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CardioNerds\xa0(Amit Goyal\xa0&\xa0Daniel Ambinder) join Baylor College of Medicine cardiology fellows (Khurrum Khan, John Suffredini, and Aliza Hussain) during restaurant week in Houston! They discuss an interesting case of STEMI in a patient with a recent diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI). Dr. Vijay Nambi provides the E-CPR and APD Dr. Arunima Misra provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident\xa0Bibin Varghese\xa0with mentorship from University of Maryland cardiology fellow\xa0Karan Desai.\xa0\xa0\xa0\n\n\n\n\n\nJump to: Patient summary - Case media - Case teaching - References \n\n\n\nEpisode graphic by Dr. Carine Hamo\n\n\n\n\n\n\n\nThe\xa0CardioNerds Cardiology Case Reports\xa0series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an\xa0\u201cExpert CardioNerd Perspectives & Review\u201d (E-CPR)\xa0for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus.\n\n\n\nWe are teaming up with the\xa0ACC FIT Section\xa0to use the\xa0#CNCR episodes\xa0to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an\xa0E-CPR\xa0segment and a message from the program director.\n\n\n\nCardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza\n\n\n\n\n\n\n\n\n\n\n\nPatient Summary\n\n\n\nA male in his mid 40s with a 30 pack year smoking history, EVALI (e-cigarette and vaping associated lung injury), and asthma presented with dyspnea and persistent chest pain.\xa0He had been vaping for the past year.\xa0One month prior\xa0, CT chest showed bilateral patchy infiltrates and he was diagnosed with EVALI and started on a steroid taper with resolution of his CT abnormalities. A nuclear stress\xa0test at that time was negative for ischemia.\xa0On arrival, he was in sinus tachycardia, normotensive, and not on oxygen supplementation. Physical exam\xa0was negative for\xa0volume overload or heart murmurs.\xa0EKG showed new Q waves with STE in V2-V4, with associated Q waves and TWI in the lateral leads and troponin returned moderately elevated.\xa0He was emergently taken to the\xa0cath\xa0lab which\xa0showed an abrupt cutoff of flow to the LAD. He received a\xa0single DES\xa0with resolution of coronary flow. A post-cath\xa0TTE showed an\xa0LVEF of 40-45% with apical anterior and anteroseptal WMA. He was monitored in the CCU the next day and he was treated with aspirin, ticagrelor,\xa0ACEi, metoprolol succinate and high intensity statin and subsequently discharged in stable condition\xa0with cardiac rehab follow-up.\n\n\n\n\n\n\n\nCase Media\n\n\n\n\nABClick to Enlarge\n\n\n\nA. Presentation ECG (Anterior STEMI) B. Baseline ECG \n\n\n\n\n\nLAD occlusion\n\n\n\n\n\nPost PCI\n\n\n\n\n\nRCA\n\n\n\n\n\n\n\nTTE 1\n\n\n\n\n\nTTE 2\n\n\n\n\n\nTTE 3\n\n\n\n\n\n\n\n\n\n\nEpisode Schematics & Teaching\n\n\n\nClick to enlarge!\n\n\n\n\n\n\n\nThe CardioNerds 5! \u2013 5 major takeaways from the #CNCR case\n\n\n\n1. The patient presented with a STEMI following a diagnosis of EVALI.\xa0What is known about the cardiovascular risks of vaping and e-cigarette use?\xa0\n\n\n\nThe overall cardiovascular risks of e-cigarette use remains to be elucidated\xa0In preclinical studies, e-cigarettes use have been linked to increased sympathetic activity, oxidative stress, endothelial dysfunction, vascular injury, and altered platelet activity\xa0One observational study has suggested that daily e-cigarette users were 1.79 times more likely to experience MI than individuals who had never used e-cigarettes.