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For the latest Our Work and Technology Correspondent Brian O'Donovan.
This week we speak with 2 pioneers in the field of pediatric cardiac critical care, Dr. Anthony Rossi and Dr. Gil Wernovsky. Both were present at the very start of the field of cardiac critical care for children. What was it like in an era before transesophageal echocardiography or even postoperative echo? Why was the advent of the bidirectional cavo-pulmonary anastomosis such a game changer in the care of children with heart disease? What do Drs. Rossi and Wernovsky think were the most important improvements to care for children with heart disease in their 35+ year careers? What about care today troubles these intensive care gurus? This is a rare opportunity to speak with two who have seen and done it all in cardiac critical care for children.For those interested to hear Dr. Rossi speak about goal directed therapy, take a listen to episode 21 and episode 200 of this podcast!
In this episode of the ASC Podcast with John Goehle we discuss the latest news in the ASC industry, recent survey experiences, debrief from ASCA 2026, review the new Anthem policy on out of network providers, discuss Cardiac Ablations in the ASC environment and in our focus segment interview Becky Ziegler-Otis Assistant Executive Director at the ASC Quality Collaboration. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and Ambulatory Healthcare Strategies. Notes and Resources from this Episode: ASC News- May 11, 2026 - Anthem Expands Out of Network Policy: https://ascnews.com/2026/05/hospitals-take-aim-at-anthem-as-insurer-expands-out-of-network-policy-whats-at-stake-for-ascs/?spMailingID=198771&puid=4098726&E=4098726&utm_source=newsletter&utm_medium=email&utm_campaign=198771 ASC News - May 27th - Cardiac Ablations Moving to ASC's https://ascnews.com/2026/05/this-is-better-for-patients-doctor-details-advocacy-push-best-practices-for-cardiac-ablations-in-ascs/?spMailingID=201106&puid=4098726&E=4098726&utm_source=newsletter&utm_medium=email&utm_campaign=201106 ASC Quality Collaboration: Website: https://ascquality.org/ 4th Quarter Quality Report: https://ascquality.org/wp-content/uploads/2026/04/ASC-Quality-Collaboration-Quality-Report-Fourth-Quarter-2025.pdf ASC Safety & Quality Assessment: https://ascquality.org/asc-safety-quality-assessment/ Flyer for the Assessment: https://www.dropbox.com/scl/fi/l038sdgdmsu33ub7ujm8v/ASC-Safety-Quality-Assessment-Flyer-2026.pdf?rlkey=au3vzvt62hs4zmifroufq6do9&dl=0 INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central, a sister site to http://ascpodcast.com provides a link to all of our bootcamps, educational programs and membership programs! https://conferences.asc-central.com/ Join one of our Membership Programs! Our Patron Program: Patron Members of the ASC Podcast with John Goehle have access to ASC Central - an exclusive membership website that provides a one-stop ASC Regulatory and Accreditation Compliance, Operations and Financial Management resource for busy Administrators, nurse managers and business office managers. More information and Become Member The ASC-Central Premium Access Program A Premium Resource for Ambulatory Surgery Centers including access to bootcamps, education programs and private sessions More Information and Become a Premium Access Program Members Today! Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers
CardioNerds (Dr. Billy-Joe Mullinax, Dr. Dinu Balanescu, and Dr. Jane Ehret) discuss risk stratification in acute pulmonary embolism with Dr. Stavros Konstantinides, Chair of the 2019 ESC Pulmonary Embolism Guidelines. Using a real-world case, this episode explores how modern PE care has moved beyond “massive” and “submassive” labels toward a dynamic, physiology-based approach. The discussion highlights the limitations of static risk scores, the importance of right ventricular dysfunction and biomarkers, and why normotension does not imply stability. Special emphasis is placed on intermediate-high risk PE, early identification of impending hemodynamic collapse, and the role of lactate, serial reassessment, and PERT teams in guiding escalation of care. Audio editing by CardioNerds intern, Joshua Khorsandi.The 2026 American multi-society PE guidelines were published after this episode was recorded. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium. 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 Stable blood pressure does not mean low risk in PEHypotension is a late finding. Patients may have severe RV failure, hypoxia, and tissue hypoperfusion while remaining normotensive — a key concept behind “normotensive shock.” Risk stratification in PE must be dynamic, not staticLegacy scores like PESI and Bova provide a snapshot and predict 30-day mortality, but they do not capture short-term trajectory or impending hemodynamic collapse. Intermediate-high risk PE is a dangerous and heterogeneous groupPatients with RV dysfunction, positive biomarkers, tachycardia, hypoxemia, and elevated lactate may have in-hospital mortality approaching 15%, rivaling STEMI. Lactate is a critical but underutilized marker in PEElevated lactate reflects tissue hypoxia and early circulatory failure and may identify patients at risk for collapse before blood pressure declines. PERT enables physiology-driven, patient-centered PE carePERT teams operationalize continuous reassessment, integrate imaging, labs, and clinical trajectory, and allow timely escalation — shifting PE management from rigid categories to real-time decision-making. Notes Drafted by Dr. Jane Ehret. 1. What is the contemporary framework for risk stratification in acute pulmonary embolism? Modern PE risk stratification prioritizes hemodynamics and right ventricular (RV) function rather than clot burden. The 2019 ESC Guidelines classify PE into high risk, intermediate risk (low vs high), and low risk, based on: Hemodynamic status, RV dysfunction on imaging, and Cardiac biomarkers. This framework emphasizes early mortality risk but requires clinical context to guide escalation decisions. 2. Why is normotension insufficient to define “stability” in PE? Blood pressure is a late marker of circulatory failure in PE. Patients can maintain normal BP through Tachycardia, Increased sympathetic tone, and RV compensation. Many patients with preserved BP may already have shock physiology, including hypoxemia, elevated lactate, and RV failure — sometimes referred to as “normotensive shock.” 3. How should intermediate-risk PE be conceptualized clinically? Intermediate-risk PE is heterogeneous, ranging from patients who do well on anticoagulation to those who deteriorate rapidly. Intermediate-high risk PE is defined by RV dysfunction on imaging and positive cardiac biomarkers. Clinical features such as tachycardia, increasing oxygen requirement, and elevated lactate identify patients at highest risk within this group. 4. What are the strengths and limitations of commonly used PE risk scores? Legacy scores are useful for initial risk categorization but are static and limited in predicting short-term deterioration. Most scores were developed to predict mortality or complications at fixed time points rather than dynamic clinical trajectory. 5. What are the commonly used risk scores and clinical tools in PE, and what is each designed to predict? ESC Risk Stratification Algorithm: Identifies high-risk PE by hemodynamics. Uses PESI or sPESI in normotensive patients to distinguish low-risk from non–low-risk PE. Uses RV dysfunction and biomarkers to differentiate intermediate-low from intermediate-high risk. Forms the basis of many institutional PE pathways. PESI and sPESI: Validated to predict 30-day mortality. Widely used to identify low-risk patients appropriate for outpatient management. Heavily influenced by age and comorbidities. Bova Score: Predicts 30-day PE-related complications in normotensive patients. Composite PE Shock Score (CPES): Predicts normotensive shock in hemodynamically stable PE patients. Pulmonary Embolism Progression (PEP) Score: Predicts progression from intermediate-risk to high-risk PE within 72 hours of diagnosis. PE Short-term Clinical Outcomes Risk Estimation (PE-SCORE): Predicts clinical deterioration or death within 5 days of PE diagnosis. Hestia Criteria: Identifies low-risk PE patients safe for outpatient treatment. Wells' Criteria and Revised Geneva Score: Determine pretest probability for diagnostic triage. PERC Score: Rules out PE in very low-risk patients. 6. What is the role of biomarkers in PE risk stratification? Troponin and natriuretic peptides reflect RV myocardial injury and strain. Current guidelines treat biomarkers as binary (positive vs negative), despite risk being continuous. Biomarkers are most helpful for: Initial risk classification. They are less useful for: Short-interval monitoring and Detecting rapid clinical deterioration. 7. Why is lactate an important physiologic marker in PE? Lactate reflects global tissue hypoxia and impaired perfusion. Elevated lactate may identify patients with: Early circulatory failure and Increased risk of imminent hemodynamic collapse. Lactate is not currently included in ESC risk algorithms but may add important prognostic information in intermediate-risk patients. 8. How does trajectory influence decision-making in PE management? Risk stratification should be viewed as a dynamic process, not a one-time label. Worsening clinical trajectory may include: Rising heart rate, Increasing oxygen needs, Rising lactate, and Progressive RV dysfunction. Serial reassessment is essential for timely escalation of care. 9. What role do Pulmonary Embolism Response Teams (PERT) play in risk stratification? PERT facilitates: Multidisciplinary decision-making and Integration of imaging, biomarkers, and clinical physiology. PERT is most valuable for: Intermediate-risk and high-risk PE and Patients with complex comorbidities or uncertain trajectory. PERT enables a shift from category-based to physiology-driven PE care. References 1. Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). Eur Respir J. 2019;54(3):1901647. Published 2019 Oct 9. doi:10.1183/13993003.01647-2019 2. Leidi A, Bex S, Righini M, Berner A, Grosgurin O, Marti C. Risk Stratification in Patients with Acute Pulmonary Embolism: Current Evidence and Perspectives. J Clin Med. 2022;11(9):2533. Published 2022 Apr 30. doi:10.3390/jcm11092533 3. Choi WH, Kwon SU, Jwa YJ, et al. The pulmonary embolism severity index in predicting the prognosis of patients with pulmonary embolism. Korean J Intern Med. 2009;24(2):123-127. doi:10.3904/kjim.2009.24.2.123 4. Jiménez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383-1389. doi:10.1001/archinternmed.2010.199 5. Chen X, Shao X, Zhang Y, et al. Assessment of the Bova score for risk stratification of acute normotensive pulmonary embolism: A systematic review and meta-analysis. Thromb Res. 2020;193:99-106. doi:10.1016/j.thromres.2020.05.047 6. Zhang RS, Yuriditsky E, Zhang P, et al. Composite Pulmonary Embolism Shock Score and Risk of Adverse Outcomes in Patients With Pulmonary Embolism. Circ Cardiovasc Interv. 2024;17(8):e014088. doi:10.1161/CIRCINTERVENTIONS.124.014088 7. Zhang RS, Alam U, Sharp ASP, et al. Validating the Composite Pulmonary Embolism Shock Score for Predicting Normotensive Shock in Intermediate-Risk Pulmonary Embolism. Circ Cardiovasc Interv. 2024;17(2):e013399. doi:10.1161/CIRCINTERVENTIONS.123.013399 8. Ehret J, Wakefield D, Badlam J, Antkowiak M, Erdreich B. Development of the Pulmonary Embolism Progression (PEP) score for predicting short-term clinical deterioration in intermediate-risk pulmonary embolism: a single-center retrospective study. J Thromb Thrombolysis. 2025;58(2):243-253. doi:10.1007/s11239-024-03051-5 9. Weekes AJ, Raper JD, Lupez K, et al. Development and validation of a prognostic tool: Pulmonary embolism short-term clinical outcomes risk estimation (PE-SCORE). PLoS One. 2021;16(11):e0260036. Published 2021 Nov 18. doi:10.1371/journal.pone.0260036 10. Zondag W, Hiddinga BI, Crobach MJ, et al. Hestia criteria can discriminate high- from low-risk patients with pulmonary embolism. Eur Respir J. 2013;41(3):588-592. doi:10.1183/09031936.00030412 11. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med. 2001;135(2):98-107. doi:10.7326/0003-4819-135-2-200107170-00010 12. Wolf SJ, McCubbin TR, Feldhaus KM, Faragher JP, Adcock DM. Prospective validation of Wells Criteria in the evaluation of patients with suspected pulmonary embolism. Ann Emerg Med. 2004;44(5):503-510. doi:10.1016/j.annemergmed.2004.04.002 13. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144(3):165-171. doi:10.7326/0003-4819-144-3-200602070-00004 14. Kline JA, Mitchell AM, Kabrhel C, Richman PB, Courtney DM. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2(8):1247-1255. doi:10.1111/j.1538-7836.2004.00790.x 15. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6(5):772-780. doi:10.1111/j.1538-7836.2008.02944.x
We react the Huskers walkoff win against the Arkansas Razorbacks in the WCWS.
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 CME information, and to apply for credit, please visit us at PeerView.com/JYN865. CME credit will be available until May 23, 2027.Electrophysiologic Insights Into Transthyretin Cardiac Amyloidosis: From Red Flags to Rhythm Control 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 BridgeBio Pharma, 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 CME information, and to apply for credit, please visit us at PeerView.com/JYN865. CME credit will be available until May 23, 2027.Electrophysiologic Insights Into Transthyretin Cardiac Amyloidosis: From Red Flags to Rhythm Control 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 BridgeBio Pharma, Inc.Disclosure information is available at the beginning of the video presentation.
In this episode, Jeffrey Farber, MD, President & CEO of The New Jewish Home, discusses the organization's accredited heart failure program within a skilled nursing facility setting. He shares how specialized cardiac rehabilitation, interdisciplinary care, and close partnerships with academic medical centers are helping medically complex older adults recover safely and regain quality of life after hospitalization.
From the World Congress of Anesthesiologists in Marrakech, TopMedTalk hosts Mike Grocott and Kate Leslie discuss perioperative cardiac risk assessment with Hilary Grocott, Professor and Head of, The Department of Anesthesiology, Pharmacology & Therapeutics (University of British Columbia) and Michelle Chew Professor of Anesthesiology and Intensive Care Medicine at Karolinska Institutet, Stockholm, Sweden, and editor for the British Journal of Anaesthesia. The conversation reviews perioperative cardiac biomarkers, noting abundant prognostic data but limited evidence for biomarker-led management. The discussion emphasizes that elevated troponins can reflect non-cardiac complications (AKI, PE, sepsis) as well as myocardial injury or heart failure, requiring context-specific follow-up pathways. The group highlights NT-proBNP as a specific marker for heart failure and useful for screening and optimization. The podcast then focuses on pulmonary hypertension and failing right ventricle: detect via history, exam, echo, and biomarkers; prioritize preemptive preparation, arterial beat-to-beat monitoring, modest fluids, early vasopressors/inotropes (norepinephrine, low-dose epinephrine), ventilatory optimization, and vigilant, rapid intervention. If you enjoyed this piece there's a fantastic Perioperative Profile with Michelle Chew you can hear here: https://topmedtalk.libsyn.com/perioperative-profiles-professor-michelle-chew-on-seizing-opportunities-in-anaesthesia-research-editing-and-guideline-work -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/
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, spoke with Dr. Nadia Hensley, Associate Professor and Physician Advisor for Anesthesiology and Critical Care Medicine at John Hopkins School of Medicine; Dr. Nawwar Al-Attar, consultant cardiac surgeon at NHS Golden Jubilee National Hospital in Scotland; and Dr. Serdar Gunadyin, Head of Department at the University of Health Sciences in Turkey. The focus of their conversation was on surgical bleeding. Chapters 00:00 Intro 02:35 Case 1, Diffuse Coagulopathy 03:26 Bleeding Scale 08:13 Team-Wide Bleeding Language 11:07 Alternative Approaches 14:09 Standardizing Test Results Response 18:04 No Access to Visoelastic Testing 19:55 Topical Hemostatic Agents 23:08 Case 2 24:14 Coagulopathy vs Surgical Bleeding 28:08 Passive Hemostatic Agent 29:10 Visoelastic Testing 31:29 Closing Points They discussed two different cases, including patient details and case specifics: one involving diffused coagulopathy and the other concerning focal bleeding. While examining these cases, they talked about hemostasis and the hemostasis checklist. They also discussed the validated intraoperative bleeding (VIBe) scale and its purposes, and the importance of being on the same page as your team. Additionally, they delved into viscoelastic testing and algorithms and addressed scenarios where access to viscoelastic testing may not be available. They also explored the thresholds for guided therapy, including functional fibrinogen levels. Lastly, the experts touched on passive hemostatic and how to teach residents coagulopathy and surgical bleeding. 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.
For patient referrals: call 602-521-3661What happens when the heart's electrical system spirals into a life-threatening rhythm disorder? In this episode of Beyond the Rounds, we explore ventricular arrhythmias — dangerous heart rhythm disturbances that can lead to sudden cardiac death, repeated ICD shocks and severe heart failure complications. Dr. Nolan Fisher sits down with cardiac electrophysiologist Dr. Peter Weiss to break down how these arrhythmias develop, why they are so difficult to treat and how new ablation technologies are changing outcomes for patients with complex ventricular tachycardia (VT).Dr. Weiss, Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix, shares how advanced mapping systems, catheter ablation and emerging technologies like ultra-cold cryoablation and pulsed field ablation are helping physicians target dangerous electrical circuits deep within the heart muscle. The discussion also explores how Banner Health is building a multidisciplinary referral center capable of rapidly managing critically ill patients experiencing VT storm and recurrent ICD shocks.This episode is designed for physicians, advanced practice providers and clinicians seeking a practical understanding of ventricular arrhythmias, advanced electrophysiology procedures and the evolving role of catheter ablation in complex cardiac care.What We Cover• The difference between ventricular arrhythmias and atrial fibrillation (AFib)• Why ventricular tachycardia (VT) can become life-threatening• How scar tissue and cardiomyopathy create electrical “short circuits”• Understanding PVCs (premature ventricular contractions) and when they should be treated• How electrophysiologists map the heart's electrical system in real time• What catheter ablation actually does during a VT procedure• The role of ICDs (implantable cardioverter defibrillators)• Why antiarrhythmic medications like amiodarone can be difficult long term• New technologies including ultra-cold cryoablation and pulsed field ablation• The importance of multidisciplinary VT storm programs and rapid referral pathwaysKey Topics for Clinicians• Ventricular tachycardia (VT)• Ventricular arrhythmias• VT storm• Cardiac electrophysiology• Catheter ablation• Premature ventricular contractions (PVCs)• Implantable cardioverter defibrillators (ICDs)• Pulsed field ablation• Cryoablation• Ischemic cardiomyopathy• Advanced heart failure• Electrophysiology mapping systems• Structural heart disease• Sudden cardiac death preventionAbout Our GuestDr. Peter Weiss is a cardiac electrophysiologist and Director of the Center for Ventricular Arrhythmias and Robotics at Banner – University Medical Center Phoenix and the University of Arizona College of Medicine – Phoenix. He specializes in complex ventricular arrhythmia management, robotic catheter ablation and advanced electrophysiology procedures. Dr. Weiss trained at Stanford University and completed additional advanced electrophysiology training at the University of Pennsylvania. Prior to joining Banner Health, he spent 14 years building a regional ventricular arrhythmia referral program at Intermountain Health.How to Refer a PatientBanner Health providers: Use Cerner's Ambulatory Referral Management (ARM) tool.Community providers: Please call 602-521-3661 for referral information and scheduling assistance.DisclaimerThis podcast is intended for educational purposes only and is designed for a clinical audience. Any patient scenarios discussed are modified and de-identified to protect privacy. No protected health information (PHI) is disclosed. The information presented should not replace independent medical judgment or individualized patient care decisions.Subscribe to Beyond the Rounds for physician-focused conversations on clinical innovation, specialty collaboration and evolving standards of care.
Anjali Tiku Owens, MD - Contemporary Data, Differentiation, and Decision-Making in Hypertrophic Cardiomyopathy: A Guide to Cardiac Myosin Inhibition for the Managed Care Professional
Please join special guests Heather Viamonte, MD (CHOA/Emory), Fawaaz Shaw, MD (CHOA/Emory) and Virginia Horan, PA (Intermountain Health/U. Utah) discussing the bidirectional partnership with Global Health Office of Pediatrics at Emory (GHOPE) and Jakaya Kikwete Cardiac Institute, a public national specialized cardiovascular teaching and research hospital within Muhimbili National Hospital affiliated with Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. They speak to the collaboration and partnership in support guideline development and education simulation of critical care of children with congenital heart disease generously funded by Thoracic Surgical Foundation, Every Heart Beat Matters Award. Host and Editor: Gina Patel, MD (CHOA/Emory). Co-host and Producer: Saidie Rodriguez, MD (CHOA/Emory). Sponsor: Alabama Children's
Anjali Tiku Owens, MD - Contemporary Data, Differentiation, and Decision-Making in Hypertrophic Cardiomyopathy: A Guide to Cardiac Myosin Inhibition for the Managed Care Professional
Anjali Tiku Owens, MD - Contemporary Data, Differentiation, and Decision-Making in Hypertrophic Cardiomyopathy: A Guide to Cardiac Myosin Inhibition for the Managed Care Professional
Dr. Clint Sliker breaks down the critical imaging findings of cardiac and non-thoracic vascular trauma, highlighting how these rare but life-threatening injuries appear on CT. He shares practical insights to help radiologists recognize subtle signs, choose the right protocols, and maintain a high index of suspicion in high-stakes trauma cases. Imaging of Cardiac and NonaorticThoracic Vascular Trauma. Costenbader and Beheshtian et al. RadioGraphics 2026; 46(2):e250097.
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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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.
PeerView Family Medicine & General Practice CME/CNE/CPE Video Podcast
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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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.
PeerView Family Medicine & General Practice CME/CNE/CPE Audio Podcast
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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/VXA865. CME/AAPA credit will be available until May 15, 2027.Hidden in Plain Sight: Recognizing and Referring Patients With Transthyretin Cardiac Amyloidosis in Internal Medicine 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.
In this episode Rosie Moss speaks with Corinne Longland-Malam, known online as the “Fairy Grief Mother,” about losing her partner Lee after a rare and devastating illness turned their lives upside down in the space of months.Corinne shares the story of meeting Lee “very romantically on Facebook,” falling quickly into a relationship that felt less like fireworks and more like finally feeling safe. Together they built a blended family, a quiet life, and the kind of love rooted in contentment, companionship and being fully yourself with another person.Everything changed when Lee was diagnosed with cardiac amyloidosis caused by myeloma, a rare condition affecting both the heart and blood. What follows is a brutally honest conversation about sudden illness, complicated treatment decisions, and the impossible balance between hope and reality.Corinne speaks candidly about becoming Lee's advocate while trying to protect their children, the trauma of repeated cardiac arrests at home, and the night he died beside her after another emergency. She describes performing CPR, waiting for the coroner, making impossible phone calls, and the surreal practical reality of grief in its earliest hours.Rosie and Corinne also talk about what comes afterwards: the secondary losses that ripple through blended families, being forced to leave the home they shared, parenting while grieving, and using TikTok as an outlet for pain that felt too raw to share anywhere else.This episode covers:• Falling in love after difficult past relationships and finding safety in another person• Cardiac amyloidosis and myeloma, including missed symptoms and delayed diagnosis • The emotional impact of rare illness and navigating uncertainty around treatment• Advocacy, medical trauma, and protecting loved ones from frightening realities• Cardiac arrests at home, CPR, and the shock of sudden death• Parenting grieving children while trying to survive your own grief• Wills, legal planning, and the practical chaos that follows loss• Social media, community, and why sharing grief online can sometimes feel safer than doing it face to face• Rebuilding safety, identity and family life after losing your person
In hour 1 Mark Zinno and Rusty get in to Falcons draft picks arriving, and Dawg softball pulls a massive upset in SEC Tournament
Welcome to the third in this week's series of Lead episodes covering late breaking clinical trials from Heart Rhythm 2026 in Chicago. Join host Michael Lloyd, MD, FHRS, and his guests Christopher Kowalewski, MD and Karin Benali, MD, PhD for this discussion. This first-in-human, prospective study presented at Heart Rhythm 2026 evaluated noninvasive proton beam cardiac radioablation for patients with refractory ventricular tachycardia who had failed prior ablation and medical therapy. In a small, high-risk cohort, proton therapy was feasible and demonstrated substantial reductions in VT burden (approximately 80%) with no significant treatment-related toxicity observed during follow-up. These early findings highlight proton beam radioablation as a promising, highly targeted, noninvasive treatment option, though larger studies are needed to confirm long-term safety and durability. Learning Objectives: Describe the principles of cardiac radioablation and the advantages of proton beam therapy compared with photon-based approaches for treating ventricular tachycardia. Evaluate early feasibility, safety, and efficacy outcomes of proton beam therapy in patients with refractory ventricular tachycardia. Assess the potential role of noninvasive cardiac radioablation in the treatment algorithm for patients with drug- and ablation-refractory ventricular tachycardia. Podcast Contributors Michael S. Lloyd, MD, FHRS Christopher Kowalewski, MD Karin Benali, MD, PhD Host and Contributor Disclosure(s): M. Lloyd •Honoraria/Speaking/Teaching/Consulting: Medtronic •Membership on Advisory Committees: Boston Scientific K. Bemali Nothing to disclose. D. Chew Nothing to disclose.
2 wins in one week
EECP Therapy and Stroke Recovery: Can a Cardiac Treatment Help Grow New Blood Vessels? When I first heard about EECP therapy in the context of stroke recovery, I was skeptical. It’s a cardiac device approved in Australia for stable angina and congestive heart failure. Stroke is not on the label. So why are we talking about it on a stroke recovery podcast? Because the mechanism is fascinating. And the research, while still emerging, is pointing somewhere worth paying attention to. In this episode, I sat down with Jack Clifford, a heart disease patient who discovered EECP therapy and began exploring its potential beyond its approved indications. What started as a cardiac conversation quickly became one of the most scientifically interesting discussions I’ve had on the show. What Is EECP Therapy? EECP stands for Enhanced External Counterpulsation. The treatment involves a set of pneumatic cuffs fitted around the calves, thighs, and buttocks. These cuffs inflate and deflate in precise synchrony with the heartbeat, inflating during the heart’s resting phase (diastole) to push blood back toward the heart, and deflating just before the heart contracts. The result is an increase in blood flow and a specific type of fluid shear stress on blood vessel walls. It’s that shear stress that makes things interesting. The Biology: Arteriogenesis and Angiogenesis To understand why EECP therapy might be relevant to stroke survivors, you need to understand two terms: angiogenesis and arteriogenesis. Angiogenesis is the sprouting of entirely new capillary vessels — the body builds small blood channels where none existed before. Arteriogenesis is different: it’s the remodelling of pre-existing, dormant collateral vessels into functional bypass channels. Think of it like upgrading a dirt track into a highway. The track was always there; the body just wasn’t using it. When blood flow is obstructed, whether by a blocked coronary artery or a stroke, the body can, under the right conditions, activate these collateral pathways. The shear stress produced by EECP therapy appears to be one of the triggers that stimulate arteriogenesis. By generating repeated waves of increased blood flow, the treatment creates the mechanical signal that tells blood vessel walls to grow and remodel. This is why cardiac researchers originally developed EECP for heart patients. But it raises a legitimate scientific question: could the same mechanism support blood flow recovery in the brain after stroke? What Does the Research Say? A 2026 meta-analysis published in the QJM: An International Journal of Medicine examined 15 randomized controlled trials involving 506 participants, looking specifically at EECP’s effects on functional outcomes in stroke patients. The results showed statistically significant improvements, with EECP outperforming control conditions on standard functional recovery measures. This is preliminary evidence, not a settled clinical consensus. The studies are relatively small, the methodology varies across trials, and EECP remains off-label for stroke in Australia. But for a therapy with a well-understood safety profile and an existing approval framework, 15 studies and 506 participants is not nothing. It’s enough to warrant serious discussion. What I Discussed with Jack Clifford Jack came to EECP as a patient, not a researcher. His experience with heart disease led him to explore the therapy, and he’s spent considerable time understanding the evidence base and connecting with practitioners. He’s not a clinician, and neither am I, but what we can do together is examine what the research actually says, what the mechanism actually is, and what questions remain unanswered. In our conversation, we discussed: How Jack first encountered EECP therapy and what led him to investigate it further The difference between approved and off-label use, and why that distinction matters What the shear stress mechanism actually looks like in practice The existing network of EECP practitioners and how stroke survivors might access the therapy The questions both of us still have about where the research needs to go Important Disclaimers EECP therapy is approved in Australia by the TGA for stable angina pectoris and congestive heart failure (ARTG Entry 376470). Stroke is NOT an approved indication. This article and podcast episode are not medical advice. Speak with your treating physician before pursuing any treatment. This episode is not medical advice. It is a conversation about an area of emerging research that I find scientifically credible and worth understanding. The goal is to help you ask better questions, not to tell you what treatment to pursue. Where to Learn More ecplocator.com a directory of EECP therapy providers eecpbook.com is a dedicated resource on the treatment and its evidence base recoveryafterstroke.com for stroke survivors looking for a broader community Research cited: Zhao et al. (2026). Enhanced external counterpulsation for ischaemic stroke: a systematic review and meta-analysis. QJM: An International Journal of Medicine. DOI: 10.1093/qjmed/hcag010. Therapy and Stroke Recovery: Can a Cardiac Treatment Help Grow New Blood Vessels? Bill Gasiamis sits down with Jack Clifford to explore EECP therapy, a TGA-approved cardiac treatment that may stimulate the growth of new blood vessels. Together, they examine the emerging research on angiogenesis, arteriogenesis, and whether this off-label approach holds promise for stroke survivors seeking to improve blood flow to the brain. Highlights: 00:00 Introduction – EECP Therapy06:06 Recognizing Health Issues and Seeking Help09:50 Hospital Experience and Heart Health12:12 Decisions Against Medical Advice16:28 Exploring Alternative Treatments18:06 Understanding Enhanced External Counter Pulsation (EECP)21:58 The Mechanism of EECP27:03 Personal Transformation Through EECP30:29 Lifestyle Changes and Holistic Health34:35 The Impact of Stress on Health38:30 The Journey of Writing a Book43:29 The Role of EECP in Heart Health48:21 Raising Awareness for EECP Therapy56:05 Exploring the Future of EECP Therapy Transcript: Introduction – EECP Therapy Jack Clifford (00:00)Mine was really severe. 100 % blocked in my widow maker, the left anterior descending. I’m 95 in my left coronary artery and in my right main, I am 80%. And I’m still that way today, but I can run a sub seven mile. Bill Gasiamis (00:16)Welcome to the Recovery After Stroke podcast. I am your host, Bill Gassiamus. Before we get into today’s interview, I need to share something important. The topic we’re exploring today involves a medical device called an EACP, Enhanced External Counterpulsation Machine. In Australia, EACP is registered with the Therapeutic Goods Administration for the treatment of stable angina and congestive heart failure. It is not approved for stroke. What we are discussing today is emerging off-label research, not a treatment recommendation. Everything in this episode is for informational purposes only. This is not medical advice. Please speak with your treating physician before pursuing any treatment, therapy or intervention discussed here. With that said, let’s talk about something that genuinely fascinated me when I started reading the research. Your body has the capacity to grow new blood vessels, not just small capillaries, but to remodel dormant pre-existing channels into functional bypass routes. Scientists call this arteriogenesis. There’s also angiogenesis, the sprouting of entirely new Both processes matter deeply for stroke because stroke is fundamentally a blood flow problem. Now here’s where it gets interesting. A cardiac therapy developed for heart patients, not stroke patients, trigger exactly this kind of vascular remodeling. And in 2026, a meta-analysis published in the QJM across 15 randomized controlled trials and 506 participants found that EECP produced statistically significant improvements in functional outcomes for ischemic stroke patients. Now, that’s not proof. That’s not a green light to go and get an EECP, but it is worth a serious conversation. My guest today is Jack Clifford. Jack is a heart disease patient who discovered EECP therapy while managing his own cardiac condition and who has since spent considerable time investigating its potential. beyond cardiac care. I should tell you, I was skeptical going into this conversation, but I’ve learned that skepticism without curiosity isn’t really skepticism. It’s just closed mindedness. So I read the research and then I sat down with Jack. So if you find this episode valuable, I’d love for you to grab a copy of my book, The unexpected way that a stroke became the best thing that happened at recoveryafterstroke.com/book. And if you want to support the show, you can join Patreon at patreon.com/recoveryafterstroke. And I want to thank everyone who is supporting me on Patreon, especially the people that have been around for a long time and the people who have just recently signed up. I very much appreciate it. And now here’s my conversation with Jack Clifford. Bill Gasiamis (03:19)Welcome to the podcast. Jack Clifford (03:22)Thanks, Bill. Great to be here. Bill Gasiamis (03:24)Let’s give the listeners a bit of a background understanding of why you’re on the podcast. You’re not a stroke survivor, but we have something in common as ⁓ somebody who has been unwell before myself and you in the past. Tell me a little bit about your journey to the podcast So we just kind of give people an understanding as to how it is that somebody who’s not a stroke survivor. Jack Clifford (03:34)We do. Bill Gasiamis (03:51)how we ended up chatting together? Jack Clifford (03:54)Yeah, absolutely. So the quick version here is ⁓ I was on the brink five years ago of having ⁓ unsentable emergency triple bypass surgery. And ⁓ I chose a different path, which we’ll get to. ⁓ But you you have some level of placking if you have a stroke, typically, depends on the stroke, but that’s typically the case. And in my case, I had placking in my coronary arteries. So it resulted in heart disease. Mine was really severe. 100 % blocked in my widow maker, the left anterior descending. ⁓ I’m 95 in my ⁓ left coronary artery and in my right main, I am 80%. And I’m still that way today, but I can run a sub seven mile. I can do some things that a guy that’s as blocked up as that should not theoretically be able to do. ⁓ Bill Gasiamis (04:49)All right. Tell me about life before the injury. What kind of work did you do? How did you go about life? What was generally a day like for you? Jack Clifford (04:59)Yeah. So I’m retired military guy. Um, so, you know, been in the military most of my life, um, retired about 10 years ago, a little over that. And, um, so I’ve always been a pretty fit guy. It wasn’t, you know, it wasn’t a fitness issue per se. Um, and, uh, I, I, I had kind of lost some of my self care because my wife had been going through some real significant medical issues that really required my full attention for quite a while. And because of that, really stopped taking care of myself in the ways I had in the past for about 10 years. And when we had just moved to Florida, I started trying to take care of myself again. And that’s when I discovered all these problems. Bill Gasiamis (05:44)So what does not taking care of yourself look like though? Jack Clifford (05:47)Gotta be in a couch potato and being on my computer way too much research and for ⁓ trying to help my wife get better and hold down a job at the same time and raise a family and all these other things that took the priority off of me in that sense that one should be taking care of themselves, meaning exercising, meaning eating the right foods, so on and Recognizing Health Issues and Seeking Help Bill Gasiamis (06:09)You know, caregivers tend to die before the person they’re caring for much more often. And it’s cause of that reason, right? Because time is really taken up by especially full-time caregiving with somebody’s in the house and they need caregiving. need care. The caregiver tends to neglect themselves in every way, shape and form and tends to ⁓ make it about the other person. And then the other person. Jack Clifford (06:14)I’ve seen that and heard about it. Yeah. Mm-hmm. Bill Gasiamis (06:39)seems to be doing okay, but the caregiver is struggling and doesn’t ask for help and doesn’t go and doesn’t go and get looked after. And then things tend to catch up with them and they become the ⁓ sickest person in that relationship. Jack Clifford (06:55)It’s like that whole put your oxygen mask on first on the airplane type thing, right? Like, you know, we can’t we can’t give what we don’t have to give Bill Gasiamis (07:01)Uh-huh. Yeah. So you, did you notice, did you notice the steady decline in your health? Did you kind of go, I’m not feeling right. I’m a feel a bit sluggish like 10 years down the track, or did it just creep up on you? then you got to this point. Jack Clifford (07:15)It really crept, it really crept. I, you know, like I had initially exercise induced angina, but it wasn’t much exercise that induced the angina. And then it very quickly progressed to trying to walk and getting out of breath and, know, at very basic walking speeds, just moderately paced, you know, anything anybody would do out in your neighborhood. ⁓ Bill Gasiamis (07:39)Did you know that you had an angina? Jack Clifford (07:41)I did, yeah. I didn’t have a big heart attack episode like some people have. I’m 100 % blocked. There’s no heart attack to happen, right? Because the stuff is, I’m so blocked that it’s just a pure blood flow issue. A lot of people don’t understand that that 50 % blockage is a huge risk for a heart attack because you’re gonna burst a plaque and then go from 50 % to 100 % like that. But you know about collaterals. And if you have collaterals in place, the blood’s not getting flowing this way, you’re gonna recruit some lead oval collaterals to be able to just get by with your activities of day living. But if you don’t push yourself, you don’t know that you don’t have enough blood flow to do these other things. Bill Gasiamis (08:22)Okay, so you got to the point where you were so unwell as far as the blood vessels around your heart were so unwell, they were so blocked that angina led to another escalation or something happened that got you to the point where you realized, okay, things are not good. Now, tell me what angina is exactly and what it’s like to have it. How do you experience it? Jack Clifford (08:39)Yeah. yeah, yeah. I’d love to talk about that. Bill. at its most basic, it’s a supply demand mismatch. So, you know, the blood flow that’s supplying your heart ⁓ is adequate for X, Y, or Z activities of daily living. You know, walking around the house, doing the dishes, you might have enough blood flow for that, but you don’t have enough blood flow to go run a mile or even walk potentially, you know, or Hospital Experience and Heart Health but it’s all about supply demand mismatch. And that’s about just the size of the pipes, you know, if they’re clogged up, how clogged up are they? And, know, ⁓ that’s, really it. So, and what it feels like is it’s scary because it feels like a heart attack. all like, what does a heart attack feel like? Well, there’s a thousand different sort of, ⁓ descriptions of it. ⁓ you know, radiating down your arm or nausea or something in your back, but. you know, if it’s right over your heart, it’s unmistakable. And that’s at least my presentation of angina. And I think it was a pretty typical one is, you know, I have this weird kind of deep pain. initially, when I, when I started, you know, run, trying to run and got it, I thought, ⁓ you know, I just pulled a chest muscle weirdly over my heart. You know, I’ll stop and let’s see if it goes away. I come back, you know, no, same thing. Okay. Still not better. Let’s do it again. Another couple of days later, so on and so forth. I was just kidding myself, but I didn’t know anything about the horror at that point. hadn’t had to research all this stuff and do all the deep dive. Bill Gasiamis (10:16)That’s the same crazy logic that stroke survivors put to, I’m feeling weird. I’m dizzy. I’m going to go and lie down. I’m going to rest. It’ll be better later. ⁓ I’m too busy. I’ve got to go to work. ⁓ I’ve even had stroke survivors where somebody’s telling them you maybe you’re having a stroke, you know, just tongue in cheek and they’re like, yeah, no, probably not. ⁓ it’s the same crazy logic that we say about things that are unfamiliar to us that we cannot potentially. Jack Clifford (10:25)Mm-hmm. Mm-hmm. Yeah. Yeah. Bill Gasiamis (10:46)link to something so serious because we have no knowledge, we’re ignorant, right? Jack Clifford (10:47)Yeah. Well, yeah, I think that’s really part of the key there is like most times with something as sudden as what you’re talking about or what I’m talking about in my instance, because it was pretty, pretty sudden, you know, weeks and months. ⁓ We went from being these, you know, healthy people that felt like we were on top of the world to all of a sudden not. you you didn’t have a frame for what not looked like. ⁓ Bill Gasiamis (11:14)Exactly. Yeah. That’s such an important comment. We don’t have the frame for what not healthy looks like and therefore you don’t know what you don’t know. So you don’t take any action. You just brush it off. Okay. I hear you. All right. We got to the bottom of the stupidity behind a lot of my decisions as well to avoid going to hospital for a week, et cetera, the first time. ⁓ So you end up Jack Clifford (11:24)Exactly. That’s it. Bill Gasiamis (11:43)being really unwell on this particular date. Kind of what is that day like? Explain us. Jack Clifford (11:46)Yeah. Yeah. Decisions Against Medical Advice So I got tight. I, I, I’ve been a biohacker for a while. So that’s probably the only reason I’m here talking to you because I went off the beaten path really far off the beaten path to get to the place where I know what I know and I have to share what I have to share. ⁓ because I’ve been trying to help my wife get better for some significant issues, including a really bad traumatic brain injury. And some other things and doctors didn’t have the answers for those so we had to we had to kind of biohack our way out of some things I was comfortable back. I’m saying that to say my wife got me a Chili pad for my bed because you know been trying to biohack sleep for a while and the colder environments to sleep are you know better to some degree at least in theory ⁓ and so Yeah, correct Bill Gasiamis (12:32)Chili meaning cold, not spicy. Jack Clifford (12:37)Yeah, correct. A chili pad as in the cold. So it’s a device that just, you know, cools your bed off. And so I crank that down to 55. She got it for me for Christmas. So Christmas day Eve, I’m like hopping into bed, like I’m going to sleep really well tonight, you know, and I woke up at four AM like, Oh, you know, I thought that was the big one because it felt that way. I a dead sleep woke me up with, with intense chest pain. And I knew something was going on, you but I was kidding myself. I hadn’t talked to family about it. You know, I hadn’t shared anything about what was going on with anybody. So at this point I’m like, oh my goodness, you know, and I could be dying and have not had, you know, just been an idiot the whole time. So I rushed to the hospital and I didn’t have a heart attack. I just made it so cold that I made my heart work and that supply demand mismatch was happening all night long in my sleep. Bill Gasiamis (13:15)Mm-hmm. Jack Clifford (13:31)And so it got to this, you know, a giant, creeps up, you know, it’s like, can feel it. And then if you push it, you’re like, can really feel it. Well, you know, I woke up out of a dead sleep going from not feeling it when I went to sleep to, to feeling it to the extreme when I woke up. Um, but that’s when they gave me the, uh, the, uh, nuclear stress test with a treadmill test, right in the hospital. And it was, it was really bad. They can’t quantify your blockages with that, but they can tell you that, you know, you’re You’re kind of screwed. And I was like really screwed. Like it was 47, but they said I was one of the worst I’d ever seen. ⁓ yeah. So I had all weekend to think about it, you know, cause I was a Friday, fortunately, and they could, they weren’t going to do the heart catheterization until Monday and the doc, you know, I was signing consent forms for them to do bypass surgery and it was pretty clear that the odds of it getting stented was not really good, but that’s what you hope for. Right. And most people are like, we’ll just get a step. once then in you’re fine. And ⁓ in my case, it wasn’t looking likely. And my mother had had bypass surgery five years before that. And I watched her cognition after the bypass surgery just declined to the point where she’s in memory care now. And she had gone from being this vibrant book author of multiple books and you know, she was a hypnotherapist and she’s helped a lot of people in her life, done a lot of amazing things, but ⁓ she never. she never really came out of the bypass surgery as her whole self and pretty quickly was just completely not herself at all. ⁓ So I wasn’t ready to come back. Now she’s 76. Bill Gasiamis (15:03)How old? How old’s your mom? Yeah. I know with people that are older, ⁓ heart surgery can lead to cognitive decline and there is a link there. There is a number of it’s well researched. It’s a risk. ⁓ not one that you’re probably aware of and that they talk about much, but it definitely is a thing. so, okay. You’re, you’re you go to the hospital. They realize, ⁓ the Jack Clifford (15:15)Mm-hmm. Bill Gasiamis (15:37)charts are not looking good. ⁓ They do the tests. They suggest that what they can offer you is bypass surgery. your, and you’ve got a weekend, think about it and you, and you go home, do they go, do you go home with medication and joining the medications to keep the blood flowing with anything? What do they do? Jack Clifford (15:51)Mm-hmm. Where’d you go? Yeah, such a blessing. No, no, because I was leaving against medical advice so they weren’t going to help me, right? And I actually said to the doc, said, you hey, I’m new here because I just moved a couple of months ago to Florida. And I said, can I come see you? And I didn’t have a cardiologist. I didn’t need one before this. And he says, if you live that long, just walks out. So I was on my own at that point. There was no resources of institutional medicine. I had to go find resources myself. Exploring Alternative Treatments Bill Gasiamis (16:28)Wow. Things are pretty wild in Florida. If you live that long and he walked out. Jack Clifford (16:30)Yeah. Yep. That’s exactly what we said. It’s a very sobering moment for me. Yeah. Bill Gasiamis (16:35)And you walked out. Yeah, and you walked out. Far out, man. So what’s the thinking behind walking out of that? Because I understand ⁓ that there are very few things that, like my situation was different, right? But I’ll give you kind of my thinking behind the, I’m gonna walk out routine. It’s like, there is a part of me that sort of says, I don’t need to subscribe to all that medical stuff, all the nonsense. I wanna try and avoid the medications. I wanna do all of that. Jack Clifford (16:41)Yeah. Yeah. Bill Gasiamis (17:07)That means I’ve got to do some work to get to that point, right? I’ve got to make sure that I’m eating well. I’m sleeping well. ⁓ I’m exercising. ⁓ I’m not overweight. I’m not smoking. I’m not drinking. Like there’s a responsibility that goes with, don’t want to take that medication. Right. And one of the other things is that, ⁓ if it wasn’t for the medical industry, I would not be here recording this, ⁓ podcast. Yeah. So there’s this big thing, which is. Jack Clifford (17:31)Yeah. Double-head sword, right? Yeah. Yeah. Bill Gasiamis (17:37)They’re not fixed. My brain is not getting fixed unless they go in and take out the faulty blood vessel and potentially risk all the complications that, that I got the ones I got, but also the ones I didn’t get, which many people get, which is far worse deficits than what I visible on me. So, ⁓ I’m, you know, I’ve never met anyone in my time who hasn’t Understanding Enhanced External Counter Pulsation (EECP) who has been through the medical ⁓ system, who hasn’t benefited from it in a way that’s sort of sustained their life, supported their life, lengthened their life. Like everyone that I’ve interviewed has always gone through the medical system and has saved them, supported them, helped them, right? And you’re going to, the first place to get help you’re going to is a hospital, right? You ring up and you go, I’ve got to go. Jack Clifford (18:22)Yeah. Bill Gasiamis (18:31)to the hospital because I’m feeling like I’m having heart attack. You get there, they confirm it, and then the place that you go to for help is the place you walk out of. What’s the thinking? Yeah, yeah. You have the angina, the blockages. Yeah, you got all of that. Jack Clifford (18:41)Well, I didn’t have a heart attack. That’s a really important nuance point. you know, I’m sitting in the hospital all weekend. there was nothing at risk in an emergent moment for me. My heart wasn’t, you know, I wasn’t going to lose heart muscle if they didn’t do something. Like my mother’s instance was different. She had a heart attack. She probably needed the bypass surgery. It was really hard on her, obviously, like we talked about, but in my case, I had time, but they didn’t treat it like I had time, right? Bill Gasiamis (18:54)Okay. Okay. Jack Clifford (19:10)They treated it like, we’re gonna go in and take care of this thing for you rather than you have time to explore other options when I knew in fact I did. So it might be that getting bypass surgery is the right move for some folks, but it also might be the right move for you and me. We’ve already discussed that you take care of yourself so you never get in that situation. And yeah. Bill Gasiamis (19:32)Yeah. And this is not a interview about do as I say, this is not that interview, right? What this interview is like one person’s experience and what they did. That’s it. We’re not giving medical advice here. We’re not telling you what decisions to make. We’re not telling you any of that stuff. This has got nothing to do with advising anyone to do anything, but what it has got to do with is what either you discovered Jack Clifford (19:45)Yeah. Right. Bill Gasiamis (19:58)or you knew before and put into action or what you discovered after you left the hospital that weekend. So take us through the next sort of phase of I’m taking responsibility for this and I’m going to take advantage of something that is documented scientifically and proven. Jack Clifford (20:03)Yeah. Okay. Yeah. Mm hmm. Yeah. Yep. Yeah. And you know, like, so I’ll go into that phase, but, but I just want to share this thing because, know, you, you pretty much already told me when you first heard EECP, you like EECP what? Right. And most doctors are EECP what? Basically every patient is EECP what? And it’s, it’s just, it’s really not going to lie. really bothers me because this, this, this therapy is, is so well-documented. It’s, it’s, it’s FDA approved. It’s not controversial. Bill Gasiamis (20:25)Mm-hmm. Jack Clifford (20:43)⁓ it just anyways, okay. So, so, so yeah, so I leave the hospital and the only reason I knew about a EECP was because when my mom had her heart attack, I listened to a podcast by Ben Greenfield. He’s a pretty, you know, pretty high-level guy, right? And that had been, that was like 2015. And I just heard mention of it. was like, it was maybe like two minutes of the, of a 60-minute podcast at most, but I was like noted. So I looked into it from my mom. The closest provider was two hours away and you got to go 35 times and my mom isn’t going to drive. 35 times, you four hours round trip. It wasn’t gonna happen, so we moved on, but I just sort of knew about it. And when I say knew about it, I didn’t know, Bill, like what it actually did or how it worked. I didn’t look into it at that level. just, you know, like assessed the situation. I was like, okay, there’s something out there. That’s it. Okay, yeah. It stands for enhanced external counter pulsation. And you want me to go into a little bit about how it works? Yeah, okay, so. Bill Gasiamis (21:27)Hmm. And what is a ⁓ CP stamp? What does it stand for? Yeah, yeah, let’s do that, yeah. Jack Clifford (21:42)So EECP involves lying on a bed. From the patient experience, you’re lying on a bed. You have ⁓ cuffs wrapped around your calves, your thighs, and your hips. And inside those cuffs, there are little air bladders. Bill Gasiamis (21:55)those cuffs, are they like blood pressure cuffs? The Mechanism of EECP Jack Clifford (21:58)Yeah, like big giant Velcro blood pressure cuffs. Yes. Bill Gasiamis (22:02)Okay, so like they’re much bigger than a regular cuff, which is just over the bicep. Okay. All right. Jack Clifford (22:04)Yes. Yes. Correct. yeah, just that’s the right way to think about it. you you cinch them up, you’re getting really snug in this thing, but it looks like a giant pantsuit, you know? ⁓ And you lie on the bed and then you get a three lead EKG on you. It’s here, here, in here. And then in between heartbeats, the machine… inflates compressed air into those bladders at 1.3 psi to start with, which feels like kind of a gentle massage. And then the pressure can be increased in increments of 0.1 psi all the way up to six, which feels like the exact opposite of a gentle massage. However, if you go slowly, your body accommodates to that pressure and that pressure feels different, both over one session and over multiple sessions, meaning you might not get to six your first session, that’s unlikely, but as you do repeated sessions, you’ll increasingly get closer to six earlier in the treatment and be cumulatively more hours at those higher pressures. And what’s happening is all the blood, not all the blood, a significant amount of blood from your lower body is being pushed up in between heartbeats and it’s causing this phenomenon called sheer stress in your vascular systemically. And wherever there’s pressure differentials in the body, it’s giving a stimulus to grow. It’s saying the pipes are not big enough, you gotta grow. We’re trying to put through more than is gonna fit. The body’s like, wait a second, it’s not big enough. But growing things in the body takes time. And so you need those repeated sessions. Like I mentioned, T.R., before we started recording, it works just like cardiovascular exercise, but at levels humans can’t do on their own. ⁓ And so, yeah. Bill Gasiamis (23:52)That’s important to talk about. so just for a moment, we’ll talk about that. Like it works like cardiovascular exercise. So the idea with cardiovascular exercise is that what, does cardiovascular exercise do that’s similar to EECP? Jack Clifford (24:04)Sure. If you’re out running, when you hit that stride on your feet, you’re doing that same thing, right? You’re ⁓ sending blood up, right? And then your circulation, your heart’s beating twice as fast maybe than it normally is, or substantially more than you’re just sitting here heartbeat is. And that’s because the heart is responding to the environment around it and saying, I gotta get… a lot more blood, a lot more places. So I gotta work a lot harder. you know, is maintenance. So collateral blood flow. have alternate routes that we can use that lie dormant throughout our body. And those collaterals, if they never get used, they honestly, they get weaker and they close off, but they also can be reopened, you know? And then you can grow more of them. And… Bill Gasiamis (24:38)And what’s the result of that? Uh-huh. Okay, so there’s blood vessels that get less ⁓ blood flow because people are sedentary or people aren’t doing the type of exercise that would activate those blood vessels, for example. And then what in theory, not in theory, and then what happens in cardiovascular exercise, the body goes, we need more blood flow, let’s open up. Jack Clifford (25:12)Exactly. Bill Gasiamis (25:26)other areas where normally blood flow wouldn’t be required or doesn’t go. And EECP kind of mimics that mechanism. Jack Clifford (25:27)Yeah. Exactly. Yeah, but not kind of, it’s really important just to note, cause I don’t want, I don’t want any of your listeners thinking, well I’m just going to go run more. Right? I mean, by all means do that safely. You know, the dose always makes the poison with everything, but, but don’t think that you can, you can just go do this. You can do it to a limited degree with exercise, but you’re not going to grow, you know. that I didn’t have that before. And I like it because it shows you like the world of the possibly or it might be a little unsightly, but it’s feeding my brain. EECP has changed my cognition in addition to my heart, you know, my pelvis and my kidneys and my liver. you know, like it’s, it’s optimized blood flow systemically. Um, yeah. Yeah. Bill Gasiamis (26:19)Okay, so let’s go back to the cuff, the cuff that we put on and then what happens. Jack Clifford (26:24)Yeah. Yeah. So, so you just lie on the machine. Typically you do 35 hours on a machine for a course of treatment and one hour a day is a typical, you know, five days a week. That’s just typically you’re going to the doctor. There’s lots of other variations of that, but that’s the typical course. And that’s the most well-researched course. And, ⁓ you know, over time, usually about halfway through those 35 sessions, if you had angina, you’re going to notice a difference, but Personal Transformation Through EECP you know, they use this to treat dementia. It’s a well studied in dementia. There’s a recent study in the US that was profound, a year-long study, a hundred demented patients, roughly a hundred non-demented or a hundred treated patients. Everybody had dementia and a hundred CHAM patients, placebo. The demented patients that got an EECP, they all got better when we know dementia, people get worse in a year, right? They all got better, all of them. And yeah, so that’s like, you know, similar phenomenon erectile dysfunction, similar phenomenon kidney disease, similar phenomenon stroke recovery. So, you know, these are studies. I’m not making it up. It’s just literally like really well documented. It’s not. Bill Gasiamis (27:33)studies that we can get a hold of and put in the show notes, link to the show notes. Jack Clifford (27:36)Yeah, go to to EECPLocator.com and all these studies are there. ⁓ Yeah. So what I did is in the U.S., I, you know, it’s really hard to find. so I couldn’t find it. I had to, I had to call around and like, I could find a few doctors, none of them near me, but a few of them that would had machines, but they would only use them after everyone had failed stints and failed bypass and they had nothing else to offer them, which makes no sense. But that’s how the insurance reimbursements work. Bill Gasiamis (27:41)Okay. Jack Clifford (28:04)That’s the only time they’ll actually pay for it. So that’s what they say it’s good for, but that’s not what it’s good for. That’s just what they can get money for, I guess. but, so I had to drive three hours and take a chance on a doctor and stay in a hotel to get my treatments. And it was really difficult. I mean, I ended up buying one of these machines and got it at my house and I’ve just been using it for the last five years. So, you know, 35 hours was great, but I was pretty bad off. Now I got about 700 hours and, uh, you know, more hours is just greater stimulus to the body to grow vasculature, right? And I mean, I… Bill Gasiamis (28:38)how do you know that you’ve grown? I know there’s this ⁓ feeling or this change that happens in the person. ⁓ Like you said, dementia, ⁓ people who experienced dementia have a better outcome later or a change in the way that they’re brain working, et cetera. can you see the, is there a way to see the difference between the blood vessels and Jack Clifford (29:02)You can’t, you can’t image, could image on a, on a cardiac pet would be like the only imaging or I guess, you know, if I went back and did a stress test again, you would, you would be able to see, cause it’s not quantifying specific arteries. It’s, quantifying the total volume, but I tried that they were, actually wouldn’t let me, they said it’s not safe because you have it at a stent or a bypass. So I went back to the same place that I got it, you know, and I was like, literally they put me through the imaging machine. gave me the dye and then they got Lifestyle Changes and Holistic Health I went to go on the stress test and the same doctor was there and he refused to tell me to go. So I like, wanted to say, hey doc, let’s go for a run. Cause like, you’re not going to keep up with me, but you know, so I, I didn’t bother with that, but I’ve got my own, you know, I did my own little stress, stress test with a treadmill, right? I started, I was getting chest pain. I found out where I can induce angina and I try and say just below it, you know, so I know where it is, right? I was 2.2 miles an hour. That’s not a fast walk. And then after the first 19 sessions where I was staying in the hotel, I got up to 2.7. That’s a really big difference even if it doesn’t sound like a lot. And then I got my machine and I kept going. And then within a couple of months, I was starting to do a running stride. And I could keep that up, no angina. I know where angina would come in. I had time calculations and everything. And then eventually, now I can run. comfortably 6.5 mile an hour pace for quite a while, know, push it up to 14 miles an hour for 30 second sprints and you know, like all kinds of stuff. So, ⁓ Bill Gasiamis (30:38)How long before you break the two hour barrier for the marathon? Like was recently done. Maybe, maybe the more blood vessels, the more blood flow. Maybe you can get there. Jack Clifford (30:42)⁓ I got zero interest in that. Yeah. I think so though, I think those Kenyans should be ⁓ hopping on these EECP machines and they’re I mean, they’re already amazing but. Bill Gasiamis (30:58)Well, you want the Kenyans to just completely own marathon running for the rest of eternity. It’s unbelievable what they did. Right. Like I imagine that there is something else going on there, but I imagine blood flow, oxygenation, more blood vessels. Like it’s got to potentially be a thing. reckon if you do a check between the last guy, me, who’s going to like 50 hours before you get to the other side and those dudes, there would Jack Clifford (31:03)Yeah, yeah, it’ll just be a Kenyan Yeah. ⁓ Bill Gasiamis (31:27)definitely be a difference because they’re exercising all the time, right? Jack Clifford (31:31)Sure, yeah, they’re pushing the collaterals as wide open as, know, whatever, whatever a human can do on their own, they’re doing it to the max to, know, the same phenomenon that EECP is doing for folks lying down. You know, they’re doing it to whatever the max you can without the machine, I would say. Bill Gasiamis (31:48)So this is a bog standard human body task. Like it just does that all the time. I have heard the blood vessels can reroute in the brain when somebody experiences a blockage and then, and it’s not useful at the time of the blockage, obviously, and it causes potential cell death when somebody has a stroke. But then later on. Jack Clifford (32:11)If there’s too much blood, the revascularization, yeah. Bill Gasiamis (32:14)Yeah, so EECP can kind of occur naturally and then it can support as much of the surrounding tissue as possible so that it doesn’t all die off. ⁓ So what you’re talking about is just encouraging EECP ⁓ to happen more than it would normally happen by ⁓ inducing it through this device where people ⁓ get sort of strapped in and then Jack Clifford (32:23)Yeah. Bill Gasiamis (32:43)the machine runs, what does it run like a program? Explain how that works. Jack Clifford (32:47)Literally, it’s just air pressure. got different pumps to pump the calves, the thighs and the hips up. And then it’s really just about the timing, right? It’s got to hit it at the right interval of your heartbeat. So it’s at the right place in diastole where your heart is at rest. that timing is very, crucial. And that’s really… Yeah, it’s not, it’s very old technology. The machine I have was built in 2009. You know, they have new machines that are portable now that I’m working with some of the manufacturers to actually, you know, make these available in the U S because there aren’t any in the U S but they do have portable machines that don’t require a bed. You could get treated on your couch. You could get treated, you know, on your own bed, uh, lying on the floor, I suppose. Um, so, you know, we’ve, we’ve really like technology hasn’t Bill Gasiamis (33:19)Wow. Jack Clifford (33:42)slowed down. just China’s like taking this thing and you know, have a basically every Chinese hospital has several of these machines and they treat patients in the, in the room with us. It’s, part of their standard of care for all kinds of different, different diseases that they’re treating. You know, and it’s adjunctive to just about everything. There’s nothing that you couldn’t do EECP with, right? ⁓ yeah. Bill Gasiamis (34:03)Okay, okay, so. How do you experience your body differently now? And actually, let’s go back actually, how long has it been since you came across this, decided to get the first treatment, implemented yourself ⁓ at home and then how do you feel different now? Jack Clifford (34:08)Oof. Yeah, it’s been five years and four months now. And every since like, this is this is a little hard part to quantify, because there’s been a lot of brain changes to from this, right? So so I don’t even like feel like my 47 year old self who was in the hospital, that feels really like somebody else to me. You know, it’s a version of me, I suppose, but I can’t really relate to that person. Because I like a small example. The Impact of Stress on Health I used to sleep eight to nine hours a night. That was my normal, my whole life. I was generally like the guy that would come in the latest. You could come to work. was the guy that came in the latest. You And now I get up at two 30 most mornings and I’m like, like rare to go with energy. I’m, you know, I’m working out doing resistance training. I’m reading, you know, I wrote a book, I’m writing another book. I’m writing a book on rectal dysfunction as it relates to this phenomenon, because that’s a whole other, you know, case study. and I work a full-time job and I just have an incredible amount of energy basically all the time. My mood is way better. My sense of touch is really different now. I give a lot more hugs because it feels really good. ⁓ My sense of smell and taste and… You know, hearing, you know, I used to like have to go to the bathroom at night sometimes, you know, wake me up to go to the bathroom. Long gone. Bill Gasiamis (35:47)So at the same time though, it sounds like also you might have changed other things as well though, right? So what else have you changed in the meantime? Jack Clifford (35:55)sure. Yeah. Yeah. Yeah. It hasn’t just been EECP. Absolutely. you know, really good supplement routine. ⁓ Pretty extensive, but, you know, managing my lipids, for example, I take a thousand milligrams of niacin twice a day. I’ve been able to bring my triglyceride to HDL ratio to kind of an optimal one-to-one, using fish oil and some other things. ⁓ And, you know, I… I really stay away from carbs for the most part. I like to eat keto, but I like it to be what I call clean keto. So I’m not like pounding keto ice cream or all these things that are, you know, they taste good and yeah, they’re keto, but they got all kinds of oils in them that aren’t really good for your body. ⁓ And, ⁓ you know, I’m big into moving and being active and, you know, having an engaged social life as much as possible as well. I mean, I think that’s a very underrated thing. That’s actually an area I struggle in because I’m working so much, but you even this helps just, you know, getting to know people even online. But, ⁓ Bill Gasiamis (37:04)It sounds like you haven’t re it doesn’t sound like you’ve reinvented the wheel. Like everything that you say is things that people take for granted that if they implemented would improve their life before EECP. We’re talking about EECP today, right? But just those things alone would make a massive difference to somebody’s experience. And that’s kind of the message that I’m trying to kind of get into the Jack Clifford (37:17)Totally agree. I thought it a good Sure. Bill Gasiamis (37:30)⁓ minds and hearts of the stroke survivors who I interview and who listened to the podcast. My book, I’m going to, we’re going to talk about your book in a sec, but I’m going to talk about my book. My book, when I wrote it, I thought I discovered all these things that people, should know about that no one knows about, but it’s not true in here is mindset. ⁓ there’s a chapter about emotional intelligence. There’s a chapter about nutrition. There’s a chapter about sleep. There’s a chapter about community. Jack Clifford (37:32)Yeah. Yeah. No, please. Bill Gasiamis (38:00)⁓ that’s just the five that I can just rattle off the top of my head right now. And you’ve already mentioned that in the last few minutes, that’s exactly the things that you mentioned. And people take it for granted how much that improves your overall health. Right. The Journey of Writing a Book Jack Clifford (38:13)That’s so true. And also what’s wrapped up in the wrapper of all of those things that are threaded together is stress, right? ⁓ If you do all of those things, right, you’re lowering stress. How did I get heart disease at 47 when it happened to my grandfather in his late 60s and my mom in her mid 60s and it happened to me at 47? And we know it didn’t happen at 47. It was years earlier and I realized it at 47. Stress, you know? Like I was the guy that took on a lot. Bill Gasiamis (38:38)Hiding earlier. Jack Clifford (38:44)and had some traumatic things happen in my life and whatever, and I don’t need to go into that. But I always felt like it was all rolling off my back. Like, you know, I’m fine. know, like I didn’t, and there are reasons why I felt that way. ⁓ However, at the end of the day, I know that I wasn’t processing. There was so much I did not process. And I didn’t learn how to like have really good boundaries and that, you know, begot more stress because of those lack of boundaries and, but stress, right? You know, like, but if you have good good social life and healthy people in your lives, that takes stress off. Eating the right food takes oxidative stress off your body. You could go on and on, but I think stress is gonna kill you before anything else. Bill Gasiamis (39:17)you Yeah. I love that you said that. I love what I love that. That was the answer that you gave when I said, what else did you do? Because it’s not just, you know, it’s like, I’m going to eat well, but smoke, you know, I’m going to eat well, but drink excessive amounts of alcohol. Like, no, it doesn’t work. You know, you can’t do that. Yeah. can’t do. Yeah. Small. Jack Clifford (39:42)No, you gotta do it all in concert. It’s the layers, right? Yeah. Bill Gasiamis (39:49)numbers, know, the percentages they add up, you know, 1 % here, 1 % there all adds up and you get a result at the end of it. Okay. So, so you’re you’ve gone, I’m going to see if I can grow new blood vessels to support my heart. And what you’re found between the time that you went to hospital around five years ago to now is that the angina has Jack Clifford (39:55)Yeah. Mm-hmm. Bill Gasiamis (40:17)⁓ improved, they’ve gone away. The heart has improved, I beg your pardon, the blood flow. And have you had a medical examination since then to do other comparison? Jack Clifford (40:28)Yeah, I have. Yeah, I’ve got a cardiologist. I haven’t seen him and I’ve talked to him the other day because I talked about the book, but I haven’t gone to see him because he’s a plane flight away. But I’ve been worked up for the crowded intermediate thickness. You might be familiar with that as it relates to stroke. okay, well, they just measure your crowded arteries and look at the placking in your crowded arteries as a proxy for your systemic plaque burden. And flow mediated deletation, is they totally occlude the… the arm with a blood pressure cuff and then see how quickly you can refill it after, you know, like, it’s like five minutes of this, your hand is completely numb. And those all, you know, workups were good and that was after a couple of years of treatment. You know, I tried to have that stress test, like I mentioned, but you know, now I just see my primary care, you know, he’s a good guy and he runs on my lipid panels and, ⁓ you know, so I’m definitely monitored, but. What I haven’t done is gotten re-imaged because I don’t want to put extra dye in my system. Sure, somebody wants the images because they don’t believe me, but I’m not trying to sell anybody anything here. I’m just trying to spread the word on something. If somebody doubts my honesty, they can, it’s fine. Bill Gasiamis (41:38)I know what you mean, Jack. I know what you mean. I and I asked you because yeah, I would love to see that before and after. would love to see the blood flow. What’s happening, watch change. would be amazing. story to tell, but I also went out of my way if I could to avoid having more dyes and all that kind of stuff injected into my body. I totally get it. It’s okay. Yeah. ⁓ Jack Clifford (41:49)Yeah. Yeah. Yeah. Bill Gasiamis (42:01)Okay. So you wrote a book about it. Like, what was the idea behind the book? What were you thinking? Show us the one that you got there with the old book cover. And then I’ll include the new book cover in this image as we chat. Jack Clifford (42:06)yeah. Yeah. Yeah. Yeah. Thanks. Yeah. So I started writing this book, in, know, ⁓ November timeframe, ⁓ after I mentioned to you, so my, my friend came down, ⁓ and stayed with me for 13 days and he had had some stroke damage five years before that was, you know, his whole right side, he just had like numbness and then pain. And then, you know, it this weird cascade of symptoms so bad, you know, sometimes he couldn’t sleep from it. And so All the time he took off work he could he came and he used the machine three times a day and then he left pain free and like nothing else had worked and then this worked and I didn’t per se expect that I but I was like, you I know it does stuff. It’s helpful. But anyways, when I saw that, you know, I really started digging even more because before that I was like, well, Jesus is amazing. But maybe it’s just me, you know, and and anyways, so, ⁓ so then I, you know, I just started writing the book one day and The Role of EECP in Heart Health You know, my mom was a book author and I always wanted to write a book. didn’t really have anything particular to write about and all of sudden I do. So I’m like, you know, let’s see what happens. And, uh, and you dig into the research more and more, and you’re just like, increasingly frustrated by how everyone has known about this. And yet, you know, they don’t promote it. They don’t talk about it because it’s inconvenient. You know, and I’m going to get a little, try not to get like soapboxy here, but Bill Gasiamis (43:36)Do it, do it, go for it man. Jack Clifford (43:37)Okay, okay, because, you know, cardiologists will say it, some of them, the ones that are honest, they’ll be like, like mine. He says, I was making obscene amounts of money, giving people bypass surgeries instance. And then I was given the same people bypass surgeries instance, a couple years later. And, you know, and then he stumbled upon some answers and EECP is one of them that helps his patients stay well. And, you know, he makes a lot less money. because of it, because he doesn’t go in and do these interventional approaches. And, you know, EECP, the most you could pay somebody is like $100 an hour, and you’re going to tie up a patient room for 35 hours with a tech, it doesn’t make any sense. I go pop a stint and you make 10 grand in two hours and never see you again. You know, like it just, I get it from, you know, I want to own a portion of Ferrari and have a lake house and a winter house, but You know, like, I don’t know how you live with yourself. You said go for it, man. I’m going to go for it. you know, and my son’s about to graduate. Okay. Yeah. Okay. Fair enough. I’m good with it. Yeah. Yeah. Bill Gasiamis (44:38)But come on, come on, Jack. Yeah, you go for it. I’m going to push back. I’m going to push back as well. You go for it. I’ll push back. There’s yeah. Which is cool. Right? That’s what I want. I want to have a conversation and I don’t want to control the narrative, but the guy that goes in needs a stint today has a blockage. Like that’s life saving. That does work. What I am afraid of that happens sometimes when people go in and they’ve got a blockage and then they get ⁓ even even a stroke blockage. Right. in carotid or a vertebral artery. What happens is sometimes people go in and they get told you need a stent. Fair enough. You’re about to have a heart attack. You’re about to have a major stroke. If we don’t put one in, you’ll have a, that’s necessary. The challenge is, that that person sometimes doesn’t learn the lesson of what got them into the situation where they need a stent. Jack Clifford (45:22)Good. Exactly. sure. Yeah, by all means. Like emergency medicine is great. And we’ll put that in the emergency medicine category of cardiology, right? Why aren’t they offering you, why aren’t they saying, Hey, you’re at risk for a whole lot of other things just by this happening. Why don’t you come 35 times to this EECP machine and you know, like, or why don’t we have centers Bill Gasiamis (45:36)Yeah. Yes, and then later… Jack Clifford (45:55)all over. I found exactly one place in Australia so far that I’m not focusing on Australia right now. I do plan to take EECP Locator International, but right now the access points in the US are abysmal. 70, 80 % of the people in the United States could not get to a center. There’s no access point that’s at all realistic for them to get to. And yet these machines are not that expensive. They’re the price of a Decent not that great car. ⁓ Bill Gasiamis (46:24)we’re starting to see them in, I don’t know, health spas or something like that, where people will go, they’ll get yoga, they’ll get this, they’ll get that, they’ll get infusions perhaps and all sorts of other things. And there’ll be a machine or there’ll be a suit that people can put on and they can go through one hour. Jack Clifford (46:29)Yeah, that’s good. That’s great. Yeah, although I do want to say that the Normatech, like the compression boots that they have and some of those things, when they don’t use the pressures that EECP uses up to 6 PSI and they’re not sinking it in between heartbeats, it’s helpful, but we’re not talking about things that can do the same thing in the body. It’s on the right path and I’m not digging it as being worthless because it’s not, but it’s just not the right thing. Bill Gasiamis (46:47)Yes. Yeah. Yeah. Yeah, that’s kind of what we’re seeing. And to go back to your point is because the medical profession does medical profession stuff. this is not, it’s not that it’s not medically kind of aligned. It definitely is. But when you’re told that the way you solve a problem is through putting a stent in and then never talking to that patient again, to tell them how to avoid to get a stent in that’s Jack Clifford (47:31)Yeah, that’s your job. Bill Gasiamis (47:34)what they do, like they’ve been trained to do that forever. And that’s what they do. And that works and it saves the life. But what it doesn’t do, which I also have a challenge with this, it doesn’t teach the lesson. What it reinforces is that if I have something wrong with me and I go to a doctor, they’ll fix it. So next time it goes wrong, I’ll just go to the doctor and they’ll fix it again. And I didn’t have to change my life. Like this even bloody advertisements that do that. They Jack Clifford (47:51)just I’ll go and he’ll fix it. Yeah. Yes. Yes. Bill Gasiamis (48:03)They hijack that part of the person’s brain and they say, you know, have you got reflux, heartburn, that kind of stuff? Don’t let reflux and heartburn get in the way of eating the foods that you love. Just take a tablet. You know, that’s the same kind of thing, right? And that’s why the medical profession doesn’t do that because they’re not trained to do anything other than sell their thing. And their thing is what they went to work, to school for. Raising Awareness for EECP Therapy Jack Clifford (48:17)Yes. Bill Gasiamis (48:30)20 years to be able to administer. But every so often you come across an amazing doctor, surgeon, et cetera, who says, I can’t do anything more for you, but maybe somebody else can. Those guys are better than the doctor who says, we can’t do anything else for you and then send you off their way. That next sentence, but maybe somebody else can, I don’t know who they are. That is. Jack Clifford (48:43)Mm-hmm. Bill Gasiamis (48:57)I think a great thing to say this is where I think EACP kind of fits in that now that I’m here and things are not good. Jack Clifford (49:05)I totally agree. I totally agree. And yeah. And you, so you, you mentioned like the wellness spas and whatnot. And here’s the thing in 2015. So, you know, somewhat recently the FDA approved EECP for a brand new indication, general circulation, right? In healthy people. Like it’s right on the FDA indication. And also in one case in increase in VO2 max, but rough, that’s roughly saying the same thing. ⁓ yeah. Bill Gasiamis (49:32)for healthy people, was that part of it? Jack Clifford (49:35)Yeah, it said unhealthy patients and healthy people didn’t call patients. So, so, ⁓ but, but, know, the litmus test for that is, is your doctor say you’re healthy enough to undergo circulation enhancement? If the answer is yes, you know, it doesn’t matter if you got all that other stuff or not, you know, we’re just not treating you for it. We’re not saying ECPs is fix for this, your erectile dysfunction. It might help it. You know, what’s not saying it’s, it’s the fix for your stroke, but it might really help your stroke, recovery, but. Bill Gasiamis (49:47)which Jack Clifford (50:03)Anyhow, so like you can, you know, I don’t know about in Australia, but in the United States, you could get an EECP machine and create a viable business model off of helping people as soon as people actually know about it and what it does, right? I’m trying to solve the access issue in the United States by aggregating demand, right, as one of the solutions. So I have a website, eecplocator.com. And if people… ⁓ tell me that they like EECP to be available in their area, when I get like five to 10 patients in one area, we’re gonna find a way to get it to them. ⁓ The how is, you there’s a bunch of different possible ways we can get EECP to them, but at the end of the day, you know, like people need this treatment. They really, really do. Bill Gasiamis (50:50)Yeah. We’re not talking about anything ⁓ out there. Like this is not an out there thing. This is definitely common. Now I, I don’t know how I haven’t come across it. I’ve all these years after all these years now I’ve just because of our conversation right now, I just did a Google search and I typed in EECP machine Australia. And the first thing that came up was an Australian government department of health, disability and aging. Jack Clifford (50:57)No, it’s that. Bill Gasiamis (51:20)document from the Therapeutic Goods Administration, which talks about a mid-trade Australia EECP system model, external counter pulsation system stationary. So it seems like they have a… Jack Clifford (51:36)Like they’ve approved it, sounds like they have some approved devices. Yeah. Bill Gasiamis (51:38)Something like they’re at least looking at it. Let me see what that says. The inclusion of the kind of device in the AI community is subject to compliance with conditions placed in post. Yeah, it sounds like it’s been through some regulated body in 2021. Jack Clifford (51:52)Yeah. Mm-hmm. Yep. There you go. Bill Gasiamis (51:57)This device is intended to provide external counter pulsation therapy and is indicated for use in the treatment of stable angina. Jack Clifford (52:06)Mm-hmm. Bill Gasiamis (52:08)pectoris and congestive heart failure. There you go, my friend. Jack Clifford (52:10)Yeah, it works great for people with art failure. It really does. Bill Gasiamis (52:14)Dude, father-in-law had heart failure. He passed away from heart failure just a few, about a year and a half ago. ⁓ Now, I don’t know, I’m not saying anything, but we’ve never heard of this before. Today’s my first time where I’m really going to deep dive about this thing with you. ⁓ So what are the challenges that you face? what are the, what is it? ⁓ The barriers that you face? Jack Clifford (52:20)Yeah. Bill Gasiamis (52:44)when you’re speaking to people about this or how people finding out about it, how do you help people like Jack Clifford (52:50)It’s just an awareness piece. It’s an EECP what? And then, you you get in with some physicians and then you got to duke it out a little bit. Not with all of them. There’s plenty of physicians, you know, I’ve talked to the physicians that have machines and are doing the right thing for society and still making plenty of money. ⁓ They’ll just tell you, you know, I’ve talked to some cardiologists and just they kno
A cardiac score is a quick heart screening detecting early signs of heart disease, even in people who feel completely healthy. In this episode, doctors from The University of Kansas Health System explain how a CardioScore test works, who should consider getting one, and why early detection can be so important. Cardiac score educator Kaye Ness joins us to explain what the test measures and how it helps identify risk for coronary artery disease. We also hear from Catherine Jacobson, whose story shows how one simple screening helped uncover a serious heart issue and changed the way she looks at her health. Additionally, Dr. Richard Korentager discusses Journavx. A new non-opioid pain relief option changing how doctors treat moderate to severe acute pain in adults. The episode also highlights a special partnership with the Kansas City Current. Through the Goals for Heart initiative, every KC Current goal helps support access to cardiac scores for women, helping remove barriers to preventive heart care.
This week, Dr. Kahn reviews new data from the Global Burden of Disease study analyzing the relationship between diet and death from heart disease. In 2023, an estimated 5.9 million deaths worldwide were linked to poor dietary choices, led by excessive sodium intake and insufficient consumption of fruit and whole grains. It's a fascinating and important study with clear takeaways. Other topics include stents for angina, causes of sudden cardiac death, daytime napping and health outcomes, plastic-free diets, PCSK9 inhibitors vs. statins, calcium supplements, and the purity of fish oil samples. Thanks to the Fresh Pressed Olive Oil Club. Visit getfreshdrkahn.com for an incredible introductory offer.
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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/ZCE865. CME/AAPA credit will be available until April 27, 2027.Transthyretin Cardiac Amyloidosis: Integrating New Paradigms Into Cardiology Practice In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and The Mended Hearts, Inc.. 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 CME/AAPA information, and to apply for credit, please visit us at PeerView.com/ZCE865. CME/AAPA credit will be available until April 27, 2027.Transthyretin Cardiac Amyloidosis: Integrating New Paradigms Into Cardiology Practice In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and The Mended Hearts, Inc.. 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.
Heart failure (HF) affects more than 64 million individuals worldwide, and 20% to 30% of patients with HF and systolic dysfunction have cardiac dyssynchrony due to conduction system disease. JAMA Review author Mihail Chelu, MD, PhD, of Baylor College of Medicine discusses cardiac resynchronization therapy with JAMA Associate Editor David Simel, MD, MHS. Related Content: Cardiac Resynchronization Therapy Leadless Ultrasound-Based Cardiac Resynchronization System in Heart Failure
With five of the Mag 7 reporting this week, we discuss whether investors should temper their capex expectations. The trial between Elon Musk and Sam Altman kicks off. Plus, the potential next frontier in preventing heart attacks. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Drs. Maron and Rowin review how treatment for symptomatic obstructive hypertrophic cardiomyopathy has evolved from mainly using beta blockers and invasive procedures to now including newer cardiac myosin inhibitor drugs. These newer medications more reliably reduce obstruction and improve patient symptoms and exercise capacity, but require careful safety monitoring with regular heart function checks.
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 CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WMQ865. CME/MOC/AAPA/IPCE credit will be available until April 28, 2027.Cardiac Myosin Inhibition in the Real World: What Have We Learned From Long-Term Experience in Obstructive HCM? In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and The Mended Hearts, Inc.. 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 through an educational grant from Bristol Myers Squibb.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 CME/MOC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/WMQ865. CME/MOC/AAPA/IPCE credit will be available until April 28, 2027.Cardiac Myosin Inhibition in the Real World: What Have We Learned From Long-Term Experience in Obstructive HCM? In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and The Mended Hearts, Inc.. 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 through an educational grant from Bristol Myers Squibb.Disclosure information is available at the beginning of the video presentation.
CardioNerds Drs. Dinu Balanescu, Billy-Joe Mullinax, and Mariana Garcia discuss systemic thrombolysis in pulmonary embolism with expert Dr. Allison Burnett. Audio editing by CardioNerds Academy intern, student doctor, Pace Wetstein. Pulmonary embolism is the third leading cause of cardiovascular death in the US, and high-risk PE carries a 30-day mortality risk as high as 30-50%. In this episode, we discuss the indications for systemic thrombolysis, including high-risk PE and cardiac arrest. We addressed how to appropriately select candidates for systemic thrombolysis, balancing the high risk of bleeding. Additionally, we discussed anticoagulation management and timing concurrent with lytic therapy, as well as the importance of multidisciplinary PERT teams. The 2026 American multi-society PE guidelines were published after this episode was recorded. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium. 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 Risk stratification is crucial in acute pulmonary embolism care. Based on the ESC 2019 guidelines, low-risk PE patients are those who are normotensive with no evidence of right ventricular dysfunction. Intermediate risk includes two categories: intermediate-low, with normotensive patients who have a high PE score with negative biomarkers, and intermediate-high risk, which has elevated biomarkers or signs of RV strain. High-risk PE includes hemodynamically unstable patients (SBP
Shingles vaccination in adults with established cardiovascular disease was associated with dramatic reductions in heart attack, stroke, and mortality in a large real-world analysis, supporting its role as a cardiovascular risk-reduction tool beyond infection prevention. The VESALIUS-CV trial found evolocumab significantly reduced major cardiovascular events in high-risk diabetic patients without known ASCVD, challenging the convention of reserving PCSK9 inhibitors for secondary prevention only. AI-analyzed smartwatch data predicted heart failure hospitalizations days to weeks in advance, signaling a shift toward continuous remote monitoring in heart failure management.
In this episode, we speak with the UK based solo musician Adrien Rodes (Furii) about playing with other people versus writing own music, playing with The Spratleys and Cardiacs, trying not to be self conscious, and your relationship with your music versus how other people connect to it. Plus, using half broken sounds, self censorship, and success as measured by creating music.You can check out Adrien here:https://www.amontobin.com/furiihttps://furii.bandcamp.com/album/aphanthttps://spratleys.bandcamp.com/album/her-handsPaul works a day job and puts out vinyl and puts on shows via Katzulhu Productionshttps://www.facebook.com/paul.neil.12https://www.facebook.com/katzulhuhttps://www.facebook.com/Dont-Quit-Your-Day-Job-podcast-107924851339602
CardioNerds (Drs. Natalie Marrero, Shivani Reddy, and Rebecca S. Steinberg), discuss the role of SGLT2i in cancer therapy-related cardiac dysfunction (CTRCD) with Dr. Manu Murali Mysore. This episode was produced as part of the CardioNerds Academy curriculum by House Taussig under the guidance of House Chief, Dr. Natalie Marrero, and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Summary: Cancer therapy-related cardiac dysfunction (CTRCD) spans a spectrum from subclinical biomarker elevation to overt heart failure, with risk amplified by preexisting cardiovascular disease, diabetes, hypertension, obesity, and exposure to therapies, such as anthracyclines, HER2-targeted therapies, or radiation. This episode explores the emerging and promising role of SGLT2 inhibitors as a cardioprotective adjunct in cardio-oncology — examining mechanisms, clinical evidence, ongoing trials, and critical knowledge gaps — while affirming that guideline-directed medical therapy remains the cornerstone of prevention and treatment. 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 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 CTRCD is a spectrum — catch it early. CTRCD ranges from subclinical injury detected by imaging and biomarkers to overt heart failure. Early identification in high-risk patients (preexisting CVD, diabetes, HTN, obesity, anthracycline/HER2/radiation exposure) is essential, and early initiation of guideline-directed medical therapy — including ACE inhibitors/ARBs/ARNIs, mineralocorticoid receptor antagonists, and beta-blockers — remains the backbone of prevention and treatment to preserve LVEF and allow safe continuation of cancer therapy. SGLT2 inhibitors are a promising new pillar of cardioprotection in cardio-oncology. They act through a unique combination of mechanisms: renal effects, metabolic reprogramming of the myocardium, anti-inflammatory and antioxidant pathways, and vascular fibrosis modulation — making them a compelling complement to standard therapies rather than a replacement. Early clinical data is encouraging but not yet definitive. The 2024 EMPACARD-PILOT trial demonstrated preserved LVEF and reduced CTRCD in higher-risk patients with diabetes or kidney disease. Ongoing trials — EMPACT and PROTECT — are actively exploring SGLT2 inhibitors for primary prevention during anthracycline and HER2-targeted therapy. SGLT2 inhibitors are NOT yet indicated for ICI-related myocarditis. Immune checkpoint inhibitor (ICI)-related myocarditis is mechanistically immune-driven. While SGLT2 inhibitors have theoretically anti-inflammatory benefits, there is currently no clinical evidence to support their use in this specific setting. The use of SGLT2 inhibitors should be guided by patient risk, existing indications, and ongoing research. Large prospective trials, clarity on timing and patient selection, long-term safety data, and deeper mechanistic understanding in humans remain the most urgent gaps in the field before broader adoption can be recommended. References Theofilis P, Vlachakis PK, Oikonomou E, et al. Cancer therapy-related cardiac dysfunction: A review of current trends in epidemiology, diagnosis, and treatment. Biomedicines. 2024;12(12):2914. doi:10.3390/biomedicines12122914. https://pubmed.ncbi.nlm.nih.gov/39767820/ Lyon AR, Dent S, Stanway S, et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. 2020;22(11):1945-1960. doi:10.1002/ejhf.1920. https://pmc.ncbi.nlm.nih.gov/articles/PMC8019326/ Li X, Li Y, Zhang T, et al. Role of cardioprotective agents on chemotherapy-induced heart failure: A systematic review and network meta-analysis of randomized controlled trials. Pharmacol Res. 2020;151(104577):104577. doi:10.1016/j.phrs.2019.104577. https://pubmed.ncbi.nlm.nih.gov/31790821/ Lee YH, Lim S, Davies MJ. Cardiometabolic and renal benefits of sodium-glucose cotransporter 2 inhibitors. Nat Rev Endocrinol. 2025;21(12):783-798. doi:10.1038/s41574-025-01170-4. https://pubmed.ncbi.nlm.nih.gov/40935880/ Dabour MS, George MY, Daniel MR, Blaes AH, Zordoky BN. The cardioprotective and anticancer effects of SGLT2 inhibitors: JACC: CardioOncology state-of-the-art review. JACC CardioOncol. 2024;6(2):159-182. doi:10.1016/j.jaccao.2024.01.007. https://pubmed.ncbi.nlm.nih.gov/38774006/ Armillotta M, Angeli F, Paolisso P, et al. Cardiovascular therapeutic targets of sodium-glucose co-transporter 2 (SGLT2) inhibitors beyond heart failure. Pharmacol Ther. 2025;270(108861):108861. doi:10.1016/j.pharmthera.2025.10886. https://pubmed.ncbi.nlm.nih.gov/40245989/ Góes-Santos BR, Castro PC, Girardi ACC, Antunes-Correa LM, Davel AP. Vascular effects of SGLT2 inhibitors: evidence and mechanisms. Am J Physiol Cell Physiol. 2025;329(4):C1150-C1160. doi:10.1152/ajpcell.00569.2025. https://pubmed.ncbi.nlm.nih.gov/40908107/ Daniele AJ, Gregorietti V, Costa D, López-Fernández T. Use of EMPAgliflozin in the prevention of CARDiotoxicity: the EMPACARD – PILOT trial. CardioOncology. 2024;10(1):58. doi:10.1186/s40959-024-00260-y. https://pubmed.ncbi.nlm.nih.gov/39237985/ Clinicaltrials.gov. Clinicaltrials.gov. Accessed April 16, 2026. https://clinicaltrials.gov/study/NCT05271162 Greco A, Quagliariello V, Rizzo G, et al. SGLT2i Dapagliflozin in primary prevention of chemotherapy induced cardiotoxicity in breast cancer patients treated with neo-adjuvant anthracycline-based chemotherapy +/- trastuzumab: rationale and design of the multicenter PROTECT trial. CardioOncology. 2025;11(1):79. doi:10.1186/s40959-025-00368-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC12400668/ Key Guideline Reference: Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC guidelines on cardio-oncology developed in collaboration with the European hematology association (EHA), the European society for therapeutic radiology and oncology (ESTRO) and the international cardio-oncology society (IC-OS). Eur Heart J Cardiovasc Imaging. 2022;23(10):e333-e465. doi:10.1093/ehjci/jeac106. https://pubmed.ncbi.nlm.nih.gov/36017575/ Be sure to check out the corresponding review article on the cardioprotective role of SGLT2 inhibitors in CTRCD that will be published in US Cardiology Review, the official journal of CardioNerds. Additionally, please reference CardioNerds Cardio-Oncology Episodes 261 and 274 for related content.
The JournalFeed podcast for the week of April 6-10, 2026.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday's Spoon Feed:Cardiac standstill on transthoracic echocardiography is a strong predictor of failing to achieve return of spontaneous circulation (ROSC). However, while it offers high diagnostic accuracy, emergency physicians should use it as one prognostic marker among others rather than a sole reason to terminate efforts.Tuesday's Spoon Feed:Of patients with return of spontaneous circulation (ROSC) after in-hospital cardiac arrest (IHCA), CT imaging revealed new findings 65.2% of the time while POCUS did so in 57.6% of IHCA patients.
Episode 242 NPTEFF Cardiac Output & Blood Pressure: When Exercise Should Stop
Work With Me 1:1 Coaching - https://ericrobertsfitness.com/erf-1on1.html On today's episode I sit down with James, the winner of our 8-Week New Year's Challenge, along with coach Jamie to break down exactly how he pulled it off. James dropped over 20 pounds, took his resting heart rate from 92 to 49, and cut his cholesterol nearly in half — all while working long shifts in food service and raising three kids in the UK. He opens up about the moment that kicked all of this off: giving CPR to his stepdad in his own home, and the promise he made to himself that day. Jamie and I get into how we built the plan around his chaotic schedule, and how James' journey has now pulled his chef, his sister, and his own dad into taking their health seriously too. Join my Clubhouse App - https://ericrobertsfitness.com/clubhouse-page.html Free Calorie Calculator https://ericrobertsfitness.com/free-calorie-calculator/ 20% Off Legion Athletic Supplements Code “ERIC” HERE https://legionathletics.rfrl.co/qj2dy Youtube Channel https://www.youtube.com/@ericrobertsfitness Video Podcast: https://www.youtube.com/@EricRobertsFitnessPodcast
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This week we speak with Assistant Professor of Pediatrics at Harvard Medical School, Dr. Audrey Dionne about a recent work she co-authored on sinus node dysfunction following congenital heart surgery. How common was this encountered and how often were either temporary or permanent pacing needed? Are there certain surgeries that are more associated with the need for pacing after surgery? Why is this so common following heart surgery? Dr. Dionne shares her deep knowledge this week on this surprisingly common problem. DOI: 10.1016/j.hrthm.2026.01.049
Kavus began in dual-guitar London math-rock bands in the '90s, joined The Cardiacs for their final lineup. His band Knifeworld released the first of its four albums in 2009, he released solo albums in 2020 and 2024, and since 2014 he has released six albums with legacy prog-rock band Gong. He has also released four studio albums with electronica band The Utopia Strong since 2019. We discuss "Stars in Heaven" by Gong from Bright Spirit Haulix (2026), "Send Him Seaworthy" by Knifeworld from The Unraveling (2014), "You Broke My Fall" by Kavus Torabi from Hip to the Jag (2020), and "Wise Guy" by The Monsoon Bassoon, a 1998 single. Intro: "Ditzy Scene" by The Cardiacs, a 2007 single eventually released on LSD (2025). Hear more Nakedly Examined Music at nakedlyexaminedmusic.com. Support us at patreon.com/nakedlyexaminedmusic.
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