Podcasts about cardiac

Cardiac arrest remains one of the most scrutinised and resource-intensive presentations in prehospital care. We invest heavily in improving what happens in the moment, compression quality, airway strategies, defibrillation timing, and team coordination. Yet one of the most powerful determinants of system performance often sits outside the resuscitation itself: what we do with the data afterwards.In many services, once the patient is handed over or resuscitation is terminated, the process effectively stops. Information is fragmented, device data is reviewed inconsistently, and structured debriefing is applied variably. As a result, opportunities to identify system errors, reinforce high performance, and drive meaningful quality improvement are frequently lost.At the same time, prehospital systems are generating more data than ever before CPR metrics, rhythm timelines, drug administration logs, and physiologic trends. The challenge is no longer collection, but conversion: turning raw resuscitation data into actionable learning. Layered on top of this is an emerging opportunity to deliver meaningful information to hospitals in real time, supporting earlier decision-making in the ED and cath lab before the patient even arrives.In this episode, we explore how structured debriefing, post-arrest analysis, and improved data integration could transform cardiac arrest care from a series of isolated events into a continuous learning system spanning prehospital teams and receiving hospitals.This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Dr. Philip Ovadia, MD, is a board-certified heart surgeon who became a leading advocate for metabolic health after confronting both his patients' outcomes and his own struggle with obesity and insulin resistance. With decades of surgical experience, he has witnessed firsthand the consequences of metabolic disease. Today, he focuses on prevention, education, and empowering individuals to reverse metabolic dysfunction before surgery becomes necessary. Founder of Ovadia Heart Health and host of The Stay Off My Operating Table Podcast. BUY THE BOOK!  Stay Off My Kitchen Table can be purchased here: https://stayoffmykitchentable.com/ Instagram: https://www.instagram.com/ifixhearts/ Facebook: https://www.facebook.com/ifixhearts YouTube: https://www.youtube.com/@UCu8xppo0Y7mJz4uqkc7o7TQ  Apple Podcasts: https://podcasts.apple.com/ca/podcast/stay-off-my-operating-table/id1587212660 Timestamps: 00:00 Trailer 01:11 Introduction 03:27 Interest in cardiac surgery and metabolic health 07:35 Healthcare system restrictions on doctors 12:31 Cardiac diet and post-surgery care 15:28 Book release and diet exploration 19:54 Moving to Florida and health insights 22:53 Controversial PCSK9 trial results 26:09 Challenges in understanding cholesterol 30:19 Discussing heart disease diagnoses 31:33 Importance of arterial plaque screening 37:26 Heart attacks and undiagnosed diabetes 39:13 Understanding CAC score progression 44:38 Discussing blood pressure guidelines 46:40 Where to find Dr. Ovadia Join Revero now to regain your health: https://revero.com/YT Revero.com is an online medical clinic for treating chronic diseases with this root-cause approach of nutrition therapy. You can get access to medical providers, personalized nutrition therapy, biomarker tracking, lab testing, ongoing clinical care, and daily coaching. You will also learn everything you need with educational videos, hundreds of recipes, and articles to make this easy for you. Join the Revero team (medical providers, etc): https://revero.com/jobs ‪#Revero #ReveroHealth #shawnbaker  #Carnivorediet #MeatHeals #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree Disclaimer: The content on this channel is not medical advice. Please consult your healthcare provider.

Ethan Pratt, Head of Engineering at SandboxAQ's AQMed division, joins Tai-Danae Bradley for a conversation about building heart-health technology that can meet clinicians where they are: in the fast, messy reality of the emergency room.In this episode, Ethan explains AQMed's work on magnetocardiography, a technique designed to capture the heart's magnetic signals and help address one of medicine's toughest everyday challenges: evaluating chest-pain patients in the ER's diagnostic “gray zone.” He shares why the team has focused so intensely on real hospital workflows, how an “algorithmic shield” helps separate the heart's signal from ambient magnetic noise, and why getting prototypes into real clinical settings matters more than waiting for perfection in the lab.The conversation also traces Ethan's unconventional path into medtech, from rebuilding a 1967 Camaro and studying physics at Cal Poly to earning a PhD at Cornell and eventually discovering that his strengths lay not in abstract theory alone, but in building experiments, devices, and teams that work in the real world. Along the way, he reflects on math anxiety, interdisciplinary collaboration, and the guiding principle that has shaped both his career and his leadership style: start with what you know.CAUTION— CardiAQ is an investigational device. Limited by Federal (or United States) law to investigational use.LinksLearn more about SandboxAQ's AQMed team here: https://www.sandboxaq.com/solutions/aqmed Connect with Ethan on LinkedIn: https://www.linkedin.com/in/ethanpratt/ About this podcastThis podcast is hosted by Tai-Danae Bradley and features the stories of amazing people working in science and technology at SandboxAQ and beyond. All curious humans are invited to join!Want to get in touch? Write us at faq-podcast@sandboxaq.comFor previous episodes, check out https://www.youtube.com/@sandboxaq

Scott Coleman and Stephen Tolbert discuss three wild games in Baltimore over the weekend, capped off by a wacky 11th inning win on Sunday to improve the Braves to 7-3 in the second half. The boys also discuss the nearing trade deadline, a fatigued bullpen, Ronald Acuña Jr.'s pending return, and much more.

Tony Haskel is fighting cardiac sarcoidosis.  He has been battling the disease since 2022, and it's been a long road back.  In fact, he will tell you he's nowhere close to where he once was or where he wants to be.  Tony is a return visitor to the podcast, having first joined me in March of 2023.  We both felt like it was time for an update.   SHOW NOTES FSR helps patients navigate insurance:  https://www.stopsarcoidosis.org/foundation-for-sarcoidosis-research-announces-new-partnership-with-patient-advocate-foundation-to-expand-insurance-and-disability-support-for-sarcoidosis-patients/    Sarcoidosis News Pulmonary relapse report: https://sarcoidosisnews.com/news/relapse-common-pulmonary-sarcoidosis-treatment-changes/ John's story from the White House on Col. John Ripley: https://www.wsls.com/video/news/2026/06/19/col-john-ripley-of-radford-receives-posthumous-medal-of-honor/   MORE FROM JOHN: Cycling with Sarcoidosis http://carlinthecyclist.com/category/cycling-with-sarcoidosis/ Do you like the official song for the Sarc Fighter podcast?  It's also an FSR fundraiser! If you would like to donate in honor of Mark Steier and the song, Zombie, Here is a link to his KISS account.  (Kick In to Stop Sarcoidosis)  100-percent of the money goes to the Foundation.  https://stopsarcoidosis.rallybound.org/MarkSteier The Foundation for Sarcoidosis Research https://www.stopsarcoidosis.org/ Donate to my KISS (Kick In to Stop Sarcoidosis) fund for FSR  https://stopsarcoidosis.rallybound.org/JohnCarlinVsSarcoidosis?fbclid=IwAR1g2ap1i1NCp6bQOYEFwOELdNEeclFmmLLcQQOQX_Awub1oe9bcEjK9P1E My story on Television https://www.stopsarcoidosis.org/news-anchor-sarcoidosis/ email me  carlinagency@gmail.com #sarcoidosis #sarcoidosisawareness #kidney #dermatology                

In this bonus episode, Dr. Kahn interviews functional medicine specialist Ivan Rusilko about the importance of advanced lab panels. Together, they explore the full spectrum of cardiac lab testing, with a special focus on inflammation, insulin resistance, and how these markers can uncover hidden cardiovascular risk. If you are a health care practitioner, set up an account at accessmedlab.com. Mention the Heart Doc VIP Podcast when creating your new practitioner account to receive 50% off CardioPro™ Advanced Diagnostic Panels, providing unparalleled insights into patient health.

CardioNerds (Drs. Apoorva Gangavelli, Jenna Skowronski, and Hannah Every) discuss the continuum of prevention and heart failure with Drs. Anu Lala and Martha Gulati. Grounded in a clinical case of a 55-year-old woman with uncontrolled hypertension, type 2 diabetes, and obesity who is on the trajectory toward heart failure, this episode unpacks a paradigm-shifting framework from a joint HFSA/ASPC Scientific Statement. The discussion explores how prevention should not be siloed from heart failure management but rather integrated across a patient’s lifespan—from primary prevention in at-risk individuals, to secondary prevention in those with established heart failure, to tertiary prevention in patients with advanced therapies such as LVADs and heart transplantation. The experts highlight the importance of aggressive risk factor management, biomarker-guided screening, the AHA’s Life’s Essential 8, and the need for multidisciplinary collaboration and systems-level change to shift heart failure care from reactive to proactive. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk Heart failure prevention is a continuum, not a checkpoint. Prevention applies at every stage—from at-risk (Stage A) through advanced/post-transplant care—and every clinical encounter is an opportunity to intervene. The AHA’s Life’s Essential 8 (diet, physical activity, nicotine exposure, sleep, BMI, blood lipids, blood glucose, blood pressure) forms the foundation at every stage. Hypertension carries the highest population-attributable risk for heart failure of any modifiable risk factor. In the Framingham Heart Study, 91% of patients with newly diagnosed HF had pre-existing hypertension. The SPRINT trial demonstrated a 38% reduction in HF incidence with intensive blood pressure targets (30 ng/L or NT-proBNP >125 ng/L) identify individuals at heightened risk for progression to symptomatic HF. The ACC/AHA/HFSA guidelines give a Class IIa recommendation for natriuretic peptide screening in at-risk patients. Urine albumin-to-creatinine ratio (UACR) is an underutilized screening tool that provides additional insight into CKM risk. The heart failure label does not close the prevention window—it accentuates it. Secondary prevention through GDMT optimization (quadruple therapy in HFrEF) and continued risk factor management remains critical. Tertiary prevention extends to post-LVAD and post-transplant patients, where hypertension, diabetes, obesity, and CKD management remain essential to long-term outcomes. Show notes For a comprehensive review, please review the full HFSA/ASPC Joint Scientific Statement: Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine. J Card Fail. 2026;32:75-105. doi:10.1016/j.cardfail.2025.06.013 1. What is the “continuum of prevention” framework, and how does it differ from traditional approaches to heart failure prevention? Historically, prevention and heart failure management have been treated as separate disciplines—primary prevention handled by preventive cardiologists and treatment managed by heart failure specialists. This joint HFSA/ASPC Scientific Statement reframes prevention as a dynamic, continuous process that spans a patient’s entire lifespan, regardless of HF stage or ejection fraction. The framework maps onto the ACC/AHA HF staging system: Primary prevention targets Stage A (“at risk”) and Stage B (“pre-HF”) patients to reduce the burden of incident HF. Secondary prevention targets Stage C (symptomatic) and Stage D (advanced) patients to reduce the impact of established HF through GDMT optimization and ongoing risk factor management. Tertiary prevention encompasses risk factor management in patients with LVADs or heart transplants—populations where hypertension, diabetes, and obesity still drive outcomes. The Central Figure of the statement illustrates that Life’s Essential 8 (blood pressure and lipid control, diabetes management, exercise, sleep, smoking cessation, weight management, and diet/nutrition counseling) forms the foundation at every stage, with pharmacologic and device-based therapies layered on top as disease progresses (Figure) 2. How do traditional risk factors drive heart failure, and what should clinicians prioritize? Hypertension carries the greatest population-attributable risk for HF. In the Framingham Heart Study (N=5,143), HTN was associated with a 2- to 3-fold increased risk of HF, with a population-attributable risk of 39% in men and 59% in women. The SPRINT trial showed a 38% reduction in HF incidence and 25% reduction in the primary composite outcome with intensive BP targets (30 ng/L or NT-proBNP >125 ng/L) are associated with heightened risk for progression to symptomatic HF. In the ARIC study, incorporating NT-proBNP reclassified 20% of older adults without HF into Stage B. Factors that affect interpretation include age, sex, obesity (lower values), and CKD (higher values). High-sensitivity cardiac troponin (hs-cTn): Concentrations above the 99th percentile are now included in the definition of Stage B HF. Troponin testing may complement natriuretic peptides, particularly when BNP/NT-proBNP values are ambiguous. Risk scores: The PCP-HF equation predicts 10-year HF risk using traditional risk factors plus QRS duration. The AHA PREVENT score incorporates HF risk calculation and includes markers of kidney function (albuminuria, eGFR), though it may underestimate risk in men and Black adults. The CKM syndrome staging framework (Stages 0–4) provides a holistic approach to assessing systemic cardiovascular-kidney-metabolic risk. 4. What are the key nontraditional risk factors and cross-cutting themes in heart failure prevention? Genetics: Pathogenic cardiomyopathy variants exist in ~1 in 200 individuals in the general population. The HFSA and ACMG recommend cascade testing to identify at-risk family members. Polygenic risk scores for dilated cardiomyopathy show a 3.8-fold risk for DCM in the top 10th percentile compared with the median. Sex-specific considerations: Women have 2.8 times the odds of developing HFpEF, while men have similarly increased odds of HFrEF. A complete obstetric/gynecologic history is essential—preeclampsia is associated with a 4-fold increased risk of HF. Peripartum cardiomyopathy requires intentional screening in high-risk populations. Cardiotoxic exposures: Clinicians should be aware of medications that cause direct myocardial toxicity (e.g., anthracyclines, trastuzumab, tyrosine kinase inhibitors). A team-based approach with pharmacists can help optimize medication selection and risk factor modification. Social determinants of health: Environmental exposures (air pollution, arsenic, lead, cadmium), food insecurity, financial instability, and limited healthcare access contribute to HF risk and progression. Equity-focused, risk-based prevention strategies are needed. Psychological health: Depression is common in HF and independently associated with worse outcomes. Screening with brief questionnaires (e.g., PHQ-2) is recommended. Meditation, spirituality, and holistic wellness approaches remain underutilized. 5. What systems-level and policy changes are needed to move the needle on heart failure prevention? Multidisciplinary HF prevention clinics that bring together preventive cardiologists, HF specialists, endocrinologists, nephrologists, dietitians, pharmacists, exercise physiologists, and genetic counselors are advocated by the statement. EHR-embedded risk stratification could proactively flag patients on a trajectory toward HF—analogous to sepsis alerts or fall risk flags—enabling earlier intervention, particularly for patients who may not reach a cardiologist. Cardiac rehabilitation remains underutilized, particularly in HFrEF (Class 2b recommendation) and HFpEF (not yet covered by Medicare). The HF-ACTION trial showed quality-of-life benefits, and the REHAB-HF trial showed particular benefit in older patients with HFpEF. Policy priorities include expanding insurance coverage for preventive screening and novel therapies (SGLT2i, GLP-1 RAs, nsMRAs), reducing clinical inertia through team-based care models with closer follow-up intervals, and ensuring equitable access to evidence-based therapies across diverse populations. Digital health and AI hold promise for personalized risk prediction, remote monitoring (e.g., wearable devices, implantable PA pressure monitors), and virtual cardiac rehabilitation to overcome access barriers. Figure  Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013) References Key references are bolded. Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013 Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146(5):e18-e43. doi:10.1161/CIR.0000000000001078 SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103-2116. doi:10.1056/NEJMoa1511939 Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557-1562. doi:10.1001/jama.1996.03530440037034 Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981-2997. doi:10.1001/jama.288.23.2981 Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145-153. doi:10.1056/NEJM200001203420301 Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720 Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038 Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286 Filippatos G, Anker SD, Agarwal R, et al. Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation. 2022;145(6):437-447. doi:10.1161/CIRCULATIONAHA.121.057983 Solomon SD, McMurray JJV, Vaduganathan M, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2024;391(16):1475-1485. doi:10.1056/NEJMoa2407107 Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563 Deanfield J, Verma S, Scirica BM, et al. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial. Lancet. 2024;404(10454):773-786. doi:10.1016/S0140-6736(24)01498-3  Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963 Ndumele CE, Neeland IJ, Tuttle KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation. 2023;148(20):1636-1664. doi:10.1161/CIR.0000000000001175 Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association’s PREVENT equations. Circulation. 2024;149(6):430-449. doi:10.1161/CIRCULATIONAHA.123.067626 Khan SS, Ning H, Shah SJ, et al. 10-year risk equations for incident heart failure in the general population. J Am Coll Cardiol. 2019;73(19):2388-2397. doi:10.1016/j.jacc.2019.02.057 Bozkurt B, Fonarow GC, Goldberg LR, et al. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am Coll Cardiol. 2021;77(11):1454-1469. doi:10.1016/j.jacc.2021.01.030 Packer M. Leptin-aldosterone-neprilysin axis: identification of its distinctive role in the pathogenesis of the three phenotypes of heart failure in people with obesity. Circulation. 2018;137(15):1614-1631. doi:10.1161/CIRCULATIONAHA.117.032474 Lala A, Tayal U, Hamo CE, et al. Sex differences in heart failure. J Card Fail. 2022;28(3):477-498. doi:10.1016/j.cardfail.2021.10.006 Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure. Eur J Heart Fail. 2021;23(3):352-380. doi:10.1002/ejhf.2115 Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy—a Heart Failure Society of America practice guideline. J Card Fail. 2018;24(5):281-302. doi:10.1016/j.cardfail.2018.03.004 Levine GN, Cohen BE, Commodore-Mensah Y, et al. 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Energy Drinks Can Damage a Healthy Heart; Plus When Anxiety Symptoms Are Really Cardiac Link for CME Credit Coming Soon! A recent case involving a teenage cheerleader's death has prompted a closer look at energy drinks and cardiovascular risks in young people. Host Holly Wayment and pediatric cardiologist Dr. Elaine Maldonado discuss how high-caffeine and stimulant drinks—often marketed to teens and available in school vending machines or coffee bars—can trigger palpitations, chest pain, high blood pressure, and dangerous heart rhythms. The American Academy of Pediatrics recommends no role for caffeine in children; parents and pediatricians should watch for red flags (persistent rapid heartbeat, unexplained chest pain, fainting during exertion), counsel on sleep, hydration, and exercise, and offer safer alternatives to energy drinks.

Contributor; Taylor Lynch, MD Educational Pearls: Thoracotomy  Thoracotomy is used in traumatic cardiac arrest to replace conventional CPR with direct access to the chest. Goals include identifying and controlling reversible causes of bleeding, prioritizing blood flow to the heart and brain, and performing open cardiac massage. Trauma categories Penetrating trauma: Gunshot wounds and stab wounds. Has a higher chance of survival because the injury may be localized and directly repairable. Cardiac stab wounds may have the highest survivability because the defect can be visualized, repaired, and treated with blood administration. Blunt trauma: Motor vehicle collisions and falls from height. Has a much lower chance of survival. Western guidelines EMS must witness the patient lose pulses. Penetrating trauma: CPR for less than 15 minutes. Blunt trauma: CPR for less than 10 minutes. Survival decreases to essentially zero beyond these time limits. Eastern guidelines Focus on the presence of signs of life in blunt or penetrating trauma. Signs of life may include: Pupillary response. Measurable blood pressure. Purposeful movement. Patient selection Thoracotomy should only be performed when the patient has a reasonable chance of survival. It is a highly morbid procedure with significant occupational risks, including needlestick injury. Appropriate patient selection and timing are essential. Procedure Begin on the left side of the chest. Cross-clamp the aorta to restrict blood flow below the heart and prioritize circulation to the heart and brain. Identify and repair visible sources of bleeding involving structures such as the heart or lungs. Perform open cardiac massage as the equivalent of CPR. ACLS medications may still be administered. References: Cothren CC, Moore EE. Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World J Emerg Surg. 2006;1:4. Published 2006 Mar 24. doi:10.1186/1749-7922-1-4 Rhee, Peter M. ; Acosta, Jose ; Bridgeman, Amy et al. / Survival after emergency department thoracotomy : Review of published data from the past 25 years. In: Journal of the American College of Surgeons. 2000 ; Vol. 190, No. 3. pp. 288-298. Nunn, Andrew ; Prakash, Priya ; Inaba, Kenji et al. / Occupational exposure during emergency department thoracotomy : A prospective, multi-institution study. In: Journal of Trauma and Acute Care Surgery. 2018 ; Vol. 85, No. 1. pp. 78-84. Burlew CC, Moore EE, Moore FA, et al. Western Trauma Association critical decisions in trauma: resuscitative thoracotomy. J Trauma Acute Care Surg. 2012;73(6):1359-1363. doi:10.1097/TA.0b013e318270d2df Seamon MJ, Haut ER, Van Arendonk K, et al. An evidence-based approach to patient selection for emergency department thoracotomy: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015;79(1):159-173. doi:10.1097/TA.0000000000000648 Summarized by Steven Fujaros NREMT | Edited by Steven Fujaros & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/   Join our mailing list: http://eepurl.com/c9ouHf

In this episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Andre Cap to unpack the evolving role of calcium in trauma resuscitation. What started as the “new hotness” in forward blood transfusion protocols has become far more nuanced. They discuss the dangers of both hypocalcemia and hypercalcemia, how citrate in all blood products binds ionized calcium, cardiac effects, recent observational data showing worse outcomes with hypercalcemia, and practical guidance for when, how, and how much calcium to give in austere and prolonged field care environments.Whether you're running a Role 2, working prolonged field care, or just trying to keep your patient alive until definitive care, this episode challenges long-held assumptions and offers field-practical recommendations.Key Takeaways:All blood products contain citrate, which binds ionized calcium — expect hypocalcemia with significant transfusion.Both hypo- and hypercalcemia are bad; recent data shows hypercalcemia is associated with worse mortality than hypocalcemia.Current TCCC guidance (1g calcium after first unit) was written to fix under-use; it may now be too aggressive in some scenarios.Give calcium after blood products, not before. Consider waiting until after 2+ units in most cases.Slow IV push (over ~5 minutes) through a confirmed good peripheral line; calcium chloride is a vesicant — use caution (gluconate is safer).Avoid calcium chloride via IO if possible. Titrate to clinical response when monitoring isn't available.In refractory shock you can give more, but don't give calcium as a standalone resuscitation drug — it can be harmful without volume replacement.Ideal future state: Bring i-STAT capability forward when feasible and get better RCT data.Perfect for medics, PAs, physicians, and anyone managing hemorrhagic shock in austere environments.Links:⁠www.prolongedfieldcare.org⁠ | @prolonged_field_carePodcast Chapters (with Timestamps):00:00 – Intro & Welcome00:39 – Why Calcium Became “The New Hotness” in Trauma Care01:18 – The Joint Trauma System Audit That Started It All03:46 – Citrate in Every Blood Product – The Science Behind the Bind05:44 – Why We Actually Care: Cardiac Repolarization, Contractility & Vascular Tone08:49 – Hypocalcemia vs Hypercalcemia in Trauma Patients10:21 – Shocking New Data: Hypercalcemia Carries Higher Mortality13:14 – TCCC Guidelines – After First Unit? Is This Too Aggressive?14:03 – When Should You Actually Give Calcium in the Field?19:34 – Clinical Triggers Without Monitoring + Dosing Strategy24:56 – Safety First: IV Patency, Calcium Chloride vs Gluconate, IO Concerns28:44 – When to Stop Giving Calcium & Avoiding Over-Correction32:00 – Historical Lessons: When Calcium Alone Made Things Worse33:39 – Practical PFC Recommendations & Final Thoughts38:04 – Closing & Where to Find MoreFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠⁠

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete NCPD information, and to apply for credit, please visit us at PeerView.com/NKC865. NCPD credit will be available until July 23, 2027.Winning Strategies for Managing Transthyretin Cardiac Amyloidosis: The Heart Failure Nurse's Game Plan In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Alnylam Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.

Broadcast from KSQD, Santa Cruz on 7-16-2026: Dr. Dawn dissects a June 2026 JAMA Internal Medicine paper that claimed simultaneous flu and COVID vaccination in veterans reduced cardiac events, arguing the retrospective natural-experiment design cannot support causal conclusions. The 20% versus 2% dropout rates between groups signal fundamentally non-comparable populations, and the divergence in cardiac events starting within a month of vaccination is clinically implausible—suggesting an X-factor other than vaccine effect is driving the numbers. Dr. Dawn delivers a pointed critique of a major chain pharmacy—part of a vertical healthcare monopoly—for creating deliberate friction around controlled-substance prescriptions through claims of stock shortages, unnecessary prior authorizations, and phantom "clarification" requests. She acknowledges the real paperwork burden of DEA compliance (quarterly reporting, six-month inspections, legitimate-need documentation) but argues chains are pushing pain patients away rather than doing due diligence, while independent pharmacies are closing at alarming rates in California. Following up on last week's Kampo medicine caller, Dr. Dawn reports research on Goshajinkigan showing it suppresses voltage-gated sodium channels at the motor end plate, functioning as a muscle relaxant used clinically in Japan for low back pain, extremity numbness, and chemotherapy- and diabetic-induced neuropathy. An emailer asks about a case report of an 80-year-old woman with 10-year Alzheimer's whose function dramatically improved after 5g oral psilocybin (Enigma strain), regaining conversation, continence, and autonomous dressing. Dr. Dawn notes plausible mechanisms (neuroplasticity, anti-inflammatory action, elevated BDNF) but cautions the diagnosis was clinical rather than confirmed with imaging or CSF markers, and recommends the emailer pursue exercise and sleep optimization for word-finding difficulties instead. An emailer asks how to reassure her chemically-hypersensitive adult son that their remediated apartment is safe. Dr. Dawn recommends commercial ERMI (Environmental Relative Moldiness Index) testing along baseboards where spores concentrate, plus urine mycotoxin testing on the parents themselves to demonstrate objectively low exposure levels. Drosophila fruit-fly males produce sperm longer than their own 2mm bodies—40 times longer than human sperm—with thousands packed inside. Fluorescent-dye imaging shows the sperm remain unusually still and coordinated, moving in synchronized slow waves like flocking birds or kelp in tides, preventing tangling. A Washington University study of 154,000 UK and 10,000 US participants used nine blood biomarkers to calculate biological age, finding people born in the 1990s show accelerated biological aging compared to those born three decades earlier. The gap between biological and chronological age correlated with increased risk of lung, colon, and uterine cancers—all rising in younger populations. A University of Pennsylvania study of 493 mouse litters found germ-free mice had shorter reproductive lifespans, more ovarian scarring, and accelerated loss of primordial follicles. Introducing gut bacteria at birth or weaning reversed these effects, as did supplementation with short-chain fatty acids alone (butyrate, isobutyrate, acetate). Dr. Dawn suggests ghee as a readily available butyrate source for those interested in the theoretical fertility-preservation benefit.

Dr. Adam Brockman sits down with functional medicine and wellness-tech expert Dr. Dave Heitmann to unpack a landmark shift in cardiovascular care — from a $10 billion acquisition reshaping the wearable- tech landscape to an FDA-cleared wrist device tracking your heart's every beat and movement in real time. They break down what continuous cardiac monitoring actually means for the "normal lab lie" how AI is reshaping who interprets your health data, and what it could mean for the millions of Americans one heartbeat away from a warning sign they'd otherwise never catch in time.

The long run is a staple of training plans from the 5K to ultra - but why? In this episode, we discuss the science of long runs, including the physiological adaptations, progressions, specificity and more. Plus, we answer your questions about why sleep is difficult after a long run, if walk breaks are okay, and if you treadmill long runs at a lower heart rate are better than outdoors.Thank you to our sponsors:✨ Mizuno: Shop Mizuno's newest bouncy supertrainer: https://runtothefinish.com/neovista3/In this episode, you'll learn:✅ Why long runs are beneficial✅ If fueling your long runs compromises adaptations✅ How to progress your long runs✅ How often you should do long runs at goal race pace✅ Cardiac drift, cadence, and other things to pay attention to on long runs✅ Terrain specificity during long runsIf you enjoyed this episode, you may like:

Recorded at EHRA 2026, this episode of The Lead features host Michael S. Lloyd, MD, FHRS, in conversation with Tina Baykaner, MD, MPH, and Kenneth Ellenbogen, MD, FHRS, about the journal article, Real-time smartphone alerts during atrial fibrillation episodes with implantable cardiac monitors and wearable devices: SMART-ALERT study. Together, they discuss the study findings and explore the use of real-time smartphone alerts in conjunction with implantable cardiac monitors and wearable devices during atrial fibrillation episodes. Learning Objectives Review the design and key findings of the SMART-ALERT study evaluating real-time smartphone alerts during atrial fibrillation episodes. Discuss the use of implantable cardiac monitors and wearable devices for real-time detection and notification of atrial fibrillation episodes. Explore the potential clinical implications of integrating smartphone alerts with cardiac monitoring technologies.   Host: Michael S. Lloyd, MD, FHRS   Guests: Tina Baykaner, MD, MPH Kenneth A. Ellenbogen, MD, FHRS   Disclosures: M. Lloyd ·      Honoraria/Speaking/Consulting Fee: Medtronic, Boston Scientific, Other   T. Baykaner ·      Honoraria/Speaking/Consulting Fee: Volta Medical, Medtronic, Pacemate, Johnson & Johnson, Abbott Medical, Boston Scientific ·      Research: NIH, Boston Scientific   K. Ellenbogen ·      Honoraria/Speaking/Consulting Fee: American College of Cardiology, Heart Rhythm Society, Boston Scientific, Medtronic, Inc., Abbott ·      Royalty Income: Wiley-Blackwell, Elsevier

On this episode of MedAxiom HeartTalk, host Melanie Lawson, MS sits down with April Mann, MBA, CNMT, NCT, RT(N), MASNC, FSNMMI-TS, stakeholder engagement lead at GE HealthCare. Together, they discuss a collaborative two-part webinar series establishing shared cardiac PET services. Learn about operational, technical, and business case considerations for building a sustainable program. Expert insights will guide administrators and leadership through governance, accountability, and overcoming common challenges in shared service models.

In this episode of The Cardiac Recovery Room, moderator Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, USA, spoke with Drs. V. Seenu Reddy, a cardiothoracic surgeon at HCA's TriStar Cardiovascular Surgery in Nashville, TN, USA, and Kevin Lobdell, Professor and Director of Regional Cardiovascular and Thoracic Quality, Education, and Research at Atrium Health, NC, USA, about postoperative rehabilitation and readmission prevention. Chapters  00:00 Intro  01:51 Readmission Risk Factors  05:17 Discharging Patients Living Alone  07:31 Importance of Readmission Reduction  10:21 Reducing Readmissions  15:45 Postop Rehabilitation  19:36 Bringing Rehab to Patients  23:43 Behavior Modification & Engagement  25:55 Coordination of Care  26:36 Personal Engagement  They explore various factors influencing patient readmission following cardiac surgery, encompassing both medical and social determinants. A significant focus is placed on the challenges faced by patients living alone, the associated risks, and the mitigation strategies that can be implemented to support them, noting how success is higher if patients have a social structure around them. Furthermore, the conversation highlights the importance of reducing readmission rates and using remote monitoring. They also examine the survival benefits of rehabilitation and barriers of postoperative rehabilitation, including transportation. The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.     Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week we delve again into the world of adult congenital heart disease and specifically the realm of biomarkers when we review a recent report of the proteomics of the adult Fontan patient. What is proteomics and how can this inform our understanding of the pathophysiology and adaptive pathways of the Fontan circulation? Are there meaningful differences in the patterns of protein expression between the adult Fontan patient and control 2 ventricle subjects? What might account for differences and how can we understand these differences to explain outcomes in the Fontan adult patient? We speak with the first and senior authors of this week's work, Professor Alexander Opotowsky of the University of Cincinnati and Mr. Ismael Assi who is a Sarnoff Fellow and soon to be 4th year medical student at the University of Cincinnati. DOI: 10.1016/j.jacadv.2026.102810 

Host: Emer Joyce Guests: Marianna Fontana Want to watch that extended interview on the management of heart failure in cardiac amyloidosis, go to: https://esc365.escardio.org/event/2551?resource=interview Want to watch that episode? Go to: https://esc365.escardio.org/event/2551   Disclaimer  ESC TV Today is supported by Novartis and Novo Nordisk through an independent funding. The programme has not been influenced in any way by its funding partners. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Marianna Fontana has declared to have potential conflicts of interest to report: consultancy for Alnylam, Alexion/Caelum Biosciences, Astra Zeneca, Bridgbio/Eidos, Prothena, Attralus, Intellia Therapeutics, Ionis Pharmaceuticals, Cardior, Lexeo Therapeutics, Janssen Pharmaceuticals, Pfizer, Novo Nordisk, Bayer, Mycardium. Research grants from: Alnylam, Bridgbio, Astra Zeneca, Pfizer. Share options in LexeoTherapeutics and shares in Mycardium. Emer Joyce has declared to have potential conflicts of interest to report: Alnylam, Bayer, Pfizer, Fire-1. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers: Cardiology This Week: A concise summary of recent studies AI & digital solutions in emergency medicine Management of heart failure in cardiac amyloidosis Spotlight: Orthodexia-Platypnoea Syndrome Host: Emer Joyce Guests: Marianna Fontana, Wolf Hautz, Konstantinos Koskinas Want to watch that episode? Go to: https://esc365.escardio.org/event/2551 Want to watch that extended interview on the management of heart failure in cardiac amyloidosis, go to: https://esc365.escardio.org/event/2551?resource=interview   Disclaimer  ESC TV Today is supported by Novartis and Novo Nordisk through an independent funding. The programme has not been influenced in any way by its funding partners. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. All declarations of interest are listed at the end of the episode. The ESC is not liable for any translated content of this video. The English language always prevails. ESC TV Today uses a range of tools and resources (including AI) to support content production. All content is reviewed and approved by the editorial team. Statements and opinions expressed by guest speakers are their own.   Declarations of interests Stephan Achenbach, Yasmina Bououdina, Wolf Hautz and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede, Viatris. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI.  Davide Capodanno has declared to have potential conflicts of interest to report: Abbott Vascular, Bristol Myers Squibb, Daiichi Sankyo, Edwards Lifesciences, Novo Nordisk, Sanofi Aventis, Terumo. David Duncker has declared to have potential conflicts of interest to report: lecture honoraria from Abbott, Astra Zeneca, Biotronik, Boehringer Ingelheim, Boston Scientifics, Bristol Meyers Squibb, CVRx, Daiichi Sankyo, Medtronic, Microport, Pfizer, Sanofi, Zoll. Marianna Fontana has declared to have potential conflicts of interest to report: consultancy for Alnylam, Alexion/Caelum Biosciences, Astra Zeneca, Bridgbio/Eidos, Prothena, Attralus, Intellia Therapeutics, Ionis Pharmaceuticals, Cardior, Lexeo Therapeutics, Janssen Pharmaceuticals, Pfizer, Novo Nordisk, Bayer, Mycardium. Research grants from: Alnylam, Bridgbio, Astra Zeneca, Pfizer. Share options in LexeoTherapeutics and shares in Mycardium. Emer Joyce has declared to have potential conflicts of interest to report: Alnylam, Bayer, Pfizer, Fire-1. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Felix Mahfoud has declared to have potential conflicts of interest to report: research grants from Deutsche Forschungsgemeinschaft (SFB TRR219), Deutsche Gesellschaft für Kardiologie (DGK), Deutsche Herzstiftung, Ablative Solutions, ReCor Medical. Consulting fees, payment honoraria lectures, presentations, speaker, support travel costs: Ablative Solutions, Astra-Zeneca, Novartis, Inari, Recor Medical, Medtronic, Philips, Merck. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In this edition of the CTSNet podcast, The Lifeline, host and nurse educator Jill Ley, Clinical Professor at the University of California San Francisco School of Nursing, Founder of the Essentials of Cardiac Surgical Resuscitation, and former Cardiac Surgery Clinical Nurse Specialist at California Pacific Medical Center in San Francisco, CA, USA, speaks with expert guest Amy Hackmann, adult cardiac surgeon at Brigham and Women's Hospital, Boston, MA, USA. Together, they explore extracorporeal membrane oxygenation (ECMO) vs emergency resternotomy for cardiac surgical arrest. Chapters  00:00 Intro  01:36 Resuscitation Algorithm  02:14 Current State of ECMO  04:25 Speed, Quality Assurance  08:28 ECMO Concerns  12:16 Performance Metrics, Decision-Makers  15:08 Prime Circuits  15:24 Non-Surgical Arrest Training  17:42 MCS Devices  18:41 Instances to Avoid ECMO  20:16 Time Targets  21:58 Avoiding Complications, VIS Score  25:09 Key Points  The discussion covers quality assurance metrics, patient-specific decisions regarding ECMO vs resternotomy, and chest compressions. The experts also review the importance of advanced preparation, common causes of cardiac arrest following cardiac surgery, and small-incision surgeries, including the use of surgical saws. Furthermore, the discussion emphasizes the importance of mock drills and team training, as well as the use of ECMO on patients who have not experienced cardiac arrest. Finally, they explore scenarios where ECMO would not be used, vasoactive-inotropic score (VIS), and lactate levels. Every month, The Lifeline features intensive care specialists sharing their expert insights into the rapid and effective management of critically ill cardiac surgical patients. Don't miss next month's episode!   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

This week we're joined by Kendra Cunningham and Kayla Messana, sisters and co-hosts of the podcast Flatlined and Fine, and their stories are almost impossible to believe. Kayla was 31, healthy, three kids, husband just back from deployment, when she woke him up with agonal breathing in the middle of the night. He dragged her to the floor, did CPR for 10 minutes, and she was shocked twice by an AED before going on to have cardiac arrest approximately eight more times in the next 24 hours. Four years later, she's been shocked by her ICD three additional times and still has no clear diagnosis. Then, a few years after Kayla's event, Kendra had her own cardiac arrest while awake and feeding her newborn twins, told her husband she was about to faint, and was gone within seconds, saved by a man whose only CPR training was a few American Heart Association videos he'd watched before their first child was born. Kristin and I swap notes with them on everything: what it's like to wake up in an ICU with no memory of what happened, how you explain cardiac arrest to kids who are five, six, and eight years old, the psychological weight of an idiopathic diagnosis that gives you no answers and no closure, and the very real experience of being a 31-year-old in a cardiology waiting room surrounded by people forty years older than you. We also get into the insurance disaster of a $15,000 whole exome sequencing test that Blue Cross Anthem denied, why Kendra couldn't pick up her newborn twins for months after her ICD surgery, and why I was cleared to perform eye surgery but not allowed to drive for six months. I also get publicly shamed for not having plugged in my ICD data transmitter in two years. It's earned. Takeaways: Cardiac arrest in young, healthy adults often has no identifiable cause. CPR saves lives even when the person doing it is terrified and untrained. The co-survivor experience is its own separate, underserved story. Young cardiac arrest survivors often get inadequate guidance from the healthcare system. Being shocked by an ICD is traumatic and disruptive in ways that don't get talked about enough. — Want more Kendra Cunningham and Kayla Messana? @flatlined.and.fine on Instagram Flatlined and Fine on Spotify: https://open.spotify.com/show/2nRXIK5OvgAv2CXKvCwrQu?si=eHV4s_CZTQyLAXLvf7A14A&nd=1&dlsi=359ec698e7c64c90 To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. Head to http://www.cozyearth.com and use my code KNOCKKNOCK for an exclusive 20% off. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Cardiac imaging expert Kim Mischo spent 20 years inside the cardiology machine — running nuclear stress tests that told patients they were fine, then watching some of those patients have heart attacks the following week. She knew the system was broken long before she could prove it.Now she can prove it.A non-invasive scan exists that can detect coronary artery disease at 5% blockage — before symptoms, before a stress test would ever flag anything. It's been guideline-recommended since 2021. It's 99% accurate. And insurance won't cover it.The reason why is the part of this conversation that will stay with you.Dr. Philip Ovadia and Kim Mischo walk through the technology, the economics, and the quiet institutional logic that keeps a life-saving diagnostic tool out of reach for most Americans — while a far less accurate, far more expensive alternative continues to dominate cardiology practices nationwide.This is a conversation about what early detection of heart disease could look like, and why it doesn't yet.BIG IDEABetween 50 and 60 percent of patients die from their first heart attack — which means the insurance company never had to pay a single claim related to their coronary disease.Kim Mischo Contact Info: Website: https://clearheartandlung.com/Send Dr. Ovadia a Text Message. (If you want a response, you must include your contact information.) Dr. Ovadia cannot respond here. To contact his team, please send an email to team@ifixhearts.com WEBSITE: Stay Off My Kitchen Table Like what you hear? Head over to IFixHearts.com/book to grab a copy of my book, Stay Off My Operating Table. Ready to go deeper? Talk to someone from my team at IFixHearts.com/talk.Ready to take control of your health?  Grab Dr. Ovadia's brand new book Stay Off My Kitchen Table now! This isn't just another diet book; it reveals why it's not just what you eat, but what your body actually absorbs that determines your health.If you're struggling with low energy, stubborn weight, or feeling like “healthy eating” isn't working… this book shows you exactly how to fix it.Learn how to reset your gutEliminate hidden foods sabotaging your progressUnlock real energy, metabolism, and longevityDon't wait until it's too late. Take action today. Get your copy of Stay Off My Kitchen Table now.Learn More:Take Dr. Ovadia's metabolic health quiz: iFixHearts Dr. Ovadia's website: Ovadia Heart HealthTheme Song : Rage AgainstWritten & Performed by Logan Gritton & Colin Gailey (c) 2016 Mercury Retro RecordingsAny use of this intellectual property for text and data mining or computational analysis including as training material for artificial intelligence systems is strictly prohibited without express written consent from Dr. Philip Ovadia.

 CardioNerds (Drs. Apoorva Gangavelli, Rebecca Garber, and Tina Reddy discuss INOCA with Dr. Claire Raphael. Audio editing by CardioNerds Academy intern, student doctor Pacey Wetstein. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli, and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. Non-obstructive coronary artery disease (CAD) is more common than often recognized, particularly in women and individuals with risk factors like diabetes or hypertension. Conditions such as INOCA, ANOCA, and MINOCA can cause ischemia and chest pain despite “clean” angiograms, often due to microvascular dysfunction, coronary spasms, or subtle plaque. Diagnosing these conditions requires advanced imaging or invasive studies to assess blood flow and vessel function. Treatment focuses on reducing cardiovascular risk with aspirin, statins, ACE inhibitors, or ARBs, and managing symptoms with beta-blockers or calcium channel blockers. The key takeaway: A normal angiogram doesn't rule out disease, and these patients need a comprehensive, evidence-based approach to care. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls: When patients present with chest pain but do not have obstructive coronary artery disease, the story does not end there! Other pathologies that must be ruled out include spontaneous coronary artery disease (SCAD), coronary vasospasm, microvascular disease, Takotsubo, and cardiomyopathy. A TTE can help rule out other pathologies. Cardiac MRI can help identify myocardial fibrosis, scarring, or edema that may suggest prior events or alternative diagnoses.  About 60-70% of INOCA cases are in women. However, it is estimated that about half of the patients with so-called “normal” angiograms actually have positive stress tests. Patients with elevated troponins are more likely to have recurrent events. Patients with INOCA are more likely to come back to the ER multiple times before getting diagnosed. These patients have a 1.4x increased risk of adverse cardiovascular events (such as HFpEF, MI, and recurrent hospitalizations for cardiac chest pain).  INOCA is a complex condition with a variety of causes, primarily linked to microvascular disease. Within microvascular disease, there are different “endotypes” (types or subcategories) classified by specific characteristics. In centers that conduct microvascular testing, patients are categorized as endothelium-independent or endothelium-dependent, based on their responses to adenosine or acetylcholine during testing. Additionally, microvascular disease can be classified as either structural or functional, depending on the results of tests measuring microvascular resistance. The field is moving towards the term ANOCA, or angina with non-obstructive coronary arteries, to include patients with anginal symptoms without objective ischemia.  The field is moving toward using genotyping and hemodynamic testing to guide first-line therapies for microvascular disease, a heterogeneous condition. Current treatments mostly come from obstructive coronary artery disease, but specialized approaches—like the coronary sinus reducer—may offer unique benefits for microvascular disease. Treatment includes sublingual nitroglycerin, ACE inhibitors/ARBs, and beta-blockers. Remember to also treat any additional comorbidities, such as diabetes, hypertension, and hyperlipidemia. Unfortunately, many of these patients may still have refractory chest pain, so it is important to reassure them. These patients can still exercise, but they may be hesitant to do so for fear of having chest pain. Cardiac rehab may be helpful for these patients as it helps them build up their tolerance. References Lawton JS, Tamis-Holland JE, Bangalore S, et al; Writing Committee Members. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(3):e18-e114. doi:10.1161/CIR.0000000000001039 Hwang D, Park S, Koo B-K. Ischemia with nonobstructive coronary artery disease. JACC: Asia. 2023;3(2):169-180. doi:10.1016/j.jacasi.2023.01.004 Yukselen Z, Majmundar V, Dasari M, Kumar PA, Singh Y. Chest pain risk stratification in the emergency department: current perspectives. Open Access Emerg Med. 2024;16:29-43. doi:10.2147/OAEM.S419657

WSJM Afternoon News for 07-01-26See omnystudio.com/listener for privacy information.

This segment highlights key insights into diet, lifestyle, and cardiovascular health. #HeartHealth #Nutrition #LifestyleMedicine

In this 337th episode I welcome Dr. Andreas Plackis to the show. Dr. Plackis is the creator and host of the TEE Time Podcast and a cardiac anesthesiologist. We talk about TEE for the non-cardiac anesthesiologist, how it can be used and how to go about learning it. Our Sponsors:* Check out BetterHelp and use my code betterhelp.com for a great deal: https://www.betterhelp.com* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com* Check out Factor and use my code factormeals.com/accrac50off for a great deal: https://www.factor75.com* Check out Kiwi Biosciences and use my code icaneatagain.com/accrac for a great deal: https://www.kiwibiosciences.com* Check out Quince and use my code quince.com/accrac for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

After losing Monday's opener, the Phillies made MLB history with two incredible 9th inning comebacks against the Washington Nationals in DC. The Good Phight's John Stolnis recaps an incredible week in the nation's capital. So many heroes! Is this team channeling the 2022 NL champs? Also, Justin Klugh joins the show to talk about his book, "Summer of the Cheap Weiners," and Hittin' Season Nationals Insider Ethan Stolnis (yep, they're related).

America Out Loud PULSE with Dr. Peter McCullough and Malcolm Out Loud – Cherry-picked data can be made to say almost anything if the window is narrow enough and the question is framed just right. The public is then handed a reassuring headline while the real safety questions are pushed aside. Bottom line: a fourth COVID-19 booster does NOT protect against cardiovascular events...

Down for most of the game, the Dunkin' Dogs flipped the script in the second half to force overtime and score a 70-68 victory over Delaware in their first-ever visit to Ruston. Freshman Jaylen Fenner tied his career-high with 15 points (all in the second half) while also tying his career-high for made three-pointers with three. He played a career-high 32 minutes.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

America Out Loud PULSE with Dr. Peter McCullough and Malcolm Out Loud – Cherry-picked data can be made to say almost anything if the window is narrow enough and the question is framed just right. The public is then handed a reassuring headline while the real safety questions are pushed aside. Bottom line: a fourth COVID-19 booster does NOT protect against cardiovascular events...

In this run-focused Q&A episode, Coach Rob tackles the most common IRONMAN and 70.3 training misconceptions.Including:How your marathon pace translates to target race paces for IRONMAN and 70.3... What's your best-case IRONMAN marathon paceSetting heart rate zones properly in TrainingPeaks (and why Garmin's defaults can't be trusted)Managing run injuries - when to see a physio, integrating rehab, and swapping runs for aerobic bike sessionsCarbon race shoes - are they worth it for you, given your speed and biomechanicsCardiac drift and decoupling: what HR:PA tells you about your aerobic fitness, and the sub-5% target* * * * * * * *SPONSORS* * * * * * * *Thinking about your first Ironman or 70.3 in 2026? At ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Team Oxygenaddict,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ we specialise in helping busy professionals fit high-quality training around demanding jobs and family life. We've just reopened for new athletes with only a handful of slots available. Book an application call today to find out if you'd be a good fit for Team Oxygenaddict for the coming season here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://team.oxygenaddict.com/consultation-call/ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠* * * * * * * * * * * *⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠precisionfuelandhydration.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Precision Fuel & Hydration help athletes personalise their hydration and fuelling strategies for training and racing. Use the free ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Fuel & Hydration Planner⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to get a personalised race nutrition plan for your next event. And then⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ book a free 20-minute video consultation⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ with a member of the PF&H Athlete Support Team to refine your strategy.Listeners get 15% off their first order of fuel and electrolytes with Precision Fuel & Hydration. Simply use code OXYGEN26 at checkout to claim your 15% discount

Shakings Coming (1) (audio) David Eells – 6-24-26 IT WILL SHAKE THE WORLD! Lynne Johnson 5-27-26 IAM, King Yeshuya wants you, My people to know that all will erupt soon in Iran. President Trump is playing a waiting game with the radicalized left in the IRGC for there are many factions vying for control. Trump is ensuring that when the United States military strikes Iran, the United States will have very few casualties. Trump doesn't want American casualties, therefore the United States is intending to use all intelligence being fathered to ensure few American casualties. When the U.S. Military strikes, there will be no doubt that the IRGC, in its radical form, is no longer in existence. Once assured of the success of this campaign, Trump will have the military pull back to the general areas away from Iran. Very shortly after the United States military pulls back from Iran, then Israel will strike. First, Damascus, Syria (a weapon depot) destroying it. Next, Israel will move against Iran's nuclear facilities along with their weapon depots. These strikes will effectively end Iran's nuclear program. Once this is concluded, then very shortly look for the First Event of MY Judgments (again these events of Mine, King Yeshuya, are not those of Tribulation, which are far worse, for a much longer time frame), the California earthquake which will shake the world as this earthquake is massive in size and in effect. I AM, King Yeshuya tells you this again so that you MY children, MY Believers are warned to plan, to prepare for what is soon to occur. IAM always warns ahead through MY prophets and messengers. Listen to My Words, heed My Warnings for they are to help protect you and your families. Continue MY children to come to ME in prayer, stay in MY Word, stay focused, stay calm. Come directly to ME, King Yeshuya with your queries. I AM will gladly answer you. IAM loves you MY children. Your King Yeshuya, the King of Kings and Lord of Lords, the Alpha and Omega, the Beginning and the End, the Most High, Commander of heaven's hosts and armies, the Lion of Judah, the Prince of Peace. Scriptures: Psalm 20:7 NKJV “Some trust in chariots and some in horses, but we will remember and trust in the name of the Lord our God.” Isaiah 43:2 NKJV “When you pass through the waters, I will be with you; and through the rivers, they will not overwhelm you. When you walk through fire, you will not be scorched, nor will the flame burn you.” Ezekiel 7:7 NKJV “Doom has come to you, you who dwell in the land; the time has come, a day of trouble is near, and not of rejoicing in the mountains.” Isaiah 17:1 NIV “A prophecy against Damascus: “See, Damascus will no longer be a city but will become a heap of ruins.” Isaiah 13:9 NKJV “Behold, the day of the Lord comes, cruel with both wrath and fierce anger, to lay the land desolate; and He will destroy its sinners from it.” Isaiah 13:6 NKJV “Wait, for the day of the Lord is at hand! It will come as destruction from the Almighty.” John 14:29 NKJV “And now I told you before it comes, that when it does come to pass, you may believe.” Lamentations 3:25 NKJV “The Lord is good to those who wait for Him, to the soul who seeks Him.”   FAMINE WILL EXTEND WORLDWIDE Lynne Johnson – 5-9-26 I AM, King Yeshuya, would like MY people to know that it is soon for the “Iranian Conflict” to conclude. It will end as IAM has stated; the United States will deploy missiles, which will effectively end the IRGC Regime's control over Iran. Then the United States will pull back their military, leaving destroyers, aircraft carriers, and such in the area. Shortly after the United States military is pulled back, Israel will strike Damascus, the other weapon depots in Syria, then strike Iran's nuclear facilities and weapon depots. Israel will present the truth with proof that Iran fully intended to finish the building of nuclear bombs to destroy Israel. There will be the usual outcry, but no one will “lift a hand” against Israel, for all of the surrounding Arab nations know the truth. They also know that they were not safe from Iran's nuclear attacks. Again MY children, this is your marker to know that you only have a short time to finish getting your food, to prepare for what is coming, MY First Event – Judgment upon California. Do not put off procuring your food, your other necessities. Use cash as much as possible and by going to different stores. Do not discuss storing food with ANY OTHERS as IAM has clearly stated unless you have spoken directly with ME, King Yeshuya, the King of Kings and Lord of Lords to find out who you are able to trust. Ensure that you get your answer from ME, BEFORE you talk with others. If you choose not to listen to ME here, you and your family will suffer harm. People will become desperate quickly for food – any food that they are able to find. They do not wish to share, and they will harm others to get food. Those who have not done so recently or at all, are to read Jeremiah – ALL OF IT! You will see what hunger does to people. There will be few people who you will be able to trust now, so be discreet and come to ME, King Yeshuya to find out who you can SAFELY SHARE YOUR FOOD WITH. You must also accept MY answer as final. IAM alone sees the hearts, minds, thoughts and intentions of ALL people! You do not. You must also understand that the famine will extend worldwide. It will not be located only in specific cities, areas, or countries. With the famine, there will be deaths and then pestilences due to these deaths. IAM will give you more specific detail on this soon. FOR NOW YOUR JOB IS TO PREPARE. COME DIRECTLY TO ME WITH YOUR QUESTIONS AS I AM WILL GLADLY ANSWER YOU. MY BELOVED CHILDREN, STAY IN PRAYER TO ME, STAY IN MY WORD, STAY FOCUSED, STAY CALM. Your King Yeshuya, the King of Kings and Lord of Lords, the Most High, the Alpha and Omega, the Beginning and the End, the Lion of Judah, the Prince of Peace Scriptures: Isaiah 17:1 NKJV “The burden against Damascus. “Behold, Damascus will cease from being a city, and it will be a ruinous heap.” Luke 21:11 NKJV “And there will be great earthquakes in various places, and famines and pestilences; and there will be fearful sights and great signs from heaven.” Psalm 9:8 NKJV “He shall judge the world in righteousness, and He shall administer judgment for the people in uprightness.” Ecclesiastes 8:6 NKJV “Because for every matter there is a time and judgment, though the misery of man increases greatly.” Psalm 76:8 NKJV “You caused judgment to be heard from heaven; the earth feared and was still.” Deuteronomy 8:6 NKJV “Observe the commands of the LORD your God, walking in obedience to Him and revering Him.” Proverbs 15:11 NKJV “Hell and Destruction are before the Lord; so how much more the hearts of the sons of men.” Psalm 112:5 NKJV “A good man deals graciously and lends; he will guide his affairs with discretion.” Deuteronomy 32:24 NKJV “They shall be wasted with hunger, devoured by pestilence and bitter destruction; I will also send against them the teeth of beasts, with the poison of serpents of the dust.” Romans 12:12 NKJV “Rejoicing in hope, patient in tribulation, continuing steadfastly in prayer,”   GOLDEN DOME MR POOL X - *GOLDEN DOME went fully operational on June 14, 2026.** Not announced. Not disclosed. ACTIVATED. Posted By: Lymerick 6-23-26 www.rumormill.news/269653   Mr. Pool @MrPool_QQ

In this episode, we review the high-yield topic of ⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Cardiac Tamponade⁠⁠⁠⁠⁠⁠ from the Cardiovascular section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

This week, Skyler and Evan discuss a crowded outfield that's about to get even more full with players coming off of the injured list. What decisions will the Colorado Rockies make with their outfielders? Meanwhile, the Rockies bullpen has been significantly... anti-clutch. Cardiac antics and blown games, especially in the ninth inning, have been costing the Rockies potentially winnable games. Finally, we congratulate Kyle Freeland on 1,000 career strikeouts and take a look at how CBA negotiations appear to be going. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us Fan MailLee has been a perfusionist for over 43 years.  He was at the Cleveland Clinic for 17 years, during which the team there was involved in creating many techniques still used today.  He now has a TikTok page where he tells stories from the early years of heart surgery and also discusses modern techniques.Learn about career options from the people doing it

"Making the effort earlier totally changes the trajectory for the rest of your life,” says Jeremy London, MD. London is a board-certified cardiovascular surgeon with more than 25 years of clinical experience caring for patients across the full spectrum of heart disease — from prevention to advanced intervention. Dr. London received his medical degree from the Medical College of Georgia and completed his general surgery residency at Joseph's Hospital in Denver, Colorado. He completed a general vascular and thoracic surgical fellowship at the Carolinas Medical Center in Charlotte, N.C. To deepen his understanding of medicine, he completed the Institute of Functional Medicine core program. 00:00 - When a cardiac surgeon has a heart attack 10:46 - Waking up with different priorities 13:49 - Missed signals 18:35 - The CGM experiment that revealed pre-diabetes 21:43 - The 5 tests that actually matter 25:44 - Diving into Lp(a) 30:36 - Target numbers for primary prevention 32:26 - Why taking medication isn't failure 38:24 - Atherosclerosis starts in childhood 41:19 - Why a zero calcium score doesn't mean you're safe 45:40 - What we don't know 48:41 - GLP-1s & the future of prevention For more about London, visit his website: https://drjeremylondon.com/  We hope you enjoy this episode, and feel free to watch the full video on YouTube! Whether it's an article or podcast, we want to know what we can do to help here at mindbodygreen. Let us know at: podcast@mindbodygreen.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Is your heart racing? Are you wondering if it's a panic attack or a heart attack? In today's episode of Calming Anxiety, we dive deep into the physiological response of a racing heart due to anxiety. Hosted by Martin Hewlett, a clinical hypnotherapist and former paramedic, this session provides professional insight into why your body triggers the fight or flight response and how to signal to your nervous system that you are safe.If you frequently experience sudden chest tightness, palpitations in your throat, or health anxiety regarding your heart health, this 10-minute guided relaxation and breathing exercise is designed for you. Learn the difference between a medical emergency and an anxiety-driven surge of adrenaline from someone who has seen both on the front lines.What You Will Learn:How to differentiate anxiety symptoms from cardiac emergencies.The role of the parasympathetic nervous system in calming a pounding heart.A guided box breathing technique to lower your heart rate instantly.How adrenaline affects your blood vessels and lungs during stress.Time Chapters00:00 – Emergency Screening: Vital signs of a cardiac event vs. anxiety.01:04 – Introduction: Meet Martin Hewlett, former paramedic and hypnotherapist.01:56 – Guided Breathing: Using the extended out-breath to signal safety.03:38 – The Science of Adrenaline: Why your heart races when you aren't in danger.05:12 – Visualization: The "Control Room" technique for nervous system regulation.07:18 – Affirmations: Rewiring your internal dialogue about heart health.08:32 – 3 Daily Caring Tips: Practical tools for managing heart rate anxiety.10:05 – Closing Thoughts: Embracing your body's natural responses.Heart-Centered AffirmationsRepeat these internally to ground your nervous system:"My heart is strong and it is working exactly as it should"."A racing heart is not proof of danger; it is proof that I am alive and responding"."I know the difference between anxiety and emergency. Anxiety does not require a rescue"."I trust my body to regulate; I trust my breath to lead me home".3 Daily Caring TipsEstablish Your Baseline: Take your resting heart rate on a calm morning to provide a factual reference point for when anxiety spikes.The Physiological Sigh: Use the "double inhale" (two sips of air through the nose) followed by a long, slow exhale to mechanically reset your stress levels.Break the Freeze: Anxiety thrives in stillness. If your heart races, stand up and take three slow, deliberate steps to tell your brain you are not in a "life or death" freeze state.Support the ShowIf this session helped you find a moment of peace, please subscribe to Calming Anxiety on Apple Podcasts. With over 2,300 free episodes, we are here for you every single day.Leave a Review: Your feedback helps others find these tools.Share: Send this episode to a friend struggling with health anxiety.Stay Connected: Visit calminganxiety.fm for more resources.Remember: Smile often, and to your beautiful self, be kind.

Ibogaine is regularly categorized as a psychedelic — but that label may be misleading in ways that matter. In this micro, James offers a crash course in what ibogaine actually is: where it comes from, how its unusual pharmacology works, what it does to the mind, and why it holds a position in addiction medicine that no other drug on earth can claim. The risk profile is part of the picture too. This is a clip from 'Psychedelics in Research & Practice | James W. Jesso', Adventures Through The Mind Podcast, episode 200 FULL EPISODE Listen on Apple Podcasts Listen on Spotify Watch on YouTube Read the show notes MORE IBOGAINE EPISODES Treating Traumatic Brain Injury with Ibogaine | Dr. Nolan Williams ~ ATTMind 188 Ibogaine Medical Subculture | Jonathan Dickinson ~ ATTMind 003 SUPPORT THE PODCAST

Cardiac arrest care hinges on high‑quality CPR, but pulse checks remain a stubborn source of interruptions — often longer than the recommended 10 seconds and repeated every two minutes. What if we could detect ROSC without ever pausing compressions? This diagnostic accuracy study evaluates whether femoral arterial Doppler waveforms obtained during active CPR can predict arterial line pulsatility at the next pulse check. Join Dr. Qin as she reviews how well Doppler‑detected pulsatility and anterograde flow signal true cardiac activity — and whether ultrasound could offer a future where pulse checks no longer slow us down.

This week we go back 2.5 years and delve into the world of cardiovascular surgery when we review a review of STS data on the pulmonary artery band (PAB). The STS assigns a STAT category of 4 to this operation, denoting higher risk for mortality. Is this warranted? Are all PAB candidates equal? What features are associated with higher or lower mortality rates in patients undergoing banding? Should the data in this work drive innovation to avoid the PAB in some settings? These are amongst the questions posed to the senior author of this week's work, cardiovascular surgeon Dr. Tara Karamlou who is Professor of Surgery at the Cleveland Clinic in Cleveland, Ohio. DOI: 10.1016/j.athoracsur.2023.09.020

In this episode, we review the high-yield topic of ⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Blunt Cardiac Injury⁠⁠⁠⁠⁠ from the Cardiovascular section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets