If you're interested in learning more about medical emergencies—whether or not you work in the field—you should go check out Sam Ghali's X/Twitter account. Dr. Ghali, M.D., is an Emergency Medicine Physician at University of Florida Health in Jacksonville. In his bio he lists his expertise as: "Resuscitation | Airway | Cardiovascular Emergencies | ECGs | Emergency Radiology | Trauma | Critical Care | #FOAMed | Patient Advocate."
On his account, he poses questions about possible diagnoses, and follows up the next day with answers. In one recent post, he shows a short video of an echocardiogram, and writes, "To this day the spookiest Echo I've ever seen. What's the diagnosis?" In the follow up post, he explains the answer:
This is an Apical 4 chamber view of the heart. This patient has profound Heart Failure with severely depressed Ejection Fraction. The resulting stasis of blood flow—in both ventricles—has unfortunately lead to the formation of large apical thrombi (ie: blood clots). In this extremely rare clip, a pair of Premature Ventricular Complexes (PVCs) can be seen interrupting an otherwise Normal Sinus Rhythm, and the massive Left Ventricular Apical thrombus is subsequently captured dislodging in action—and actively embolizing distally. With the only pathway being to exit the Aorta and enter the systemic circulation, the fate of the thrombus literally could be anywhere in the entire body. One can only hope that it did not take the path of the carotid arteries, which supply blood flow to the brain, as this indeed would have resulted in a devastating stroke.
In another recent post that has been shared widely, he states, "Watch this video breaking down a very important case of a 38-year-old lady with chest pain." The patient went to the ER and explained that she was sitting on the couch watching television and developed chest pain that wouldn't go away. Dr. Ghali explains how the patient's ECG clearly shows signs of acute myocardial infarction (heart attack) even though the patient was "hemodynamically stable" (i.e. her blood pressure and heart rate were stable).
I don't know much about medicine or emergency medicine, but I agree with X/Twitter user Wendy Peffercorn, who commented on Dr. Ghali's posts, exclaiming, "It's such fascinating stuff even if you've never stepped foot in the industry."
Dr. Ghali's public education efforts have definitely saved lives. In a pinned tweet, he shares feedback from an ER resident physician in training who had benefited greatly from Dr. Ghali's work. Ghali explains:
Here's a message that was sent to me by an ER resident physician in training who saved a patient's life half way across the country from me. When people ask "why teach on social media?" This is why.
For more fascinating medical mysteries and emergency medicine educational content, follow Dr. Ghali on his X/Twitter.
