperK does not necessarily need to be treated.
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Sam Ghali, M.D. 21h
Replying to @davidcarr333
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