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6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
CardioNerds (Dr. Apoorva Gangavelli, Dr. Rebecca Garber, and Dr. Tina Reddy), discuss pre-pregnancy risk stratification and counseling with Dr. Katy Young across a range of risks. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern, Dr. Patrick Pekyi-Boateng. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes: Why is pregnancy considered a “physiologic stress test,” and why does risk extend beyond delivery? Blood volume, heart rate, and cardiac output rise while systemic vascular resistance falls, peaking in the late second/early third trimester; underlying (even undiagnosed) heart disease can be unmasked or worsened. Postpartum (“fourth trimester”) is a high-risk period, not a safe zone – fluid shifts, rising SVR, and bleeding risk can precipitate decompensation in patients with heart failure, pulmonary hypertension, valvular disease, or aortopathy. Adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, peripartum cardiomyopathy) are markers of future cardiovascular risk and warrant long-term preventive follow-up. What is the practical framework for approaching pre-pregnancy cardiovascular risk? Four broad categories: (1) patients who may need cardiac screening before pregnancy, (2) patients needing risk-factor/medication optimization, (3) known cardiovascular disease where pregnancy is reasonable with structured risk stratification, and (4) high-risk disease where pregnancy may need to be delayed, modified by intervention, or discouraged. Testing should be targeted, not blanket – reserved for symptoms, abnormal exam, concerning family history, or reduced functional capacity. How is risk stratified in patients with known cardiovascular disease? Use a combination of tools per 2025 ESC guidelines: mWHO 2.0 (broad maternal risk category), CARPREG II (additional predictors of maternal cardiac events), and ZAHARA (useful in congenital heart disease). Key lesion-specific factors: aortic size/growth, valve severity, ventricular function, symptoms, blood pressure, and family history of dissection. Translate risk into practical terms for patients rather than leading with a numerical score. Which cardiovascular medications require review before conception? ACE inhibitors, ARBs, and ARNIs should be transitioned off before pregnancy; statins, MRAs, and SGLT2 inhibitors also need review. DOACs are contraindicated in pregnancy and lactation; mechanical valve anticoagulation requires individualized shared decision-making, as no strategy is risk-free for mother and fetus. Medication changes are best made proactively, before conception, rather than reactively. This is not an exhaustive list! The medication list needs to be reviewed carefully. Which conditions carry high or prohibitive risk in pregnancy? Pulmonary arterial hypertension, Eisenmenger syndrome, severe ventricular dysfunction, prior peripartum cardiomyopathy with residual LV dysfunction, severe left-sided obstructive valve disease (e.g., severe mitral stenosis), mechanical valves, significant aortopathy, cyanotic congenital heart disease, and Fontan physiology. Common theme: limited cardiovascular reserve and high risk of decompensation, thrombosis, arrhythmia, heart failure, aortic dissection, or death. These patients need expert multidisciplinary evaluation before pregnancy. Severe mitral stenosis is poorly tolerated because tachycardia shortens diastolic filling time and raises left atrial pressure, risking pulmonary edema and decompensation. When should genetic testing or counseling be offered? Consider when a diagnosis may be inherited or affect the patient, pregnancy, or family members: inherited cardiomyopathies, aortopathies, channelopathies, select congenital heart disease, and some pulmonary hypertension syndromes. Recurrence risk of congenital heart disease in offspring is roughly 6-10% when the mother has CHD; fetal echocardiography should be offered. How should contraception be approached in high-risk cardiac patients? Frame contraception as part of the cardiac care and reproductive safety plan to prevent unplanned high-risk pregnancy. Long-acting reversible contraception is often preferred; progestin-only methods are generally safer than estrogen-containing options with thrombosis risk, pulmonary hypertension, or mechanical valves. What are key delivery-planning considerations for cardiac patients? Vaginal delivery is preferred unless there is an obstetric indication for cesarean or a specific cardiac reason (e.g., unstable maternal status, therapeutic INR) to avoid labor. Planning should address delivery location, anesthesia involvement, telemetry needs, fluid management, and postpartum monitoring, clearly communicated across the multidisciplinary team in advance. How should clinicians counsel patients when pregnancy is discouraged but strongly desired? Acknowledge the patient’s goals and the emotional weight of the conversation; separate the goal (family building) from the timeline (safety now vs. after optimization). If pregnancy remains prohibitively risky, discuss alternatives for family building and ensure adequate patient support. What are the key gaps and future directions in cardio-obstetric risk stratification? Current risk tools (mWHO, CARPREG II, ZAHARA) provide common language but do not fully capture functional status, prior pregnancy history, or how risk evolves over time. Future direction: individualized, dynamic risk prediction incorporating imaging, biomarkers, exercise capacity, and social drivers of health, with better long-term links between pregnancy complications and cardiovascular prevention. References 1. European Society of Cardiology. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. 2. Mehta LS, et al. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association. Circulation. 2020;141:e884-e903. PMID: 32362133. doi:https://doi.org/10.1161/CIR.0000000000000772 3. ACOG Practice Bulletin No. 212. Pregnancy and Heart Disease. Obstet Gynecol. 2019;133(5):e320-e356. PMID: 31022123. doi:https://doi.org/10.1097/AOG.0000000000003243
In this episode, we review the high-yield topic of Eisenmenger Syndrome from the Cardiovascular section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
Illinois quarterback commit Dane Eisenmenger meets the media for the first time and discusses why he chose the Illini, his fit in Barry Lunney Jr.'s offense, and what he hopes to bring to the future of Illinois football. Plus, Jordan Sigler from Chi City Sports joins the show to break down the next steps in the Bears' proposed move to Indiana, the political and NFL hurdles that remain, impressions from Bears minicamp, the growing buzz around Caleb Williams, and his recent "war of words" with Micah Parsons. We also hit the latest Illini and Bears headlines and react to a busy day across the sports landscape. Follow The Drive on Twitter, Instagram, and Facebook!
Tristan Thomas joins the show to discuss St. Joseph-Ogden's run in IHSA baseball, the impact of quarterback commit Dane Eisenmenger on the future of Illinois football, and settles the score on whether he or Evan Stone would come out on top in the upcoming charity basketball showdown. Plus, we preview a weekend interleague matchup between the St. Louis Cardinals and Minnesota Twins, as well as the Chicago Cubs taking on the San Francisco Giants. We wrap up the week with another edition of Friday Toasts, celebrating the people, teams, and moments that deserve a raise of the glass.
Kyle Tausk of Illini Inquirer breaks down why the addition of Lincoln Williams was perfect timing for Brad Underwood and Illinois Basketball after the late recruiting cycle. Williams finished his high school career with 1,853 points and gives the Illini another talented in-state guard with scoring ability and defensive upside. Plus, Kyle reviews the impressive start by Illinois signee Quentin Coleman with Team USA at the FIBA U18 AmeriCup, where the freshman forward opened tournament play with an 11-point, 15-rebound double-double and showcased the athleticism that has Illini fans excited. Also, the guys discuss Tolono Unity quarterback Dane Eisenmenger committing to Illinois Football and what the local standout brings to Bret Bielema's quarterback room moving forward.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
This week on The Beat, CTSNet Editor-in-Chief Joel Dunning spoke with Dr. Randas Batista, cardiac surgeon and founder of Vilela Batista Heart Foundation, about the surgical treatment of Eisenmenger syndrome. Chapters 00:00 Intro 02:51 JANS 1, DAMSUN-HF Study 05:41 JANS 2, TAVR vs SAVR Guidelines 07:45 JANS 3, Myocardial Infarction After CABG 10:31 JANS 4, VAD Bridge-to-Transplant 12:27 New Recruitment Guide 13:54 Video 1, Anomalous Right Coronary Artery 15:27 Video 2, Beating Heart Transplant OCS 17:51 Video 3, Aortic Dissection Podcast w Marc Moon 19:26 Randas Batista Interview 37:38 Upcoming Events They explored what Eisenmenger syndrome is and outlined the most common causes of the condition. They also delved into the history of this syndrome, highlighting the significant contributions of Viktor Eisenmenger and Paul H. Wood. Furthermore, they discussed the impact of this syndrome on lung function and extracting oxygen within the pulmonary artery. Dr. Batista shared valuable technical tips for performing the surgical procedure as well as solutions for managing this syndrome. Joel also highlights recent JANS articles on the DAMSUN-HF study on AI-enabled digital auscultation for detecting heart failure with reduced ejection fraction in Sub-Saharan Africa, transcatheter or surgical aortic-valve replacement in low-risk patients at seven years, current clinical practices and future perspectives on periprocedural myocardial infarction after coronary artery bypass grafting, and an analysis of UNOS. In addition, Joel explores anomalous right coronary artery, beating heart transplantation using the Organ Care "Heart-in-a-Box" System (OCS), and an episode of The Atrium podcast featuring host Dr. Alice Copperwheat speaking with Dr. Marc Moon about aortic dissection. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 1.) AI-Enabled Digital Auscultation for Detecting Heart Failure With Reduced Ejection Fraction in Sub-Saharan Africa: The DAMSUN-HF Study 2.) Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years 3.) Periprocedural Myocardial Infarction After Coronary Artery Bypass Grafting: Current Clinical Practices and Future Perspectives 4.) Analysis of UNOS: Ventricular Assist Device as Bridge-to-Transplant in Paediatric Patients With Congenital Heart Disease CTSNet Content Mentioned 1.) Anomalous Right Coronary Artery 2.) Beating Heart Transplantation Using the Organ Care "Heart-in-a-Box" System (OCS) 3.) The Atrium: Aortic Dissection Other Items Mentioned 1.) The Cardiac Recovery Room 2.) Resident Video Competition 3.) 2025 CTSNet Recruitment Guide 4.) Career Center 5.) 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.
Joel and Steve are delighted to welcome musician/songwriter Cole Eisenmenger from Omaha, NE on the pod! They talk about his band Wyrmwood and their upcoming album release, music, music therapy, bobble heads, discovering new music and more! Wyrmwood is having an album release party at Slowdown in Omaha on Friday, November 21st - it's going to be a great night of music! TTBB friend and past guest Darren 'Problems' Keen is kicking things off, Wyrmwood will play their new album then Funk Trek finish the night with a funky dance party - don't miss it! https://www.facebook.com/wyrmwoodmusic/ **Due to technical difficulties, there are some audio anomalies in this episode. The person responsible for this has been sacked. Sincere TTBB apologies to Cole, who sounds great!** Be sure to Like, Follow, Subscribe to and Review Joel and Steve wherever you listen to them! Limited Time Offer - if you email Joel and Steve at ttbbpodcast@gmail.com or DM on Bluesky you will be entered into a quarterly drawing for a now Limited Edition TTBBPodcast sticker! Winners will be notified by response email, please allow 6-8 weeks for delivery. Joel and Steve also now have a Discord server - TTBBPodcast. There's... not a lot happening on it, but there Could be... #TootYourHooter #What'sInAName https://www.youtube.com/@TTBBPodcast https://www.instagram.com/tryingtobebetterpodcast/ https://bsky.app/profile/ttbbpodcast.bsky.social
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
Do you have to come close to death to invent a groundbreaking medical device? That's certainly not something we would wish upon every medtech entrepreneur. But it is the story of Shavini Fernando and the connected earring OxiWear that she developed. Shavini lives with Eisenmenger syndrome, a condition where the two ventricles of her heart communicate. This condition dramatically increases the pressure in her pulmonary vasculature and severely limits the oxygen carried in her blood. It's a critical situation that has already caused her four cardiac arrests and three strokes, all of which she has survived. Constantly reliant on supplemental oxygen to live, she dreamed of a way to measure her oxygen levels in real time while staying active. This would allow her to anticipate sudden variations in the future and the life-threatening risks they bring. And she made that dream come true by creating the first connected earring, FDA-certified, capable of measuring blood oxygen saturation in real time. All in a discreet format, lighter than an AirPod, and designed for use during everyday activities, including sports. In many ways, this innovation has transformed her own life, as well as those of hundreds of patients who have benefited from it so far. In this episode, we revisit her story as a patient and survivor. Shavini opens up about the immense challenges of living with Eisenmenger syndrome and developing OxiWear, sharing her vision for this technology and the potential it holds for the future of cardiorespiratory monitoring. A touching and sincere conversation with a truly exceptional figure in the healthtech ecosystem! Timeline: 00:00:00 - Shavini's story as a pulmonary hypertension patient surviving four cardiac arrests and three strokes 00:19:13 - Building the first smart earring to continuously measure oxygen levels while staying active 00:25:20 - The design behind OxiWear and the challenges to bring it to life 00:31:24 - The blessing of COVID to access funding and educate the general public about cardiorespiratory health 00:36:57 - Making OxiWear the ultimate cardiorespiratory device for remote patient monitoring 00:39:47 - The business model behind OxiWear from a medical and consumer perspective 00:43:10 - Overcoming the torture of creating a medical device from scratch What we also talked about with Shavini: MedTech World Georgetown University Johns Hopkins University Leonsis Family Entrepreneurship Prize “Bark Tank” created by Ted Leonsis MassMEDIC Renal cholesteatoma Sickle cell anemia Photoplethysmography As we mentioned during the episode, you can watch here the recording of the panel I hosted alongside Shavini at MedTech World in 2024. As Shavini shared in the episode, you can learn more about OxiWear at Oxiwear.com and [Oxiwear.fitness](http://Oxiwear.fitnesshttps://www.oxiwear.fitness/). Although we did not explicitly talk about it, I also recommend you watch Shavini's TEDx Talk recorded in 2019. You can follow OxiWear's activities on LinkedIn, Facebook, X, TikTok, and get in touch with Shavini via LinkedIn too! ✉️ If you want to give me feedback on the episode or suggest potential guests, contact me over LinkedIn or via email! ⭐️ And if you liked the episode, please share it, subscribe to the podcast, and leave a 5-star review on streaming platforms!
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
Timely consodering Darryl Cooper's series - Pete6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
This episode covers questions on Eisenmenger syndrome.Written notes can be found at https://zerotofinals.com/paediatrics/cardiology/eisenmengersyndrome/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.
This episode covers Eisenmenger syndrome.Written notes can be found at https://zerotofinals.com/paediatrics/cardiology/eisenmengersyndrome/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.
6 Hours and 57 MinutesPG-13This is the complete audio of Pete reading and commenting on Anna Eisenmenger's "Blockade."Pete and Thomas777 'At the Movies'Support Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
27 MinutesPG-13Pete concludes his reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
31 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
36 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
36 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
32 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
54 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
46 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
56 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
55 MinutesPG-13Pete continues a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
43 MinutesPG-13Pete begins a reading and lite commentary on "Blockade: The Diary of an Austrian Middle-Class Woman 1914-1924."FoxnSons Coffee - Promo code "peter" for 18% off - https://www.foxnsons.com/VIP Summit 3-Truth To Freedom - Autonomy w/ Richard GroveSupport Pete on His WebsitePete's PatreonPete's Substack Pete's SubscribestarPete's GUMROADPete's VenmoPete's Buy Me a CoffeePete on FacebookPete on TwitterBecome a supporter of this podcast: https://www.spreaker.com/podcast/the-pete-quinones-show--6071361/support.
Today Dan and Ellen talk to Anne Eisenmenger, who is president of Beaver Dam Partners and publisher of several weekly newspapers in southeast Massachusetts, including Wareham Week and Sippican Week. Anne has a laser focus on developing and operating hyperlocal for-profit newspapers. Anne lives in Wareham, and she founded her community news company there in 2010 with the launch of Wareham Week. And, yes, it's an actual print newspaper, with a for-profit business model, and it's packed with ads. Dan dives into one of the best newspaper stories in the country, which is right here in our backyard, or at least in the western sector of our backyard. It involves the Berkshire Eagle, a daily based in Pittsfield, Massachusetts, that was once regarded as one of the best small papers in the country. Then it fell into the hands of Alden Global Capital, so we all know what happened next. This story, though, has a happy ending, at least so far, and I'll talk about it in our Quick Takes. Ellen talked recently with Paul Hammel, a reporter doing a story on the loss of small-town newspapers across Nebraska. He focused on a couple who sold their paper, in a town of 1,000, but had to come back after retirement when the new owner quit in the middle of the night.
CardioNerds (Dr. Josh Saef and Dr. Sumeet Vaikunth) join Dr. Sheng Fu, Dr. Payton Kendsersky, and Dr. Aniqa Shahrier from the Medical University of South Carolina for some off-shore fishing. They discuss the following featuring a patient with D-TGA and Eisenmenger's syndrome treated with a Heartmate 3. Expert commentary was provided by Dr. Brian Houston. The episode audio was edited by student Dr. Adriana Mares. A 39-year-old woman with a history of D-transposition of the great arteries (D-TGA) with prior atrial switch repair (Mustard) was admitted from the clinic with cardiogenic shock. She underwent right heart catheterization which demonstrated elevated biventricular filling pressures and low cardiac index. An intra-aortic balloon pump was placed, and the patient was evaluated for advanced therapies. A liver biopsy showed grade 3 fibrosis, which, in combination with her shock state, made her a high-risk candidate for isolated heart or combined heart-liver transplantation. After a multi-disciplinary discussion, the patient underwent a Heartmate III left ventricular assist device (LVAD) implant in her systemic right ventricle. Although she did well post-operatively, she was admitted after a month with recurrent cardiogenic shock, with imaging showing her inflow cannula had become perpendicular to the septum. The patient and family eventually decided to pursue comfort measures, and the patient passed. 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 - D-TGA and Eisenmenger's syndrome treated with a Heartmate 3 Pearls - D-TGA and Eisenmenger's syndrome treated with a Heartmate 3 Early diagnosis of cyanotic congenital heart disease is paramount for treatment and prevention of future complications. Adult congenital heart disease requires a multi-disciplinary team for management in consultation with an adult congenital cardiology specialist. Eisenmenger syndrome is related to multiple systemic complications and has a high rate of mortality. Advancement in PAH medical management can offer noninvasive treatment options for some patients. Transthoracic echocardiography is the cornerstone for diagnosis. Other modalities (e.g. cardiac CT, cardiac MRI, invasive catheterization) can aid in diagnosis and management. Pearls - D-TGA and Eisenmenger's syndrome treated with a Heartmate 3 While advances in pediatric surgery have allowed many patients born with congenital heart disease to survive into adulthood, adult congenital heart disease (ACHD) patients are complex and prone to numerous adverse sequalae including arrhythmias, heart failure, valvular disease, and non-cardiac organ dysfunction. Heart failure can be a challenging presentation in ACHD patients due to a longstanding history of clinical compensation. Their unique and complex anatomy, as well as highly variable clinical presentation, present unique challenges when it comes to advanced heart failure options such as durable left ventricular assist devices (LVAD) or transplantation. While durable LVAD implantation is possible in patients with systemic right ventricles, anatomic compatibility is paramount and poses ongoing challenges in their management. Goals of care discussions should be had early, as options for treatment may be limited. Show Notes - D-TGA and Eisenmenger's syndrome treated with a Heartmate 3 What are some common sequelae in ACHD patients? ACHD patients are a heterogeneous population, but atrial tachycardias are extremely frequent in this patient population, often due to re-entrant pathways around surgical suture lines. These can often be treated with radiofrequency ablation while paying clos...
CardioNerds (Dr. Josh Saef, Dr. Agnes Koczo) join Dr. Iva Minga, Dr. Kifah Hussain, and Dr. Kevin Lee from the University of Chicago - NorthShore to discuss a case of unrepaired congenital heart disease that involves D-TGA complicated by Eisenmenger syndrome. The ECPR was provided by Dr. Michael Earing. Audio editing by Dr. Akiva Rosenzveig. A 25-year-old woman with an unknown congenital heart disease that was diagnosed in infancy in Pakistan presents to the hospital for abdominal pain and weakness. She is found to be profoundly hypoxemic, and an echocardiogram revealed D-transposition of the great arteries (D-TGA) with a large VSD. As this was not repaired in childhood, she has unfortunately developed Eisenmenger syndrome with elevated pulmonary vascular resistance. She is stabilized and treated medically for her cyanotic heart disease. Unfortunately given the severity and late presentation of her disease, she has limited long-term options for care. CardioNerds discuss the diagnosis of D-TGA and Eisenmenger's syndrome, as well as long-term management and complications associated with this entity. 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 - Unrepaired Congenital Heart Disease Pearls - Unrepaired Congenital Heart Disease Early diagnosis of cyanotic congenital heart disease is paramount for treatment and prevention of future complications. Adult congenital heart disease requires a multi-disciplinary team for management in consultation with an adult congenital cardiology specialist. Eisenmenger syndrome is related to multiple systemic complications and has a high rate of mortality. Advancement in PAH medical management can offer noninvasive treatment options for some patients. Transthoracic echocardiography is the cornerstone for diagnosis. Other modalities (e.g. cardiac CT, cardiac MRI, invasive catheterization) can aid in diagnosis and management. Show Notes - Unrepaired Congenital Heart Disease Cyanotic congenital heart disease is often diagnosed in infancy and timely treatment is paramount. As these diseases progress over time, pulmonary over-circulation often pulmonary hypertension (PH), elevated pulmonary vascular resistance, and Eisenmenger syndrome will develop, which preclude definitive treatment. For D-TGA, before PH develops, there are surgical options such as the arterial switch procedure that can treat the disease. Unfortunately, once Eisenmenger syndrome develops, there are multiple systemic complications including hyperviscosity, thrombosis, bleeding, kidney disease, iron deficiency, arrhythmias, etc. that can occur. Management requires a multi-disciplinary team including an adult congenital cardiology specialist, but mortality rates remain high, with median survival reduced by 20 years, worse with complex cardiac defects. Bosentan is a first line treatment for patients with Eisenmenger syndrome, with PDE-5 inhibitors as a second line either by themselves or in combination with bosentan. Data are currently limited for latest-generation PH treatments in Eisenmenger syndrome and further study is still underway. References Ferencz C. Transposition of the great vessels. Pathophysiologic considerations based upon a study of the lungs. Circulation. 1966 Feb;33(2):232-41. Arvanitaki A, Gatzoulis MA, Opotowsky AR, Khairy P, Dimopoulos K, Diller GP, Giannakoulas G, Brida M, Griselli M, Grünig E, Montanaro C, Alexander PD, Ameduri R, Mulder BJM, D'Alto M. Eisenmenger Syndrome: JACC State-of-the-Art Review. J Am Coll Cardiol. 2022 Mar 29;79(12):1183-1198. Earing MG, Webb GD. Congenital heart disease and pregnancy: maternal and fetal risks. Clin Perinatol.
Eisenmenger syndrome is an end-stage complication of congenital heart disease that occurs when a left to right shunt causes pulmonary over-circulation, leading to vascular remodeling, increased vascular resistance, and ultimately even shunt reversal. Aside from cardiac complications, this pathology has unique complications secondary to chronic cyanosis. In this episode of CardioNerds co-founder Dr. Amit Goyal, ACHD series co-chair Dr. Josh Saef, and Dr. Khaled Tuwairqi (ACHD cardiologist at King Faisal / Elite Hospitals) join Dr. Alexander (Sasha) Optowsky (Director of the Adult Congenital Heart Disease Program at Cincinnati Childrens) to discuss diagnosis and management of Eisenmenger syndrome. Show notes were drafted by Dr. Anna Scandinaro and episode audio was edited by CardioNerds Academy Intern Dr. Akiva Rosenzveig. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Eisenmenger Syndrome First described in 1897 by Victor Eisenmenger, Eisenmenger syndrome is a long-term complication of unrepaired left to right shunts, resulting from pulmonary vascular remodeling and pulmonary hypertension. This eventually leads to reversal of the shunt, with right to left flow causing cyanosis. Evaluation for Eisenmenger syndrome should include a comprehensive history, physical exam, ECG, echocardiogram, cardiac catheterization, and laboratory work to identify multi-system complications of cyanosis and secondary erythrocytosis. The most definitive means to diagnose Eisenmenger syndrome in a patient with a prior left-to-right shunt lesion is with a right heart cardiac catheterization showing right to left shunting (Qp:Qs < 1). Eisenmenger syndrome is a multi-organ disease and many manifestations occur due to secondary erythrocytosis. Prevention and treatment of these complications are the major goals of care in this population. Complications of Eisenmenger syndrome include gout, bilirubin gallstones, stroke, paraganglioma/pheochromocytoma, thrombophilia, retinal changes, hypertrophic osteoarthropathy, and kyphoscoliosis. Emergency non-cardiac complications of Eisenmenger syndrome include cerebral abscess and hemoptysis. Pregnancy is contraindicated in Eisenmenger syndrome due to high maternal and fetal mortality. Notes- Eisenmenger Syndrome 1. How does Eisenmenger syndrome develop? Does everyone with a left-to-right shunt develop it? Can it develop as an iatrogenic complication? The pulmonary vasculature is not used to seeing the increased flow it receives in the context of a left to right shunt. Over time this leads to an increase in pulmonary vascular resistance and pulmonary hypertension. When pulmonary pressures exceed systemic pressures, this causes shunt reversal with right to left shunting causing deoxygenated blood to cross from right side of the heart to the left side bypassing the lungs and causing cyanosis. The process of developing Eisenmenger syndrome is chronically progressive and so adaptive changes have time to occur. Not all persons with unrepaired shunts will develop Eisenmenger syndrome ...
In this episode, we review the high-yield topic of Eisenmenger Syndrome from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Eisenmenger Syndrome from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://podcasters.spotify.com/pod/show/medbulletsstep1/message
Learn about the bonkers life of Johannes Eisenmenger, a man who spent 19 years under false pretenses within the Jewish community. Over those 19 years, he meticulously studied the Talmud, and eventually wrote a wild 2000-page text about the evils of the Talmud. In this episode, Yael and Schwab explore the personal motives, societal implications, and long-lasting effects of his actions. Join us as we dissect this tale of deception and bigotry in the light of history, faith, and human behavior. This episode was hosted by Jonathan Schwab and Yael Steiner. Our education lead is Dr. Henry Abramson. Audio was edited by Rob Pera, and we're produced by Rivky Stern. For more on Johannes Eisenmenger, and this episode: https://docs.google.com/document/d/1KeADzNKcvU0A5UjvwAwnA0SONmunnrGxFCjaD8Kpr3o/edit?usp=sharing Tell us what you think about the podcast here: https://jewishunpacked.com/nerdsurvey
Belen Blanton was born with tricuspid atresia in Caracas, Venezuela back in 1965. When she was born, many doctors told her mom that she was not going to make it. Fortunately, her mother took her to a cardiologist that had contact with Houston Children's hospital in Texas, where she had surgery, a Potts Shunt procedure performed by Dr. Denton Cooley. From age 15 she began to experience complications including arrhythmia. When she was 21 she moved to the US and from age 30 experienced atrial fibrillation, endocarditis, Eisenmenger Syndrome, and pulmonary hypertension. She is married with two sons and has recently started a charity to help those living in her home country of Venezuela. She believes her life has been a gift and she has felt a need to give back to others in her country by creating a nonprofit organization called ‘Estrellita de Belen Foundation.'Belen's foundation can be found at https://fundacionestrellitadebelen.orgOr email her at belenblanton@fundacionestrellitadebelen.orghttps://www.linkedin.com/in/belenblantonaltuve/https://www.instagram.com/estrellitadbelen/Website: The Heart Chamber (theheartchamberpodcast.com)Transcript: Joyful Beat | The Heart Chamber (theheartchamberpodcast.com)The Heart Chamber (@theheartchamberpodcast)Thanks to Michael Moeri for being my right hand man. Michael Moeri - Audio Editor, Podcast Producer and Marketing Director
Imagine a patient with a SPO2 in the 80's, not in distress, and acting normal. Their echocardiogram shows an atrial septal defect and a pulmonary artery pressure of 95!!! What can we do for this patient? What could cause such a high PA pressure?Today's guest Nick McGowan MSN, RN, CCRN, had this experience and is sharing his patient's story with Sarah. Nick revisits how this case evolved, from getting test results to discovering his shockingly high PA pressure and transferring the patient to the ICU.Many nurses haven't heard of this condition before, but you'll understand the pathophysiology of Eisenmenger syndrome and its prognosis by the end of this episode. We also go over the importance of establishing goals of care with patients, and the role of nurses in the ICU.Nick is also a nursing educator, so tune in to learn his helpful tips on treating elevated PA pressures!Topics discussed in this episode:Nick finding his passion in intensive care nursingHow he became a Nursing EducatorInitial assessment of his Eisenmenger syndrome patientThe pathophysiology of Eisenmenger syndromeTreatment optionsWhat to remember when treating elevated PA pressuresLearn more from Nick here:Website: https://www.ccrnacademy.comLinkedIn: https://www.linkedin.com/in/ccrnacademy/Instagram: https://www.instagram.com/critical_care_academy/Youtube: https://www.youtube.com/@criticalcareacademy8312Facebook: https://www.facebook.com/CCRNacademy/Use the code "RAPID10" to get 10% off his e-learning course just for being a podcast listener! https://www.ccrnacademy.comANDIf you would like to check out Sarah's 1hr, 1 CE course, go to: http://www.rapidresponseandrescue.comTo get the FREE Rapid Response RN Assessment Guide and the coupon code for $10 off the cost of the course, message Sarah on Instagram @TheRapidResponseRN and type the word PODCAST!This episode was produced by Podcast Boutique http://www.podcastboutique.com
Join CardioNerds to learn about patent ducts arteriosus and Eisenmenger syndrome! Dr. Dan Ambinder (CardioNerds co-founder), ACHD series co-chair Dr. Dan Clark, Dr. Tony Pastor (ACHD fellow, Harvard Medical School), and Dr. Kate Wilcox, Medicine/Pediatrics Resident, Medical College of Wisconsin join Dr. Candice Silversides (Editor-in-chief #JACCAdvances) for this terrific discussion. Notes were drafted by Dr. Kate Wilcox. .Audio editing by CardioNerds Academy Intern, Dr. Maryam Barkhordarian. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Patent Ductus Arteriosus & Eisenmenger Syndrome The ductus arteriosus, which is formed from the distal portion of the left sixth arch, is key to fetal circulation because it allows blood to bypass the high resistance pulmonary circuit present in utero. After birth there is a significant drop in pulmonary vascular resistance (PVR) which generally leads to functional ductal closure within 48 hours (permanent seal takes 2-3 weeks to form). Risk factors for having a PDA include birth before 37 weeks of gestation, trisomy 21, and congenital rubella. A PDA results in a left to right shunt (qP:qS >1) which over time overloads the left side of the heart and causes pulmonary vascular remodeling. The extra workload on the left side of the heart causes left atrial (can cause atrial arrhythmias) and left ventricular dilation. If left untreated you can eventually have shunt reversal due to very high PVR (Eisenmenger physiology). There are some treatment options at this point (pulmonary vasodilators, etc) but it's definitely better to close the PDA before this point. One interesting physical exam finding that can stem from shunt reversal in a hemodynamically significant PDA is differential cyanosis (upper body or pre-ductal saturations will be higher than lower body/post-ductal saturations). You can also see clubbing in the toes but not the hands for the same reason. Meet Our Collaborators! Adult Congenital Heart AssociationFounded in 1998, the Adult Congenital Heart Association is an organization begun by and dedicated to supporting individuals and families living with congenital heart disease and advancing the care and treatment available to our community. Our mission is to empower the congenital heart disease community by advancing access to resources and specialized care that improve patient-centered outcomes. Visit their website (https://www.achaheart.org/) for information on their patient advocacy efforts, educational material, and membership for patients and providers CHiP Network The CHiP network is a non-profit organization aiming to connect congenital heart professionals around the world. Visit their website (thechipnetwork.org) and become a member to access free high-quality educational material, upcoming news and events, and the fantastic monthly Journal Watch, keeping you up to date with congenital scientific releases. Visit their website (https://thechipnetwork.org/) for more information.
Congenital heart disease is the most common birth defect, affecting 1 in 100 babies. Amongst these ventricular septal defects are very common with the majority of patients living into adulthood. In this episode we will be reviewing key features of VSDs including embryologic origin, anatomy, physiology, hemodynamic consequences, clinical presentation and management of VSDs. Dr. Tommy Das (CardioNerds Academy Program Director and FIT at Cleveland Clinic), Dr. Agnes Koczo (CardioNerds ACHD Series Co-Chair and FIT at UPMC), and Dr. Anu Dodeja (Associate Director for ACHD at Connecticut Children's) discuss VSDs with expert faculty Dr. Keri Shafer. Dr. Shafer is an adult congenital heart disease specialist at Boston Children's Hospital, and an assistant professor of pediatrics within Harvard Medical School. She is a medical educator and was an invited speaker for the inaugural CardioNerds Sanjay V Desai Lecture, on the topic of growth mindset. Script and notes were developed by Dr. Anu Dodeja. Audio editing by CardioNerds Academy Intern, Shivani Reddy. The CardioNerds Adult Congenital Heart Disease (ACHD) series provides a comprehensive curriculum to dive deep into the labyrinthine world of congenital heart disease with the aim of empowering every CardioNerd to help improve the lives of people living with congenital heart disease. This series is multi-institutional collaborative project made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Josh Saef, Dr. Agnes Koczo, and Dr. Dan Clark. The CardioNerds Adult Congenital Heart Disease Series is developed in collaboration with the Adult Congenital Heart Association, The CHiP Network, and Heart University. See more Disclosures: None Pearls • Notes • References • Guest Profiles • Production Team CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - Ventricular Septal Defects Most common VSDs: Perimembranous VSD The shunt volume in a VSD is determined largely by the size of the defect and the pulmonary vascular resistance. VSDs cause left to right shunt. The long-term effects are left sided chamber dilation, as is the case with PDAs (post-tricuspid shunts) VSDs can be associated with acquired RVOTO, double chamber right ventricle, LVOTO/sub aortic membrane formation, and aortic regurgitation from aortic valve prolapse. Eisenmenger syndrome results from long-term left-to-right shunt, usually at higher shunt volumes. The resulting elevated pulmonary artery pressure is irreversible and leads to a reversal in the ventricular level shunt, desaturation, cyanosis, and secondary erythrocytosis. Endocarditis prophylaxis is not indicated for simple VSD. It is required for 6 months post VSD closure, in patients post VSD closure with a residual shunt and in Eisenmenger patients with R—>L shunt and cyanosis. Show notes - Ventricular Septal Defects Notes (developed by Dr. Anu Dodeja): What are types OF VSD? (Please note that there are several nomenclatures) Perimembranous VSDMost common type of VSD - 80% of VSDsOccurs in the membranous septum and can be associated with inlet or outlet extensionLocated near the tricuspid and aortic valves, often time can be closed off by tissue from the septal leaflet of the tricuspid valve and associated with abnormalities in the septal leaflet of the tricuspid valve secondary to damage from the left to right shuntCan be associated with acquired RVOTO, double chamber right ventricle, LVOTO/sub aortic membrane formation On TTE, the parasternal short axis view at the base demonstrates this type of VSD at the 10-12 o'clock position. Muscular VSDSecond most common VSD - 15-20% of VSDsCompletely surrounded by muscle,
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