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Part 2 of a 2-part series recapping the 2025 POSNA Annual Meeting in Las Vegas. In this episode, we sit down with the 2025 Program Committee — Drs. Julie Samora, Tony Riccio, John Vorhies, and Christine Ho — to hear what's new and what makes this year's meeting stand out. Drs. Lindsay Andras, Apurva Shah, Firoz Miyanji, and Christine Ho highlight some standout presentations from the Awards Papers session. Drs. Stu Weinstein and John Birch share their thoughts on memorable Case Reports and how this new format adds a unique dimension to the meeting. We also chat with Dr. Jon Schoenecker, winner of the Best Basic Science Paper, and Dr. Dan Sucato, winner of the Best Clinical Paper, to learn more about their award-winning research. Hosted by Tyler McDonald (University of South Alabama) and Will Morris (Scottish Rite for Children). Music by A. A. Aalto.
Send us a text✅ Write your case report.✅ Earn CEUs.✅ Make real progress on your ABPTS Oncology application.In this quick bonus episode, I'm sharing the major updates to Case Report Writing Workshop — including 18 contact hours for PT CEUs, new module upgrades, and a streamlined path to finishing your case report (without the burnout).
ST elevation is clearly a worrying finding that can herald life-threatening conditions, such as ST elevation myocardial infarction. But not all ST-elevations are created equal, and Trainees would benefit from considering a broader number of causes for this presentation. In today's podcast the team will discuss a case of ST elevation observed in a 65-year-old female during the routine elective procedure of atrial fibrillation ablation. A range of pathophysiologies is discussed that can help listeners work though the differentials in a systematic way. Guests Assoc Prof Pramesh Kovoor FRACP FACC PhD (Westmead Hospital; the University of Sydney) Dr Neil Warwick FANZCA (Westmead Hospital) HostsAssociate Professor Stephen Bacchi FRACP (University of Adelaide)Dr Joshua Kovoor (Ballarat Base Hospital)ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Game show music courtesy of Waderman. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Aafreen Khalid, Hugh Murray and medical student Nivida Dixit.Key Reference (Spoiler Alert)* * * * *Metaraminol-induced coronary vasospasm masquerading as ST-elevation myocardial infarction during general anaesthesia [Br J Anaesth. 2024] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
CardioNerds Critical Care Cardiology Council members Dr. Gurleen Kaur and Dr. Katie Vanchiere meet with Dr. Yash Patel, Dr. Akanksha, and Dr. Mohammed El Nayir from Trinity Health Ann Arbor. They discuss a case of pulmonary air embolism, RV failure, and cardiac arrest secondary to an ocular venous air embolism. Expert insights provided by Dr. Tanmay Swadia. Audio editing by CardioNerds Academy intern, Grace Qiu. A 36-year-old man with a history of multiple ocular surgeries, including a complex retinal detachment repair, suffered a post-vitrectomy collapse at home. He was found hypoxic, tachycardic, and hypotensive, later diagnosed with a pulmonary embolism from ocular venous air embolism leading to severe right heart failure. Despite a mild embolic burden, the cardiovascular response was profound, requiring advanced hemodynamic support, including an Impella RP device (Abiomed, Inc.). Multidisciplinary management, including fluid optimization, vasopressors and mechanical support to facilitate recovery. This case underscores the need for early recognition and individualized intervention in cases of ocular venous air embolism. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest Hypoxia, hypotension and tachycardia in a patient following ocular instrumentation are classic findings suggestive of pulmonary embolism from possible air embolism. The diagnosis of RV failure is based on clinical presentation, echocardiographic findings (such as McConnell's sign), and invasive hemodynamic assessment via right heart catheterization. Mechanical circulatory support can be considered as a temporary measure for patients with refractory RV failure. Central Figure: Approach to Pulmonary Embolism with Acute RV Failure Notes - Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest 1. What is an Ocular Venous Air Embolism (VAE), and how can it be managed in critically ill patients? An Ocular Venous Air Embolism is defined as the entry of air into the systemic venous circulation through the ocular venous circulation, often during vitrectomy procedures. Early diagnosis is key to preventing cardiovascular collapse in cases of Ocular Venous Air Embolism (VAE). The goal is to stop further air entry. This can be done by covering the surgical site with saline-soaked dressings and checking for air entry points. Adjusting the operating table can help, especially with a reverse Trendelenburg position for lower-body procedures. The moment VAE is suspected, discontinue nitrous oxide and switch to 100% oxygen. This helps with oxygenation, speeds up nitrogen elimination, and shrinks air bubbles. Hyperbaric Oxygen Therapy can reduce bubble size and improve oxygenation, especially in cases of cerebral air embolism, when administered within 6 hours of the incident. Though delayed hyperbaric oxygen therapy can still offer benefits, the evidence is mixed. VAE increases right heart strain, so inotropic agents like dobutamine can help boost cardiac output, while norepinephrine supports ventricular function and systemic vascular resistance, but this may also worsen pulmonary resistance. Aspiration of air via multi-orifice or Swan-Ganz catheters has limited success, with success rates ranging from 6% to 16%. In contrast, the Bunegin-Albin catheter has shown more promise, with a 30-60% success rate. Catheterization for acute VAE-induced hemodynamic compromise is controversial, and there's insufficient evidence to support its ...
Send us a textThinking about board certification in oncologic physical therapy but feeling stuck on where to start — or whether you can even do it? This episode is your roadmap and your pep talk in one. Theresa Walchner, PT, shares exactly how writing her case report and earning her Oncology Specialist Certification transformed her clinical confidence and sharpened her patient care. And more importantly, she shows how you can do the same.By listening, you'll learn how to:Approach your case report with less overwhelm and more clarityAvoid common pitfalls and plan your writing timeline wiselyUse peer feedback to make both your report and your clinical reasoning strongerBuild the confidence and validation that comes with reflecting deeply on your practiceTheresa's candid advice and hard-won lessons will help you skip the guesswork and start your own board certification journey with a clear plan and new motivation. If you're serious about specializing and want to make a bigger impact in oncology rehab, this conversation is packed with the tools and mindset shifts to help you get there.Listen now!Follow TheOncoPT on Instagram.Follow TheOncoPT on LinkedIn.
Two wide open cases from the latest issue of the journal. Starting with a case from Italy (1:18), of a 63-yo man having a history of behavioural and cognitive problems since retiring. His many changes included low mood, significant weight loss, and problems with sleep and temperature regulation. He had a background of type 2 diabetes. Initial treatment was on a suspicion of Alzheimer's, but there was no clinical improvement. https://pn.bmj.com/content/25/2/159 A case from the United States is next (17:36), featuring a 66-yo lady experiencing 10 days of generalised weakness, with episodes of forgetfulness and a series of falls. She had previously been treated for left-sided ophthalmic herpes zoster. Neurological examination showed mild right arm and leg weakness. https://pn.bmj.com/content/25/2/164 The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the February 2025 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Neurology Registrar, University Hospitals Sussex. (3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.
Welcome to Episode 45 of “The 2 View,” the podcast for EM and urgent care nurse practitioners and physician assistants! Show Notes for Episode 45 of “The 2 View” – All things toxicology: the intoxicated patient, propranolol overdose and suicide, snake bites, and a special guest. Segment 1 – The intoxicated patient Kaufman J, Fitzpatrick P, Tosif S, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ. The BMJ. Published April 7, 2017. https://www.bmj.com/content/357/bmj.j1341 Kraaijvanger N, Raven W, van Dijken T, Gresnigt F. The PIRATE mnemonic: providing a structured approach in the care for intoxicated patients at the emergency department. Int J Emerg Med. Educational Advances in Emergency Medicine. BMC: Part of Springer Nature. Published March 1, 2024 https://intjem.biomedcentral.com/articles/10.1186/s12245-024-00606-4 Thiessen P. A simple new technique for collecting urine in infants. Thischangedmypractice.com. The University of British Columbia. Faculty of Medicine: This Changed My Practice (TCMP) by UBC CPD. Published November 18, 2015. https://thischangedmypractice.com/new-technique-for-collecting-urine-in-infants/ Van Oyen A, Barney N, Grabinski Z, et al. Urine Toxicology Test for Children With Altered Mental Status. Aap.org. Pediatrics. Case Reports. American Academy of Pediatrics: Dedicated to the Health of All Children. Published October 6, 2023. https://publications.aap.org/pediatrics/article/152/5/e2022060861/194346/Urine-Toxicology-Test-for-Children-With-Altered?autologincheck=redirected Segment 2 – Propranolol overdose and suicide Khalid MM, Galuska MA, Hamilton RJ. Beta-Blocker Toxicity. In: StatPearls. StatPearls Publishing. NIH: National Library of Medicine – National Center for Biotechnology Information. Published July 28, 2023. https://www.ncbi.nlm.nih.gov/books/NBK448097/ Srettabunjong S. Fatal Self-Poisoning With Massive Propranolol Ingestion in a Young Male Physician. Am J Forensic Med Pathol. PubMed®. NIH: National Library of Medicine – National Center for Biotechnology Information. Published September 2017. https://pubmed.ncbi.nlm.nih.gov/28691951/ Segment 3 – Snake bites Rohl S, Meredith M, Anderson, T, et al. Comparing the Use of Crotaline-Polyvalent Immune Fab (Ovine) Versus Observation in Children. Pediatric Emergency Care: Dedicated to the Care of the Ill or Injured Child. Lww.com. Published November 2024. https://journals.lww.com/pec-online/abstract/2024/11000/comparingtheuseofcrotalinepolyvalentimmune.19.aspx Snake bites. Wikem.org. WikiEM. Last edited March 17, 2021. https://wikem.org/wiki/Snake_bites Toxicology resources Goldfrank LR, Flomenbaum NE, Howland MA, et al. Goldfrank's Toxicologic Emergencies. 8th ed. McGraw-Hill Medical; 2006. Katz K, O'Connor A, Amaducci AM. EMRA and ACMT Medical Toxicology Guide: 2nd Edition.; 2022. National Poison Data System. Poisoncenters.org. America's Poison Centers: Treatment, Education, Prevention. Accessed April 9, 2025. https://poisoncenters.org/national-poison-data-system Poison Control: National Capital Poison Center. Poison.org. Accessed April 9, 2025. https://www.poison.org/ Segment 4 – Special guest: Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN, of Arizona Linkedin.com. Accessed April 9, 2025. https://www.linkedin.com/in/nancy-denke-dnp-acnp-bc-fnp-bc-faen-a62851 Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN, of Arizona. ENA Hall of Honor. Published July 26, 2024. Accessed April 9, 2025. https://hall-of-honor.org/nancy-denke PodBean Development. Talking Toxicology: A Recipe for Disaster (Nancy Denke). BCEN & Friends Podcast. PodBean. Published March 7, 2023. https://bcenandfriends.podbean.com/e/talking-toxicology-a-recipe-for-disaster-nancy-denke/ *Recurring Sources * Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!
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Send us a text“One day you will tell your story of how you overcame what you went through, and it will be someone else's survival guide.” – Brené BrownYour case report is exactly that—a survival guide for future OncoPTs.When you share your clinical reasoning, decision-making, and outcomes, you're not just fulfilling an application requirement. You're shaping how oncology physical therapy is practiced in the future.In this episode of TheOncoPT Podcast, we're diving deep into what makes a strong case report for your ABPTS Oncology Specialty application, how to start writing it (without getting stuck), and why your voice and experience truly matter in advancing our field.Listen now!Follow TheOncoPT on Instagram.Follow TheOncoPT on LinkedIn.
In this episode we hear about an emergency presentation to a South Australian hospital, of a 74-year-old male with shortness of breath. The curve ball is that he had undergone ablation for drug-refractory atrial fibrillation less than two weeks prior. This discussion gives an overview of developing technologies for AF treatment and developing knowledge about the possible complications. We also have some multiple choice questions to test your understanding.Guest Dr Shaun Evans, FRACP (Royal Adelaide Hospital; University of Adelaide) HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)Jasmine Le (University of Adelaide) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Hugh Murray, Aidan Tan, Aafreen Khalid, Sebastiaan Lambooy, Amy Hughes and Lauren Gomes. Key Reference (Spoiler Alert)*****Delayed cardiac tamponade from pericarditis following pulmonary vein cryo-balloon ablation [IMJ. 2020] Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
In this episode, we get into the world of reverse logistics in the cold chain. Our guest, Dan Spitale Vice President, Global Sales At Ups Capital sheds some light on common errors shippers are making in reverse logistics and where to find improvements. For more information subscribe to Running on Ice the newsletter or podcast. Follow the Running on Ice Podcast Other FreightWaves Shows Learn more about your ad choices. Visit megaphone.fm/adchoices
CardioNerds (Drs. Daniel Ambinder and Eunice Dugan) join Dr. Namrita Ashokprabhu, Dr. Yulith Roca Alvarez, and Dr. Mehmet Yildiz from The Christ Hospital. Expert commentary by Dr. Odayme Quesada. Audio editing by CardioNerds intern, Christiana Dangas. This episode highlights the pivotal role of cardiac MRI and functional testing in uncovering coronary vasospasm as an underlying cause of MINOCA. Cardiac MRI is crucial in evaluating myocardial infarction with nonobstructive coronary arteries (MINOCA) and diagnosing myocarditis, but findings must be interpreted within clinical context. A 58-year-old man with hypertension, hyperlipidemia, diabetes, a family history of cardiovascular disease, and smoking history presented with sudden chest pain, non-ST-elevation on EKG, and elevated troponin I (0.64 µg/L). Cardiac angiography revealed nonobstructive coronary disease, including a 40% stenosis in the LAD, consistent with MINOCA. Eight weeks later, another event (troponin I 1.18 µg/L) led to cardiac MRI findings suggesting myocarditis. Further history revealed episodic chest pain and coronary vasospasm, confirmed by coronary functional angiography showing severe vasoconstriction, resolved with nitroglycerin. Management included calcium channel blockers and long-acting nitrates, reducing symptoms. Coronary vasospasm is a frequent MINOCA cause and can mimic myocarditis on CMRI. Invasive coronary functional testing, including acetylcholine provocation testing, is indicated in suspicious cases. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes - Coronary Vasospasm What are the potential underlying causes of MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)? Plaque Rupture: Plaque disruption, which includes plaque rupture, erosion, and calcified nodules, occurs as lipids accumulate in coronary arteries, leading to inflammation, necrosis, fibrosis, and calcification. Plaque rupture exposes the plaque to the lumen, causing thrombosis and thromboembolism, while plaque erosion results from thrombus formation without rupture and is more common in women and smokers. Intravascular imaging, such as IVUS and OCT, can detect plaque rupture and erosion, with studies showing plaque disruption as a frequent cause of MINOCA, particularly in women, though the true prevalence may be underestimated due to limited imaging coverage. Coronary Vasospasm: Coronary vasospasm is characterized by nitrate-responsive chest pain, transient ischemic EKG changes, and >90% vasoconstriction during provocative testing with acetylcholine or ergonovine, due to hyper-reactivity in vascular smooth muscle. It is a common cause of MINOCA, with approximately half of MINOCA patients testing positive in provocative tests, and Asians are at a significantly higher risk than Whites. Smoking is a known risk factor for vasospasm. In contrast, traditional risk factors like sex, hypertension, and diabetes do not increase the risk, and vasospasm is associated with a 2.5–13% long-term risk of major adverse cardiovascular events (MACE). Spontaneous Coronary Artery Dissection: Spontaneous coronary artery dissection (SCAD) involves the formation of a false lumen in epicardial coronary arteries without atherosclerosis, caused by either an inside-out tear or outside-in intramural hemorrhage. SCAD is classified into four types based on angiographic features, with coronary angiography being the primary diagnostic tool. However, in uncertain cases, advanced imaging like IVUS or OCT may be used cautiously. While the true prevalence is unclear due to missed diagnoses, SCAD is more common in women and is considered a cause of MINOCA when i...
In today's episode Nat Beuse, chief safety officer at Aurora joins us to talk about the recent release of an Informational Report on the final steps required to deploy driverless trucks safely. Follow the Truck Tech Podcast Other FreightWaves Shows Learn more about your ad choices. Visit megaphone.fm/adchoices
Andrea Scotti, MD, JACC: Case Reports Deputy Editor, is joined by authors Richard Carrick, MD, PhD and Drew Bidmead, BS discussing this study from Carrick et al presented at ACC.25 and published in JACC: Case Reports. Left atrial dissection is a rare, but potentially serious, complication that most commonly arises following mitral valve surgeries. In this report, we describe an unusual case of left atrial dissection that occurred after multi-valve surgical replacement in a patient with hypertrophic cardiomyopathy. While permanent pacemaker placement was required due to recurrent episodes of complete heart block, the patient was otherwise managed safely using a conservative approach without surgical re-intervention.
Sandra M. Oliver-McNeil, DNP, ACNP-BC, FACC, JACC: Case Reports Associate Editor, is joined by author Victor A. Ferrari, MD, FACC discussing this study from Ravindra et al presented at ACC.25 and published in JACC: Case Reports. This clinical vignette highlights the case of a 62-year-old male who presented with worsening dyspnea and was ultimately found to have constrictive pericarditis secondary to primary pericardial mesothelioma. The use of multimodality imaging can facilitate early diagnosis of this rare condition, helping to initiate treatment options for an otherwise high-mortality disease.
Maurice Enriquez-Sarano, MD, FACC JACC: Case Reports Associate Editor, is joined by author Emmanuel Daniel, MD, discussing this study from Daniel et al presented at ACC.25 and published in JACC: Case Reports. Large lead-associated vegetations carry a significant risk of pulmonary embolism with hemodynamic instability when transvenous lead extraction is attempted. In this case, a 54-year-old male came to the hospital with fever and dyspnea. He was found to have MSSA bacteremia and a large RV lead vegetation on echo. He had multiple co-morbidities and was a high-risk surgical candidate. He underwent successful vegetation aspiration using the Flowtriever system, followed by endovascular lead extraction.
Miho Fukui, MD, JACC: Case Reports Associate Editor, is joined by author Ree Lu, MD, discussing this study from Cho et al presented at ACC.25 and published in JACC: Case Reports. Intravenous leiomyomatosis (IVL) is a rare benign uterine growth that extends into the venous system. This case describes a 48-year-old female who presented with 1 month of chest pain and dyspnea on exertion. She was found to have a right atrial mass that transiently crossed into the right ventricle with associated moderate tricuspid regurgitation. Computed tomography revealed a uterine mass with contiguous intravascular extension through the inferior vena cava terminating in the right atrium. This case of symptomatic tricuspid valve obstruction due to IVL illustrates the importance of maintaining preload. Chest and abdominal imaging may be necessary to identify the source of the mass and ensure appropriate surgical planning.
Mary Norine Walsh, MD, MACC, JACC: Case Reports Deputy Editor, is joined by author Alexander C Sacher, DO, discussing this study from Sacher et al presented at ACC.25 and published in JACC: Case Reports. Antiphospholipid syndrome (APS) is known for thrombotic events and pregnancy complications, but its association with myocarditis is rare and poorly understood. In this case, a 44-year-old female presented with acute chest tightness, elevated cardiac biomarkers, and severe anemia. Diagnostic workup revealed ST-segment changes on ECG, preserved left ventricular function on echocardiography, and myocardial inflammation on cardiac MRI, suggestive of acute myocarditis. Positive antiphospholipid antibodies confirmed APS. She was managed with close multidisciplinary follow up. This case highlights the role of cardiac MRI in diagnosing myocarditis early, guiding management strategies, and the need for heightened clinical suspicion in APS patients presenting with cardiac symptoms.
CardioNerds co-founders Dr. Daniel Ambinder and Dr. Amit Goyal are joined by Dr. Spencer Weintraub, Chief Resident of Internal Medicine at Northwell Health, Dr. Michael Albosta, third-year Internal Medicine resident at the University of Miami, and Anna Biggins, Registered Dietitian Nutritionist at the Georgia Heart Institute. Expert commentary is provided by Dr. Zahid Ahmad, Associate Professor in the Division of Endocrinology at the University of Texas Southwestern. Together, they discuss a fascinating case involving a patient with a new diagnosis of hypertriglyceridemia. Episode audio was edited by CardioNerds Intern Student Dr. Pacey Wetstein. A woman in her 30s with type 2 diabetes, HIV, and polycystic ovarian syndrome presented with one day of sharp epigastric pain, non-bloody vomiting, and a new lower extremity rash. She was diagnosed with hypertriglyceridemia-induced pancreatitis, necessitating insulin infusion and plasmapheresis. The CardioNerds discuss the pathophysiology of hypertriglyceridemia-induced pancreatitis, potential organic and iatrogenic causes, and the cardiovascular implications of triglyceride disorders. We explore differential diagnoses for cardiac and non-cardiac causes of epigastric pain, review acute and long-term management of hypertriglyceridemia, and discuss strategies for the management of the chylomicronemia syndrome, focusing on lifestyle changes and pharmacotherapy. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Hypertriglyceridemia Cardiac sarcoidosis can present with a variety of symptoms, including arrhythmias, heart block, heart failure, or sudden cardiac death. The acute management of hypertriglyceridemia-induced pancreatitis involves prompt recognition and initiation of therapy to lower triglyceride levels using either plasmapheresis or intravenous insulin infusion +/- heparin infusion. Insulin infusion is used more commonly, while plasmapheresis is preferred in pregnancy. Medications such as fibrates and omega-3 fatty acids can be used to maintain long-term triglyceride reduction to prevent the recurrence of pancreatitis, especially in patients with persistent triglyceride elevation despite lifestyle modifications. Statins can be used in patients for ASCVD reduction in patients with a 10-year ASCVD risk > 5%, age > 40 years old, and diabetes or diabetes with end-organ damage or known atherosclerosis. Consider preferential use of icosapent ethyl as an omega-3 fatty acid for triglyceride lowering if the patients fit the populations that appeared to benefit in the REDUCE IT trial. Apply targeted dietary interventions within the context of an overall healthy dietary pattern, such as a Mediterranean or DASH diet. Limit full-fat dairy, fatty meats, refined starches, added sugars, and alcohol. Encourage high-fiber vegetables, whole fruits, low-fat or fat-free dairy, plant proteins, lean poultry, and fish. Pay special attention to the cooking oils to ensure the patient is not using palm oil, coconut oil, or butter when cooking. Instead, use liquid non-tropical plant oils. Initiate a very low-fat diet (< 5% of total daily calories from fat) for 1-4 weeks when TG levels are > 750 mg/dL. Recommend and encourage patients to exercise regularly, with a minimum goal of 150 minutes/week of moderate-intensity aerobic activity. If weight loss is required, aim for more than >225 - 250 minutes/week. Develop patient-centered and multidisciplinary stra...
Mary Norine Walsh, MD, MACC, JACC: Case Reports Deputy Editor, is joined by author Dena Hayes, MD, discussing this study from Hayes et al presented at ACC.25 and published in JACC: Case Reports. The diagnosis of cardiac sarcoidosis (CS) is often challenging, particularly in atypical cases. The authors describe a case of a previously healthy 33-year-old woman who was found to have a biatrial mass and evidence of a diffuse inflammatory or neoplastic process on multimodality imaging. Percutaneous biopsy of the cardiac mass was performed and histopathology revealed granulomas consistent with CS. This case adds to the growing number of reports of CS presenting as an intracardiac mass.
Andrea Scotti, MD, JACC: Case Reports Deputy Editor, is joined by authors Richard Carrick, MD, PhD and Drew Bidmead, BS discussing this study from Carrick et al presented at ACC.25 and published in JACC: Case Reports. Left atrial dissection is a rare, but potentially serious, complication that most commonly arises following mitral valve surgeries. In this report, we describe an unusual case of left atrial dissection that occurred after multi-valve surgical replacement in a patient with hypertrophic cardiomyopathy. While permanent pacemaker placement was required due to recurrent episodes of complete heart block, the patient was otherwise managed safely using a conservative approach without surgical re-intervention.
Julien Dreyfus, MD, PhD, JACC: Case Reports Associate Editor, is joined by author Khalid Shakfeh, MD, discussing this study from Shakfeh et al presented at ACC.25 and published in JACC: Case Reports. A 56 year old man with chronic chest pain syndrome presented with sudden onset of weakness. Evaluation for a stroke revealed a large mass in the right atrium measuring approximately 2.2 x 2.0 cm immediately above the tricuspid valve annulus and adjacent to the atrio-ventricular groove on TTE. Cardiac MRI ruled out intracardiac mass, but rather demonstrated an RCA fusiform aneurysm. Coronary CTA characterized this as two fusiform RCA aneurysms. A LHC confirmed this. Giant coronary aneurysms appearing as a large space-occupying intracavitary cardiac mass are rarely diagnosed. Escalating multimodal imaging is essential for accurate diagnosis and surgical planning. Kawasaki disease can have a late presentation and should be considered in the differential diagnosis of coronary aneurysms. A multimodal imaging approach is essential for accurate diagnosis and management of giant coronary aneurysms.
Sandra M. Oliver-McNeil, DNP, ACNP-BC, FACC, JACC: Case Reports Deputy Editor, is joined by author Liam S. Flanagan, MD discussing this study from Flanagan et al presented at ACC.25 and published in JACC: Case Reports. Pulmonary arterial hypertension (PAH) has a diverse range of etiologies and carries significant morbidity and mortality. Here, a 45-year-old female presented with shortness of breath and was found to be in acute right heart failure due to PAH. Exam demonstrated features of scurvy. She initially required vasopressors, supplemental oxygen therapy, and PAH therapies but rapidly improved with vitamin C supplementation.
CardioNerds (Dr. Rick Ferraro and Dr. Dan Ambinder) join Dr. Sri Mandava, Dr. David Meister, and Dr. Marissa Donatelle from the Columbia University Division of Cardiology at Mount Sinai Medical Center in Miami. Expert commentary is provided by Dr. Pranav Venkataraman. They discuss the following case involving a patient with cardiac sarcoidosis presenting as STEMI: A 57-year-old man with a history of hyperlipidemia presented with sudden onset chest pain. On admission, he was vitally stable with a normal cardiorespiratory exam but appeared in acute distress and was diffusely diaphoretic. His ECG revealed sinus rhythm, a right bundle branch block (RBBB), and ST elevation in the inferior-posterior leads. He was promptly taken for emergent cardiac catheterization, which identified a complete thrombotic occlusion of the mid-left circumflex artery (LCX) and large obtuse marginal (OM) branch, with no underlying coronary atherosclerotic disease. Aspiration thrombectomy and percutaneous coronary intervention (PCI) were performed, with one drug-eluting stent placed. An echocardiogram showed a left ventricular ejection fraction (EF) of 31%, hypokinesis of the inferior, lateral, and apical regions, and an apical left ventricular thrombus. The patient was started on triple therapy. A hypercoagulable workup was negative. A cardiac MRI was obtained to further evaluate non-ischemic cardiomyopathy. In conjunction with a subsequent CT chest, the results raised suspicion for cardiac sarcoidosis with systemic involvement. In view of a reduced EF and significant late-gadolinium enhancement, electrophysiology was consulted to evaluate for ICD candidacy. A decision was made to delay ICD implantation until a definitive diagnosis of cardiac sarcoidosis could be established by tissue biopsy. The patient was started on HF-GDMT and discharged with a LifeVest. Close outpatient follow-up with cardiology and electrophysiology was arranged. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Cardiac Sarcoidosis Presenting as STEMI Cardiac sarcoidosis can present with a variety of symptoms, including arrhythmias, heart block, heart failure, or sudden cardiac death. Symptoms can be subtle or mimic other cardiac conditions. Conduction abnormalities, particularly AV block or ventricular arrhythmias, are common and may be the initial indication of cardiac involvement with sarcoidosis. The additive value of Echocardiography, FDG-PET, and cardiac MR is indispensable in the diagnostic workup of suspected cardiac sarcoidosis. Specific role of MRI/PET: Both cardiac MRI and FDG-PET provide a complementary role in the diagnosis of cardiac sarcoidosis. Cardiac MRI is an effective diagnostic screening tool with fairly high sensitivity but is limited by its inability to decipher inflammatory (“active” disease) versus fibrotic myocardium. FDG-PT helps to make this discrimination, refine the diagnosis, and guide clinical management. Ultimately, these studies are most useful when interpreted in the context of other clinical information. Primary prevention of sudden cardiac death in cardiac sarcoidosis focuses on risk stratification, with ICD placement for high-risk patients. For patients awaiting definitive diagnosis, a LifeVest may be used as a temporary measure to protect from sudden arrhythmic events until an ICD is placed. Notes - Cardiac Sarcoidosis Presenting as STEMI 1. Is STEMI always a result of coronary artery disease? By definition, a STEMI is an acute S-T segment elevation myocardial infarction. This occurs when there is occlusion of a major coronary artery, which results in transmural ischemia and damage,
This case report comes to you from Brigham and Women's Hospital in Boston, a huge teaching hospital that serves the Harvad Medical School. The 52-year-old female presented with clumsiness and paresthesia of the right hand that had persisted for several days. She also had a headache and three weeks prior to presentation had undergone a suboccipital craniotomy for a Chiari I malformation. To complicate things, there was a past medical history of migraines and a family history of a Factor V Leiden mutation. The identified diagnosis is one in which evidence is limited for aspects of management, and the topics of uncertainty and mentorship in medicine also arise in this discussion.Guest Galina Gheihman, MD D (Brigham and Women's Hospital; Harvard Medical School) HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)HaeLynn Gim (Harvard Medical School) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by Dr Sebastiaan Lambooy.Key Reference (Spoiler Alert)* * * * *Isolated Cortical Vein Thrombosis [Neurohospitalist. 2023] Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
A puzzling pair of Case Reports from the most recent issue of the journal. First up (1:35) is a man in his mid-fifties, presenting with lumbar spine fractures, which then developed into confusion, vomiting, and abdominal pain. An x-ray showed dilated intestinal loops and his blood sodium levels were low. https://pn.bmj.com/content/25/1/87 The second case (23:06) involves a 21-yo woman, who presented at 18 weeks pregnant with multiple episodes of right upper limb tonic extension, and subsequently developed new-onset refractory status epilepticus (NORSE). https://pn.bmj.com/content/25/1/56 The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Xin You Tai³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the February 2025 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Neurology Registrar, University Hospitals Sussex. (3) Clinical Academic Fellow, Nuffield Department of Clinical Neurosciences, Oxford University, and Neurology Specialty registrar, Oxford University Hospital. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Letícia Amorim and Brian O'Toole. Thank you for listening.
This episode delves into key findings in the literature, focusing on the nuances of neuromuscular blockade in pediatric patients and novel advancements in intubation techniques to enhance patient safety. We explore significant insights from recent studies that highlight age-related differences in recovery times from neuromuscular blockade and practical recommendations. We also discuss a novel flexible stylet for intubation and the implications of intravenous catheter design during emergency needle decompression.Highlights include:• Exploring age-based variability in neuromuscular recovery • Understanding the effects of volatile anesthetics on younger patients • Emphasizing the importance of quantitative monitoring in pediatrics • Introducing a new flexible intubation aid to enhance airway management • Discussing a case report on emergency needle thoracostomy • Practical recommendations for training to improve response in emergency situationsFor show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/243-unlocking-insights-for-safer-anesthesia-key-findings-from-the-literature-and-a-case-report/© 2025, The Anesthesia Patient Safety Foundation
CardioNerds (Dr. Colin Blumenthal and Dr. Saahil Jumkhawala) join Dr. Rohan Ganti, Dr. Nikita Mishra, and Dr. Jorge Naranjo from the Rutgers – Robert Wood Johnson program for a college basketball game, as the buzz around campus is high. They discuss the following case involving a patient with ventricular tachycardia: The case involves a 61-year-old man with a medical history of hypothyroidism, hypertension, hyperlipidemia, seizure disorder on anti-epileptic medications, and major depressive disorder, who presented to the ER following an out-of-hospital cardiac arrest. During hospitalization, he experienced refractory polymorphic ventricular tachycardia (VT), requiring 18 defibrillation shocks. Further evaluation revealed non-obstructive hypertrophic cardiomyopathy (HCM). We review the initial management of electrical storm, special ECG considerations, diagnostic approaches once ischemia has been excluded, medications implicated in polymorphic VT, the role of multi-modality imaging in diagnosing hypertrophic cardiomyopathy, and risk stratification for implantable cardioverter-defibrillator (ICD) placement in patients with HCM. Expert commentary is provided by Dr. Sabahat Bokhari. Episode audio was edited by CardioNerds Intern and student Dr. Pacey Wetstein. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - A Curious Case of Refractory Ventricular Tachycardia - Rutgers-Robert Wood Johnson Diagnostic Uncertainty in VT Storm: In VT storm, ischemia is a primary consideration; when coronary angiography excludes significant epicardial disease, alternative causes such as cardiomyopathies, channelopathies, myocarditis, electrolyte disturbances, or drug-induced arrhythmias must be explored. ST elevations in ECG lead aVR: ST elevations in lead aVR and diffuse ST depressions can sometimes represent post-arrest oxygen demand and myocardial mismatch rather than an acute coronary syndrome. This pattern may occur in the context of polymorphic VT (PMVT), where myocardial oxygen demands outstrip supply, especially after an arrest. While these ECG changes could suggest myocardial ischemia, caution is needed, as they might not always indicate coronary pathology. However, PMVT generally should raise suspicion for underlying coronary disease and may warrant a coronary angiogram for further evaluation. Medication Implications in PMVT and HCM: Certain medications, including psychotropic drugs (e.g., antidepressants, antipsychotics) and anti-epileptic drugs, can prolong the QT interval or interact with other drugs, thereby increasing the risk of polymorphic VT in patients with underlying conditions like HCM. Careful management of these medications is critical to avoid arrhythmic events in predisposed individuals. Multi-Modality Imaging in HCM: Cardiac MRI with late gadolinium enhancement (LGE) is invaluable in assessing myocardial fibrosis, a key predictor of arrhythmic risk, and can guide decisions regarding ICD implantation. Echocardiography and contrast-enhanced CT can provide additional insights into structural abnormalities and risk assessment. Polymorphic VT in Nonobstructive HCM: Polymorphic ventricular tachycardia (PMVT) can occur in nonobstructive hypertrophic cardiomyopathy due to myocardial fibrosis and disarray, even in the absence of significant late gadolinium enhancement and left ventricular outflow tract obstruction. ICD Risk Stratification in HCM: Risk stratification for ICD placement in HCM includes assessment of clinical features such as family history of sudden cardiac death, history of unexplained syncope, presence of nonsustained VT on ambulatory monitoring,
This case report describes a 42-year-old male from Arizona with a complex course characterised by fever following an orthotopic liver transplant. A general approach to fever in the post-transplant patient is discussed, along with specific considerations regarding travel in post-transplant patients or those on immunosuppressants for other indications. A/Prof Camille Kotton and Dr Simran Gupta from the Massachusetts General Hospital and Brigham and Women's Hospital take listeners through the case and related issues in a step-by-step manner at a level targeted for trainees and generalists.Guest A/Prof Camille Kotton (Massachusetts General Hospital, Harvard University)Dr Simran Gupta (Brigham and Women's Hospital, Harvard University) HostsAssociate Professor Stephen Bacchi FRACP (Fulbright Fellow, Mass General Brigham; University of Adelaide)Christina Gao (University of Adelaide)ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by doctors Maansi Arora, Brandon Stretton, Matt Lim and Ben Cook.Key Reference (Spoiler Alert)* * * * *Coccidioidal Meningitis after Liver Transplantation in a Nonendemic Region: A Case Report [Transplantation 2006]Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
PodChatLive 163: Phenol still the king when it comes to nail surgery, big toe joint arthrodesis in elite athletes, and dorsalis pedis artery occlusion case report Contact us: getinvolved@podchatlive.com Links from this episode: Return to Sport after First Metatarsophalangeal Arthrodesis in Elite Athletes Evaluating the Effectiveness, Safety, and Satisfaction Rates of Phenol 90%, Trichloroacetic Acid 100%, and Radiofrequency in Lateral Matricectomy for the Treatment of Ingrown Toenails Occlusion of Dorsalis Pedis Artery in an Athlete
On today's podcast: 1) Fire-Scarred Los Angeles Braces for More Extreme Wind 2) DOJ Report Says Trump Would Have Been Convicted in Election Case 3) China Weighs Sale of TikTok US to Musk as a Possible OptionSee omnystudio.com/listener for privacy information.
Two more fascinating Case Reports from the latest issue of the journal. The first case (1:15) is of a 57-yo woman, with an intermittent posterior headache, which had an associated bilateral pressure-like sensation. Her symptoms had begun on a recent trip to Sri Lanka. https://pn.bmj.com/content/24/6/526 Following on is the second case (22:18), which features a 54-yo man experiencing deterioration in his speech and mobility. He had a background of chronic HIV infection with ongoing treatment. https://pn.bmj.com/content/24/6/507 The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Xin You Tai³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the June 2024 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Neurology Registrar, University Hospitals Sussex. (3) Clinical Academic Fellow, Nuffield Department of Clinical Neurosciences, Oxford University, and Neurology Specialty registrar, Oxford University Hospital. Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Letícia Amorim and Brian O'Toole. Thank you for listening.
This case report describes a 35-year-old Caucasian male presenting with 5 weeks of progressive weakness in the proximal limbs and trunk and associated changes to the skin. The man was previously well and not taking any regular medications. There are many pathways this undifferentiated patient could go down. Consultant physician, Professor Josephine Thomas demonstrates a systematic way to work through the differential diagnoses as would be expected in a long-case presentation for basic physician training exams. She's the Clinical Dean for the Adelaide Medical School at the Northern Adelaide Local Health Network.GuestProf Josephine Thomas FRACP FRACGP FANZAPHE PhD (Northern Adelaide Local Health Network; University of Adelaide)HostsAssociate Professor Stephen Bacchi (Massachusetts General Hospital; University of Adelaide)Dr Caleb Chong (Northern Adelaide Local Health Network) ProductionProduced by Stephen Bacchi and Mic Cavazzini. Music licenced from Epidemic Sound includes ‘Rockin' for Decades' by Blue Texas and ‘Brighton Breakdown' by BDBs. Image created and copyrighted by RACP. Editorial feedback kindly provided by Dr Brandon Stretton and Ben Cook.Key Reference (Spoiler Alert)*****A case of haemorrhagic myositis with concurrent anti-Ro52 and anti-NXP-2 antibodies treated with plasmapheresis [Rheumatology. 2020]Please visit the Pomegranate Health web page for a transcript and supporting references. Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
CardioNerds (Dr. Dan Ambinder and guest host, Dr. Pooja Prasad) join Dr. Donny Mattia from Phoenix Children's pediatric cardiology fellowship, Dr. Sri Nayak from the Mayo Clinic – Arizona adult cardiology fellowship, and Dr. Harrison VanDolah from the University of Arizona College of Medicine - Phoenix Med/Peds program for a sunrise hike of Piestewa Peak, followed by some coffee at Berdena's in Old Town Scottsdale (before the bachelorette parties arrive), then finally a stroll through the Phoenix Desert Botanical Gardens to discuss a thought-provoking case series full of clinical cardiology pearls. Expert commentary is provided by Dr. Tabitha Moe. Episode audio was edited by Dan Ambinder. They discuss the following case: Cardiology is consulted by the OB team for a 27-year-old female G1, now P1, who has just delivered a healthy baby boy at 34 weeks gestation after going into premature labor. She is experiencing shortness of breath and is found to have a significant past cardiac history, including atrial fibrillation and preexcitation, now with a pacemaker and intracardiac defibrillator. We review the differential diagnosis for peripartum cardiomyopathy (PPCM) and then combine findings from her infant son, who is seen by our pediatric cardiology colleagues and is found to have severe hypertrophic cardiomyopathy (HCM). Genetic testing for both ultimately reveals a LAMP2 mutation consistent with Danon Disease. The case discussion focuses on the differential diagnosis for PPCM, HCM, pearls on Danon Disease and other HCM “phenocopies,” and the importance of good history. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media Pearls Peripartum cardiomyopathy is a diagnosis of exclusion – we must exclude other possible etiologies of heart failure! Be on the lookout for features of non-sarcomeric HCM – as Dr. Michelle Kittleson said in Episode 166, “LVH plus” states. HCM with preexcitation, heart block, strong family history, or extracardiac symptoms such as peripheral neuropathy, myopathy, or cognitive impairment should be evaluated for infiltrative/inherited cardiomyopathies! As an X-linked dominant disorder, Danon disease will present differently in males vs females, with males having much more severe and earlier onset disease with extracardiac features. Making the diagnosis for genetic disorders such as Danon disease is important for getting the rest of family members tested as well as the opportunity for specialized treatments such as gene therapy Up to 5% of Danon disease cases may be due to copy number variants, which may be missed in genetic testing that does not do targeted deletion/duplication analysis!). Notes What is the differential diagnosis for peripartum cardiomyopathy? Peripartum cardiomyopathy is a diagnosis of exclusion – we must exclude other possible etiologies of heart failure! First, ensure that you are not missing an acute life-threatening etiology of acute decompensated heart failure – pulmonary embolism, amniotic fluid embolism, ACS, and SCAD should all be ruled out. Second, a careful history can identify underlying heart disease or risk factors for the development of heart failure, such as substance use, high-risk behaviors that put one at risk for HIV infection, and family history that suggests an inheritable cardiomyopathy. Lastly, a careful review of echocardiographic imaging may also identify underlying etiologies that warrant a change in management. Diagnosis of peripartum cardiomyopathy is important to consider as within 7 days of onset, patients may be eligible for treatment with bromocriptine – consider referring ...
Dando sequência à série "Naruhodo Entrevista" de conversas descontraídas com cientistas brasileiras e brasileiros, chegou a vez da Médica, Doutora em Fisiopatologia em Clínica Médica e Livre Docência em Pneumologia, Suzana Tanni.Só vem!> OUÇA (90min 14s)*Naruhodo! é o podcast pra quem tem fome de aprender. Ciência, senso comum, curiosidades, desafios e muito mais. Com o leigo curioso, Ken Fujioka, e o cientista PhD, Altay de Souza.Edição: Reginaldo Cursino.http://naruhodo.b9.com.br*Suzana Erico Tanni possui graduação em Medicina pela Universidade Estadual Paulista Júlio de Mesquita Filho (1998), doutorado em Fisiopatologia em Clínica Médica [Botucatu] pela Universidade Estadual Paulista Júlio de Mesquita Filho (2008) e Livre Docente em Pneumologia pela Universidade Estadual Paulista Júlio de Mesquita Filho (2018). Atualmente é Professora Associada da Universidade Estadual Paulista Júlio de Mesquita Filho. Foi presidente da Sociedade Paulista de Pneumologia e Tisiologia (2022-2023). Coordenadora da Comissão de Epidemiologia e Pesquisa Clínica da Sociedade Brasileira de Pneumologia e Tisiologia, com responsabilidade na construção de guidelines nacionais de conteúdo respiratório.Desde 2010 atua como Docente do curso MECOR - Methods in Epidemiologic, Clinical and Operations Research da American Thoracic Society e da Associación Latino Americana do Thorax. Atualmente é Docente Líder do nível 2, para realização de manual de procedimento operacionais e plano de análise estatística.É Editora Associada do periódico Jornal Brasileiro de Pneumologia na área de Epidemiologia e DPOC, na Revista Médica Brasileira na área de pneumologia e da Frontiers Medicine-Respiratory Diseases. Atua como "Guest Editor" nos periódicos Frontiers in Case Report in Respiratory Diseases e Women in Science: Pulmonary Medicine 2023.Desde 2008, atua em Estudos Multicêntricos sobre Doenças Respiratórias. Faz parte do 4-Consortium for Clinical Characterization of COVID-19 By EHR (4CE) liderado por pesquisadores da Harvard Medical School, Boston, USATem experiência na área de Medicina, com ênfase em Pneumologia, atuando principalmente no seguinte tema: doenças pulmonares; doença pulmonar obstrutiva crônica, tabagismo e covid-19.Lattes: http://lattes.cnpq.br/4887507894734442*APOIE O NARUHODO PELA PLATAFORMA ORELO!Um aviso importantíssimo: o podcast Naruhodo agora está no Orelo: https://bit.ly/naruhodo-no-oreloE é por meio dessa plataforma de apoio aos criadores de conteúdo que você ajuda o Naruhodo a se manter no ar.Você escolhe um valor de contribuição mensal e tem acesso a conteúdos exclusivos, conteúdos antecipados e vantagens especiais.Além disso, você pode ter acesso ao nosso grupo fechado no Telegram, e conversar comigo, com o Altay e com outros apoiadores.E não é só isso: toda vez que você ouvir ou fizer download de um episódio pelo Orelo, vai também estar pingando uns trocadinhos para o nosso projeto.Então, baixe agora mesmo o app Orelo no endereço Orelo.CC ou na sua loja de aplicativos e ajude a fortalecer o conhecimento científico.https://bit.ly/naruhodo-no-orelo
JACC: Case Reports Associate Editor Maurizio Taramasso, MD, PhD, joins author Brinder S Kanda, MD, FACC to discuss their case presented at AHA and published in JACC: Case Reports. In this case, an 83-year-old female with decompensated heart failure was found to have HOCM with SAM of the mitral valve and a large P2 flail segment with ruptured cords. TEER was performed resulting in mild MR and resolution of the prior LVOT gradient. The case supports TEER for patients with medication-refractory HOCM.
CardioNerds (Dr. Yoav Karpenshif – Chair of the CardioNerds Critical Care Cardiology Council) join Dr. Munim Khan, Dr. Shravani Gangidi, and Dr. Rachel Goodman from Tufts Medical Center's general cardiology fellowship program for hot pot in China Town in Boston. They discuss a case involving a patient who presented with stress cardiomyopathy leading to cardiogenic shock. Expert commentary is provided by Dr. Michael Faulx from the Cleveland Clinic. Notes were drafted by Dr. Rachel Goodman. A young woman presents with de novo heart-failure cardiogenic shock requiring temporary mechanical circulatory support who is found to have basal variant takotsubo cardiomyopathy. We review the definition and natural history of takotsubo cardiomyopathy, discuss initial evaluation and echocardiographic findings, and review theories regarding pathophysiology of the clinical syndrome. We also highlight complications of takotsubo cardiomyopathy, with a focus on left ventricular outflow obstruction, cardiogenic shock, and arrythmias. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Takotsubo cardiomyopathy is defined as a reversible systolic dysfunction with wall motion abnormalities that do not follow a coronary vascular distribution. Takotsubo cardiomyopathy is a diagnosis of exclusion; patients often undergo coronary angiography to rule out epicardial coronary artery disease given an overlap in presentation and symptoms with acute myocardial infarction. There are multiple echocardiographic variants of takotsubo. Apical ballooning is the classic finding, but mid-ventricular, basal, and biventricular variants exist as well. Patients with takotsubo cardiomyopathy generally recover, but there are important complications to be aware of. These include arrhythmia, left ventricular outflow tract (LVOT) obstruction related to a hyperdynamic base in the context of apical ballooning, and cardiogenic shock. Patients with Impella devices are at risk of clot formation and stroke. Assessing the motor current can be a clue to what is happening at the level of the motor or screw. Notes What is Takotsubo Syndrome (TTS)? TTS is a syndrome characterized by acute heart failure without epicardial CAD with regional wall motion abnormalities seen on echocardiography that do not correspond to a coronary artery territory (see below).1 TTS classically develops following an acute stressor—this can be an emotional or physical stressor.1 An important feature of TTS is that the systolic dysfunction is reversible. The time frame of reversibility is variable, though generally hours to weeks.2 Epidemiologically, TTS has a predilection for post-menopausal women, however anyone can develop this syndrome.1 TTS is a diagnosis of exclusion. Coronary artery disease (acute coronary syndrome, spontaneous coronary artery dissection, coronary embolus, etc) should be excluded when considering TTS. Myocarditis is on the differential diagnosis. What are the echocardiographic findings of takotsubo cardiomyopathy? The classic echocardiographic findings of TTS is “apical ballooning,” which is a way of descripting basal hyperkinesis with mid- and apical hypokinesis, akinesis, or dyskinesis.3 There are multiple variants of TTS. The four most common are listed below:3(1) Apical ballooning (classic TTS)(2) Mid-ventricular variant(3) Basal variant (4) Focal variant Less common variants include the biventricular variant and the isolated right ventricular variant.3 Do patients with TTS generally have EKG changes or biomarker elevation? Patients often have elevated troponin, though the severity wall motion abnormalities seen on TTE i...
Discover insights into the challenging landscape of Cushing syndrome, where adrenal variations require careful diagnostic and therapeutic strategies. In this podcast, Sina Jasim, MD, MPH, Editor-in-Chief of the AACE Clinical Reports (ACCR) and Associate Professor of Medicine at Washington University School of Medicine, leads a compelling discussion on two unique cases featured in the ACCR article, Histopathologic Differences Between Adrenocorticotropic Hormone–Dependent and Adrenocorticotropic Hormone–Independent Adrenal Hyperplasia Causing Cushing Syndrome. Authors, Amir H Hamrahian, MD, Endocrinologist, Associate Professor, and Medical Director of the Comprehensive Adrenal Center at Johns Hopkins University School of Medicine, and Ezra Baraban, MD, Assistant Professor of Pathology at Johns Hopkins University School of Medicine, explain the diagnostic challenges for each case, the decision-making process between medical and surgical approaches, and the critical role of pathology in guiding clinical care. Read the full case report in ACCR at https://www.aaceclinicalcasereports.com/article/S2376-0605(22)00066-9/fulltext.
Join Kim Pittis and Dr. Carol as they explore the fascinating world of Frequency Specific Microcurrent (FSM) therapy with detailed case studies and real-life miracles. This episode covers the complexities of treating long COVID, the interplay between different body systems, and the importance of addressing the root causes of ailments. We dive into intriguing patient stories, such as Christy Hughes' incredible recovery from multiple severe COVID infections and small fiber neuropathy. Learn about the critical role of the vagus nerve, the importance of stable states, and innovative treatment protocols that blend multiple modalities for comprehensive healing. Frequency Specific Microcurrent: Miracles in Healing and Dynamic Protocols In this episode, hosts delve into the fascinating world of Frequency Specific Microcurrent (FSM), sharing breakthrough stories of recovery and healing. They discuss climatic quirks in Northern California and Portland, the extraordinary improvements in a patient post-COVID, and the holistic approach of FSM in treating diverse conditions. From tendon repair to vestibular injuries, they cover how FSM addresses underlying causes rather than symptoms. The episode also highlights upcoming symposiums and conferences, and the importance of understanding the integration of different medical systems for effective treatment. Tune in for insights, case studies, and the latest FSM protocols to revolutionize your approach to healing. 00:17 Seasonal Changes and Personal Anecdotes 01:11 Christy Hughes' Miraculous Recovery 04:16 Understanding COVID's Impact on the Body 06:07 Upcoming Symposium and Presentations 07:32 FSM Core Training and Diverse Participants 08:56 Case Study: Treating Dural Adhesions 11:58 Integrating Multiple Healing Systems 17:44 Addressing Vestibular Injuries 22:41 FSM Protocols for Long COVID 28:08 Advanced Dura Treatments and Research 30:04 Cranial Sacral Therapy and FSM 31:12 Advanced Techniques and Word Formation 32:46 Understanding Muscle and Tendon Mechanics 34:11 Aging, Balance, and Fast Twitch Muscles 35:53 Small Fiber Neuropathy and Vagus Nerve Stimulation 41:24 Treating Vomiting in Children 47:33 Increased Pain with FSM Protocols 51:40 Case Reports and Frequency Therapy History As autumn settles in Northern California, the contrast between chilly mornings and warm afternoons epitomizes the transitional phase between seasons. It's not only nature that finds itself in a transition—we do too. Amidst the complex interplay of life's various aspects, frequency-specific microcurrent (FSM) offers a method to harmonize our body's physiological systems, especially during critical recovery periods. The Journey of Healing with FSM Recent sessions have unveiled remarkable transformations in individuals battling long-term effects post-COVID vaccination. For instance, Christy Hughes's journey is a testament to the healing potential of FSM. Overburdened by lingering symptoms due to COVID, she found relief after implementing customized FSM protocols focusing on vascular support. Her story speaks volumes about the intricacies and potential of FSM in aiding recovery from seemingly insurmountable health challenges. Unveiling the Science Behind FSM The physiological ramifications of COVID are profound, affecting everything from blood vessel linings to cellular signaling. It's hypothesized that the persistent issues individuals face could stem from disruptions in blood flow regulation—a process deeply tied to our body's cellular communication network. By using FSM to recalibrate these signals, practitioners have witnessed significant improvements in patient outcomes, offering new hope amid seemingly dire circumstances. Advanced Protocols for Comprehensive Care At its core, FSM embodies a holistic approach, addressing physical, neurological, acupuncture, and energetic systems concurrently. This multi-layered treatment is reshaping how practitioners like acupuncturists, MDs, and even massage therapists approach care. With a comprehensive protocol in place—from treating fascial adhesions using FSM to balancing energy centers—practitioners are equipped to deliver expansive, integrative treatments within a condensed timeframe. Integrating FSM Across Disciplines The beauty of FSM lies in its adaptability across various medical disciplines, inviting practitioners to view symptoms through a broader lens. Whether it's enhancing vagal tone in kids encountering sleep disturbances or helping patients redefine their movement post-trauma, FSM paves the way for cohesive, multi-system rehabilitation. This integrative approach not only addresses problems but delves into the etiological roots, allowing for lasting healing. Building Bridges Through Understanding Essential to this process is building a deep understanding of each patient's unique history, integrating aspects often overlooked. As practitioners, unraveling these stories helps to construct a narrative that aligns with therapeutic interventions. This reconstructive approach is becoming central to FSM practices, avidly pursuing not just symptom mitigation but unwavering health optimization. Embracing Comprehensive Healing In an era rife with complex health dynamics, FSM stands out as a beacon of hope for many. Its adaptability and comprehensive nature underscore its capability to harmonize health at both a micro and macro level. As we progress, learning to incorporate such advanced yet holistic treatment methods could redefine the landscape of healing, fostering greater well-being for all who embark on this transformative journey.
CardioNerds (Dr. Dan Ambinder and Dr. Rick Ferraro) join Dr. Mansi Oberoi and Dr. Mohan Gudiwada from the University of Nebraska Medical Center discuss a case of constrictive pericarditis. Expert commentary is provided by Dr. Adam Burdorf, who serves as the Program Director for the Cardiovascular Medicine Fellowship at the University of Nebraska Medical Center. The case discussed involves a 76-year-old woman with a history of monoclonal gammopathy of undetermined significance, chronic obstructive pulmonary disease, type 2 diabetes mellitus, and squamous cell carcinoma was admitted to the hospital for worsening shortness of breath, swelling in lower extremities, hyponatremia, and urinary tract infection. CT chest to evaluate for pulmonary embolism showed incidental pericardial calcifications; the heart failure team was consulted for the management of her decompensated heart failure. Echo images were nondiagnostic. Subsequent invasive hemodynamic monitoring showed elevated right and left-sided filling pressures, diastolic equalization of LV and RV pressures, and positive RV square root sign with ventricular interdependence. Cardiac MRI showed septal flattening on deep inspiration and septal bounce, suggestive of interventricular dependence. After a heart team discussion and with shared-decision making the patient opted for medical management owing to her comorbidities and frailty. Enjoy this 2024 JACC State-of-the-Art Review to learn more about pericardial diseases and best practices for pericardiectomy (Al-Kazac et al., JACC 2024) US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Constrictive Pericarditis Echo: Left Ventricular ejection fraction = 55-60%. Unclear septal motion in the setting of atrial fibrillation MRI: Diastolic septal flattening with deep inspiration as well as a septal bounce suggestive of interventricular dependence and constrictive physiology References Garcia, M. Constrictive Pericarditis Versus Restrictive Cardiomyopathy. Journal of the American College of Cardiology, vol. 67, no. 17, 2016, pp. 2061–2076. Pathophysiology and Diagnosis of Constrictive Pericarditis. American College of Cardiology, 2017. Geske, J., Anavekar, N., Nishimura, R., et al. Differentiation of Constriction and Restriction: Complex Cardiovascular Hemodynamics. Journal of the American College of Cardiology, vol. 68, no. 21, 2016, pp. 2329–2347. Constrictive Pericarditis. ScienceDirect. Constrictive Pericarditis. Journal of the American College of Cardiology, vol. 83, no. 12, 2024, pp. 1500-1512.
Dr. Gillett and Nurse Practitioner James O'Hara discuss Transdermal TRT. 00:00 Intro01:05 Meme01:35 Transdermal Testosterone 04:00 Testosterone Myth 08:21 What's the ideal testosterone level for me? (Timing of blood draw)09:31 Standard of care for Transdermal Testosterone 12:56 do you want your friends to know your on trt or not on trt?Link calculator17:54 Androgel package insert21:04 Case Report 23:37 Outro Studies/References:► https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245724/For High-quality labs:► https://gilletthealth.com/order-lab-panels/For information on the Gillett Health clinic, lab panels, and health coaching:► https://GillettHealth.comFollow Gillett Health for more content from James and Kyle► https://instagram.com/gilletthealth► https://www.tiktok.com/@gilletthealth► https://twitter.com/gilletthealth► https://www.facebook.com/gilletthealthFollow Kyle Gillett, MD► https://instagram.com/kylegillettmdFollow James O'Hara, NP► https://Instagram.com/jamesoharanpFor 10% off Gorilla Mind products including SIGMA: Use code “GH10”► https://gorillamind.com/For discounts on high-quality supplements►https://www.thorne.com/u/GillettHealth#testosterone #basics #podcast #trtAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
APTA Vestibular SIG Podcast: Supported by the Academy of Neurologic Physical Therapy
In this podcast episode Dr. Robin Evans, PT, DPT, GCS presents a case study of a patient with bilateral multi canal Benign Paroxysmal Positional Vertigo (BPPV) and underlying Vestibular Migraine (VM). A systematic approach in assessing and treating multi canal BPPV as well as the criteria for VM is reviewed. This case discussion highlights the importance of nystagmus identification, the approach to formulate a differential diagnosis in patients with positional vertigo as well as the need for interdisciplinary management to optimize patient outcomes. https://content.iospress.com/download/journal-of-vestibular-research/ves201644?id=journal-of-vestibular-research%2Fves201644 https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/vestibular-migraine/ https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1177/0194599816689667 Please send comments or questions on this podcast to robin.evans@ivyrehab.com To learn more about the Academy of Neurologic Physical Therapy Vestibular Special Interest Group visit www.neuropt.org.
The American Society for Microbiology is launching a new journal, ASM Case Reports. The journal is already accepting submissions and will begin publishing in January of 2025. We discuss ASM Case Reports and what you can expect from this new journal. Watch this episode: https://youtu.be/zHdZL0PYTuE Some of the questions we will discuss include: What is the scope of ASM Case Reports? What makes a case report or case series interesting and important? Why should people publish in ASM Case Reports? Guests: Dr. Carey-Ann Burnham (twitter/
In this episode, a funeral scientist does case analysis for the BrundleFly and hopes for the world's oldest cheese to hit your trick or treat bags. The Funeral Science Podcast on pH The world's oldest cheese NEW!!!! I want to promote what you do. If you are an independent creator of something and would like a little bit more exposure, I am offering to do it for free! I will be somewhat discerning about what I promote but if you'd like to pitch it to me, email me at funeralsciencepodcast@gmail.com. Follow me on Instagram @mortraqr Follow on Facebook The Funeral Science Podcast Check out my other podcast, The Funeralcast, wherever you get your podcasts
In this conversation, Lisa Paladino shares a case study of a patient with breastfeeding challenges and a complex medical history. She emphasizes the importance of a holistic approach to breastfeeding support, considering the entire family and their unique circumstances. Lisa discusses the journey of this patient, from struggling to breastfeed her first child to navigating multiple miscarriages and finally achieving a successful breastfeeding relationship with her second child. She highlights the role of education, support, and referrals to other healthcare professionals in providing comprehensive care. Lisa shares the insider view of how she manages patients individually and with a view beyond the frenum. TakeawaysA holistic approach to breastfeeding and tongue tie care is essential, considering the entire family and their unique circumstances.Education, support, and referrals to other healthcare professionals are crucial in providing comprehensive care for breastfeeding parents.The journey of breastfeeding can be challenging, but with the right guidance, successful breastfeeding relationships can be achieved.It is important for healthcare professionals to recognize the impact they have on families.—--------------------------------------------------------------------------Ways to connect with Lisa:Follow us on Instagram and Facebook as Tongue Tie ExpertsDon't miss our *new* Professional's Guide to Tongue Tie in the Breastfeeding Infant Special Coupon Code PODCAST40 to save 40% Links to other Tongue Tie Experts freebies and pro and parent's programs: https://www.tonguetieexperts.net/LinksSave 15% on any of our other courses with the code PODCAST15If you are enjoying our podcast, be sure to subscribe/follow on your favorite podcast app so you don't miss an episode.Special thanks to our sponsor for their support of the podcast. You can check out Light Scalpel here: LightScalpel.comA gentle disclaimer. Please do not consider anything discussed on this podcast, by myself or any guest of the podcast, to be medical advice. The information is provided for educational purposes only and does not take the place of your own medical or lactation provider.Mentioned in this episode:Light Scalpel Ad LinkLight Scalpel Ad LinkLight Scalpel Ad Link
HEALTH NEWS Why Raspberries Are the New Heart-Healthy Superfruit Effects of Ashwagandha (Withania Somnifera) on Stress and Anxiety: A Systematic Review and Meta-analysis Magnetic stimulation effective in helping Parkinson's patients walk Vitamin E deficiency may lead to increased colorectal cancer risk: Chinese meta-analysis Exposure to phthalates could be linked to pregnancy loss Children who claim previous life memories: A Case Report and Literature Review
CardioNerds (Amit Goyal) join Dr. Merna Hussien, Dr. Akhil Kallur, Dr. Abhinav Saxena, and Dr. Brody Deb from the MedStar Georgetown - Washington Hospital Center in DC for a stroll around Rock Creek Park as they discuss an unusual case of cobalt cardiomyopathy. Expert commentary is provided by Dr. Nana Afari Armah. Episode audio was edited by CardioNerds Intern Christiana Dangas. The case is of a middle-aged woman with a past medical history of hypertension, hyperlipidemia, and bilateral hip replacements, who presented with subacute progressive exertional dyspnea, orthopnea, and constitutional symptoms and was found to have SCAI Stage C cardiogenic shock. Transthoracic echocardiogram showed severely reduced left ventricular ejection fraction (LVEF, 20-25%) and a moderate pericardial effusion. Cardiac catheterization revealed biventricular failure with elevated filling pressures. A cardiac MRI showed diffuse late gadolinium enhancement (LGE) in the left ventricle. Endomyocardial biopsy showed nonspecific chronic inflammation. However, the evidence of mitochondrial heavy metal toxicity and elevated cobalt levels made the diagnosis of cobalt cardiomyopathy. The patient underwent revision of hip joint implants to ceramic implants and started chelation therapy. However, due to persistent stage D heart failure despite normalization of cobalt levels, she underwent orthotropic heart transplantation. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case MEdia - Cobalt Cardiomyopathy Pearls - Cobalt Cardiomyopathy A good history goes a long way in diagnosing non-ischemic cardiomyopathy (NICM). Common problems can have uncommon presentations requiring a high degree of suspicion for diagnosis. Imaging features can overlap between causes of NICM. History helps in targeting further histological workup and uncovering the root cause. Multidisciplinary effort is essential in making a rare diagnosis. Taken from1 - Singh M, Krishnan M, Ghazzal A, Halushka M, Tozzi JE, Bunning RD, Rodrigo ME, Najjar SS, Molina EJ, Sheikh FH. From Hip to Heart: A Comprehensive Evaluation of an Infiltrative Cardiomyopathy. CJC Open. 2021 Nov 1;3(11):1392–5. Notes - Cobalt Cardiomyopathy How common is cobalt cardiomyopathy? When should it be suspected? Cobalt cardiomyopathy is incredibly rare, with only a handful of reported cases. 2 It is also known as beer drinkers' cardiomyopathy, as cobalt was added to beer for fortification in Quebec 3, where it was first reported. Cobalt cardiomyopathy is characterized by its rapidly progressive nature, the presence of low voltages on EKG, and diffuse infiltration. Patients also complained of a previous history of anorexia and weight loss and were found to have polycythemia and thyroid abnormalities on labs. This syndrome was very similar to wet beriberi except for the absence of a therapeutic response to thiamine. Taken from - 2 Later, this was noted in patients with total metal hip arthroplasty 4–6, especially in patients with metal-on-metal hip arthroplasty, which led to corrosion and leakage of cobalt into the bloodstream. The syndrome in these patients was similar to those in beer drinkers from Quebec. This figure, taken from 2, shows the reports of Cobalt cardiomyopathy after cobalt alloy prostheses. [HX1] What is the pathophysiology of cobalt cardiomyopathy? Cobalt has a variety of effects on the heart, both microscopically and biochemically.Cobalt may have multiple calcium-mediated cardiac effects and may also interfere with the Krebs cycle and ATP generation by mitochondria. Histology may show modest changes with no inflammatory response o...
Send us a textMpox in Pregnancy - Risks, Vertical Transmission, Prevention, and Treatment.Nachega JB, Mohr EL, Dashraath P, Mbala-Kingebeni P, Anderson JR, Myer L, Gandhi M, Baud D, Mofenson LM, Muyembe-Tamfum JJ; Mpox Research Consortium (MpoxReC).N Engl J Med. 2024 Aug 28. doi: 10.1056/NEJMp2410045. Online ahead of print.PMID: 39197097 No abstract available. Neonatal Monkeypox Virus Infection.Ramnarayan P, Mitting R, Whittaker E, Marcolin M, O'Regan C, Sinha R, Bennett A, Moustafa M, Tickner N, Gilchrist M, Kershaw A, Rampling T; NHS England High Consequence Infectious Diseases (Airborne) Network.N Engl J Med. 2022 Oct 27;387(17):1618-1620. doi: 10.1056/NEJMc2210828. Epub 2022 Oct 12.PMID: 36223535 No abstract available.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
CardioNerds Dan Ambinder and Dr. Devesh Rai join cardiology fellows and National Lipid Association lipid scholars Dr. Jelani Grant from Johns Hopkins University and Dr. Alexander Razavi from Emory University. They discuss a case involving a patient with familial hypercholesterolemia. Dr. Archna Bajaj from University of Pennsylvania provides expert commentary. Drs. Jelani Grant and Alexander Razavi drafted notes. CardioNerds Intern Pacey Wetstein engineered episode audio. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. A classic finding in patients with familial hypercholesterolemia is the presence of markedly elevated levels of total and low-density lipoprotein cholesterol (LDL-C) with an LDL-C concentration of 190 mg/dL or greater. However, severe hypercholesterolemia is not inevitably present, and many patients who carry this diagnosis may have lower LDL-C levels. This case history describes a young woman whose mother and brother met clinical and genetic criteria for heterozygous familial hypercholesterolemia but who had only a mild elevation in LDL-C, falling to 130 mg/dL after dietary intervention. Despite this finding, genetic testing revealed the presence of the same genetic variants as were noted in her mother and brother. In addition, a second genetic variant predisposing them to cholesterol gallstone formation was identified in all three family members. If genetic testing had not been performed, the diagnosis may have been missed or delayed, resulting in an increased risk for vascular complications associated with familial hypercholesterolemia. This case supports the value of genetic testing of family members of those with familial hypercholesterolemia, even when LDL-C levels are not severely elevated. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Exposing an Unusual Presentation of Familial Hypercholesterolemia – National Lipid Association Familial hypercholesterolemia (FH) is among the most common autosomal co-dominant genetic conditions (approximately 1:200 to 1:300 for HeFH, 1:160,000 to 1:300,000 for HoFH). Genetic testing has a role for all first-degree relatives when a family history of FH is strongly suggestive, regardless of LDL-C level. Heterogeneity in ASCVD risk among individuals with FH is derived from background polygenic risk, clinical risk factors (e.g., timing of lipid-lowering initiation and adjacent risk factors), as well as subclinical atherosclerosis burden. In clinical or genetically confirmed FH, an LDL-C goal of 55 mg/dL is recommended. Beyond statins, FDA-approved non-statin therapies for FH include ezetimibe, PCSK9 mAb, bempedoic acid, inclisiran, evolocumab (only HoFH), lomitapide (only HoFH), and LDL apheresis. Notes - Exposing an Unusual Presentation of Familial Hypercholesterolemia – National Lipid Association What are the diagnostic criteria for FH? Dutch Lipid Clinic Network1 Variables: family history, clinical history, physical exam, LDL-C level, DNA (LDLR, APOB, PCSK9) Simon-Broome1 Variables: total or LDL-C, physical exam, DNA (LDLR, APOB, PCSK9), family history Emphasis on clinical history and physical exam reduces sensitivity U.S. Make Early Diagnosis Prevent Early Death (MEDPED) 1 Only one of the three where no genetic testing is required, may work well in cascade screening Variables: age, total cholesterol, family relative (and degree) with FH Definite, probable, possible, unlikely Emphasis on clinical history and physical exam reduces sensitivity
CardioNerds Dan Ambinder and Dr. Devesh Rai join cardiology fellows and National Lipid Association lipid scholars Dr. Oby Ibe from Temple University and Dr. Elizabeth Epstein from Scripps Clinic. They discuss a case involving a patient with elevated Lp(a). Dr. Jessica Pena provides expert commentary. Drs. Oby Ibe and Elizabeth Epstein drafted notes. CardioNerds Intern Christiana Dangas engineered episode audio. This episode is part of a case reports series developed in collaboration with the National Lipid Association and their Lipid Scholarship Program, with mentorship from Dr. Daniel Soffer and Dr. Eugenia Gianos. This is a 63-year-old man with hypertension, hyperlipidemia, and active tobacco smoking who presented with acute dyspnea. He was tachycardic but otherwise initially hemodynamically stable. The physical exam demonstrated warm extremities with no murmurs or peripheral edema. Chest X-ray revealed diffuse pulmonary edema, and the ECG showed sinus tachycardia with T-wave inversions in the inferior leads. A bedside echocardiogram revealed a flail anterior mitral valve leaflet. The patient was taken for cardiac catheterization that revealed nonobstructive mid-RCA atheroma with a distal RCA occlusion, which was felt to reflect embolic occlusion from recanalized plaque. PCI was not performed. Right heart catheterization then demonstrated a low cardiac index as well as elevated PCWP and PA pressures. An intra-aortic balloon pump was placed at that time. A TEE was performed soon after which showed the posteromedial papillary muscle was ruptured with flail segments of the anterior mitral leaflet as well as severe posteriorly directed mitral regurgitation. The patient ultimately underwent a successful tissue mitral valve replacement and CABG. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Little (a), Big Deal – National Lipid Association You are never too young to see a preventive cardiologist! The field of preventive cardiology is shifting focus towards the identification of early upstream risk and intervention before the development of clinical ASCVD (1,5). Patients who have a strong family history of cardiovascular disease, a personal history of CVD at an early age, multiple risk factors, or genetic disorders such as familial hypercholesterolemia especially benefit from early cardiovascular risk assessment and reduction. Female-specific risk factors to incorporate into a young woman's cardiovascular risk assessment include polycystic ovarian syndrome, hormone contraceptive use, early menarche (age 5 pregnancies), early menopause (age
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