My icon and inspiration @raylewis most cherishable moment ever @Ravens

NSTE-ACS MASTERCLASS: From Diagnosis to Long-Term Care NSTEMI or unstable angina? The right decisions can change outcomes. This 10-part visual guide covers: 🔲 ECG & troponin interpretation 🔲 TIMI/GRACE risk stratification 🔲 Antiplatelet & anticoagulant therapy 🔲 Angiography, PCI & complications 🔲 Secondary prevention & cardiac rehabilitation

Wisdom!

In a world full of Jerry Seinfelds and Larry Davids, be a Jason Alexander.

Will never not think of this play when the Ravens play the Bengals. “I tried to hit Ray” 😂

Jason Alexander says he feared visiting Palestine as a Jew until 10 Palestinians protected him during an Israeli army raid in Ramallah “How much of a risk would I be taking as an American Jew walking into Palestinian cities? And Mohammed said, ‘The greatest dishonor that could happen to a religious Muslim is to allow harm to come to an invited guest’” “And he said, ‘Jason, if they had to, they’ll take a bullet for you.’ And what was so interesting about that trip is, we were having lunch in Ramallah with a bunch of actors and artists at a sort of outdoor restaurant” “And the Israeli army was conducting a raid on a bank that they thought had terrorist ties a couple blocks away. And they must have, to announce themselves, just shot into the air. And I remember 10 of those guys at the table surrounding me. And I went, ‘Oh my God, he wasn’t kidding. They’re not going to let me get hurt’”

THE SINUSES OF VALSALVA: MORE THAN ANATOMICAL LANDMARKS The aortic root contains three sinuses of Valsalva, located just above the aortic valve leaflets. 1. Right coronary sinus: gives rise to the right coronary artery (RCA). 2. Left coronary sinus: gives rise to the left main coronary artery (LMCA). 3. Noncoronary sinus: normally has no coronary artery arising from it. Why does this anatomy matter? ⭕ Coronary ostia location influences selective coronary cannulation during angiography. ⭕ Sinus dimensions and aortic root geometry matter when assessing aortic valve disease and planning surgical or transcatheter valve interventions. ⭕ Sinus of Valsalva aneurysms may rupture into adjacent cardiac chambers, potentially causing an abnormal shunt or acute hemodynamic compromise. Key point: The sinuses lie between the aortic valve annulus and the sinotubular junction. Understanding their relationship to the valve leaflets and coronary ostia is essential in cardiac imaging and interventional procedures. Reference: Mayo Foundation for Medical Education and Research.

Arafat Minhas (6-38) 8.4 || Ball by Ball Highlights || Pakistan vs England || Match 2 || Tri Nation Series

The NFL Players Association has called for a full investigation into the treatment of Philadelphia Eagles quarterback Jalen Hurts, who played against the Jacksonville Jaguars in London despite a blood clot in his calf before later being diagnosed with additional clots in both lungs.

"Kyle Hamilton is the best defensive player in football right now." baltimoreravens.com/news/kyl…

2026 AHA/ACC/ESC/WHF Second Universal Definition of #HeartFailure is here! What’s changed in how we define and classify HF? Read here: bit.ly/4vEE7Ji #JACC #CardioX @ACCinTouch @AHAScience @escardio @worldheartfed

President of the United States of America 👇🏼

🇵🇰🔥 HISTORY IN THE MAKING! 6’7” RHP Musharaf Khan becomes the first Pakistani player to play in Australia this winter! 🇦🇺⚾ Just 21 years old, the KPK powerhouse brings a 94 MPH fastball! 🚀💪 From KPK to Australia — Pakistan baseball is rising! 🇵🇰🔥 #PakBaseball #MusharafKhan #Baseball

Management of Heart Failure With Preserved Ejection Fraction: 2026 ACC Expert Consensus Decision Pathway: A Report of the American College of Cardiology Solution Set Oversight Committee HFpEF: beyond EF! ACC 2026: • SGLT2i ± finerenone if eligible • Incretins for obesity • Diuretics for congestion • ARNI by phenotype • No routine beta-blockers without a specific indication Tailor care to phenotype and sex. #HFpEF #CardioTwitter @mvaduganathan @gcfmd @SJGreene_md @JavedButler1 @BiykemB jacc.org/doi/10.1016/j.jacc.…

⛔️Don’t forget that Muslims are taking over our country ‼️‼️

Future rad onc plans first simulation

🫀 CardioNugget™: What are memory T waves? Cardiac memory = persistent T-wave changes after a period of abnormal ventricular activation resolves. 🧠 Key: The T-wave vector “remembers” the prior abnormal QRS vector — NOT the prior T wave. Seen after: ⚡ RV pacing ⚡ Recurrent/sustained BBB ⚡ VT / frequent PVCs ⚡ Pre-excitation (WPW) 💡 Fellow pearl: It’s an accumulation phenomenon → longer abnormal activation = stronger/longer-lasting memory. ⚠️ Can mimic ischemic TWI → check the prior QRS! #CardioNuggets #ECG #EP #Cardiology

SEVERE AORTIC STENOSIS: THE GRADIENT CAN BE MISLEADING An aortic valve area ≤1.0 cm² suggests severe aortic stenosis (AS), but the mean gradient may be below 40 mmHg. The gradient depends on blood flow, not just valve narrowing. 1. High-gradient AS - AVA ≤1.0 cm² - Mean gradient ≥40 mmHg - Usually preserved or reduced LVEF 2. Classical low-flow, low-gradient AS - AVA ≤1.0 cm² - Mean gradient <40 mmHg - LVEF <50% - Stroke volume index ≤35 mL/m² 3. Paradoxical low-flow, low-gradient AS - AVA ≤1.0 cm² - Mean gradient <40 mmHg - LVEF ≥50% - Stroke volume index ≤35 mL/m² 4. Normal-flow, low-gradient AS - AVA ≤1.0 cm² - Mean gradient <40 mmHg - LVEF ≥50% - Stroke volume index >35 mL/m² Why this matters: Low flow can conceal the hemodynamic severity of a stenotic valve. Discordant findings require careful assessment of Doppler measurements, blood pressure, flow state and valve anatomy. In classical low-flow AS, dobutamine stress echocardiography can help distinguish true severe from pseudo-severe AS. CT aortic valve calcium scoring can help when severity remains uncertain. Clinical pearl: Never grade AS using the valve area or gradient alone. Integrate AVA, mean gradient, peak velocity, stroke volume, LVEF and clinical context. Reference: 2025 ESC/EACTS Guidelines for the Management of Valvular Heart Disease.

Yeah Zay might have just became my favorite Raven …

Trump: Roger Marshall was mandated by law to request money owed from patients. You have to by law go after those people, and they made it like he was some kind of a Shylock type guy, I don’t know if I should be saying it.

Could patient-administered subcutaneous furosemide help pts w/ HF get home sooner? In SUBCUT-HF II, early-discharge strategy using subq furosemide added 4 days alive & out of hospital at 1 month & shortened index stay by 5.5 days comp. to usual care. bit.ly/4hWJb6d #JACC