Podcasts about Coronary

In this episode, Dr. Amro Alsaid, Medical Director of Advanced Cardiac Imaging, and Dr. Karim Al-Azizi, Medical Director of the Catheterization Laboratory and Structural Heart Program at Baylor Scott & White The Heart Hospital, discuss how AI and advanced cardiac imaging are reshaping coronary diagnosis, improving precision in patient care, and optimizing workflow efficiency across cardiology programs.Visit Cleerly Health to learn more. https://cleerlyhealth.com/what-is-cleerly?utm_campaign=cleerly_brand&utm_medium=podcast&utm_source=beckers&utm_content=pr-podcast-11-2025

“I think everyone should have Lp(a) measured.”  - Dr. Ann Marie Navar   Key Resources to Go Deeper:  - Dr. Ann Marie Navar  - Lp(a)  - Get a Free Test to Check Your Lp(a) Level   - Previous episode with Dr. Navar about ApoB  About This Episode:  Listen to this replay of an important discussion about Lipoprotein(a), or Lp(a), a critical but often overlooked marker for cardiovascular health. In this episode, host Barbara Hannah Grufferman takes a deep dive with medical expert Dr. Ann Marie Navar from UT Southwestern Medical Center about why this single test could be vital for understanding your heart disease risk, especially if you have a family history of early cardiovascular disease.  Key Topics Covered:  - What Lipoprotein(a) is and how it differs from standard cholesterol measurements  - Why Lp(a) testing is particularly important for certain individuals  - The genetic nature of Lp(a) and its implications for family health  - Current treatment options and promising new therapies on the horizon  - Practical steps for discussing Lp(a) testing with your healthcare provider  Key Takeaways:  - Lp(a) is a distinct type of cholesterol particle not captured in routine lipid panels  - High Lp(a) levels significantly increase risk of heart disease and stroke  - Lp(a) levels are primarily determined by genetics and remain stable throughout life  - Current guidelines recommend universal Lp(a) testing for adults  - New treatments specifically targeting high Lp(a) levels are expected by 2026  - Managing other risk factors can help offset the risk of elevated Lp(a)  - Coronary artery calcium scoring can provide additional risk assessment  Learn More About Dr. Ann Marie Navar  Dr. Navar is a preventive cardiologist and epidemiologist at UT Southwestern Medical Center whose research focuses on cardiovascular disease prevention, risk prediction, and clinical decision-making. She is a leading expert in advanced lipid testing and cardiovascular risk assessment. This is Dr. Navar's second appearance on AGE BETTER, following her previous discussion about the ApoB test, which was one of the most down-loaded episodes in 2024.   Connect With Barbara:  Have ideas for future episodes? We'd love to hear from you!  - Email: agebetterpodcast@gmail.com  - Connect on Instagram HERE  Note: This episode is for informational purposes only and does not constitute medical advice. Please consult with your healthcare provider about your specific situation. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, we bring together a remarkable group of guests to discuss an often overlooked but incredibly important condition, Spontaneous Coronary Artery Dissection (SCAD). Joining us today are a SCAD survivor, the clinician who treated her, and an advocate working to raise awareness and improve patient outcomes.Together, they share their powerful and unique perspectives on what SCAD is, how it presents, and the challenges faced in recognising it, particularly in the pre-hospital environment, where diagnostic overshadowing can easily occur. We explore why SCAD is sometimes missed, how it differs from other cardiac events, and what clinicians can do to better support patients who may be experiencing it.Most importantly, we hear the real lived experience of surviving SCAD, the uncertainty, recovery, and the crucial role of awareness and advocacy in improving care pathways.This conversation is both educational and deeply human, offering vital insights for pre-hospital professionals, clinicians, and anyone interested in improving outcomes for patients with this rare and often misunderstood condition. Tune in to hear their stories, their expertise, and how we can all play a part in recognising and responding to SCAD more effectively. You can find more on SCAD here: https://beatscad.org.uk/SCAD-for-Patients/What-is-SCAD

This week we review a recent retrospective review from Phoenix Children's Hospital about coronary artery fistulae. How common are they and who needed intervention? How should the cardiologist think about the small fistula? Should they all be ‘followed' or can they be discharged from cardiology follow-up? How small is ‘small enough'? We speak with Dr. Marie Chevenon who is a fetal cardiologist at Phoenix Children's Hospital about her recent study on the Phoenix experience with coronary artery fistulae.  https://doi.org/10.1007/s00246-024-03600-y

David Frost reviews Practical and Personal Looks at Coronary Artery Diseases (CAD) in Master's Rowers - download the additional information link below. Timestamps 00:45 David Frost's journey through CAD Coronary artery calcification - men need checking after age 70 more than women. Even rowers who are known for being stoic - if you feel something in your chest, get it checked out. "You have the coronary arteries of a 92 year old" was my signal that I needed help. The Agatston Score is is a proxy for heart health. 04:30 Five things that cause inflammation - environmental stress - toxins stress - too much sunlight - smoking - exercise Inflammation in your arteries can cause an issue if you work too hard, too fast for too long. 08:00 Rowers have a higher than average incidence of atrial fibrillation (AFIB) Maybe rowers are doing themselves a disservice by training long and hard. What to do about this? 12:00 Heart age vs calendar age There are interesting heart age metrics - pulse wave velocity measure tells how elastic your arteries are. Heart Rate Variability - the higher it is the better you are recovering. David encourages masters to measure these and track their trends. Dr Churchill in Boston is studying masters rowers' aorta for ASCVD. Get a calcium CT scan - it helped David understand his condition. 18:00 A self-scan system Perceived exertion, rest and hydration are a good guide to how you are feeling each day. David is mindful of recovery as well. What age should you start getting the calcium CT scan done? For men from age 40 and women maybe 50. For the plus wave velocity test this could be done from mid life - age 40 maybe ladies a bit later. Note David is a layman, not a doctor. Rowing training is more 80% steady state and 20% higher intensity. This has trended upwards from about 60% when David was younger. As humans we are slow to recognise when our body moved into the "next" stage. The competitive mindset can make us live in denial of aging. It's not good for you to carry to much body fat - your waist to hip ratio is worth checking. 25:00 Burden or banish? David's new book Sloth and gluttony contribute to heart disease - 80% is preventable. Lifestyle measures can defer the onset of heart disease. Hopefully rowers can start to banish the preventable problem. STRESSED spelled backwards is DESSERTS. David's package of information https://1drv.ms/p/c/af369003831e6951/EZ82vA6IqaRAtv172PZYmW0BV8HomDD4kselkTqn1Ykffw

Dr Sharonne Hayes, Professor of cardiovascular medicine and founding director of Mayo Clinic women's heart clinic, and Dr. Marysia Tweet, Associate Professor of cardiovascular medicine, and co-leader of the Spontaneous Coronary Artery Dissection Registry and leader in women's heart health join the show for this amazing November chapter of Always on EM. They are world experts on Spontaneous Coronary Artery Dissection authoring over 60 peer reviewed articles on the topic and in this chapter we explore with them the pitfalls and pearls related to making this diagnosis in the ED. SCAD is an important cause of myocardial infarction especially in patients who would not otherwise seem to be at risk for heart attacks for example active young women without comorbidities, and its imperitive that we as emergency physicians are current on this diagnosis.   DONATE TO DR JIM GREGOIRE SCHOLARSHIP FUND To honor the life of Dr. Jim Gregoire, dear friend of this show, consider donating to his scholarship fund. Go to https://give.mayoclinic.org/give/616870/#!/donation/checkout Go to: What would you like your donation to support? Choose “other” Enter: James Gregoire Scholarship Fund   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda; @Marysia_Tweet; @SharonneHayes YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch; @SharonneHayes Email - AlwaysOnEM@gmail.com   DO YOU HAVE SCAD? DOES YOUR PATIENT HAVE SCAD? WANT TO GET CONNECTED? SCAD Research: www.scadresearch.org National Coalition for Women with Heart Disease: www.womenheart.org Mayo Clinic Womens Heart clinic: https://www.mayoclinic.org/departments-centers/womens-heart-clinic/overview/ovc-20442061   REFERENCES & LINKS Saleh G, Al-Abcha A, Chaaban K, Adi MZ, Tweet M, Collins JD, Alkhouli M, Gulati R. Concomitant Takotsubo Cardiomyopathy and Spontaneous Coronary Artery Dissection: Exploring the Role of Cardiac Mechanics on Coronary Disruption. JACC Cardiovasc Imaging. 2025 Oct;18(10):1161-1166. doi: 10.1016/j.jcmg.2025.05.020. Epub 2025 Aug 5. PMID: 40758075. Baqal O, Karikalan SA, Hasabo EA, Tareen H, Futela P, Qasba RK, Shafqat A, Qasba RK, Hayes SN, Tweet MS, El Masry HZ, Lee KS, Shen WK, Sorajja D. In- hospital and long-term outcomes in spontaneous coronary artery dissection with concurrent cardiac arrest: Systematic review and meta-analysis. Heart Rhythm O2. 2025 Apr 24;6(6):843-853. doi: 10.1016/j.hroo.2025.03.023. PMID: 40717849; PMCID: PMC12287955. Morosato M, Gaspardone C, Romagnolo D, Pagnesi M, Baldetti L, Dormio S, Federico F, Scandroglio AM, Chieffo A, Godino C, Margonato A, Adamo M, Metra M, Tchetche D, Dumonteil N, Tweet MS, Saw J, Beneduce A. Left Main Spontaneous Coronary Artery Dissection: Clinical Features, Management, and Outcomes. JACC Cardiovasc Interv. 2025 Apr 28;18(8):975-983. doi: 10.1016/j.jcin.2025.01.427. Epub 2025 Apr 9. PMID: 40208153; PMCID: PMC12290918. Tweet MS, Pellikka PA, Gulati R, Gochanour BR, Barrett-O'Keefe Z, Raphael CE, Best PJM, Hayes SN. Coronary Artery Tortuosity and Spontaneous Coronary Artery Dissection: Association With Echocardiography and Global Longitudinal Strain, Fibromuscular Dysplasia, and Outcomes. J Am Soc Echocardiogr. 2024 May;37(5):518-529. doi: 10.1016/j.echo.2024.02.013. Epub 2024 Mar 11. PMID: 38467311; PMCID: PMC11605948. Tweet MS, Hayes SN, Grimaldo ABG, Rose CH. Pregnancy After Spontaneous Coronary Artery Dissection: Counseling Patients Who Intend Future Pregnancy. JACC Adv. 2023 Dec;2(10):100714. doi: 10.1016/j.jacadv.2023.100714. Epub 2023 Nov 14. PMID: 38915307; PMCID: PMC11194843. Tarabochia AD, Tan NY, Lewis BR, Slusser JP, Hayes SN, Best PJM, Gulati R, Deshmukh AJ, Tweet MS. Association of Spontaneous Coronary Artery Dissection With Atrial Arrhythmias. Am J Cardiol. 2023 Jan 1;186:203-208. doi: 10.1016/j.amjcard.2022.09.032. Epub 2022 Oct 31. PMID: 36328832; PMCID: PMC10403149. Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Lu Y, Spatz ES, Gupta A, Khera R, Ng VG, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Depression and Perceived Stress After Spontaneous Coronary Artery Dissection and Comparison With Other Acute Myocardial Infarction (the VIRGO Experience). Am J Cardiol. 2022 Jun 15;173:33-38. doi: 10.1016/j.amjcard.2022.03.005. Epub 2022 Mar 29. PMID: 35365290; PMCID: PMC9133198. Johnson AK, Tweet MS, Rouleau SG, Sadosty AT, Hayes SN, Raukar NP. The presentation of spontaneous coronary artery dissection in the emergency department: Signs and symptoms in an unsuspecting population. Acad Emerg Med. 2022 Apr;29(4):423-428. doi: 10.1111/acem.14426. Epub 2021 Dec 26. PMID: 34897898; PMCID: PMC10403148. Murugiah K, Chen L, Dreyer RP, Bouras G, Safdar B, Khera R, Lu Y, Spatz ES, Ng VG, Gupta A, Bueno H, Tweet MS, Spertus JA, Hayes SN, Lansky A, Krumholz HM. Health status outcomes after spontaneous coronary artery dissection and comparison with other acute myocardial infarction: The VIRGO experience. PLoS One. 2022 Mar 23;17(3):e0265624. doi: 10.1371/journal.pone.0265624. PMID: 35320296; PMCID: PMC8942215. Adlam D, Tweet MS, Gulati R, Kotecha D, Rao P, Moss AJ, Hayes SN. Spontaneous Coronary Artery Dissection: Pitfalls of Angiographic Diagnosis and an Approach to Ambiguous Cases. JACC Cardiovasc Interv. 2021 Aug 23;14(16):1743-1756. doi: 10.1016/j.jcin.2021.06.027. PMID: 34412792; PMCID: PMC8383825. Kok SN, Tweet MS. Recurrent spontaneous coronary artery dissection. Expert Rev Cardiovasc Ther. 2021 Mar;19(3):201-210. doi: 10.1080/14779072.2021.1877538. Epub 2021 Feb 26. PMID: 33455483. Campbell KH, Tweet MS. Coronary Disease in Pregnancy: Myocardial Infarction and Spontaneous Coronary Artery Dissection. Clin Obstet Gynecol. 2020 Dec;63(4):852-867. doi: 10.1097/GRF.0000000000000558. PMID: 32701519; PMCID: PMC10767871. Tweet MS, Young KA, Best PJM, Hyun M, Gulati R, Rose CH, Hayes SN. Association of Pregnancy With Recurrence of Spontaneous Coronary Artery Dissection Among Women With Prior Coronary Artery Dissection. JAMA Netw Open. 2020 Sep 1;3(9):e2018170. doi: 10.1001/jamanetworkopen.2020. PMID: 32965500; PMCID: PMC7512056. Hayes SN, Tweet MS, Adlam D, Kim ESH, Gulati R, Price JE, Rose CH. Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Aug 25;76(8):961-984. doi: 10.1016/j.jacc.2020.05.084. PMID: 32819471. Johnson AK, Hayes SN, Sawchuk C, Johnson MP, Best PJ, Gulati R, Tweet MS. Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors. J Am Heart Assoc. 2020 May 5;9(9):e014372. doi: 10.1161/JAHA.119.014372. Epub 2020 Apr 28. PMID: 32342736; PMCID: PMC7428589. Tweet MS, Akhtar NJ, Hayes SN, Best PJ, Gulati R, Araoz PA. Spontaneous coronary artery dissection: Acute findings on coronary computed tomography angiography. Eur Heart J Acute Cardiovasc Care. 2019 Aug;8(5):467-475. doi: 10.1177/2048872617753799. Epub 2018 Jan 29. PMID: 29376398; PMCID: PMC6027604. Tan NY, Tweet MS. Spontaneous coronary artery dissection: etiology and recurrence. Expert Rev Cardiovasc Ther. 2019 Jul;17(7):497-510. doi: 10.1080/14779072.2019.1635011. Epub 2019 Jul 5. PMID: 31232618. Waterbury TM, Tweet MS, Hayes SN, Eleid MF, Bell MR, Lerman A, Singh M, Best PJM, Lewis BR, Rihal CS, Gersh BJ, Gulati R. Early Natural History of Spontaneous Coronary Artery Dissection. Circ Cardiovasc Interv. 2018 Sep;11(9):e006772. doi: 10.1161/CIRCINTERVENTIONS.118. PMID: 30354594. Hayes SN, Kim ESH, Saw J, Adlam D, Arslanian-Engoren C, Economy KE, Ganesh SK, Gulati R, Lindsay ME, Mieres JH, Naderi S, Shah S, Thaler DE, Tweet MS, Wood MJ; American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association. Circulation. 2018 May 8;137(19):e523-e557. doi: 10.1161/CIR.0000000000000564. Epub 2018 Feb 22. PMID: 29472380; PMCID: PMC5957087. Tweet MS, Kok SN, Hayes SN. Spontaneous coronary artery dissection in women: What is known and what is yet to be understood. Clin Cardiol. 2018 Feb;41(2):203-210. doi: 10.1002/clc.22909. Epub 2018 Mar 1. PMID: 29493808; PMCID: PMC5953427. Tweet MS, Codsi E, Best PJM, Gulati R, Rose CH, Hayes SN. Menstrual Chest Pain in Women With History of Spontaneous Coronary Artery Dissection. J Am Coll Cardiol. 2017 Oct 31;70(18):2308-2309. doi: 10.1016/j.jacc.2017.08.071. PMID: 29073960; PMCID: PMC5957076. Lindor RA, Tweet MS, Goyal KA, Lohse CM, Gulati R, Hayes SN, Sadosty AT. Emergency Department Presentation of Patients with Spontaneous Coronary Artery Dissection. J Emerg Med. 2017 Mar;52(3):286-291. doi: 10.1016/j.jemermed.2016.09. Epub 2016 Oct 8. PMID: 27727035. Tweet MS, Gulati R, Williamson EE, Vrtiska TJ, Hayes SN. Multimodality Imaging for Spontaneous Coronary Artery Dissection in Women. JACC Cardiovasc Imaging. 2016 Apr;9(4):436-50. doi: 10.1016/j.jcmg.2016.01.009. PMID: 27056163. Tweet MS, Gulati R, Hayes SN. What Clinicians Should Know Αbout Spontaneous Coronary Artery Dissection. Mayo Clin Proc. 2015 Aug;90(8):1125-30. doi: 10.1016/j.mayocp.2015.05.010. PMID: 26250728. Prasad M, Tweet MS, Hayes SN, Leng S, Liang JJ, Eleid MF, Gulati R, Vrtiska TJ. Prevalence of extracoronary vascular abnormalities and fibromuscular dysplasia in patients with spontaneous coronary artery dissection. Am J Cardiol. 2015 Jun 15;115(12):1672-7. doi: 10.1016/j.amjcard.2015.03.011. Epub 2015 Mar 23. PMID: 25929580. Goel K, Tweet M, Olson TM, Maleszewski JJ, Gulati R, Hayes SN. Familial spontaneous coronary artery dissection: evidence for genetic susceptibility. JAMA Intern Med. 2015 May;175(5):821-6. doi: 10.1001/jamainternmed.2014. PMID: 25798899. Liang JJ, Prasad M, Tweet MS, Hayes SN, Gulati R, Breen JF, Leng S, Vrtiska TJ. A novel application of CT angiography to detect extracoronary vascular abnormalities in patients with spontaneous coronary artery dissection. J Cardiovasc Comput Tomogr. 2014 May-Jun;8(3):189-97. doi: 10.1016/j.jcct.2014.02.001. Epub 2014 Apr 4. PMID: 24939067. Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, Gersh BJ, Khambatta S, Best PJ, Rihal CS, Gulati R. Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation. 2012 Jul 31;126(5):579-88. doi: 10.1161/CIRCULATIONAHA.112. Epub 2012 Jul 16. PMID: 22800851. Tweet MS, Gulati R, Aase LA, Hayes SN. Spontaneous coronary artery dissection: a disease-specific, social networking community-initiated study. Mayo Clin Proc. 2011 Sep;86(9):845-50. doi: 10.4065/mcp.2011.0312. PMID: 21878595; PMCID: PMC3257995.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

Full article: Utility of CAD-RADS 2.0 Plaque Burden Grades and Stenosis Categories on Coronary CTA for Predicting Cardiac Events in Patients With Acute Chest Pain: A Multicenter Study Plaque burden grade reporting was incorporated in CAD-RADS 2.0. Radhika Rajeev, MD, discusses this AJR article by Lee et al. that explores the prognostic impact of these grades.

With Jean-Benoit Le Polain de Waroux, St-Jan Hospital, Brugge - Belgium, and Maarten De Smet, AZ Sint Jan, Brugge - Belgium.  Link to European Heart Journal paper Link to European Heart Journal editorial

Host Dr. Vera Tarman speaks with Daniel Trevor—entrepreneur-turned “citizen scientist” and author of Unholy Trinity: How Carbs, Sugars, and Oils Make Us Fat, Sick, and Addicted, and How to Escape Their Grip. After a near-fatal heart attack, Daniel dove into medical literature, clinician interviews, and self-tracking. He shares the arguments behind his book, why he believes hyperinsulinemia is a “gateway disease,” how diet patterns may influence cardiometabolic risk and cravings, and the testing he advocates so people can “don't guess—test.” We also discuss controversy in nutrition science, harm-reduction ways to experiment with food choices, and how to navigate mixed messages from experts. About our guest Daniel Trevor has founded high-tech companies, worked in anti-aging projects, and spent 20 years as an actor and musician. His health crisis catalyzed a research journey that informed Unholy Trinity. He now writes and speaks about low-carb/keto to carnivore approaches, lab testing, and lifestyle change. What we cover Daniel's pivot from “Mr. Healthy” to heart-attack survivor and researcher Hyperinsulinemia → insulin resistance → cardiometabolic disease (Daniel's “gateway disease” model) Why some people see a rise in LDL on low-carb diets and what advanced lipoprotein testing (e.g., NMR LipoProfile) may reveal “Lean-mass hyper-responder” profile: high LDL with low triglycerides and high HDL—what it means and why it's debated Coronary artery calcium (CAC) scores, soft vs. calcified plaque, and the “CAC paradox” as Daniel understands it Grains, seed oils, and sugar: Daniel's case for their role in appetite, cravings, and disease risk; critique of popular diet guidance Statins, side effects, and absolute risk/benefit as presented by Daniel (and why shared decision-making matters) Practical, harm-reduction steps: food substitutions, lab work, and building a sustainable plan Where Daniel's thinking intersects—and conflicts—with mainstream guidelines, and how listeners can evaluate claims Key takeaways “Don't guess—test.” Daniel urges listeners to use accessible labs and scans (prioritizing a small set if resources are limited) and to pair results with symptoms and function. Protein and structure can reduce chaos. He advocates prioritizing animal protein, minimizing refined carbs/sugars and seed oils, and making like-for-like swaps to lower cravings. Context matters. Individual responses vary (genetics, meds, comorbidities, history with restriction/addiction). Go slow, track, and use support. Hold nuance. Nutrition science evolves; some claims remain contested. Use informed consent and a collaborative care team. The content of our show is educational only. It does not supplement or supersede your healthcare provider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.

This may be one of those episodes that could be considered controversial and I hope it does prompt questions. Dr. ChristopherKwon is a highly experienced cardiac surgeon whose practice in Lake Havasu, Arizona has brought him face-to-face with a growing number of patients living with symptomatic Myocardial Bridges.What made this conversation so compelling is Dr. Kwon's dual approach—he doesn't just perform the standard unroofing procedure. He also chooses to bypass the artery in the same operation, giving his patients the greatest chance for long-term relief, in his expert opinion. As he says, it's a “belts and suspenders” approach.We talk about everything related to the bridge unroofing procedure.The fear patients have around sternotomy,The diagnostic process including provocative testing,The reality of competitive flow in grafts,The insurance coding challenges that can delay care,And, perhaps most importantly, how critical it is to advocate for yourself.Whether you're a patient, a caregiver, or a provider trying to better understand this often-dismissed condition, I believe this episode can give you clarity, confidence, and hope.???? In This Episode, We Cover:Dr. Kwon's path from aspiring engineer to heart surgeonWhy sternotomy isn't as scary as it soundsHis unique method: unroofing + bypass for added protectionWhen provocative testing is useful—but not always requiredWhat to know about LIMA grafts and long-term outcomesWhy some cardiologists still dismiss this condition—and what he tells themThe importance of second opinions and listening to your gutHow insurance coding can make or break your surgery approvalPlus... Dr. Kwon's life outside the OR, including his two standard poodles ???????? Guest Info:Dr. KwonCardiac Surgeon – Havasu Regional Medical Center, ArizonaPhone: 928-453-0890Contact info: https://www.havasuregional.com/find-a-doctor/provider/1225074867???? Resources:Website: www.myimperfectheart.comBook: Imperfect Heart: Stories of Myocardial Bridges – Now available on Amazon or any digital platform where you find your books/ebooks/audio books.Chapter Summaries(00:00) Cardiac Surgeon Discusses Myocardial BridgesDr. Kwan's journey to becoming a cardiac surgeon, his 21-year career, advancements in cardiac surgery, and treating myocardial bridges.(11:34) Bypass Graft and Competitive Flow DiscussionNature's intricacies of bypass grafts, specifically LEMA and its interaction with competitive flow, surgical strategies, and decision-making processes in complex cardiac surgeries.(20:14) Discussion on Myocardial Bridge TreatmentMyocardial bridging treatment, stenting and surgery, sudden cardiac death, patient self-advocacy, and maintaining well-being through family, pets, and nature.(34:52) Bypass and Unroofing Procedure DiscussionDr. Korn shares insights on unroofing bypass surgery, making complex medical information accessible and concludes with a light-hearted exchange about his dogs.

With Allan Sniderman, McGill University, Montreal - Canada.  Link to European Heart Journal Editorial, by Allan Sniderman, Michael J. Pencina and George Thanassoulis Link to European Heart Journal Paper

Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Joo Lee, MD discuss the outcomes of intravascular imaging-guided PCI versus coronary artery bypass grafting for left main or three-vessel disease.

Abdullah Al-Abcha, MD, social media editor of JACC: Cardiovascular Interventions, and Aloke Finn, MD discuss the comparison of vascular injury from intravascular lithotripsy, cutting, or ultra-high-pressure balloons during coronary calcium modification.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Anders Jeppsson, a cardiothoracic surgeon at Sahlgrenska University Hospital in Gothenburg, Sweden, about his paper on “Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome,” published in The New England Journal of Medicine. Chapters 00:00 Intro  01:54 Ghana Mission Trip  06:23 JANS 1, Pig-to-Human Transplant  08:08 JANS 2, CABG Acute Type A AD  10:06 JANS 3, Chylothorax Lymph Node Management  11:22 JANS 4, ICU Resternotomy Adoption  13:38 JANS 5, Octogenarians Repair vs MV Surgery  15:10 Career Center  15:31 Video 1, MVR Patent Bilateral IMammary Grafts  16:36 Video 2, Repeat RA Thoracotomy  17:39 Video 3, Vascular Injuries in Robotics  19:12 Dr. Jeppsson Interview  33:30 EACTS 2025 & Upcoming Events  They began by providing an overview of the study, including the reason for conducting it, the expansion of the study to other Nordic countries, and its results. They also discuss the funding for the research and the recruitment process. Additionally, they cover dual antiplatelet therapy and compare this study with similar research. Finally, they explore registry-based studies and future research on ticagrelor and aspirin, or aspirin alone, following coronary surgery for acute coronary syndrome.  Joel also highlights recent JANS articles exploring whether protective coronary artery bypass grafting improves surgical outcomes in acute type A aortic dissection with coronary ostial involvement, the association of chylothorax with aggressiveness of lymph node management during pulmonary resection, if intensive care unit resternotomy should be practiced in all facilities that perform cardiac surgery, transcatheter edge-to-edge repair vs mitral valve surgery in octogenarians, and research using pig-to-human lung xenotransplantation into a brain-dead recipient.  In addition, Joel explores robotic mitral valve replacement in a patient with patent bilateral internal mammary grafts, repeat right axillary thoracotomy as a safe and feasible approach for repair of recurrent LAVVR after previous AVSD repair, and handling vascular injuries in robotic thoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Protective Coronary Artery Bypass Grafting Improves Surgical Outcomes in Acute Type A Aortic Dissection With Coronary Ostial Involvement  2.) The Association of Chylothorax With Aggressiveness of Lymph Node Management During Pulmonary Resection  3.) Expert Opinion: Intensive Care Unit Resternotomy Should Be Practiced in All Facilities That Perform Cardiac Surgery  4.) Transcatheter Edge-to-Edge Repair Versus Mitral Valve Surgery in Octogenarians: Comparative Analysis of Safety, Durability, and Survival  5.) Pig-to-Human Lung Xenotransplantation Into a Brain-Dead Recipient  CTSNet Content Mentioned  1.) Robotic Mitral Valve Replacement in a Patient With Patent Bilateral Internal Mammary Grafts: A Case Video  2.) Repeat Right Axillary Thoracotomy Is a Safe and Feasible Approach for Repair of Recurrent LAVVR After Previous AVSD Repair   3.) Handling Vascular Injuries in Robotic Thoracic Surgery: Real-Life Cases Using a Fibrin-Based Hemostatic Technique  Other Items Mentioned  1.) Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome   2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  3.) Career Center   4.) CTSNet Events Calendar  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.

In this episode of The Atrium, host Dr. Alice Copperwheat speaks with Dr. John Puskas, professor of surgery at Emory University, Chief of Cardiothoracic Surgery at Emory University Hospital Midtown, and Wilton Looney Director at the Emory Carlyle Fraser Heart Center in Atlanta, Georgia, USA, about proximal coronary anastomosis. Chapters 00:00 Intro 00:44 About Dr. Puskas 03:35 Background & History 06:56 10 Commandments for PA 10:34 When to Do It? 13:57 Aorta Site Selection 19:32 Step-by-Step 29:21 Sewing Onto Aorta 33:15 Variations & Alternatives 44:50 Key Messages 46:08 Advice to Trainees They discuss the 10 principles for proximal anastomosis during coronary artery bypass grafting, saphenous vein grafts vs free arterial grafts, as well as the optimal site selection on the aorta. They also explored key aspects of preparation and arteriotomy, and highlighted various variations and alternatives, such as clampless techniques and sequential grafting. Additionally, they examined the pitfalls and complications associated with proximal coronary anastomosis and the future of proximal coronary anastomosis.    The Atrium is a monthly podcast presenting clinical and career-focused topics for residents and early career professionals across all cardiothoracic surgery subspecialties. Watch for next month's episode on extended resection with Dr. Erinoangelo Rendina.   Related Resources   The 10 Commandments for Proximal Anastomosis During CABG: Techniques and Technologies for Vein and Arterial Grafts   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.

With David Erlinge and Sasha Koul, Lund University, Lund - Sweden Read the European Heart Journal paper Read the European Heart Journal editorial

Send us a textWelcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recently published trial looking at aspirin in patients with chronic coronary syndrome receiving oral anticoagulation. Here we go!Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (0:00 – 9:43).Throwback to EPIC-CAD: The Rounds Table Episode 94: Top Papers from the 2024 European Society of Cardiology Congress The Good Stuff:Trial Files is a free monthly newsletter on practice-changing trials, delivered straight to your inbox (https://trialfiles.substack.com/).Guidelines summaries coming to Trial Files soon!Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

This episode covers: Cardiology This Week: A concise summary of recent studies Strategic decisions in valvular heart disease Optimising drug therapy in chronic coronary syndromes Mythbusters: Does wearing a white coat make you smarter? Host: Susanna Price Guests: John-Paul Carpenter, Fabien Praz, Robert Storey Want to watch that episode? Go to: https://esc365.escardio.org/event/2092 Want to watch that extended interview on Optimising drug therapy in chronic coronary syndromes ? Go to: https://esc365.escardio.org/event/2092?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel, Fabien Praz and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Robert Storey has declared to have potential conflicts of interest to report: research grants and personal fees from AstraZeneca and Cytosorbents, and personal fees from Abbott, Afortiori Development/Thrombolytic Science, Boehringer Ingelheim/Lilly, Bristol Myers Squibb/Johnson & Johnson, Chiesi, Idorsia/Viatris, Novo Nordisk, PhaseBio and Tabuk. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Susanna Price Guest: Robert Storey Want to watch that extended interview? Go to: https://esc365.escardio.org/event/2092?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Robert Storey has declared to have potential conflicts of interest to report: research grants and personal fees from AstraZeneca and Cytosorbents, and personal fees from Abbott, Afortiori Development/Thrombolytic Science, Boehringer Ingelheim/Lilly, Bristol Myers Squibb/Johnson & Johnson, Chiesi, Idorsia/Viatris, Novo Nordisk, PhaseBio and Tabuk. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Remote Ischemic Preconditioning Prevents Acute Kidney Injury Following Coronary Angiography: The BRICK Randomized Clinical Trial.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Ideal Navitor Implant Depth for Redo-TAVR Feasibility and Coronary Access: A CT Simulation Study.

In this episode, I sit down with Ivor Cummins — a biochemical engineer turned health researcher, author, and podcaster. Ivor is known for breaking down complex science into clear, practical insights, with a focus on metabolic health and heart disease risk. His work has challenged mainstream advice and opened up new conversations about nutrition, prevention, and public health.We cover Ivor's health shock, his father's devastating health journey, the ultimate test to assess heart attack risk, the role of diet and lifestyle, statins, and more... ⏱️ Timestamps00:00 Intro01:00 Ivor's first interest in metabolic health03:00 Ivor's own heart attack risk05:00 His father's heart attack06:00 Frustration with poor nutrition advice08:00 Coronary calcium score & heart attack risk15:00 Why coronary calcium score is the ultimate test18:00 CLIP: “The medical system will put you on statins, but not tell you what really matters”21:00 The “Devil's Triad”: seed oils, processed foods, and sugars (Dr Kate Shanahan)22:00 Three steps to lower heart attack risk23:00 Dr Jeff Gerber's book recommendation24:00 The importance of sun exposure35:00 When statins are (and aren't) useful40:00 Discussion on MAHA & RFK45:00 V's and public health debates50:00 Building a low-carb food pyramid (Nina Teicholz, Tro Kal)

With Børge Nordestgaard and Anders Berg Wulff, Copenhagen University Hospital, Copenhagen - Denmark. Read the European Heart Journal - Cardiovascular Imaging paper Read the European Heart Journal - Cardiovascular Imaging editorial

Commentary by Dr. Jian'an Wang.

SummaryIn this conversation, Dr. Janelle Nassim shares her journey as a dermatologist and a mother, detailing her experience with a life-altering heart attack caused by a coronary artery dissection (SCAD) shortly after the birth of her second child. She discusses the symptoms leading up to the event, her hospital experience, and the emotional and physical recovery process. Janelle reflects on the changes in her perspective towards life, motherhood, and work, emphasizing the importance of gratitude, vulnerability, and accepting help from others.Time stamps00:00 Introduction and Background04:52 Life as a Dermatologist and Mother09:53 The Day of the Heart Attack19:58 The Experience in the Hospital24:30 Processing Trauma and Growth24:30 Navigating the Hospital Experience25:57 The Journey of Recovery29:25 Reconnecting with Family31:25 Shifting Perspectives on Parenting31:53 Physical Recovery and Exercise35:38 Emotional Grief and Acceptance44:03 Work-Life Balance Post-Diagnosis47:02 Current State: A Year LaterKeywordsdermatology, heart attack, SCAD, recovery, motherhood, emotional health, trauma, resilience, work-life balance, personal growthSupport the show

Send us a textDr. Michael Koren joins Kevin Geddings to explain how having a conversation with a medical professional who is tuned into your personal situation can help you understand the confusing and sometimes counterintuitive world of medical information. Cardiologist Dr. Koren uses the examples of coronary calcium scores and total cholesterol levels, which must be interpreted in the context of individual factors, such as age and HDL/LDL ratio. They then discuss clinical research and how the experience in a clinical research setting is one of shared knowledge, where medical professionals take the time to explain everything you need to know about your health.Be a part of advancing science by participating in clinical research.Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.comListen on SpotifyListen on Apple PodcastsWatch on YouTubeShare with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.Follow us on Social Media:FacebookInstagramX (Formerly Twitter)LinkedInWant to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.comMusic: Storyblocks - Corporate InspiredThank you for listening!

Angiographic and clinical impact of balloon inflation time in percutaneous coronary interventions with sirolimus-coated balloon: A sub analysis of the EASTBOURNE study

Commentary by Dr.  Jian'an Wang.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

Giuseppe Tarantini, MD, PhD and Mirza Umair Khalid, MBBS, MD, FACC discuss the Coronary Access After TAVI (CAvEAT) Study.

With Edward Hulten, Brown University, Providence, and Islam Shatla, University of Kansas Medical Center, Kansas City, USA. Link to edi

CT Scan for Coronary Artery Calcification Window   Guest: Thomas C. Gerber, M.D., Ph.D. Host: Stephen L. Kopecky, M.D.   Coronary artery calcification (CAC) scanning can help improving our assessment of the risk of heart attack or stroke in thoughtfully selected patients. Not everyone needs a CAC scan! The results of a CAC scan can be particularly helpful in deciding whether a patient should start medications to reduce their risk. Coronary artery calcium scanning is *not* used to follow a patient's risk over time (to see whether the risk is decreasing or increasing).   Topics Discussed: How is a coronary artery calcification (CAC) scan done, and what can the results tell us about a patient's cardiovascular risk and management? Who should consider having a CAC scan? Should a patient discuss the possibility of a CAC scan with their doctor, and should they just self-refer to a screening center? What changes can we make in patient management based on CAC scan findings? How should we monitor whether the management is improving the patient's cardiovascular risk? How often should a CAC scan be done?    Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

While CT heart scans are becoming increasingly popular to generate a coronary calcium score as a gauge of coronary atherosclerotic plaque and thereby risk for heart attack, there is actually a treasure trove of other useful information provided by the scan—but often not reported to you. In this episode of the Defiant Health podcast, I therefore help make you aware of the wealth of information provided by a CT heart scan that can empower you further in maintaining health and preventing heart disease. Support the showYouTube channel: https://www.youtube.com/@WilliamDavisMD Blog: WilliamDavisMD.com Membership website for two-way Zoom group meetings: InnerCircle.DrDavisInfiniteHealth.com Books: Super Gut: The 4-Week Plan to Reprogram Your Microbiome, Restore Health, and Lose Weight Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health; revised & expanded ed

Please join host Michael S. Lloyd, MD, FHRS at HRS 2025 in San Diego as he discusses this article with Stephanie Wang, MD and Emily Zeitler, MD. The study investigated whether PFA-induced coronary spasms during ablation could cause lasting changes—such as mild lumen narrowing—at the ablation site over a three-month period. https://www.hrsonline.org/education/TheLead https://www.jacc.org/doi/10.1016/j.jacep.2025.03.014 Host Disclosure(s): M. Lloyd: Honoraria/Speaking/Consulting: Medtronic, Arga Medtech, Circa Scientific Membership on Advisory Committees: Boston Scientific Contributor Disclosure(s): E. Zeitler: Honoraria/Speaking/Consulting: Biosense Webster, Inc., Medtronic Inc., Boston Scientific, Element Science, Inc., Sanofi, V-Wave S. Wang: Nothing to disclose.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Automated Real-Time Percutaneous Coronary Intervention Risk Model Leveraging Electronic Health Records.

King and I | S5 E9 | Management of Stable Angina with Peculiar Coronary Anatomy Findings

With Francesca Coraducci Marche Polytechnic University of Ancona, Ancona - Italy, Marco Guglielmo, University Medical Center Utrecht, Utrecht - The Netherlands, and Anna Giulia Pavon, Cardiocentro Ticino Institute, Lugano - Switzerland. Link to editorial Link to paper

FACT (fentanyl And Crushed Ticagrelor) PCI: A Randomized Control Trial of Patients Undergoing Percutaneous Coronary Intervention Who Receive Ticagrelor and Fentanyl

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Salvatore Brugaletta from Barcelona, Spain. They discuss the role of inflammation in atherosclerosis, how to detect it using imaging and biomarkers, and promising drugs in the pipeline to reduce inflammation levels. If you enjoy the show, please leave us a positive review wherever you get your podcasts. It helps us to reach more people - thanks! Link to published paper: https://heart.bmj.com/content/early/2025/03/25/heartjnl-2024-325408

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With Frank Flachskampf, Uppsala University, Uppsala - Sweden, and James Thomas, Northwestern University, Chicago - USA.  Link to editorial  Link to paper  

“We started Cleerly with the intent to make a comprehensive care pathway for evaluation, education, treatment and tracking for heart disease,” said Dr. Jim Min, the company’s founder and CEO. In this Vanguards of Health Care episode, Min sits down with BI analyst Matt Henriksson to discuss Cleerly and its comprehensive management platform that uses AI algorithms to boost the accuracy of interpreting CT scans, avoid false positives and make the diagnosis stage of treating the disease more efficient for doctors and hospitals. They also cover the need to drive the iterative process of clinical studies, including the TRANSFORM randomized trial for screening asymptomatic individuals with the aim of preventing sudden cardiac death.See omnystudio.com/listener for privacy information.

In this episode, Dr. Valentin Fuster discusses a study showing that elevated cardiac troponin levels after intense exercise in middle-aged recreational athletes are common but not linked to hidden coronary artery disease. The findings raise important questions about the origin and significance of these elevations, highlighting the need for long-term follow-up.

This episode covers:  Cardiology this Week: A concise summary of recent studies Coronary sinus reducer: promise in refractory angina Best strategies to reach LDL cholesterol goals in high-risk patients Snapshots Host: Susanna Price Guests: Carlos Aguiar, Rasha Al-Lamee, J. Wouter Jukema, Steffen Petersen Want to watch that episode? Go to: https://esc365.escardio.org/event/1807 Want to watch that extended interview on LDL management? Go to: https://esc365.escardio.org/event/1807?resource=interview Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Rasha Al-Lamee has declared to have potential conflicts of interest to report: speaker's fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. J. Wouter Jukema has declared to have potential conflicts of interest to report: J. Wouter Jukema/his department has received research grants from and/or was speaker (CME accredited) meetings sponsored/supported by Abbott, Amarin, Amgen, Athera, Biotronik, Boston Scientific, Dalcor, Daiichi Sankyo, Edwards Lifesciences, GE Healthcare Johnson and Johnson, Lilly, Medtronic, Merck-Schering-Plough, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, Shockwave Medical, the Netherlands Heart Foundation, CardioVascular Research the Netherlands (CVON), the Netherlands Heart Institute and the European Community Framework KP7 Programme. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

On this episode, we discuss chronic coronary syndrome (CCS) and describe its clinical presentation, underlying pathophysiology, and progression. We review current guidelines and evidence-based treatment strategies for managing CCS, including both pharmacological and non-pharmacological interventions. Our primary pharmacotherapy focus was on comparing and contrasting antianginal therapies, but we also touch on antiplatelet agents, and risk factor modification strategies. Cole and I are happy to share that our listeners can claim ACPE-accredited continuing education for listening to this podcast episode! We have continued to partner with freeCE.com to provide listeners with the opportunity to claim 1-hour of continuing education credit for select episodes. For existing Unlimited (Gold) freeCE members, this CE option is included in your membership benefits at no additional cost! A password, which will be given at some point during this episode, is required to access the post-activity test. To earn credit for this episode, visit the following link below to go to freeCE's website: https://www.freece.com/ If you're not currently a freeCE member, we definitely suggest you explore all the benefits of their Unlimited Membership on their website and earn CE for listening to this podcast. Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. If you purchase an annual membership, you'll also get a free digital copy of High-Powered Medicine 3rd edition by Dr. Alex Poppen, PharmD. HPM is a book/website database of summaries for over 150 landmark clinical trials.You can visit our Patreon page at the website below:  www.patreon.com/corconsultrx We want to give a big thanks to Dr. Alex Poppen, PharmD and High-Powered Medicine for sponsoring the podcast..  You can get a copy of HPM at the links below:  Purchase a subscription or PDF copy - https://highpoweredmedicine.com/ Purchase the paperback and hardcover - Barnes and Noble website We want to say thank you to our sponsor, Pyrls. Try out their drug information app today. Visit the website below for a free trial: www.pyrls.com/corconsultrx We also want to thank our sponsor Freed AI. Freed is an AI scribe that listens, prepares your SOAP notes, and writes patient instructions. Charting is done before your patient walks out of the room. You can try 10 notes for free and after that it only costs $99/month. Visit the website below for more information: https://www.getfreed.ai/  If you have any questions for Cole or me, reach out to us via e-mail: Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com

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...

Most people think heart disease happens suddenly—but it builds quietly over decades. In this episode, Ted reveals the simple, noninvasive test that helped him assess his heart disease risk and could potentially save your life. If you're over 40, this test might be the most important one you've never heard of. Listen now! 

In this episode, we review the new 2025 ACC/AHA Acute Coronary Syndrome (ACS) guidelines, with a particular focus on guideline recommendations for analgesics, P2Y12 inhibitors, parenteral anticoagulation, and lipid management. Key Concepts Nitrates and opioids are recommended for symptomatic relief of chest pain. Some patients may not be appropriate for nitrates (e.g. recent PDE-5 inhibitor use, hypotension, or right ventricular infarction). Opioids are used for nitrate-refractory angina but have a theoretical risk of delaying the effect of oral antiplatelet medications. Prasugrel and ticagrelor are preferred P2Y12 inhibitors over clopidogrel in most patients. Patient-specific factors, including the use of PCI, play a role in P2Y12 inhibitor selection. Anticoagulation with heparin is recommended in nearly all acute coronary syndrome (ACS) scenarios. Alternative anticoagulants may be used depending on whether PCI/CABG is planned and whether the anticoagulant is used prior to PCI/CABG (“upstream”) or during the PCI procedure itself. LDL goals after ACS have changed again. All ACS patients should have an LDL goal < 70 with a consideration of an LDL goal of 55-69. A variety of non-statin therapies may be added to a high intensity statin regimen if LDL is not at goal. References Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online February 27, 2025. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309