Phil Riley
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nwamacman.bsky.social
Phil Riley
@nwamacman.bsky.social
Player of Music
Caregiver for Hearts in Northwest Arkansas
Reader of Medical Journals
Teacher of the Art of Medicine
Practioner of Politics-Free Social Media
#CardioSky
#MedSky
Great consolidation of the evidence! Thanks for sharing!
November 27, 2025 at 2:44 PM
Kudos! Easy way has led us to non-physician PCPs who can't/don't know/won't do this counseling and refer this to cardiology. The SYSTEM only allows 5 minute problem-oriented visits = no time to counsel. Energy bills are rising due to data centers without regulation so the wheel keeps spinning ...
November 22, 2025 at 4:02 PM
Keep up the good fight. But, speak up. When the patient has a stroke after Watchman, the implanter will be cool or throw you under the bus. I'd rather be the patient that woke up with knowledge of why it wasn't completed than a sense of false hope that I'll be okay off of DOAC.
November 22, 2025 at 3:54 PM
This sounds fun until you realize that NIL athletes are now suing you for their future lost earnings and your malpractice coverage is less than ten percent of the jury’s verdict. You are on the hook for the rest. Think hard. #CardioSky
November 22, 2025 at 2:39 PM
This is a “keeper” article. It will be reference material for a long time.
November 22, 2025 at 2:36 PM
How do you explain the variability in sensitivity/specificity in these devices with the exact same plethysomographic tech? I’m sure is no way that bias is involved. But, they’re all really good at making all of us VERY busy! #cardiosky
November 22, 2025 at 2:33 PM
Great article!
November 22, 2025 at 2:27 PM
I’m reading “Super Agers” by Eric Topol. He breaks this down to studies about which proteins we consume. There’s a gradation of bad to not-as-bad mortality and CB events with all meats from red meat to chicken but legume-based proteins are helpful in reducing mortality. You’re right … also the T ??
November 22, 2025 at 2:23 PM
So did you stop the case from continuing?
November 22, 2025 at 2:09 PM
⭐️ not gonna lie … A.I. will do this in two years ⭐️
November 19, 2025 at 4:40 AM
❤️
November 17, 2025 at 12:00 PM
⭐️Treating Diabetic patients as though they already have CAD would be a robust start. High intensity statin, aggressive treatment of blood sugar, blood pressure, weight management +/- baby aspirin (I know the data … it will change). We don’t need to “go looking”. We need to DO THE WORK.
November 15, 2025 at 7:15 PM
darwinian
October 27, 2025 at 4:04 AM
“Beta-blockers are generally
considered first-line pharmacologic therapy because
of their negative chronotropic and inotropic effects.”

Non-dihydropyradines also have negative chronotropic effects. This is also why ranolazine is mentioned in the next paragraph.

Good article!
October 18, 2025 at 2:59 PM