Podcasts about advanced heart failure

Rush cardiologists use sophisticated diagnostic and therapeutic tools and work in a collaborative, interdisciplinary manner to provide superior outcomes for patients with advanced heart failure. Featured in this episode of Rounding at Rush are Tisha Suboc, MD, a cardiologist and the medical director of Advanced Heart Failure at Rush, and Karolina Marinescu, MD, a cardiologist and the director of the Infiltrative Cardiomyopathy Program at Rush. “When we see patients, we see them on a continuum,” says Dr. Suboc: When we see them in the hospital, the care doesn't just stop once they're discharged. We take care of them from the time they're in hospital to when they're discharged and follow them long-term. It's not just the patients' heart failure team; they're seen by their cardiologist, endocrinologist, electrophysiologist and primary care doctor. The multidisciplinary approach we use at Rush has brought us success in managing these types of patients.”

With Justyna Sokolska, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw - Poland, and Maja Cikes, University of Zagreb School of Medicine, Head at the Unit for Heart Failure and Mechanical Circulatory Support, Department of Cardiovascular Diseases, University Hospital Center, Zagreb - Croatia. In this episode of HFA CardioTalk, Justyna Sokolska interviews Maja Cikes on the challenges in management of long-term left ventricular assist device in patients with advanced heart failure. The discussion emphasizes the importance of selecting appropriate patients at the optimal time, examines the adverse events and highlights major ongoing clinical trials.  Recommended readings:  Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial, Mehra MR, et al. JAMA. 2023 Dec 12;330(22):2171-81  Trends and Outcomes of Left Ventricular Assist Device Therapy: JACC Focus Seminar, Varshney AS, et al. J Am Coll Cardiol 2022 Mar 22;79(11):1092-1107 Cardiac implantable electronic devices with a defibrillator component and all-cause mortality in left ventricular assist device carriers: results from the PCHF-VAD registry, Cikes M, et al. Eur J Heart Fail 2019 Sep;21(9):1129-41 A Fully Magnetically Levitated Left Ventricular Assist Device — Final Report, Mehra MR, et al. N Engl J Med 2019 Apr 25;380(17):1618-27 This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

Nikhil Narang, MD, social media editor of JACC: Heart Failure, discusses a recently published original research paper on the clinical trajectory of patients with advanced ambulatory heart failure in the REVIVAL trial.

Sarah E. Chuzi, MD, and Courtney Bartelstein, PA-C, offer insights on the broad clinical and community impact of the COMPASS-HF program at Northwestern Medicine Bluhm Cardiovascular Institute. COMPASS-HF, which stands for Comprehensive Palliative Care and Supportive Services for People with Heart Failure, seeks to support patients with advanced heart failure and their caregivers as they navigate a variety of symptoms, unique psychosocial challenges and complex decisions. 

This episode of VHHA's Patients Come First podcast features Dr. Keyur Shah, Chief of Advanced Heart Failure at the VCU Health Pauley Heart Center. Dr. Shah joins us for a conversation about his career, working with heart failure patients, the VCU Health experience with life-saving left ventricular assist devices, and more. Send questions, comments, feedback, or guest suggestions to pcfpodcast@vhha.com or contact on X (Twitter) or Instagram using the #PatientsComeFirst hashtag.

In this episode, Holli and Brett discuss the integration of the Family Frailty Score as an assessment tool for patients undergoing advanced heart failure therapies. Various key considerations surrounding the tool are discussed, including multidisciplinary team involvement, socioeconomic challenges, patient and family support, and more. Featuring: Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Holli Martinez FNP-BC, ACHPN®, FPCN Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Brett Snodgrass has been a registered nurse since 1997 and a family nurse practitioner since 2007, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain, and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She is a nationally recognized nurse practitioner, speaker and teacher. Brett Is a chronic pain expert, working for more than 20 years with chronic pain patients in a variety of settings. She currently serves on the TN Chronic Pain Task Force. She is a director at large of the TN Pain Society. Past awards include AANP State Excellence Award for Tennessee for her work across the state on the TN Chronic Pain Task Force, as well as advocating for TN Full Practice Authority for Nurse Practitioners and the 2017 Memphis Business Journal Healthcare Hero Award. Holli Martinez FNP-BC, ACHPN®, FPCN Holli has been a nurse for 26 years with the last 17 as an advanced practice registered nurse. In addition to providing palliative care consultations to patients and families, Holli also serves as the Program Director for the Supportive and Palliative Care Program at the University of Utah Hospital and Huntsman Cancer Institute; an adjunct faculty member for the University of Utah College of Nursing; past Board president for the Hospice and Palliative Nurses Association and the Hospice and Palliative Nurses Foundation; and faculty member for UCoPE - Utah Certificate of Palliative Education and Senior Faculty for VitalTalk. She is Board certified as a Family Nurse Practitioner and an Advanced Certified Hospice and Palliative Nurse. Holli has been inducted as an HPNA Fellow in Palliative Care Nursing and has been honored with the Cambia Foundation Sojourns Award and the American Association of Nurse Practitioners State of Utah Award for Excellence.

Learn what happens next when heart failure becomes advanced with advice and insight from Gautam Ramani, MD, assistant professor of medicine at the University of Maryland School of Medicine, cardiologist and medical director of University of Maryland Medical Center's Pulmonary Hypertension Program.

CardioNerds Co-Founder Dr. Daniel Ambinder, Episode Chair Dr. Dinu Balanescu, and FIT Lead Dr. Natalie Tapaskar discuss advanced heart failure in CardioOncology with expert Dr. Richard Cheng. Audio editing by CardioNerds Academy Intern, Dr. Akiva Rosenzveig. In this episode, we discuss the spectrum of advanced heart failure in patients with a history of cancer. We dissect cancer therapy-related cardiac dysfunction (CTRCD) cases and the imaging and biomarker tools available for risk stratification and disease monitoring. We delve into the data on the use of guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy (CRT) in these patients. We discuss the risk of prior radiation and chemotherapy during cardiac surgery. Finally, we learn about the post-transplant risk of rejection, recurrent malignancy, and de-novo malignancies, as well as treatment strategies we can employ for these patients. This episode is supported by a grant from Pfizer Inc. This CardioNerds Cardio-Oncology series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Giselle Suero Abreu, Dr. Dinu Balanescu, and Dr. Teodora Donisan.  CardioNerds Cardio-Oncology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Advanced Heart Failure in CardioOncology Use the HFA-ICOS risk tool to understand the baseline risk of developing cancer therapy-related cardiac dysfunction (CTRCD). Key factors are type of cancer therapy, baseline CV risk factors, and age. A relative change in global longitudinal strain of more than 15% from baseline is a marker of early cardiac dysfunction and predicts the subsequent risk for systolic dysfunction in patients undergoing cardiotoxic chemotherapy. Statins may be useful in prevention of cardiovascular dysfunction in patients receiving anthracycline chemotherapy. There is limited data on the 4 pillars of GDMT in prevention of CTRCD, but should be started early once CRTCD is suspected or diagnosed! Mediastinal radiation causes adhesions and scarring which increase the risk of bleeding during cardiac surgery, lead to longer operative times, and can lead to RV failure and poor wound healing. Patients with a pre-transplant history of malignancy have a higher risk of mortality due to post-transplant malignancy. And patients with active cancer should not be considered for heart transplant. Post-transplant malignancy risk can be mitigated by utilizing an mTOR based, CNI free immunosuppression regimen. Show notes - Advanced Heart Failure in CardioOncology How do cardio-oncology and advanced heart failure intersect? There are 3 basic populations of patients to consider:Patients with advanced heart failure who develop cancer.Patients with pre-existing chemotherapy and radiation exposure for cancer treatment who later develop advanced heart failureHeart transplant recipients who, in the long term are at very high risk of developing cancer Cardio-oncologists must consider risk assessment and mitigation, long-term prognosis, and treatment strategies for each of these unique populations. How can we assess the risk of developing cardiovascular disease during cancer treatment (CTRCD)? There are many proposed risk tools. However, the majority are not well-validated. One of the most used tools is the HFA-ICOS risk tool.1You can select the planned cancer therapy for the patient (anthracyclines, HER-2, VEGF, RAF/MEK inhibitors, Kinase inhibitors, multiple myeloma therapies) and then calculate their risk of developing CV disease during cancer treatment based on baseline variables:1) previous history of CV disease,2) biomarkers – troponin and NT-proBNP3)age,4) CV risk factors -HTN, DM,

ACC.24: RELIEVE-HF trial

Everyone is concerned about cardiac health. The reason being it is impacted by many other functions in the body, so we are always striving to be healthier to make our heart healthier. In this episode, we speak to Dr. Kenneth Varian, cardiologist about many topics, diabetes, ozempic, cholesterol. We had so many questions that we are already planning for another episode. Dr. Varian is an Advanced Heart Failure Cardiologist in Akron OH.  He studies at Ohio State for medical school and completed his PhD at Brigham and Women's Hospital in Boston for Internal Medicine Residency, and Cleveland Clinic Foundation for Cardiology fellowship and Advanced Heart Failure and Transplant Cardiology fellowship.  He has been practicing at Summa in Akron, Ohio since 2018.  

This is a story that inspires, that can instantly give us perspective on our own lives, and how so precious our time here on this earth is, and how it can all be taken away from us at any moment…or we may get lucky and get a 2nd chance.  Well maybe that's what we all are getting when we hear this story. A 2nd chance to change the way we show up in the world.  A 2nd chance to live our life with joy and gratitude, a 2nd chance to appreciate all that we have, right here and now.Today's guest is Dr. Darcy Benway.  I've asked Darcy to come on the show to share her incredible story of learning one day less than 3 years ago that she had a fatal heart condition and was going to die unless she had a heart transplant.  Imagine being perfectly healthy, an athlete living your best life, to suddenly have a rapid decline and be sitting face to face with death. Darcy is going to bravely walk us through that experience…the days leading up to the transplant, the actual event, and the days thereafter, including dealing with the emotions of knowing that someone had to die, in order for her to live.Also joining us on the show is her cardiologist, Dr. Joel Schilling, who does a fantastic job of sharing what goes on behind the scenes and with the patient before during and after a transplant.  Dr. Schilling is board certified in Cardiology and Advanced Heart Failure and Transplant Cardiology. In light of April being National Donate Life Month, please consider registering to become an organ donor and give the gift of life.Please visit:https://www.barnesjewish.org/To stay connected with Better Place Project and for updates and behind the scenes info, please follow us on social media:Website:https://www.betterplaceproject.org/ Instagram: @BetterPlaceProj To follow Steve on Instagram@SteveNorrisOfficialFacebook: Facebook.com/BetterPlaceProjectPodcastTwitter: @BetterPlaceProjEmail: BetterPlaceProjectPodcast@gmail.com

In this week's episode of Parallax, Dr Ankur Kalra welcomes Dr Shashank Sinha. Dr Sinha is an Advanced Heart Failure, Mechanical Circulatory Support, and Transplant Cardiologist at Inova Fairfax Medical Campus, where he serves as Co-Medical Director of the Cardiac Intensive Care Unit and Director of the Cardiovascular Critical Care Research Program. Additionally, he holds the position of Assistant Professor of Medical Education at the University of Virginia School of Medicine. In this episode, Dr Sinha shares his insights on leadership after participating in the prestigious Presidential Leadership Scholars Programme. This programme, designed for mid-career professionals with 10+ years of experience, aims to foster bipartisan, action-oriented leaders. Dr Sinha discusses what motivated him to apply for the programme and guides us through the practical details of the process. Ankur asks him about his modules and the lessons he derived from this multidisciplinary programme. Dr Sinha and Dr Kalra discuss civic duty and the values that can be nurtured to make a difference on a larger scale. Dr Kalra also asks about Dr Sinha's approach to conflict management and combating inherent bias. What is the Presidential Leadership Programme? What qualities constitute a good leader? How can individuals foster their leadership skills?

Learning Objectives:- Discuss the barriers and the necessary resources required for successful rapid up-titration of GDMT - Recognize the appropriate timing for referral of patients with advanced heart failure for percutaneous/surgical intervention- Understand indications/contraindications for HF patients requiring advanced therapies (i.e., transplant or mechanical circulatory support)- Recognize the current advanced non-medical therapy available for heart failure patients- Anticipate future advancements in non-medical therapy on the brink of mainstreamSpeakers:Selma Mohammed, MBBS, Advanced Heart Failure and Transplant Cardiology, CHI HealthKenneth Liao, MD, PhD, FACS, Professor and Chief, Cardiothoracic Transplantation and Circulatory Support, Baylor College of MedicinePanelists:Andrew Civitello, MD, FACC, Associate Professor, Cardiology, Medical Director, Heart Transplant Program, Baylor College of MedicineAlexis Edward Shafii, MD, FACS, Associate Professor of Surgery, Cardiothoracic Transplant and Circulatory Support, Baylor of Medicine

In this episode Alin and Colby sit down and chat with Dr. Anu Lala. They discuss dealing with a diagnosis of heart failure, the approach to changing the narrative to heart function not failure, and patient advocacy. Dr. Lala also turns the tables and interviews Alin and Colby about how they dealt with being told their diagnosis and their resilience in the face of adversity. Dr. Anuradha Lala-Trindade (Anu Lala) is an Advanced Heart Failure and Transplant Cardiologist at Mount Sinai. Her clinical interests encompass all aspects of management of heart failure including the selection and care of patients with mechanical circulatory support devices and heart transplantation as well as genetic cardiomyopathies and perioperative management of high risk cardiac surgical cases. She believes in a patient-centered approach, where each individual's unique needs and preferences are essential components of developing a personalized treatment plan. Dr. Lala seeks to implement guideline directed medical and device based therapies while integrating emotional and spiritual aspects of care.https://www.goredforwomen.org/en/about-heart-disease-in-womenhttps://onlinejcf.com/article/S1071-9164(21)00088-9/abstractThis episode is sponsored by Paragonix Technologies, an industry leader committed to protecting the gift of organ donation. To learn how Paragonix is reshaping the standard of care across transplantation to optimize patient outcomes, visit paragonix.com.  Email: bothsidesofthestethoscope@gmail.com Instagram: @bothsidesofthestethoscope Twitter: @bsotsthethoscope 

Learning Objectives:Define the key pharmacologic therapies for HFrEH and HFpEF and describe their optimal use in specific patient populationDiscuss the barriers and the necessary resources required for successful rapid up-titration of GDMTIdentify how improvement in medical therapy influences patient outcomes, including hospitalizations, re-admissions, and mortalitySpeakers:Biykem Bozkurt, MD, PhD, Professor of Cardiology, Baylor College of MedicineSelma Mohammed, MBBS, Advanced Heart Failure and Transplant Cardiology, CHI HealthPanelists:Joseph Rogers, MD, President and Chief Executive Officer, Texas Heart InstituteJessica Brown, MD, Cardiology and Heart Failure Specialist, Baylor St. Luke's Medical Group Woodlands North Houston Heart CenterModerator:Reza Ardehali, MD, Ph.D., FAHA, Professor and Chief of Cardiology, Baylor College of Medicine

Of the more than 6 million Americans living with heart failure, about 10% have advanced heart failure and when conventional heart therapies and symptom management strategies are no longer working, you may need more advanced options. Dr. Keyur Shah discusses the options available to treat advanced heart failure.

Dr. Douglas Johnston, Chief, Division of Cardiac Surgery, Surgical Director, Bluhm Cardiovascular Institute, and Dr. Baljash Singh Cheema, Advanced Heart Failure & Transplant Cardiology, Bluhm Cardiovascular Institute, join John Williams to tell us what we should know about heart failure. Dr. Johnston and Dr. Cheema explain what heart failure is, the risk factors and health […]

Dr. Douglas Johnston, Chief, Division of Cardiac Surgery, Surgical Director, Bluhm Cardiovascular Institute, and Dr. Baljash Singh Cheema, Advanced Heart Failure & Transplant Cardiology, Bluhm Cardiovascular Institute, join John Williams to tell us what we should know about heart failure. Dr. Johnston and Dr. Cheema explain what heart failure is, the risk factors and health […]

Dr. Douglas Johnston, Chief, Division of Cardiac Surgery, Surgical Director, Bluhm Cardiovascular Institute, and Dr. Baljash Singh Cheema, Advanced Heart Failure & Transplant Cardiology, Bluhm Cardiovascular Institute, join John Williams to tell us what we should know about heart failure. Dr. Johnston and Dr. Cheema explain what heart failure is, the risk factors and health […]

Title: Comprehensive Care of the Cardiomyopathy Patient: From Pillars that Sustain to Buttresses that Assist Presented by: J. Eduardo Rame, MD, MPhil, FAHA, FESC Director of Advanced Heart Failure & Cardiac Transplant Thomas Jefferson University Division of Cardiology, Philadelphia, PA Financial Disclosure: Co-Primary Investigator ReSTAGE HF (Thoratec, now Abbott, Inc) Primary Investigagor ADVANCE and ENDURANCE (HeartWare, now Medtronic Inc) National PI: SoPRANO (Macitentan post LVAD, Jannsen) Objectives: 1. To describe the different adaptations of human heart failure 2. To describe the potential for myocardial recovery 3. To describe the pillars of heart failure therapy

The following question refers to Section 4.3 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by Texas Tech University medical student and CardioNerds Academy Intern Dr. Adriana Mares, answered first by Rochester General Hospital cardiology fellow and Director of CardioNerds Journal Club Dr. Devesh Rai, and then by expert faculty Dr. Eldrin Lewis.Dr. Lewis is an Advanced Heart Failure and Transplant Cardiologist, Professor of Medicine and Chief of the Division of Cardiovascular Medicine at Stanford University. The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance.Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #26 A 45-year-old man presents to cardiology clinic to establish care. He has had several months of progressive dyspnea on exertion while playing basketball. He also reports intermittent palpitations for the last month. Two weeks ago, he passed out while playing and attributed this to exertion and dehydration. He denies smoking and alcohol intake.   Family history is significant for sudden cardiac death in his father at the age of 50 years. Autopsy has shown a thick heart, but he is unaware of the exact diagnosis. He has two children, ages 12 and 15 years old, who are healthy.   Vitals signs are blood pressure of 124/84 mmHg, heart rate of 70 bpm, and normal respiratory rate. On auscultation, a systolic murmur is present at the left lower sternal border. A 12-lead ECG showed normal sinus rhythm with signs of LVH and associated repolarization abnormalities. Echocardiography reveals normal LV chamber volume, preserved LVEF, asymmetric septal hypertrophy with wall thickness up to 16mm, systolic anterior motion of the anterior mitral valve leaflet with 2+ eccentric posteriorly directed MR, and resting LVOT gradient of 30mmHg which increases to 60mmHg on Valsalva.   You discuss your concern for an inherited cardiomyopathy, namely hypertrophic cardiomyopathy. In addition to medical management of his symptoms and referral to electrophysiology for ICD evaluation, which of the following is appropriate at this time? A  Order blood work for genetic testing B  Referral for genetic counseling C  Cardiac MRI D  Coronary angiogram E  All of the above Answer #26 Explanation   The correct answer is B – referral for genetic counseling.  Several factors on clinical evaluation may indicate a possible underlying genetic cardiomyopathy. Clues may be found in: ·       Cardiac morphology – marked LV hypertrophy, LV noncompaction, RV thinning or fatty replacement on imaging or biopsy ·       12-lead ECG – abnormal high or low voltage or conduction, and repolarization, altered RV forces ·       Presence of arrhythmias – frequent NSVT or very frequent PVCs, sustained VT or VF, early onset AF, early onset conduction disease ·       Extracardiac features – skeletal myopathy, neuropathy, cutaneous stigmata, and other possible manifestations of specific syndromes In select patients with nonischemic cardiomyopathy, referral for genetic counseling and testing is reasonable to identify conditions that could guide treatment for patients and family members (Class 2a, LOE B-NR). In first-degree relatives of selected patients with genetic or inherited cardiomyopathies, genetic screening and counseling are recommended to ...

Heart failure impacts more than 8 million people in the United States today, but with the right treatments, the course of the disease can be corrected. Dr. Nir Uriel is determined to do just that. He's spent his career pushing forward advancements to better diagnose and treat advanced heart failure patients. These advancements include a new, magnetic levitated pump that can improve the outcomes of patients denied transplantation due to their age or severity of disease, as well as breakthrough testing that analyzes cell-free DNA to detect transplant rejection, changing the course of immunosuppressive therapy. Dr. Uriel is also pioneering the use of technology to remotely monitor heart failure patients, and diagnose heart failure before symptoms even occur. In this episode, Dr. Uriel details his multifaceted methods to treating heart failure, the value of a team approach, and the importance of empathetic, patient-centered care.

Advanced heart failure treatment is complex but highly necessary, given the rise of an aging population, lifestyle factors, and increased diagnoses of hypertension, type 2 diabetes and obesity.    During episode two of Making the Rounds' “Failure is not an option” series, Dr. Radha Gopalan discusses the rise in heart failure diagnosis in America and the importance of optimal cardiovascular medical therapy in the management of patients with a heart failure diagnosis.    Dr. Gopalan is a heart failure cardiologist and medical director of Advanced Heart Failure at Banner – University Medicine Phoenix, specializing in heart failure, advanced heart failure, mechanical circulatory support and heart transplant.   

In this episode Alin and Colby  welcome on Dr. Rohan Goswami. Dr. Goswami is an advanced heart failure and transplant cardiologist at the Mayo Clinic in Jacksonville Florida. He specializes in the use of AI in the field of heart transplantation and the use of mechanical support systems as a bridge to recovery or a bridge to heart transplantation. This episodes discussions on both of those topics and much, much more! 

The following question refers to Section 9.3 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by Keck School of Medicine USC medical student & CardioNerds Intern Hirsh Elhence, answered first by Cedars Sinai medicine resident, soon to be Vanderbilt Cardiology Fellow, and CardioNerds Academy Faculty Dr. Breanna Hansen, and then by expert faculty Dr. Anu Lala.Dr. Lala is an advanced heart failure and transplant cardiologist, associate professor of medicine and population health science and policy, Director of Heart Failure Research, and Program Director for the Advanced Heart Failure and Transplant fellowship training program at Mount Sinai. Dr. Lala is Deputy Editor for the Journal of Cardiac Failure. Dr. Lala has been a champion and role model for CardioNerds. She has been a PI mentor for the CardioNerds Clinical Trials Network and continues to serve in the program's leadership. She is also a faculty mentor for this very 2022 heart failure decipher the guidelines series.The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance.Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #23 Mrs. Hart is a 63-year-old woman with a history of non-ischemic cardiomyopathy and heart failure with reduced ejection fraction (LVEF 20-25%) presenting with 5 days of worsening dyspnea and orthopnea.   At home, she takes carvedilol 12.5mg BID, sacubitril-valsartan 24-46mg BID, empagliflozin 10mg daily, and furosemide 40mg daily.   On admission, her exam revealed a blood pressure of 111/79 mmHg, HR 80 bpm, and SpO2 94%. Her cardiovascular exam was significant for a regular rate and rhythm with an audible S3, JVD to 13 cm H2O, bilateral lower extremity pitting edema with warm extremities and 2+ pulses throughout.  What initial dose of diuretics would you give her? A Continue home Furosemide 40 mg PO B Start Metolazone 5 mg PO C Start Lasix 100 mg IV D Start Spironolactone Answer #23 Explanation The correct answer is C – start Furosemide 100 mg IV. This is the most appropriate choice because patients with HF admitted with evidence of significant fluid overload should be promptly treated with intravenous loop diuretics to improve symptoms and reduce morbidity (Class 1, LOE B-NR). Intravenous loop diuretic therapy provides the most rapid and effective treatment for signs and symptoms of congestion. Titration of diuretics has been described in multiple recent trials of patients hospitalized with HF, often initiated with at least 2 times the daily home diuretic dose (mg to mg) administered intravenously. Titration to achieve effective diuresis may require doubling of initial doses, adding a thiazide diuretic, or adding an MRA that has diuretic effects in addition to its cardiovascular benefits. Choice A is incorrect as continuing oral loop diuretics is not recommended for acute decongestion. Moreover, Ms. Hart has become congested despite her home, oral diuretic regimen. Choice B and D are incorrect as starting a thiazide diuretic or a mineralocorticoid receptor antagonist are not first-line therapy for acute HF. Rather, in patients hospitalized with HF when diuresis is inadequate to relieve symptoms and signs of congestion, it is reasonable to intensify the diuretic regimen using either: a.

There is increased recognition of the right ventricle's pivotal role in health and disease. In this episode, we will discuss Right Ventricular Failure in the context of critical illness. Our guest is Dr. Ryan Tedford, a practicing cardiologist focusing on heart failure. Dr. Tedford is the Dr. Peter C. Gaze Endowed Chair in Heart Failure. He is a Professor of Medicine and Cardiology, Section Chief for Heart Failure, Medical Director of Cardiac Transplantation, and Director of the Advanced Heart Failure & Transplant Fellowship Training Program at the Medical University of South Carolina. Additional Resources Right Ventricular Failure. Houston B, Britain EL, and Tedford R. N Engl J of Med 2023: https://pubmed.ncbi.nlm.nih.gov/36947468/ Diuretic versus placebo in intermediate-risk acute pulmonary embolism: a randomized clinical trial. Lim P, et al. Eur Heart J Acute Cardiovasc Care 2022: https://pubmed.ncbi.nlm.nih.gov/34632490/ Multimodality Imaging of Right Heart Function. Hahn R, et al. JACC 2023: https://pubmed.ncbi.nlm.nih.gov/37164529/ Ventricular dilation is associated with improved cardiovascular performance and survival in sepsis. Zanotti, s et al. CHEST 2010: https://pubmed.ncbi.nlm.nih.gov/20651022/ Link to recent podcast on Acute Pulmonary Embolism: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1463000353 Books Mentioned in this Episode: The Right Ventricle in Health and Disease. N Voelkel and D Schranz, Editors: https://bit.ly/436iROd The Code Breaker: Jennifer Doudna, Gene Editing, and the Future of the Human Race. By W Isaacson: https://bit.ly/3IDUL5a

The following question refers to Section 9.1 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.  The question is asked by Keck School of Medicine USC medical student & CardioNerds Intern Hirsh Elhence, answered first by Duke University cardiology fellow and CardioNerds FIT Ambassador Dr. Aman Kansal, and then by expert faculty Dr. Anu Lala. Dr. Lala is an advanced heart failure and transplant cardiologist, associate professor of medicine and population health science and policy, Director of Heart Failure Research, and Program Director for the Advanced Heart Failure and Transplant fellowship training program at Mount Sinai. Dr. Lala is deputy editor for the Journal of Cardiac Failure. Dr. Lala has been a champion and role model for CardioNerds. She has been a PI mentor for the CardioNerds Clinical Trials Network and continues to serve in the program's leadership. She is also a faculty mentor for this very 2022 heart failure decipher the guidelines series. The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #13 Mrs. Hart is a 63-year-old woman with a history of non-ischemic cardiomyopathy and heart failure with reduced ejection fraction (LVEF 20-25%) presenting with 5 days of worsening dyspnea and orthopnea. She takes carvedilol 12.5mg BID, sacubitril-valsartan 24-46mg BID, empagliflozin 10mg daily, and furosemide 40mg daily and reports that she has been able to take all her medications. What is the initial management for Mrs. H? A Assess her degree of congestion and hypoperfusion B Search for precipitating factors C Evaluate her overall trajectory D All of the above E None of the above Answer #13 Explanation The correct answer is D – all of the above.   Choice A is correct because in patients hospitalized with heart failure, the severity of congestion and adequacy of perfusion should be assessed to guide triage and initial therapy (Class 1, LOE C-LD). Congestion can be assessed by using the clinical exam to gauge right and left-sided filling pressures (e.g., elevated JVP, S3, edema) which are usually proportional in decompensation of chronic HF with low EF; however, up to 1 in 4 patients have a mismatch between right- and left-sided filling pressures. Hypoperfusion can be suspected from narrow pulse pressure and cool extremities, intolerance to neurohormonal antagonists, worsening renal function, altered mental status, and/or an elevated serum lactate. For more on the bedside evaluation of heart failure, enjoy Episode #142 – The Role of the Clinical Examination in Patients With Heart Failure – with Dr. Mark Drazner. Choice B, searching for precipitating factors is also correct. In patients hospitalized with HF, the common precipitating factors and the overall patient trajectory should be assessed to guide appropriate therapy (Class 1, LOE C-LD). Common precipitating factors include ischemic and nonischemic causes, such as acute coronary syndromes, atrial fibrillation and other arrhythmias, uncontrolled HTN, other cardiac disease (e.g., endocarditis), acute infections, anemia, thyroid dysfunction, non-adherence to medications or new medications. When initial clinical assessment does not suggest congestion or hypoperfusion, symptoms of HF may be a result of transient ischemia, arrhythmias, or noncardiac disease such as chronic pulmonary disease or pneumonia,

Drs Michelle Kittleson and Jason N. Katz discuss how to navigate uncertain terrain using a few rules to balance choices, risks, and goals in managing device therapy for individuals with heart failure. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982158). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Medical Management of Advanced Heart Failure https://pubmed.ncbi.nlm.nih.gov/11829703/ William Osler https://pubmed.ncbi.nlm.nih.gov/3289809/ Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/35862152/ Experience With Univentricular Support in Mortally Ill Cardiac Transplant Candidates https://pubmed.ncbi.nlm.nih.gov/2306148/

The following question refers to Section 8.1 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.  The question is asked by Western Michigan University medical student & CardioNerds Intern Shivani Reddy, answered first by Brigham & Women's medicine resident and Director of CardioNerds Internship Dr. Gurleen Kaur, and then by expert faculty Dr. Prateeti Khazanie. Dr. Khazanie is an Associate Professor and Advanced Heart Failure and Transplant Cardiologist at the University of Colorado. She was an undergraduate at Duke University as a B.N. Duke Scholar. She spent two years at the NIH in the lab of Dr. Anthony Fauci and completed a dual MD-MPH program at Duke Medical School. When she started residency, she thought she was going to be an ID doctor, but she fell in love with cardiology at Stanford where she was an intern, resident, and then chief resident. She went back to Duke for her general cardiology and advanced heart failure/transplant fellowships as well as research training at the DCRI. Dr. Khazanie joined the University of Colorado in 2015 as a health services clinician researcher with a focus on improving health equity and bioethics in advanced heart failure care. She mentors medical students, residents, and fellows and is a faculty mentor for the University of Colorado Cardiology Fellows “House of Cards” mentoring group. She has research funding from the NIH/NHLBI K23, NIH Ethics Grant, and Ludeman Center for Women's Health Research. Dr. Khazanie is an author on the 2022 ACC/AHA/HFSA HF Guidelines, the 2021 HFSA Universal Definition of Heart Failure, and multiple scientific statements. The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #11 A 64-year-old woman with a history of chronic systolic heart failure secondary to NICM (LVEF 15-20%) s/p dual chamber ICD presents for routine follow-up. She reports several months of progressive fatigue, dyspnea, and peripheral edema. She has been hospitalized twice in the past year with acute decompensated heart failure. Efforts to optimize guideline directed medical therapy have been tempered by episodes of lightheadedness and hypotension. Her exam is notable for an elevated JVP, an S3 heart sound, and a III/VI holosystolic murmur best heard at the apex with radiation to the axilla. Labs show Na 130 mmol/L, Cr 1.8 mg/dL (from 1.1 mg/dL 6 months prior), and NT-proBNP 1,200 pg/mL. ECG in clinic shows sinus rhythm and a nonspecific IVCD with QRS 116 ms. Her most recent TTE shows biventricular dilation with LVEF 15-20%, moderate functional MR, moderate functional TR and estimated RVSP of 40mmHg. What is the most appropriate next step in management? A Refer to electrophysiology for upgrade to CRT-D B Increase sacubitril-valsartan dose C Refer for advanced therapies evaluation D Start treatment with milrinone infusion Answer #11 Explanation The correct answer is C – refer for advanced therapies evaluation. Our patient has multiple signs and symptoms of advanced heart failure including NYHA Class III-IV functional status, persistently elevated natriuretic peptides, severely reduced LVEF, evidence of end organ dysfunction, multiple hospitalizations for ADHF, edema despite escalating doses of diuretics, and progressive intolerance to GDMT. Importantly, the 2018 European Society of Cardiology revised definition of advanced HF focuses...

In this episode we discuss advanced heart failure and the CTVSA Heart Failure practice with Dr. William Cotts and Dr. Christopher Sciamanna. Tune in to learn about their experience caring for heart failure patients, medications used for treatment, and more.This episode is sponsored by CTVSA

What if we told you that the decisions you do (or don't) make now concerning your heart health could have major implications for your quality of life 10 or 20 years down the road? Heart disease is the leading cause of death in the U.S., but it's often misunderstood. How do we build heart-healthy habits? How much exercise is enough? Should we rely on trackers to give a clear picture of cardiovascular fitness?In this episode, cardiologist Jennifer Haden Haythe, MD, explains how to improve and maintain your cardiovascular health in order to increase your longevity. HOST: Ella Dove, Sr. Director of Creative Development at Well+GoodGUESTS: Dr. Jennifer HaytheWHAT WE TALKED ABOUT:Dr. Jennifer Haythe talked with us about all things heart health 101. Her specialties in Cardiovascular disease and Advanced Heart Failure shape important insight on how we can apply simple practices into our daily lives to support cardiovascular health. You can find more from Dr. Haythe hereABOUT THIS PODCASTAt Well+Good HQ, we spend our days talking to and learning from the most interesting people in wellness—experts, thought-leaders and celebrities. On The Well+Good Podcast we're inviting you to join the conversation. With each episode, our hosts will dig into our most clicked on topics in order to reimagine what it means for you to live well. Tune in weekly to find the wellness that fits your frequency.You can also find us on our website on YouTube or social in between shows.Got thoughts? Shoot us a line at podcast@wellandgood.com See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Over 6 million adults in the United States are living with heart failure. Simply put, heart failure means that the heart isn't pumping as well as it should be. While this is a serious condition, many people with heart failure can lead a full life when it is managed properly. It's important to recognize the symptoms and understand the various treatment options –from medical management through transplant. Dr. Erika Feller, a MedStar Health heart failure and transplant cardiologist, shares her insights on these topics and more in this episode of MedStar Health DocTalk.For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

The following question refers to Section 4.1 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. The question is asked by Texas Tech University medical student and CardioNerds Academy Intern Dr. Adriana Mares, answered first by Baylor University cardiology fellow and CardioNerds FIT Trialist Dr. Shiva Patlolla, and then by expert faculty Dr. Eldrin Lewis. Dr. Lewis is an Advanced Heart Failure and Transplant Cardiologist, Professor of Medicine and Chief of the Division of Cardiovascular Medicine at Stanford University. The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Question #4 Mr. Stevens is a 55-year-old man who presents with progressively worsening dyspnea on exertion for the past 2 weeks. He has associated paroxysmal nocturnal dyspnea, intermittent exertional chest pressure, and bilateral lower extremity edema. Otherwise, Mr. Stevens does not have any medical history and does not take any medications.  Which of the following will be helpful for diagnosis at this time? A  Detailed history and physical examination B  Chest x-ray C  Blood workup including CBC, CMP, NT proBNP D  12-lead ECG E All of the above   Answer #4   The correct answer is E – All of the above.  Mr. Stevens presents with signs and symptoms of volume overload concerning for new onset heart failure. The history and physical exam remain the cornerstone in the assessment of patients with HF. Not only is the H&P valuable for identifying the presence of heart failure but also may provide hints about the degree of congestion, underlying etiology, and alternative diagnoses. As such H&P earns a Class 1 indication for a variety of reasons in patients with heart failure: 1.       Vital signs and evidence of clinical congestion should be assessed at each encounter to guide overall management, including adjustment of diuretics and other medications (Class 1, LOE B-NR) 2.       Clinical factors indicating the presence of advanced HF should be sought via the history and physical examination (Class 1, LOE B-NR) 3.       A 3-generation family history should be obtained or updated when assessing the cause of the cardiomyopathy to identify possible inherited disease (Class 1, LOE B-NR) 4.       A thorough history and physical examination should direct diagnostic strategies to uncover specific causes that may warrant disease-specific management (Class 1, LOE B-NR) 5.       A thorough history and physical examination should be obtained and performed to identify cardiac and noncardiac disorders, lifestyle and behavioral factors, and social determinants of health that might cause or accelerate the development or progression of HF (Class 1, LOE C-EO) Building on the H&P, laboratory evaluation provides important information about comorbidities, suitability for and adverse effects of treatments, potential causes or confounders of HF, severity and prognosis of HF, and more. As such, for patients who are diagnosed with HF, laboratory evaluation should include complete blood count, urinalysis, serum electrolytes, blood urea nitrogen, serum creatinine, glucose, lipid profile, liver function tests, iron studies, and thyroid-stimulating hormone to optimize management (Class 1, LOE C-EO). In addition, the specific cause of HF should be explored using additional laboratory testi...

This podcast, Dr. Peter Eckman, a cardiologist and heart failure specialist, with Minneapolis Heart Institute, discusses heart failure and why it is an extensive medical issue. Enjoy the podcast. Objectives:Upon completion of this podcast, participants should be able to: Recognize heart failure as a problematic clinical disease and its morbidity and mortality that leads to comprehensive medical management. Identify and describe optimal contemporary medical therapy for heart failure. Describe novel options for heart failure. CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at Education@ridgeviewmedical.org. Click the link below, to complete the activity's evaluation. CME Evaluation (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker's outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. Thank-you for listening to the podcast. SHOW NOTES:  *See the attachment for additional information.  Heart Failure (HF)- Can occur without congestion or fluid retention - Characterized by fatigue, fluid retention, SOB, PND, orthopnea - We should consider the same urgency for heart failure as patients with CAD and CA. Heart Failure Preserved/Reduced Ejection Fraction (HFpEF/HFrEF)- HFpEF is a Preserved Ejcetion Fraction over about 50% - HFpEF - congestive phenotype more of a fluid retention       - an exercise intolerant phenotupe where the patient becomes intolerant of exercise induced dyspnea.       - Pulm HTN phenotype       - Increased pressure in the heart that gets transmitted to the lungs - HRrEF is Reduced EF is usually below 40% Medications- 4 classes of medications (MRAs, BB, SGLT2, ARNIs) - Treatment with mineralocorticoid receptor antagonists (MRAs) has been demonstrated to improve clinical outcomes in patients with HFrEF with mild to severe symptoms and also in patients with left ventricular dysfunciton after myocardial infarction. - SGLT2 inhibitors reduced the risk of cardiovascular death and hospitalizations for heart failure in a broad range of patients with heart failure, supporting their role as a foundational therapy for heart failure, irrespective of ejection fraction or care setting. - ARNI (angiotensin receptor/neprilysin inhibitor) medication is a newer treatment for heart failure. The combination of sacubitril and valsartan has helped people live longer and have a better quality of life. - Comprehensive EF therapy involves BB, ARNI, MRAs, angiotensin receptor/neprilysin inhibitors. Spironolactone, SGLT2 inhibitors. Treatment- Traditional therapy usually involves a BB and ACE inhibitor. - Currently we should be looking at comprehensive therapy when it comes to HF treatment.       - STOP USING LISINOPRIL.- SGLT2 inhibitors contraindicated ketoacidosis, amputation UTI, weight loss       - (SGLT2 inhibitors) DAPA-HF trial showed that dapagliflozin was superior to placebo at preventing cardiovascular deaths and heart failure events among patients with heart failure.  (Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1911303#article_citing_articles ) - Catheterization - a vast majority of HF patients will need a right heart catheterization. - Cardiac pulmonary pressure monitoring Cardio MEMS - same day outpatient surgery which helps with medication adjustments and hospitalization in half. Works regardless of EF. - CardioVere laser spectroscopy which uses different wavelengths to detect light characteristics to determine the level of edema/fluid present wihin someone's tissues. Currently in development. - Casana is a toilet seat with certain sensors that detect and monitor impedance that check levels between different tissues, monitors HR and weight. - Cardiac contractility modulation causing electrical stumulation during a particular contraction of the myocyets it will augment potential (like a pacemeaker). -CORCHINCH - HF trial catheter based device that cinches up the heart, thereby making it smaller. It works more efficiently.  (Source: Clinical Evaluation of the AccuCinch® Ventricular Restoration System in Patients Who Present With Symptomatic Heart Failure With Reduced Ejection Fraction (HFrEF): The CORCINCH-HF Study) Novel Treatments- Atrial shunting procedure is investigational trials. Potentially impactful in exercise capacity and pressures but stay tuned as the verdict is not out. HfPEF exercise induced intolerance may be the best candidate. - SVC trial feasibility trial more durable effects of cardiac output.  Stay tuned. - LVAD for advanced therapies. Sometimes a bridge for candidacy as well as recovery. - Biventricular pacing has shown promise. *Heart failure is a problematic clinical disease entity with significant morbidity and mortality often leading to comprehensive medical management. It is often beneficial to enlist the help of our heart failure colleagues for these complicated patients.  Thanks to Dr. Peter Eckman - MHI heart failure specialist for his knowledge and contribution to this podcast. Please check out the additonal show notes for additional information/resources.

Description- In this podcast, Dr Williams speaks with Dr Lee Goldberg and Dr Stuart Prenner from the Advanced Heart Failure program at Penn about the management of both HfREF and HfPEF in light of recent studies and the new guidelines from the AHA/ACC.

This episode is focused on Palliative Care and Shared Decision-Making in the CICU. In this episode, we learn about how the principles of palliative care and shared decision-making apply to our patients across the spectrum of cardiovascular care, especially in the cardiac intensive care unit. We discuss pivotal trials of specialty palliative care and decision aids in cardiology and how they might inform our practice to enhance patient quality of life and improve goal-concordant care. Finally, we discuss practical tips and communication strategies for how to engage patients about end-of-life decisions and topics that can be utilized from outpatient to inpatient to critical care settings. “We need to help patients hope for the best and plan for the worst as time goes on.” Dr. Larry Allen Series co-chairs Dr. Eunice Dugan and Dr. Karan Desai, along with CardioNerds Co-founder Amit Goyal are joined by FIT lead, Dr. Sarah Chuzi. Dr. Chuzi is a Chicagoan and completed her internal medicine residency, cardiology fellowship, AHFTC fellowship and is now Assistant Professor at Northwestern University. Our episode expert is a true national leader in shared decision-making and palliative care in heart failure – Dr. Larry Allen, Medical Director of Advanced Heart Failure and the Co-Director of the Colorado Program for Patient-Centered Decisions at the University of Colorado School of Medicine. Audio editing by CardioNerds Academy Intern, Dr. Christian Faaborg-Andersen. The CardioNerds Cardiac Critical Care Series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Mark Belkin, Dr. Eunice Dugan, Dr. Karan Desai, and Dr. Yoav Karpenshif. Pearls • Notes • References • Production Team CardioNerds Cardiac Critical Care PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Palliative Care and Shared Decision-Making in the CICU 1. “Much of what we do in cardiology is thinking about how to make people feel better (not just improving cardiac function or length of life). So, on a day-to-day basis we are really providing primary palliative care.” – Dr. Larry Allen 2. “Risk models in cardiology can only be so accurate… While risk models can give us some grounding, we also need to embrace the concept of uncertainty, and help patients understand that there are a variety of things that might happen to them, suggest some things they might plan for, and continue to iteratively come back to the patient and reevaluate what their options are.” – Dr. Larry Allen 3. “Our goal is to help people live happy, healthy, full lives. But, everyone dies. So understanding that death is a part of life and understanding how to help them make those transitions is critical” – Dr. Larry Allen 4. “Having good deaths is a part of good healthcare. We can't ignore that. We can't fight against it. We should embrace it. And we have the opportunity to do that.” – Dr. Larry Allen 5. We should still keep in mind the concept of medical futility and determining what options are reasonable for patients. Part of shared decision-making includes discussing what interventions would not be feasible or helpful with patients and families Show notes - Palliative Care and Shared Decision-Making in the CICU Notes drafted by Dr. Sarah Chuzi. 1. How are the basic principles of palliative care relevant to cardiology, and can you define the key concepts of shared decision-making, primary palliative care, specialty (or secondary) palliative care, and hospice care? Throughout medicine, we confront the concepts of symptom control, difficult medical decision-making, and end-of-life. These are the principles of palliative care and they apply very easily across the spec...

“PulseCheck” is a new series within CardiaCast that is designed for nurses or allied healthcare professionals who are new, or new to cardiology, offering practical team-based solutions to the challenges that nurses and allied health professionals face every day. In these panel discussions, host Andrea Price MS, RCIS, CPHQ, AACC brings together Bailey Estes MSN, AGNP-C, Adam Burget RN, Benjamin Hocutt MSN, ACNP, AACC, Robert Page PharmD, and Lauren Eyadiel PA-C to explore best practices related to heart failure. In this episode, the focus is on advanced heart failure.

On this week's Truth to Power, we bring you highlights from the 2022 Environmental Justice Conference - Climate Change and Health: People, Principles, Priorities and Policy Making that was held online on Saturday, Oct. 1, 2022 from 10am to 3pm. The West Jefferson County Community Task Force, NAACP, and UofL's Envirome Institute were proud to present this 6th annual Environmental Justice Conference with presentations on health, climate change, EPA and state new environmental policies, alternative energy, what we can do to improve the environment, odors, biomarker studies, Park Hill neighborhood activities, and more. Find more info at http://facebook.com/WJCCTF or email wjcctf.lou@gmail.com On this second edition of highlights, we hear from:
 - Swannie Jett, DrPH, MSc, New CEO of Park DuValle Health Center Sharing the vision and challenges for the center - Ted Smith, PhD, University of Louisville Research associate professor, Division of Environmental Medicine; Director, Center for Healthy Air Water and Soil, Christina Lee Brown Envirome Institute, on “Flushing Health Insights Down the Drain” - Natasha DeJarnett, PhD MPH, University of Louisville on “Climate Change and Environmental Justice” - Dr. Kelley McCants, MD, Cardiovascular Disease, Advanced Heart Failure and Transplant Cardiology; Director, Norton's West End Hospital On Truth to Power each week, we gather people from around the community to discuss the state of the world, the nation, the state, and the city! It's a community conversation like you won't hear anywhere else! Truth to Power airs every Friday at 9pm, Saturday at 11am, and Sunday at 4pm on Louisville's grassroots, community radio station, Forward Radio 106.5fm WFMP and live streams at http://forwardradio.org

In this episode Richard Cheng MD and Michelle Kittleson MD discuss treatment for amyloidosis, including evidence-based therapies, pitfalls, and advanced heart failure management. This podcast is part of the Cardiac Amyloidosis: Accelerating Diagnosis and Treatment grant initiative. (https://learn.acc.org/Page/LEARNCARDIACAMYLOID) Educational grant support is provided by Alnylam.  Subscribe on iTunes | Subscribe on Google Play |

Cardiogenic shock (CS) remains a complex, multifactorial syndrome associated with significant morbidity and mortality. The CardioNerds Critical Care Cardiology Series tackles this important syndrome in a series of several episodes including: LV-predominant Shock, RV-predominant Shock, and Bi-ventricular Shock. In this episode, we review the definitions, pathophysiology, evaluation, and contemporary management, including use of inotropes and mechanical circulatory support, of left ventricular (LV) predominant CS. Series co-chairs Dr. Eunice Dugan and Dr. Karan Desai along with CardioNerds Co-founders Dr. Amit Goyal and Dr. Daniel Ambinder were joined by FIT lead, Dr. Vanessa Blumer, the recipient of the AHA 2021 Laennec Fellow in Training Clinician Award and currently pursuing Advanced Heart Failure and Transplant fellowship at the Cleveland Clinic. Our episode expert is Dr. Shashank Sinha, an Advanced Heart Failure, Mechanical Circulatory Support, and Cardiac Transplant cardiologist, Medical Director of the Cardiac Intensive Care Unit, and Director of the Cardiovascular Critical Care Research Program at INOVA Fairfax Hospital. His illustrious career accomplishments include being a Steering Committee member and site Principal Investigator for the multicenter Cardiogenic Shock Working Group and Critical Care Cardiology Trials Network. Audio editing by CardioNerds academy intern, Anusha Gandhi. The CardioNerds Cardiac Critical Care Series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Mark Belkin, Dr. Eunice Dugan, Dr. Karan Desai, and Dr. Yoav Karpenshif. Pearls • Notes • References • Production Team CardioNerds Cardiac Critical Care PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - LV Predominant Cardiogenic Shock LV-CS is complex! It is important to recognize that the pathophysiology of heart failure-related cardiogenic shock (HF-CS) is distinct from that of acute myocardial infarction (AMI-CS), and also crucial to differentiate between LV-dominant, right ventricular (RV)-dominant and biventricular (BiV)-shock.The SCAI SHOCK Stage Classification provides a unified and standardized vocabulary when assessing severity of CS, and facilitates communication about the diagnosis, presentation, and evolving nature of CS.Norepinephrine is considered the initial vasopressor of choice in most CS patients; the initial inotrope choice is a bit more nuanced!When considering mechanical circulatory support (MCS) for LV shock, high-quality data to guide therapy is lacking but one must always consider “the right patient, for the right device, at the right time” and remember that “pumps pump blood, decisions save lives”.Multidisciplinary, team-based care is paramount to improving survival of the critically ill patient with CS. Show notes - LV Predominant Cardiogenic Shock 1. What tools do you use to define LV CS? CS is a hemodynamically complex and multifactorial syndrome, one of the most common indications for admission to a cardiac intensive care unit, with short-term mortality ranging from 35-50%.It is defined by systemic hypoperfusion and tissue hypoxia due to a primary cardiac insult or dysfunction.Clinical criteria used to define CS typically include evidence of hypotension (classically defined as SBP < 90 mmHg for 30 minutes and/or use of vasopressors, inotropes, or MCS to maintain systolic blood pressure > 90 mmHg) AND evidence of end-organ hypoperfusion (for example, serum lactic acid > 2 mmol/L, acute kidney injury, acute liver injury, altered mental status) in the setting of acute coronary syndrome or acute decompensated heart failure.Laboratory markers, including serum lactic acid, liver function tests,

In this episode, Dr. Carly Fabrizio (Advanced Heart Failure and Transplant Cardiology Physician at Christiana Care Hospital), CardioNerds Critical Care Series Co-Chair Dr. Mark Belkin (Advanced Heart Failure and Transplant Fellow at University of Chicago) and CardioNerds Co-Founder Dr. Amit Goyal (Cleveland Clinic) join Dr. Gavin Hickey (Director of the AHFTC Fellowship and medical director of the left ventricular assist device program at UPMC) and Dr. David Kaczorowski (Surgical Director for the Advanced Heart Failure center, Department of Cardiothoracic Surgery at UPMC) for a discussion on post-cardiotomy shock. Audio editing by CardioNerds Academy Intern, student doctor, Shivani Reddy. Post-cardiotomy shock is characterized by heart failure that results in the inability to wean from cardiopulmonary bypass or develops post cardiac surgery. Patients who develop post-cardiotomy shock typically require inotropic support and may ultimately require temporary mechanical circulatory support. Post-cardiotomy shock carries a high mortality rate. However, early recognition and prevention strategies can help mitigate the risk for developing post-cardiotomy shock. The CardioNerds Cardiac Critical Care Series is a multi-institutional collaboration made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Mark Belkin, Dr. Eunice Dugan, Dr. Karan Desai, and Dr. Yoav Karpenshif. Pearls • Notes • References • Production Team CardioNerds Cardiac Critical Care PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Post-cardiotomy Shock Weaning from cardiopulmonary bypass is an intricate process that includes: rewarming the patient, de-airing the cardiac chambers, ensuring a perfusing heart rhythm, confirming adequate ventilation and oxygenation, removing the intracardiac catheters and cannulas and slowly reducing the blood diverted to the cardiopulmonary circuit and returning it small aliquots to the patient. Much to monitor during the process! Assessing the risk for post-cardiotomy shock prior to going to the OR is important. Consider left ventricular, right ventricular, and valvular function, and don't forget about the value of hemodynamic assessments (pulmonary artery catheter evaluations) to ensure patients are adequately compensated. Close peri-operative monitoring of hemodynamics, hemo-metabolic derangements, and acid/base status can help identify patients who are failing therapy and may require upgrade to temporary MCS. RV assessment is challenging. Utilizing both imaging and hemodynamic evaluations can help understand which RV's will require more support. Multi-disciplinary discussions with a heart team approach prior to cardiac surgery are valuable in identifying high risk patients for post cardiotomy shock and discussing contingency plans if issues arise. Show notes - Post-cardiotomy Shock (drafted by Dr. Carly Fabrizio) How can we diagnose post cardiotomy shock?We can diagnose post cardiotomy shock as patients who are undergoing cardiac surgery that develop hypotension and or tachycardia with hypoperfusion and end organ dysfunction. How can assess the risk of developing postcardiotomy shock prior to going to the OR?LV systolic function is not the only evaluation of cardiac functionDon't ignore the RV!Valvular function must be evaluated in conjunction with LV/RV functionHemodynamics can be helpful prior to going to the ORFilling pressures and CO/CI evaluation --> the more normal range - the less risk of post cardiotomy shockIf going in more deranged --> more complications are likely to occurThink about what options are available post operatively if issues ariseInclude a multi-disciplinary discussions and planning prior to going to the OR ...

VA's first cardiology lab was established at the Washington DC hospital in 1935. Since then, VA has been a leader in developing groundbreaking surgical techniques, conducting hypertension studies, and home to pioneering cardiologist, Dr. Michael DeBakey. Katie and Shawn end season 2 with a look at cardiology's past and future at VA in conversation with Dr. Josef Stehlik, Professor of Medicine at the University of Utah School of Medicine. He is Co-Chief of the Advanced Heart Failure section and Medical Director of the Heart Transplant Program at the University of Utah Health Center and the Salt Lake City VA Medical Center.

CardioNerds (Daniel Ambinder) and ACHD series co-chair Dr. Dan Clark discuss advanced heart failure therapies including mechanical circulatory support (MCS) and heart transplantation (HT) in patients with adult congenital heart disease (ACHD) with Dr. Rafael Alonso-Gonzalez, cardiologist and director of Adult Congenital Heart Disease program at the University of Toronto and ACHD fellow Dr. Andy Pistner (University of Washington). They cover epidemiology of heart failure in ACHD, outcomes after HT, unique challenges of HT in this population, impact of allocation policies on access to transplantation, and regionalization of advanced heart failure care. They also discuss a practical approach to advanced heart failure therapy evaluation in ACHD. Audio editing by CardioNerds Academy Intern, student doctor Adriana Mares. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Advanced Heart Failure Therapies (MCS/HT) Among ACHD Patients Heart failure is a major comorbidity and the leading cause of death in adults with congenital heart disease.Identification of advanced heart failure in ACHD is challenging. ACHD patients do not always self-identify exercise limitations or exertional dyspnea. Cardiopulmonary exercise testing is a useful tool in evaluating these patients.Patients with ACHD awaiting heart transplantation are less likely than non-ACHD patients to receive a heart transplant, and ACHD patients have an increased risk of death or delisting while awaiting heart transplantation.Evaluation of transplant candidacy and potential need for multi-organ transplantation in complex congenital heart disease (i.e., Fontan palliation) requires a multidisciplinary approach.Regionalization of care improves outcomes for ACHD patients with advanced heart failure. High volume transplant centers have better early survival for ACHD patients after heart transplant, and the highest volume ACHD transplant centers in each UNOS region have better early survival. Show notes - Advanced Heart Failure Therapies (MCS/HT) Among ACHD Patients 1. How many ACHD patients have heart failure? Patients with ACHD are a large and heterogeneous group. The signs and symptoms of heart failure vary widely depending on the underlying congenital heart disease. Patients with D-transposition of the great arteries repaired with an arterial switch operation have low rates of heart failure (~3%)1 compared to those patients Fontan palliation for single ventricle physiology (40%)2. Heart failure is the leading cause of death in patients with ACHD3,4. 2. How many patients with ACHD end up receiving a heart transplant or mechanical circulatory support? Heart transplantation for congenital heart disease in adults has been increasing in frequency since the late 1980s. Between 2010 and 2012, this accounted for 4% of all adult heart transplants in the United States5. This represents a small fraction compared to the number of adults who die due to complications of heart failure ...

Commentary by Dr. Valentin Fuster

The LIFE study, multimorbidity and evidence translation, cardiac arrest and therapeutic fashion, diabetes and cardiology, and EP cuts are the topics John Mandrola, MD, tackles in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – LIFE Study and Substudy - LIFE: ARNI Does Not Best Valsartan in Advanced Heart Failure https://www.medscape.com/viewarticle/952681 - Tolerability of Sacubitril/Valsartan in Patients With Advanced Heart Failure: Analysis of the LIFE Trial Run-In https://www.jacc.org/doi/10.1016/j.jchf.2022.04.013 - Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection FractionA Randomized Clinical Trial https://jamanetwork.com/journals/jamacardiology/fullarticle/2785700 II – Early Angiography and Therapeutic Fashion - Emergency Angiography for Cardiac Arrest Without ST Elevation? https://www.medscape.com/viewarticle/975434 - Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac ArrestResults of the Randomized, Multicentric EMERGE Trial https://jamanetwork.com/journals/jamacardiology/article-abstract/2793310 - Immediate Coronary Angiography in Survivors of Out-of-Hospital Cardiac Arrest https://www.nejm.org/doi/full/10.1056/NEJM199706053362302 - Coronary Angiography after Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa1816897 - Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.049569 - Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation https://www.nejm.org/doi/10.1056/NEJMoa2101909 - Most healthcare interventions tested in Cochrane Reviews are not effective according to high quality evidence: a systematic review and meta-analysis https://www.jclinepi.com/article/S0895-4356(22)00100-7/fulltext III – Diabetes and Cardiology - Medicare Advantage Tied to Less Use of Pricey Diabetes Drugs https://www.medscape.com/viewarticle/977181 - Diabetes Care Among Older Adults Enrolled in Medicare Advantage Versus Traditional Medicare Fee-For-Service Plans: The Diabetes Collaborative Registry https://doi.org/10.2337/dc21-1178 IV – EP Cuts - EP Ablation Rate Changes in 2022 Physician Fee Schedule https://www.acc.org/Latest-in-Cardiology/Articles/2021/11/18/01/44/EP-Ablation-Rate-Changes-in-2022-Physician-Fee-Schedule You also may like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Alex Hajduczok, MD, is a first-year cardiology fellow at Thomas Jefferson University Hospital in Philadelphia, PA. He completed his internal medicine training at Penn State Hershey Medical Center in Hershey, PA, and went to medical school at the University of Rochester School of Medicine & Dentistry in Rochester, NY. He is interested in a career as an academic cardiologist, specializing in Advanced Heart Failure and Transplant. His main research interests include remote monitoring for heart failure, hemodynamics, and cardiogenic shock. He started using WHOOP in 2017 to optimize CrossFit training and has been a Level-1 certified CrossFit trainer since 2016. Alex leads multiple clinical trials with wearables and uses device-measured objective data in his own life to improve performance. Medical Aid to Ukraine ABC World News Alex Hajduczok Twitter Alex Hajduczok Instagram Resources mentioned in the show: Stress, recovery and training (Dan Pope on the Fitness Pain Free Show)

Interventional Cardiologist Chesapeake Regional CardiopulmonaryFrank J. Amico, Jr., DO, FACC, FACPChesapeake Regional Healthcare's cardiology program saves lives by connecting our region to leading-edge technology that improves accuracy and shortens recovery .Dr. Frank Amico is board-certified in Internal Medicine, Cardiology, Advanced Heart Failure and Transplant Cardiology. He specializes in cardiovascular disease and practices at Chesapeake Regional Cardiopulmonary.What does an interventional cardiologist do?What are  common symptoms of heart disease?What can people do to improve their heart health?What is heart failure?What is a bad habit that people do and contribute to heart problems?How can people find you?For more information go to: ChesapeakeHeart.com Phone: 757-312-4047Watch the Interview on Facebook HereFor more great We Are Living Healthy content, don't forget to subscribe to the podcast on all major podcasting platforms. https://livinghealthy.buzzsprout.comAlready subscribed? Please take a moment to rate and review the podcast so that we can reach as many people that need the help as we can: https://3cstvshow.buzzsprout.com Follow us on Facebook: @WeAreLivingHealthyTVDISCLAIMER: THE CONSULTATIONS OR INTERACTIONS OFFERED ARE NOT MEANT TO REPLACE A CONSULTATION WITH YOUR PHYSICIAN. THE CONSULTATION IS FOR EDUCATIONAL PURPOSES ONLY AND NOT STRUCTURED IN A WAY TO PROVIDE HEALTH COUNSELING / DIAGNOSING OF ANY KIND. YOU UNDERSTAND THAT WE ARE LIVING HEALTHY IS NOT PROVIDING INFORMATION AS YOUR TREATING HEALTH COUNSELOR, PHYSICIAN, ATTORNEY, LEGAL COUNSEL, EMPLOYER, MEDICAL PROFESSIONAL. We offer no guarantees or promise of results from event nor assume liability for any information provided. 

Interventional Cardiologist Chesapeake Regional CardiopulmonaryFrank J. Amico, Jr., DO, FACC, FACPChesapeake Regional Healthcare's cardiology program saves lives by connecting our region to leading-edge technology that improves accuracy and shortens recovery .Dr. Frank Amico is board-certified in Internal Medicine, Cardiology, Advanced Heart Failure and Transplant Cardiology. He specializes in cardiovascular disease and practices at Chesapeake Regional Cardiopulmonary.What does an interventional cardiologist do?What are  common symptoms of heart disease?What can people do to improve their heart health?What is heart failure?What is a bad habit that people do and contribute to heart problems?How can people find you?For more information go to: ChesapeakeHeart.com Phone: 757-312-4047Watch the Interview on Facebook HereFor more great We Are Living Healthy content, don't forget to subscribe to the podcast on all major podcasting platforms. https://livinghealthy.buzzsprout.comAlready subscribed? Please take a moment to rate and review the podcast so that we can reach as many people that need the help as we can: https://3cstvshow.buzzsprout.com Follow us on Facebook: @WeAreLivingHealthyTVDISCLAIMER: THE CONSULTATIONS OR INTERACTIONS OFFERED ARE NOT MEANT TO REPLACE A CONSULTATION WITH YOUR PHYSICIAN. THE CONSULTATION IS FOR EDUCATIONAL PURPOSES ONLY AND NOT STRUCTURED IN A WAY TO PROVIDE HEALTH COUNSELING / DIAGNOSING OF ANY KIND. YOU UNDERSTAND THAT WE ARE LIVING HEALTHY IS NOT PROVIDING INFORMATION AS YOUR TREATING HEALTH COUNSELOR, PHYSICIAN, ATTORNEY, LEGAL COUNSEL, EMPLOYER, MEDICAL PROFESSIONAL. We offer no guarantees or promise of results from event nor assume liability for any information provided. 

In part 2 of this 2-part series- Dr. Williams speaks with Dr. Lee Goldberg and Dr. Stuart Prenner from the Advanced Heart Failure program at Penn about the management of both HfREF and HfPEF in light of recent studies and the new guidelines from the AHA/ACC.