Podcasts about Heart failure

As we close out American Heart Month on Full Circle, this episode centers on a story that is both heartbreaking and life-affirming.Marvale Young has always been a caregiver. A devoted mother, she fostered more than 30 children, opening her home and heart to young people who needed stability, love, and safety. She was the strong one — the one who carried others through their storms.But over time, life carried its own weight. After losing her husband and navigating years of emotional stress, Marvale began noticing subtle shifts in her health. Fatigue. Changes in her body. Signals that were easy to overlook when you are used to putting everyone else first.Then came the diagnosis: heart failure.In this intimate conversation, Marvale reflects on what it felt like to hear those words and whether prolonged stress and unresolved grief contributed to her declining health. Caregivers often ignore their own needs. Women, especially, push through discomfort. Marvale's story challenges us to reconsider that pattern.And then — in the midst of unimaginable grief, just days after losing her son — she received a call that would change everything. A donor heart was available.Her journey from heart failure to transplant is a powerful reminder of the lifesaving impact of advanced cardiac care, organ donation, and medical research. It is also a testament to resilience, faith, and the gift of second chances.Heart disease remains the leading cause of death in the United States. Symptoms are often subtle. Stress is not “just stress.” Fatigue is not always “just being tired.”This episode is about listening to your body before it whispers become emergencies.Call to Action:Make your heart health a priority. Schedule a physical. Monitor your blood pressure. Have honest conversations about stress, grief, and self-care. Learn how you can support heart health education and survivor advocacy through the American Heart Association. Share Marvale's story — it could inspire someone to seek care sooner.

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435-1443. doi:10.1056/NEJMoa012175  Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 2019;380(17):1618-1627. doi:10.1056/NEJMoa1900486  Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65(23):2542-2555. doi:10.1016/j.jacc.2015.04.039  Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328(12):1233-1242. doi:10.1001/jama.2022.16197  Rose EA, Moskowitz AJ, Packer M, et al. The REMATCH trial: rationale, design, and end points. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure. Ann Thorac Surg. 1999;67(3):723-730. doi:10.1016/s0003-4975(99)00042-9  Kittleson MM, Shah P, Lala A, et al. INTERMACS profiles and outcomes of ambulatory advanced heart failure patients: A report from the REVIVAL Registry. J Heart Lung Transplant. 2020;39(1):16-26. doi:10.1016/j.healun.2019.08.017  Mehra MR, Netuka I, Uriel N, et al. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA. 2023;330(22):2171-2181. doi:10.1001/jama.2023.23204  Mehra MR, Nayak A, Morris AA, et al. Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. 2022;10(12):948-959. doi:10.1016/j.jchf.2022.08.002  Bhardwaj A, Salas de Armas IA, Bergeron A, et al. Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella. ASAIO J. 2024;70(8):661-666. doi:10.1097/MAT.0000000000002170 

Die akute Herzinsuffizienz ist häufig die gemeinsame Endstrecke ganz unterschiedlicher Erkrankungen. Umso wichtiger ist es, die zugrunde liegenden Ursachen zu erkennen und die Zeichen einer kardialen Dekompensation richtig zu deuten.In dieser Folge von Rettungsdienst LUKS – der Notfallmedizin Podcast widmen wir uns der Pathophysiologie der akuten Herzinsuffizienz. Anhand des Akronyms CHAMPIT strukturieren wir die häufigsten Ursachen einer akuten Dekompensation und unterscheiden vier klinische Phänotypen – warm, kalt, feucht und trocken – als Grundlage für die initiale Therapiestrategie in der Präklinik.Rettungsdienst LUKS – Der Notfallmedizin Podcast mit dem Thema: Wenig vorwärts, viel rückwärts - Herzinsuffizienz systematisch erklärtIn dieser Folge: - Pathophysiologie der Herzinsuffizienz. Symptomatik des Vorwärts- und des Rückwärtsversagens- Ursachenforschung zur akuten Herzinsuffizenz mit dem Akronym CHAMPIT- Warm, kalt, feucht oder trocken? Anhand der vier Phänotypen die Herzinsuffizenz richtig TherapierenHomepage des Rettungsdienst LUKSLink zur letzten Folge zum Thema: Adieu „Grand mal“ – Neuroanatomie, Klinik und Semiologie epileptischer Anfälle  (und zu allen anderen Folgen)Alle Evidenzen zu dieser Folge findest du hier: Schmitt, D., & Güder, G. (2021). Die akute Herzinsuffizienz: Weit mehr als nur ein kardiales Problem. Notfallmedizin up2date, 16(03), 299–321. https://doi.org/10.1055/a-1341-6616Silvers, S. M., Gemme, S. R., Hickey, S., et al. (2022). Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Heart Failure Syndromes. Annals of Emergency Medicine, 80(4), e31–e59. https://doi.org/10.1016/j.annemergmed.2022.05.027Heidenreich, P. A., Bozkurt, B., Aguilar, D., et al. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Journal of the American College of Cardiology, 79(17), e263–e421. https://doi.org/10.1016/j.jacc.2021.12.012Theresa A McDonagh, Marco Metra, Marianna Adamo, Roy S Gardner et al., 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) With the special contribution of the Heart Failure Association (HFA) of the ESC, European Heart Journal, Volume 44, Issue 37, 1 October 2023, Pages 3627–3639, https://doi.org/10.1093/eurheartj/ehad195Tharmaratnam, G., Wunderl, M., Schebler, K., Jacko, T., Hossfeld, B., & Gässler, H. (2020). Die vier Schockformen – Teil 2: Kardiogener Schock. Der Notarzt, 36(01), 46–53. https://doi.org/10.1055/a-0991-5525Van Der Meer, P., Gaggin, H. K., & Dec, G. W. (2019). ACC/AHA Versus ESC Guidelines on Heart Failure. Journal of the American College of Cardiology, 73(21), 2756–2768. https://doi.org/10.1016/j.jacc.2019.03.478Bundesärztekammer, Kassenärztliche Bundesvereinigung und Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Nationale VersorgungsLeitlinie Chronische Herzinsuffizienz – Langfassung, 2019; 3. Auflage. doi:10.6101/AZQ/000465. Im Internet (Stand: 22.07.2021): https://www.leitlinien.de/themen/herzinsuffizienzDisclaimerDie Inhalte des Podcast Rettungsdienst LUKS - Der notfallmedizin Podcast sind rein akademisch. Sie dienen nur Informations-, Lern- und Trainingszwecken und sind für ärztliches Personal, Rettungssanitäter:innen und andere im Gesundheitswesen und der Akutmedizin Tätige bestimmt. Die Inhalte sind nicht zur Behandlung realer Fälle geeignet und ersetzen keinen Arztbesuch. Der Podcast wird mit größtmöglicher Sorgfalt erstellt. Das Luzerner Kantonsspital übernimmt jedoch keine Gewähr für die Richtigkeit, Vollständigkeit und Aktualität der Inhalte.

Scalable Strategies Boost Heart Failure Prescription Fills: Weston Blakeslee, PhD by Managed Care Cast

What if the health headlines you're scrolling past hold answers that could protect you and the people you love? This week, we're having real conversations about what really happened to Reverend Jesse Jackson's health in his final years, exploring Grey's Anatomy star Eric Dane's battle with ALS, investigating Ray J's bleeding eyes and heart monitor drama, honoring Miss J from America's Next Top Model's stroke journey, and exposing the hidden chemicals lurking in your hair extensions.❤️

Three major studies reshape preventive care. Long-term follow-up from diabetes prevention trials, published in The Lancet Diabetes & Endocrinology, shows that achieving remission of prediabetes—normalizing glucose levels—cuts cardiovascular death or heart failure risk by about 50%, with benefits lasting decades. In The Lancet, a multicohort analysis of 540,000 adults found obesity increases risk of severe infection by 70%, with nearly threefold higher infection-related hospitalization or death in severe obesity. Finally, a randomized trial in The Lancet Child & Adolescent Health found no increased risk of eczema or respiratory illness in infants receiving acetaminophen versus ibuprofen, providing reassurance about its safety.

This episode explores tadalafil (Cialis) as a potential longevity drug, though no randomized human trials prove it extends lifespan. Cialis works by blocking PDE5, enhancing nitric oxide signaling, and improving blood flow through vasodilation. Originally approved for pulmonary hypertension, it's also used for erectile dysfunction and BPH. Its 36-hour half-life makes it superior to Viagra for continuous longevity effects.   The host frames vascular aging and endothelial dysfunction as key drivers of age-related diseases (heart disease, stroke, dementia, kidney disease). Observational data shows Cialis users have 44% lower mortality, fewer cardiovascular events, reduced dementia risk, and lower mortality in diabetics. Additional benefits include improved cardiac function, reduced infarct size, arrhythmia suppression, and regression of left ventricular hypertrophy. A 2024 meta-analysis found it lowers hemoglobin A1C, possibly via improved microvascular perfusion, insulin sensitivity, and mitochondrial function.   Cialis crosses the blood-brain barrier and may improve neurovascular coupling and hippocampal plasticity, potentially benefiting those with or at risk of dementia. Safety is generally good with long-term daily use (2.5–5 mg), though cautions include avoiding use with nitrates, low blood pressure, or certain retinal disorders. Common side effects are headache, nasal congestion, and acid reflux. The host recommends consulting a doctor and references potential synergy with telmisartan.   Tadalafil (Cialis) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a604008.html](https://medlineplus.gov/druginfo/meds/a604008.html) Sildenafil (Viagra) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a699015.html](https://medlineplus.gov/druginfo/meds/a699015.html)   Key mechanisms mentioned Nitric Oxide (NO) — NCBI Bookshelf: [https://www.ncbi.nlm.nih.gov/books/NBK554485/](https://www.ncbi.nlm.nih.gov/books/NBK554485/) Cyclic GMP (cGMP) — NCBI Bookshelf: [https://www.ncbi.nlm.nih.gov/books/NBK542234/](https://www.ncbi.nlm.nih.gov/books/NBK542234/)   Conditions mentioned in the episode Benign Prostatic Hyperplasia (BPH) — MedlinePlus: [https://medlineplus.gov/benignprostatichyperplasia.html](https://medlineplus.gov/benignprostatichyperplasia.html) Pulmonary Arterial Hypertension (PAH) — MedlinePlus: [https://medlineplus.gov/pulmonaryhypertension.html](https://medlineplus.gov/pulmonaryhypertension.html)   Blood pressure drug mentioned Telmisartan — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a601249.html](https://medlineplus.gov/druginfo/meds/a601249.html)   Other longevity / comparison drugs mentioned Metformin — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a696005.html](https://medlineplus.gov/druginfo/meds/a696005.html) Sirolimus (Rapamycin) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a602026.html](https://medlineplus.gov/druginfo/meds/a602026.html)   Side-effect helper mentioned Ibuprofen (Advil) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a682159.html](https://medlineplus.gov/druginfo/meds/a682159.html)   Dementia meds mentioned Donepezil (Aricept) — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a697032.html](https://medlineplus.gov/druginfo/meds/a697032.html) Amantadine — MedlinePlus drug info: [https://medlineplus.gov/druginfo/meds/a682064.html](https://medlineplus.gov/druginfo/meds/a682064.html)   Lab markers mentioned Hemoglobin A1C (HbA1c) test — MedlinePlus lab test: [https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/](https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/) Insulin in blood test — MedlinePlus lab test: [https://medlineplus.gov/lab-tests/insulin-in-blood/](https://medlineplus.gov/lab-tests/insulin-in-blood/)   People referenced (where the claims were mentioned) Huberman Lab (Dr. Andrew Huberman) — site: [https://www.hubermanlab.com/](https://www.hubermanlab.com/) Clip about low-dose tadalafil (2.5–5mg) — X post: [https://x.com/tbpn/status/2022350426394534334](https://x.com/tbpn/status/2022350426394534334) Bryan Johnson (Blueprint) — site: [https://blueprint.bryanjohnson.com/](https://blueprint.bryanjohnson.com/) Dr. David Sinclair (Harvard profile) — site: [https://sinclair.hms.harvard.edu/people/david-sinclair](https://sinclair.hms.harvard.edu/people/david-sinclair)   Show Notes   00:00 Welcome to the Hart2Heart Podcast. 01:56 What Cialis Is: PDE5 Inhibition, cGMP & Nitric Oxide Explained 03:43 Approved Uses & Origin Story: Pulmonary Hypertension, ED, and BPH 05:33 Why Cialis Over Viagra: 36-Hour Half-Life & 24/7 Vascular Benefits 06:52 Vascular Aging 101: Endothelium, Perfusion, and Why It Drives Disease 11:14 What the Human Data Shows: Observational Evidence for Mortality, CVD & Dementia 13:04 Mechanisms Deep Dive: Heart Protection, Heart Failure, and Anti-Atherosclerosis 15:02 Cialis for Diabetics: Lowering A1C and Improving Insulin Sensitivity 16:21 Brain Effects: Blood–Brain Barrier, Neurovascular Coupling & Dementia Potential 18:21 Safety, Who Should Avoid It, and Daily Longevity Dosing (2.5–5 mg) + Wrap-Up   The Hart2Heart podcast is hosted by family physician Dr. Michael Hart, who is dedicated to cutting through the noise and uncovering the most effective strategies for optimizing health, longevity, and peak performance. This podcast dives deep into evidence-based approaches to hormone balance, peptides, sleep optimization, nutrition, psychedelics, supplements, exercise protocols, leveraging sunlight, and de-prescribing pharmaceuticals — using medications only when absolutely necessary. Beyond health science, we explore the intersection of public health and politics, exposing how policy decisions shape our health landscape and what actionable steps people can take to reclaim control over their well-being. Guests range from out-of-the-box thinking physicians such as Dr. Casey Means (author of "Good Energy") and Dr. Roger Sehult (Medcram lectures) to public health experts such as Dr. Jay Bhattacharya (Director of the National Institutes of Health (NIH) and Dr. Marty Mckary  (Commissioner of the Food and Drug Administration (FDA) and high-profile names such as  Zuby and Mark Sisson (Primal Blueprint and Primal Kitchen). If you're ready to take control of your health and performance, this podcast is for you.We cut through the jargon and deliver practical, no-BS advice that you can implement in your daily life, empowering you to make positive changes for your well-being.   Connect with Dr. Mike Hart Instagram: @drmikehart Twitter: @drmikehart Facebook: @drmikehart

This week, in partnership with British Heart Foundation, we explore heart failure. Leading experts from the UK's largest independent funder of cardiovascular research tell us about the condition, the symptoms to look out for, what happens when a heart fails, how heart failure has traditionally been managed, and whether it is possible to regenerate a damaged heart... Like this podcast? Please help us by supporting the Naked Scientists

Heart failure management has evolved dramatically, and nurses are central to optimizing outcomes and preventing hospital readmissions. In this episode, we break down the core medication classes used in heart failure, including ACE inhibitors, ARBs, beta blockers, mineralocorticoid receptor antagonists, diuretics, and newer agents like ARNIs and SGLT2 inhibitors. You'll learn how these medications improve symptoms and survival, key monitoring parameters such as blood pressure, potassium, and renal function, and common adverse effects to watch for. We'll also review practical bedside considerations and patient education pearls that improve adherence and safety. Your support helps me provide more free resources like this! Consider supporting and getting more amazing pharmacology content! Head on over to meded101.com/nurse

On this episode of The MisFitNation, host Rich LaMonica welcomes US Army veteran, author, and independent publisher Ken Dupar for a raw, funny, and deeply human conversation about survival, service, creativity, and meaning. Raised in Milwaukee and shaped by the University of Wisconsin before joining the U.S. Army, Ken found belonging, structure, and purpose in uniform. After the post–Persian Gulf War downsizing, life didn't follow a clean exit plan. What followed was a winding civilian path, multiple deployments, leadership under pressure, and a series of life-altering moments—including heart failure during his time as a company commander. Writing became therapy. Humor became survival. And storytelling became the way Ken processed pain, loneliness, love, suffering, and resilience. Today, as an independent author and publisher living in East Tennessee, Ken continues pushing the creative boulder uphill—not because it's easy, but because it's worth it. This episode explores military transition, identity loss, creative rebirth, leadership, suffering, and what it really means to keep running the race at 57. Learn more about Ken and his work: https://www.kennydupar.com Learn more about your ad choices. Visit megaphone.fm/adchoices

On this episode of The MisFitNation, host Rich LaMonica welcomes US Army veteran, author, and independent publisher Ken Dupar for a raw, funny, and deeply human conversation about survival, service, creativity, and meaning. Raised in Milwaukee and shaped by the University of Wisconsin before joining the U.S. Army, Ken found belonging, structure, and purpose in uniform. After the post–Persian Gulf War downsizing, life didn't follow a clean exit plan. What followed was a winding civilian path, multiple deployments, leadership under pressure, and a series of life-altering moments—including heart failure during his time as a company commander. Writing became therapy. Humor became survival. And storytelling became the way Ken processed pain, loneliness, love, suffering, and resilience. Today, as an independent author and publisher living in East Tennessee, Ken continues pushing the creative boulder uphill—not because it's easy, but because it's worth it. This episode explores military transition, identity loss, creative rebirth, leadership, suffering, and what it really means to keep running the race at 57. Learn more about Ken and his work: https://www.kennydupar.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Send a textHeart failure affects millions of Americans and is a leading cause of hospitalization. Dr. Antony Anandaraj, Cardiologist with UnityPoint Health - St. Luke's Hospital, joins the podcast to discuss CardioMEMS, a new option for heart failure patients. To learn more about heart care services at St. Luke's, Cedar Rapids' Heart Hospital, visit unitypoint.org/cr-heart.Do you have a question about a trending medical topic? Ask Dr. Arnold! Submit your question and it may be answered by Dr. Arnold on the podcast! Submit your questions at: https://www.unitypoint.org/cedarrapids/submit-a-question-for-the-mailbag.aspxIf you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.

Send a textOn this special episode, Kaitlyn Talamante chats with the radiant radio personality Nicole Calcagno about her incredible journey of resilience, faith, and self-discovery. Nicole opens up about facing life-threatening heart and blood conditions, navigating grief, and learning to show up for herself—every single day—with joy and gratitude.She shares how she transformed setbacks into strength, leaned on her community, and embraced the power of perspective to live unapologetically. Nicole's story is a heartfelt reminder that even in life's toughest seasons, hope, laughter, and light are possible.This episode is sponsored by LADYBOSS, empowering women everywhere to rise, thrive, and shine unapologetically.

Kid 'N Play's Christopher 'Kid' Reid nearly waited too late for his life-saving heart transplant, and T.K. Carter's fatal combination of diabetes, AFib, and pulmonary hypertension led to systolic heart failure at age 69. Plus, RHOP's Karen Huger got real with Andy Cohen on her Bravo TV interview about her DUI sentence, mixing alcohol with prescription meds.Did you know that prostate cancer will affect 1 in 8 men? It's a stat that hits home with Sanford and Son Star Demond Wilson's recent passing. This week, we're breaking down celebrity health news and the latest trending medical headlines with real lessons for all of us. Home Alone Star, Catherine O'Hara, lived with her heart on the wrong side for decades - these aren't just headlines - they're wake-up calls about symptoms you might be brushing off right now. Tune in for evidence-based medicine that could literally save your life. ❤️#HealthHappyLifePodcast #DrFrita #DrFritaLIVE! #CelebrityHealthNewsHere are a few helpful resources to help on your journey to wellness:▶️ Subscribe so you will never miss a YouTube video.

Master inpatient heart failure management! Learn key tips for initiating guideline-directed medical therapy, diuretic therapy pearls, and ensuring smooth transitions of care. We are joined by Dr. Gurusher Panjrath @PanjrathG (GW School of Medicine and Health Sciences-Dr. Panjrath)Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CMEShow Segments Intro Rapid Fire Questions/Picks of the Week Case Aliquot 1 Defining Heart Failure POCUS in Heart Failure Timing/Indications for Echocardiography Initiating Diuretic Therapy Adjusting Diuretic Therapy/Drip vs Bolus Adjunct Diuretic Therapy Afterload Reduction Monitoring Diuretic Response Inpatient Sodium and Fluid Restriction Case Aliquot 2 Classifying Heart Failure Pharmacotherapy for HFrEF Pharmacotherapy for HFpEF Ischemic Evaluation Interval Summary/Highlights Case Aliquot 3 Considerations for Initial Care of Cardiogenic Shock Choosing Inotrope/Vasopressor Right Heart Catheterization Case Aliquot 4 Discharge Medications for Heart Failure Titration of Goal Directed Medical Therapy Post Discharge Follow Up Washout Period for ACEi/ARB Cost/Barriers of ARNI Patient Education Take Home Points Outro Credits Writer, Producer, and Show Notes by: Reaford Blackburn, Jr., MD Infographic & Cover Art: Caroline Coleman MD Hosts: Monee Amin, MD and Meredith Trubitt, MD    Reviewer: Rahul Ganatra MD Technical Production: PodPaste Guest: Gurusher Panjrath, MD Sponsor: MDProgressEnjoy your first month free at mdprogress.ca/promo/curbsidersSponsor: QuinceGo to Quince.com/curb for free shipping on your order and 365-day returns. Now available in Canada, too.Sponsor: Sanford Guide Curbsiders listeners can get 20% off the already very moderately priced yearly subscriptions directly at sanfordguide.com.Sponsor: Babbel  Here's a special, (limited time) deal for our listeners. Right now get up to 55% off your Babbel subscription – at Babbel.com/CURB.

Dr. Dawn Mussallem shares her inspiring journey of overcoming significant health challenges, including a battle with stage four cancer. She discusses the importance of a supportive community, the role of spirituality in her healing process, and the lessons learned from adversity. Dr. Mussallem emphasizes the significance of nutrition and healthy living, advocating for both women's and men's health, and the need for personalized medical care. Her story is a testament to resilience, love, and the power of human connection. Kimberly and Dawn Mussallem discuss the importance of nutrition for healthy aging, emphasizing the need to eliminate processed foods and increase fiber intake. They explore the significance of protein, particularly plant-based sources, and debunk myths surrounding soy consumption. Dawn shares her transition from the Mayo Clinic to Fountain Life, focusing on advanced diagnostics and personalized wellness strategies.Chapters00:00 Introduction and Background03:02 Overcoming Adversity: Dawn's Health Journey05:51 The Impact of Cancer Diagnosis09:02 Navigating Treatment and Finding Meaning11:59 Spirituality and Connection in Healing15:01 The Role of Support and Community17:49 Life After Cancer: Motherhood and Challenges21:09 Advanced Heart Failure and Resilience23:59 The Gift of Life and Family28:40 The Unexpected Loss31:41 Men's Health Advocacy35:44 Integrating Lifestyle and Medicine39:42 Food as Medicine47:57 The Path to Healthy Aging52:58 Navigating Food Safety and Additives53:54 Plant-Based Proteins and Dining Out56:24 Debunking Soy Myths and Breast Cancer58:47 The Role of Soy in Cancer Prevention01:00:38 Red Meat vs. Plant Proteins01:02:26 Healthy Eating Guidelines for Families01:04:35 The Importance of Whole Foods01:07:44 Innovations in Plant-Based Proteins01:10:38 Dawn's Transition to Fountain LifeSponsors: LMNTOFFER: Right now, for my listeners LMNT is offering a free sample pack with any LMNT drink mix purchase at DrinkLMNT.com/FEELGOOD. That's 8 single serving packets FREE with any LMNT any LMNT drink mix purchase. This deal is only available through my link so. Also try the new LMNT Sparkling — a bold, 16-ounce can of sparkling electrolyte water.USE LINK: DrinkLMNT.com/FEELGOODFATTY15 OFFER: Fatty15 is on a mission to replenish your C15 levels and restore your long-term health. You can get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/KIMBERLY and using code KIMBERLY at checkout.USE LINK: fatty15.com/KIMBERLY Dr. Dawn Mussallem Resources: Website: fountainlife.com Instagram: @drdawnmussallem Bio: Dr. Dawn Mussallem is a distinguished consultant in the Division of Hematology Oncology at Mayo Clinic, where she has served as a clinician for over 20 years, and an Assistant Professor of Medicine.She is also a board-certified lifestyle medicine breast specialist at The Robert and Monica Jacoby Center for Breast Health and founded the Integrative Medicine and Breast Health Program at Mayo Clinic Florida.A stage IV cancer survivor diagnosed three months into medical school, Dr. Mussallem's personal journey is a testament to resilience and determination.In 2021, she underwent a heart transplant and remarkably became the first person to run a marathon one year post-transplant. Internationally recognized for her work in cancer prevention and integrative oncology, she is a prolific speaker and author. Her dedication to patient care and innovative approaches align perfectly with IM8's mission, making her an invaluable addition to the Medical Advisory Board.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Alanna Morris-Simon, Senior Medical Director for US Medical Affairs at Bayer, describes the symptoms and diagnostics used to classify heart failure and the key at-risk populations for this condition. The rapidly evolving landscape of heart failure treatments now includes the Bayer drug KERENDIA, a non-steroidal MRA approved to reduce cardiovascular death and heart failure in adults with an ejection fraction of 40% or more. This drug is part of an emerging trend to treat multiple related conditions simultaneously  and could prevent the onset of heart failure and treat established heart failure. Alanna explains, "At a basic level, heart failure is a clinical syndrome, and that's important. I'm actually a heart failure cardiologist as well. And so this is important because patients have to have signs and symptoms. And those signs and symptoms really result from the heart being unable to either fill with blood properly or squeeze that blood out in a way that meets the body's demands. Either way, patients experience the same symptoms, and those include symptoms like swelling and weight gain, shortness of breath, either at rest or with activity, fatigue, abdominal swelling and bloating, loss of appetite, as well as other symptoms."   "If a doctor or a clinician suspects a diagnosis of heart failure, 99.99% of the time, they'll start by ordering an echocardiogram or a heart ultrasound. Of course, the guidelines tell us to get a chest X-ray, get labs, those sorts of things. But really, we make the diagnosis for the most part based on the results of an echocardiogram because that echocardiogram allows us to visualize how the heart is pumping. It allows us to classify the type of heart failure so that if we see that the squeeze of the heart is impaired, we call that heart failure with reduced ejection fraction. And that's when the ejection fraction or EF is 40% or less. If the EF is in the 41 to 49% range, we classify that as heart failure with mildly reduced ejection fraction. And if patients have an ejection fraction of 50% or greater, we call that heart failure with preserved ejection fraction or HFpEF."   "And we were excited that the FDA actually granted a priority review for KERENDIA because this really only occurs when the FDA recognizes that a treatment can fill a significant unmet need for a disease or a population of patients. And lo and behold, in July of 2025, finerenone was approved by the FDA under the trade name KERENDIA to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with an ejection fraction of 40% or more." #Bayer #Finerenone #Pharma #HeartFailure #HFpEF #HFmrEF #MRA #UnmetNeed #Cardiology #KERENDIA #FDA #CardiovascularHealth #MedicalBreakthrough #PatientCare #Innovation Bayer.com Download the transcript here

Dr. Alanna Morris-Simon, Senior Medical Director for US Medical Affairs at Bayer, describes the symptoms and diagnostics used to classify heart failure and the key at-risk populations for this condition. The rapidly evolving landscape of heart failure treatments now includes the Bayer drug KERENDIA, a non-steroidal MRA approved to reduce cardiovascular death and heart failure in adults with an ejection fraction of 40% or more. This drug is part of an emerging trend to treat multiple related conditions simultaneously  and could prevent the onset of heart failure and treat established heart failure. Alanna explains, "At a basic level, heart failure is a clinical syndrome, and that's important. I'm actually a heart failure cardiologist as well. And so this is important because patients have to have signs and symptoms. And those signs and symptoms really result from the heart being unable to either fill with blood properly or squeeze that blood out in a way that meets the body's demands. Either way, patients experience the same symptoms, and those include symptoms like swelling and weight gain, shortness of breath, either at rest or with activity, fatigue, abdominal swelling and bloating, loss of appetite, as well as other symptoms."   "If a doctor or a clinician suspects a diagnosis of heart failure, 99.99% of the time, they'll start by ordering an echocardiogram or a heart ultrasound. Of course, the guidelines tell us to get a chest X-ray, get labs, those sorts of things. But really, we make the diagnosis for the most part based on the results of an echocardiogram because that echocardiogram allows us to visualize how the heart is pumping. It allows us to classify the type of heart failure so that if we see that the squeeze of the heart is impaired, we call that heart failure with reduced ejection fraction. And that's when the ejection fraction or EF is 40% or less. If the EF is in the 41 to 49% range, we classify that as heart failure with mildly reduced ejection fraction. And if patients have an ejection fraction of 50% or greater, we call that heart failure with preserved ejection fraction or HFpEF."   "And we were excited that the FDA actually granted a priority review for KERENDIA because this really only occurs when the FDA recognizes that a treatment can fill a significant unmet need for a disease or a population of patients. And lo and behold, in July of 2025, finerenone was approved by the FDA under the trade name KERENDIA to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with an ejection fraction of 40% or more." #Bayer #Finerenone #Pharma #HeartFailure #HFpEF #HFmrEF #MRA #UnmetNeed #Cardiology #KERENDIA #FDA #CardiovascularHealth #MedicalBreakthrough #PatientCare #Innovation Bayer.com Listen to the podcast here

Chronic kidney disease affects more than 35 million Americans, and more than half of patients with advanced disease ultimately die from cardiovascular complications.

One of the biggest challenges that healthcare faces with heart failure patients is the high number of hospital readmissions that occur. These readmissions are expensive to healthcare organizations, a bad experience for patients, and many of them are completely avoidable. This is according to Spencer H. Kubo, MD, Chief Medical Officer at CareCognitics and Shahid Shah, Member, Board of Directors at CareCognitcs who sat down to talk with me about their innovative VIP reward solution that's help heart failure patients avoid being readmitted to the hospital.Learn more about CareCognitics: https://carecognitics.com/Health IT Community: https://www.healthcareittoday.com/Learn more about VIP Care: https://www.vipcarehealth.com/

CardioNerds (Dr. Shazli Khan, Dr. Jenna Skowronski, and Dr. Shiva Patlolla) discuss the management of patients post‑heart transplantation with Dr. Shelley Hall from Baylor University Medical Center and Dr. MaryJane Farr from UTSW. In this comprehensive review, we cover the physiology of the transplanted heart, immunosuppression strategies, rejection surveillance, and long-term complications including cardiac allograft vasculopathy (CAV) and malignancy. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls The Denervated Heart: The donor heart is surgically severed from the autonomic nervous system, leading to a higher resting heart rate (90-110 bpm) due to loss of vagal tone. Because the heart relies on circulating catecholamines rather than neural input to increase heart rate, patients experience a delayed chronotropic response to exercise and stress. Importantly, because afferent pain fibers are severed, ischemia is often painless. Rejection Surveillance: Rejection is classified into Acute Cellular Rejection (ACR), which is T-cell mediated, and Antibody-Mediated Rejection (AMR), which is B-cell mediated. While endomyocardial biopsy remains the gold standard for diagnosis, non-invasive surveillance using gene-expression profiling (e.g., AlloMap) and donor-derived cell-free DNA (dd-cfDNA) is increasingly utilized to reduce the burden of invasive procedures. The Infection Timeline: The risk of infection follows a predictable timeline based on the intensity of immunosuppression. The first month is dominated by nosocomial infections. Months one through six are the peak for opportunistic infections (Cytomegalovirus, Pneumocystis, Toxoplasmosis) requiring prophylaxis. After six months, patients are primarily at risk for community-acquired pathogens, though late viral reactivation can occur. Cardiac Allograft Vasculopathy (CAV): Unlike native coronary artery disease, CAV presents as diffuse, concentric intimal thickening that affects the entire length of the vessel, including the microvasculature. Due to denervation, patients rarely present with angina; instead, CAV manifests as unexplained heart failure, fatigue, or sudden cardiac death. Malignancy Risk: Long-term immunosuppression significantly increases the risk of malignancy. Skin cancers (squamous and basal cell) are the most common, followed by Post-Transplant Lymphoproliferative Disorder (PTLD), which is often driven by Epstein-Barr Virus (EBV) reactivation. Notes Notes: Notes drafted by Dr. Patlolla 1. What are the unique physiological features of the transplanted heart? The hallmark of the transplanted heart is denervation. Because the autonomic nerve fibers are severed during harvest, the heart loses parasympathetic or vagal tone, resulting in a resting tachycardia (typically 90-110 bpm). The heart also loses the ability to mount a reflex tachycardia; thus, the heart rate response to exercise or hypovolemia relies on circulating catecholamines, which results in a slower “warm-up” and “cool-down” period during exertion. 2. What are the pillars of maintenance immunosuppression regimen? The triple drug maintenance regimen typically consists of: Calcineurin Inhibitor (CNI): Tacrolimus is preferred over cyclosporine. Key side effects include nephrotoxicity, hypertension, tremor, hyperkalemia, and hypomagnesemia. Antimetabolite: Mycophenolate mofetil (MMF) inhibits lymphocyte proliferation. Key side effects include leukopenia and GI distress. Corticosteroids: Prednisone is used for maintenance but is often weaned to low doses or discontinued after the first year to mitigate metabolic side effects (diabetes, osteoporosis, weight gain). 3. How is rejection classified and diagnosed? Rejection is the immune system’s response to the foreign graft and is categorized by the arm of the immune system involved: Acute Cellular Rejection (ACR): Mediated by T-lymphocytes infiltrating the myocardium. It is graded from 1R (mild) to 3R (severe) based on the extent of infiltration and myocyte damage. Antibody-Mediated Rejection (AMR): Mediated by B-cells producing donor-specific antibodies (DSAs) that attack the graft endothelium. It is diagnosed via histology (capillary swelling) and immunofluorescence (C4d staining). Diagnosis has historically relied on endomyocardial biopsy. However, non-invasive tools are gaining traction. Gene Expression Profiling (GEP) assesses the expression of genes associated with immune activation to rule out rejection in low-risk patients. Donor-Derived Cell-Free DNA (dd-cfDNA) measures the fraction of donor DNA in the recipient’s blood. Elevated levels suggest graft injury which can occur in both ACR and AMR. 4. What is the timeline of infectious risk and how does it guide prophylaxis? Infectious risk correlates with the net state of immunosuppression. < 1 Month (Nosocomial): Risks include surgical site infections, catheter-associated infections, and aspiration pneumonia. 1 – 6 Months (Opportunistic): This is the period of peak immunosuppression. Patients are at risk for PJP, CMV, Toxoplasma, and fungal infections. Prophylaxis typically includes Trimethoprim-Sulfamethoxazole (for PJP/Toxo) and Valganciclovir (for CMV, dependent on donor/recipient serostatus). > 6 Months (Community-Acquired): As immunosuppression is weaned, the risk profile shifts toward community-acquired respiratory viruses (Influenza, RSV) and pneumonias. However, patients with recurrent rejection requiring boosted immunosuppression remain at risk for opportunistic pathogens. 5. How does Cardiac Allograft Vasculopathy (CAV) differ from native CAD? CAV is the leading cause of late graft failure. Unlike the focal, eccentric plaques seen in native atherosclerosis, CAV is an immunologically driven process causing diffuse, concentric intimal hyperplasia. It affects both epicardial vessels and the microvasculature. Because of this diffuse nature, percutaneous coronary intervention (PCI) is often technically difficult and provides only temporary palliation. The only definitive treatment for severe CAV is re-transplantation. Surveillance is critical and is typically performed via annual coronary angiography, often using intravascular ultrasound (IVUS) to detect early intimal thickening before it is visible on the angiogram. References Costanzo MR, Dipchand A, Starling R, et al. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2010;29(8):914-956. doi:10.1016/j.healun.2010.05.034. https://www.jhltonline.org/article/S1053-2498(10)00358-X/fulltext Kittleson MM, Kobashigawa JA. Cardiac Allograft Vasculopathy: Current Understanding and Treatment. JACC Heart Fail. 2017;5(12):857-868. doi:10.1016/j.jchf.2017.07.003. https://www.jacc.org/doi/10.1016/j.jchf.2017.07.003 Velleca A, Shullo MA, Dhital K, et al. The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2023;42(5):e1-e141. doi:10.1016/j.healun.2022.10.015. https://www.jhltonline.org/article/S1053-2498(22)02187-5/fulltext

Doctors Lisa and Sara talk to Consultant Nephrologist Dr Darren Green about patients with Type 2 Diabetes who also have Chronic Kidney Disease and Heart Failure.  We go through a hypothetical case to illustrate some of the finer points of management that can commonly get missed or might not be appreciated. A really detailed talk full of useful practice enhancing tips for this complex group of patients.  Disclaimer: All educational content in this podcast was developed as part of the Circulation Health collaborative working project between Boehringer Ingelheim Limited, Greater Manchester Primary Care Provider Board and Health Innovation Manchester. Content has been created by Circulation Health Clinical Leads for educational purposes, reflecting NHS Clinical Lead and guideline-based recommendations. Boehringer Ingelheim had no input into content development. They have provided financial resources to support Podcast recordings related to this project. Darren would like us to make you all aware that he has working relationships with pharmaceutical industry partners. Specifically, that he has received speak fees and consultancy fees from AstraZeneca, GSK, Novartis, Boehringer Ingelheim, Bayer, and Lilly, and has been part of collaborative working agreements with Novartis, Boehringer Ingelheim, and AstraZeneca. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: Dr Kevin Fernando counselling diabetic patients starting an SGLT2 Inhibitors like Dapagliflozin or Empagliflozin: https://www.youtube.com/watch?v=pc99SdtlsyU Diabetes UK counselling sheets on SGLT2 inhibitors: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/tablets-and-medication/sglt2-inhibitors Kidney Care UK Patient Booklets: https://kidneycareuk.org/get-support/free-resources/patient-information-booklets/ Pumping Marvellous Heart Failure Charity with patient resources: https://pumpingmarvellous.org/ International Society for Nephrology Toolkit for Initiating or Changing RAASi - Renin Angiotensin Aldosterone System Inhibitors (like ACEis such as Lisinopril or Ramipril, or ARBs like Candesartan on Losartan): https://www.theisn.org/initiatives/toolkits/raasi-toolkit/ Royal College of General Practitioners Acute Renal Failure Toolkit: https://elearning.rcgp.org.uk/course/info.php?id=899 CONFIDENCE trial: Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes | New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMoa2410659 ATLAS trial: Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus: https://pubmed.ncbi.nlm.nih.gov/11071803/ Metformin lactic acidosis Metformin in Patients With Type 2 Diabetes and Kidney Disease: A Systematic Review: https://jamanetwork.com/journals/jama/article-abstract/2084896 UK AKI Summit report UKKA AKI Summit Report + Recommendations: https://share.google/7uw1GPQ5sV2riJtiV RCGP AKI follow up  post discharge recommendations: https://bjgpopen.org/content/early/2020/06/15/bjgpopen20X101054/tab-figures-data?versioned=true ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Ray J's heart issues, a Nipah virus outbreak, Oscar winner, Octavia Spencer speaking up about kidney health, high blood pressure, & type 2 diabetes, plus a rare stroke affecting the Blind Side star, are all part of this week's conversation. We're breaking down what it really means when someone says their heart is working at 25 percent and how outside factors can stress the heart. We'll also talk about the Nipah virus, also known as the fruit bat virus, why health officials are watching it closely, and what “contained” actually means.February is American Heart Month, so join us for my favorite game as we clear up myths about a silent heart disease and CKM syndrome that up to 90% of Americans have and don't even know! Plus, we'll explain spinal strokes using Quinton Aaron's story and why Octavia Spencer and Sofía Vergara are pushing for simple kidney screening. Listen in, ask questions, and let's make sense of these trending medical headlines and thelatest celebrity health news together.#HealthHappyLifePodcast #DrFrita #DrFritaLIVE! #CelebrityHealthNewsHere are a few helpful resources to help on your journey to wellness:▶️ Subscribe so you will never miss a YouTube video.

In this episode of the MyHeart.net podcast, Dr. Alain Bouchard discusses the interplay between Heart Failure with Preserved Ejection Fraction, or HFpEF, and obesity with Dr. Michelle Kittleson, Director of Heart Failure Research at the Smidt Heart Institute at Cedars-Sinai.Learn more about the diagnosis, challenges, and management of this condition by exploring our article, Managing Obesity in Heart Failure with Preserved Ejection Fraction (HFpEF).About the TeamDr. Alain Bouchard is a clinical cardiologist at Cardiology Specialists of Birmingham, AL. He is a native of Quebec, Canada and trained in Internal Medicine at McGill University in Montreal. He continued as a Research Fellow at the Montreal Heart Institute. He did a clinical cardiology fellowship at the University of California in San Francisco. He joined the faculty at the University of Alabama Birmingham from 1986 to 1990. He worked at CardiologyPC and Baptist Medical Center at Princeton from 1990-2019. He is now part of the Cardiology Specialists of Birmingham at UAB Medicine.Dr. Philip Johnson is originally from Selma, AL. Philip began his studies at Vanderbilt University in Nashville, TN, where he double majored in Biomedical and Electrical Engineering. After a year in the “real world” working for his father as a machine design engineer, he went to graduate school at UAB in Birmingham, AL, where he completed a Masters and PhD in Biomedical Engineering before becoming a research assistant professor in Biomedical Engineering. After a short stint in academics, he continued his education at UAB in Medical School, Internal Medicine Residency, and is currently a cardiology fellow in training with a special interest in cardiac electrophysiology.Medical DisclaimerThe contents of the MyHeart.net podcast, including as textual content, graphical content, images, and any other content contained in the Podcast (“Content”) are purely for informational purposes. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or heard on the Podcast!If you think you may have a medical emergency, call your doctor or 911 immediately. MyHeart.net does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Podcast. Reliance on any information provided by MyHeart.net, MyHeart.net employees, others appearing on the Podcast at the invitation of MyHeart.net, or other visitors to the Podcast is solely at your own risk.The Podcast and the Content are provided on an “as is” basis.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Additive Benefit of Guideline-Directed Medical Therapies at Discharge in Reducing 30-Day Readmissions in Heart Failure.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Long-Term Outcomes: Beta-Blocker Use and Permanent Pacing in Patients With Heart Failure Preserved Ejection Fraction.

Cardiologist Bob Harrington talks to Mitch Elkind, chief science officer for Brain Health and Stroke at the AHA, about the heart-brain connection and why what's good for the brain is good for the heart. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health: A Presidential Advisory From the American Heart Association  https://www.ahajournals.org/doi/10.1161/CIR.0000000000001078 Migraine Headache: An Under-Appreciated Risk Factor for Cardiovascular Disease in Women https://www.ahajournals.org/doi/10.1161/JAHA.119.014546 Cardiovascular disease patients have increased risk for comorbidity: A cross-sectional study in the Netherlands https://doi.org/10.1080/13814788.2017.1398318 Characteristics and treatment of midlife-onset epilepsy: A 24-year single-center, retrospective study https://doi.org/10.1002/epd2.20253 Traumatic Brain Injury and Risk of Neurodegenerative Disorder https://doi.org/10.1016/j.biopsych.2021.05.025 Cardiac Changes in Parkinson's Disease: Lessons from Clinical and Experimental Evidence https://doi.org/10.3390/ijms222413488 The neuropathological diagnosis of Alzheimer's disease https://doi.org/10.1186/s13024-019-0333-5 Failed Semaglutide for Early Alzheimer's Not the End of the Road? https://www.medscape.com/viewarticle/failed-semaglutide-early-alzheimers-not-end-road-2025a1000y4l Atrial Fibrillation and Dementia: A Report From the AF-SCREEN International Collaboration https://doi.org/10.1161/circulationaha.121.055018 Reduced regional cerebral blood flow in patients with heart failure https://doi.org/10.1002/ejhf.874 Heart-brain Interactions in Heart Failure https://doi.org/10.15420/cfr.2018.14.2 While You Were Sleeping, the Brain's 'Waste Disposal System' Was at Work https://www.medscape.com/viewarticle/while-you-were-sleeping-brains-waste-disposal-system-was-2025a1000mbb Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder https://doi.org/10.1001/jamapsychiatry.2024.3599 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000001356 "VOODOO" Death https://ajph.aphapublications.org/doi/full/10.2105/AJPH.92.10.1593 Longitudinal brain ageing after stroke: a marker for neurodegeneration and its relevance for upper limb motor outcome https://doi.org/10.1093/braincomms/fcaf299 Unlocking Longevity: Aging Reimagined  https://www.medscape.com/viewarticle/1002241 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Program notes:0:40 Two MMWR reports on wastewater to detect measles1:40 Subsequent detection after early identification2:40 Watch worldwide transition3:15 Weight regain after medication for weight management4:16 Cardiometabolic risk factors return in just over a year5:16 Willingness to use declined with knowledge of regain risk6:16 Prevention of obesity6:33 Chronic kidney disease and heart failure link7:35 Extracellular vesicles found8:35 Precise identification of a tangle pathway9:03 Physical activity types, varieties and mortality10:03 Higher variety conferred additional survival benefit11:03 Will you change your behavioral?12:03 Lower hypertension, BMI12:39 End

Could you discuss GABA for insomnia and sleep support?  Are there long-term health benefits?What impact does a cocktail of pharmaceutical drugs have on the microbiome?Can I take more than 2 daily doses of Dr. Ohira's probiotics?Which is the correct estrogen to take in HRT?  Estriol or estradiol?In light of the recent EPA proposal to double permissible formaldehyde emissions, how does this jibe with MAHA?

Top stories of 2025Does the use of statins lead to muscle loss?I have mitral valve prolapse with regurgitation. Should I increase my supplement dosages?

Luis Hernandez, M.D., FACC, fellowship-trained Cardiologist and Medical Director of the Advanced Heart Failure Program at Monument Health Heart and Vascular Institute, gives insight on how devices like defibrillators, pacemakers and pulmonary pressure sensors manage heart failure and help prevent hospital readmissions. He also outlines the importance of medication and patient monitoring in improving heart failure outcomes. Dr. Hernandez brings plenty of visual aides in this episode so be sure to check out the video version on YouTube! Hosted on Acast. See acast.com/privacy for more information.

With Maria Tereza Sampaio de Sousa Lira, Federal University of Pernambuco - Brazil and Anja Zupan Meznar, University Medical Centre Ljubljana - Slovenia. This episode will discuss when conduction system pacing (CSP) may be the appropriate pacing strategy for heart failure patients, particularly those with pacing-induced dyssynchrony or suspected pacing-induced cardiomyopathy (PICM). Key talking points include: Clinical clues and diagnostic approach to PICM Differentiating PICM from other causes of LV dysfunction When to consider CRT upgrade in pacemaker patients Insights from the BUDAPEST-CRT upgrade trial Advantages and limitations of CSP (His-bundle and left bundle branch pacing) Practical take-home message for clinicians managing HF patients with pacemaker This 2026 HFA Cardio Talk podcast series is supported by Bayer in the form of unrestricted financial support. The discussion has not been influenced in any way by its sponsors.

Focus Issue on Heart Failure and Cardiomypathies

Don't miss out — elevate your skills and save $100 on any online course with code START26! Join our library of live and on-demand veterinary dental courses here: https://internationalveterinarydentistryinstitute.org/veterinary-dental-online-webinars-courses-discount/?utm_source=podcast&utm_medium=podcastlink&utm_campaign=start26  —------------------------------------------------------------------- Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode of The Vet Dental Show, Dr. Victoria Lukasik, DVM, DACVAA, tackles the complexities of managing high-risk dental cases. Through detailed case studies, they discuss anesthetic protocols for patients with hepatic portal shunts and chronic heart failure. Learn how to navigate potential complications like hypoglycemia, hemorrhage, and ventricular tachycardia, while ensuring patient safety and optimizing recovery. What You'll Learn:  ✅ Understand anesthetic considerations for patients with hepatic portal shunts.  ✅ Discover strategies for managing hypoglycemia and electrolyte imbalances.  ✅ Simplify anesthetic protocols for patients with chronic heart failure.  ✅ Apply techniques for recognizing and treating ventricular tachycardia.  ✅ Master the use of short-acting and reversible drugs in high-risk patients.  ✅ Recognize and address delayed recovery in the post-anesthetic period. Key Takeaways:  ✅ Patients with hepatic portal shunts require short-acting, reversible drugs to minimize liver burden.  ✅ Intermittent hemorrhage in patients with hepatic dysfunction may lead to platelet consumption and anemia.  ✅ Bounding femoral pulses can indicate dehydration; adjust fluid therapy accordingly in cardiac patients.  ✅ Lidocaine has centrally depressing effects; anticipate mental dullness or sedation post-administration.  ✅ Early intervention with lidocaine is crucial for managing ventricular tachycardia and preventing further complications. Questions This Episode Answers: ❓ How should anesthetic protocols be adjusted for patients with hepatic portal shunts? ❓ Which anesthetic and analgesic drugs are safest for patients with true hepatic dysfunction? ❓ When should dextrose supplementation be considered in dental patients with liver disease? ❓ How do you manage intermittent hemorrhage, anemia, and low platelets during dental procedures? ❓ What causes delayed anesthetic recovery—and how do you systematically troubleshoot it? ❓ How should cardiac medications be handled on the morning of anesthesia for heart failure patients? ❓ What do bounding femoral pulses indicate, and how should fluid therapy be adjusted? ❓ Why can lidocaine cause deep sedation and delayed recovery after anesthesia? ❓ How do you recognize ventricular tachycardia intraoperatively—and when should you intervene? ❓ What recovery expectations should you have after treating ventricular tachycardia with lidocaine? —------------------------------------------------------------------- Explore Dr. Beckman's complete library of veterinary dentistry courses and CE resources! Save $100 on any online course with code START26! https://internationalveterinarydentistryinstitute.org/veterinary-dental-online-webinars-courses-discount/?utm_source=podcast&utm_medium=podcastlink&utm_campaign=start26  —------------------------------------------------------------------- Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary dentistry! —------------------------------------------------------------------- KEYWORDS: Veterinary Dentistry, IVDI, Brett Beckman, Dog Dental Care, Cat Dental Care, VetTech Tips, Animal Health, Veterinary Education, Veterinary Dental Practitioner Program, Vet Dental Show, Anesthesia, High-Risk Patients, Hepatic Portal Shunt, Chronic Heart Failure, Ventricular Tachycardia, Lidocaine, Hypoglycemia, Electrolyte Imbalance, Delayed Recovery

Research Evaluates Associations of Type 2 Diabetes, Dental Diseases, Poor Oral Hygiene, and Heart Failure RiskBy Today's RDH ResearchOriginal article published on Today's RDH: https://www.todaysrdh.com/research-evaluates-associations-of-type-2-diabetes-dental-diseases-poor-oral-hygiene-and-heart-failure-risk/Need CE? Start earning CE credits today at ⁠https://rdh.tv/ce⁠ Get daily dental hygiene articles at ⁠https://www.todaysrdh.com⁠ Follow Today's RDH on Facebook: ⁠https://www.facebook.com/TodaysRDH/⁠Follow Kara RDH on Facebook: ⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠Follow Kara RDH on Instagram: ⁠https://www.instagram.com/kara_rdh/⁠

Send us a textA single ion is changing how we read the story of canine heart failure. We sit down with cardiologist Dr. Darcy Adin and internist–nephrology researcher Dr. Autumn Harris to unpack why hypochloremia—once dismissed as collateral damage from diuretics—now stands out as a powerful predictor of survival in dogs with stable congestive heart failure. The conversation moves from physiology to practice, showing how chloride levels map to renin–angiotensin activation, diuretic resistance, and risk, and how that knowledge can guide smarter, earlier interventions.We trace the research arc: early work that spotlighted chloride as more than a bystander, data linking low chloride to advanced disease stages and higher diuretic needs, and the pivotal finding that hypochloremia predicts outcomes even after controlling for other variables. Along the way, we break down renal salt sensing at the macula densa, why chloride depletion ramps up neurohormonal stress, and how this affects real dogs with mitral valve disease and congestive heart failure. If you manage CHF cases, this is practical cardiology and nephrology in lockstep.Most importantly, we translate the science into steps you can use tomorrow. We talk thresholds and trend-watching, ensuring chloride is on every chemistry panel, covering RAS inhibition, adjusting diuretic strategies to spare chloride, and when to consider chloride supplementation. We also preview active trials targeting chloride to improve diuretic responsiveness, cut hospital time, and lift quality of life. Owners get a clear takeaway too: lab values are not just numbers; they're signals that help personalize care and extend good days.If you care for dogs with heart failure—or love one at home—this deep dive reframes a humble electrolyte as a crucial guide. Listen, share with your team, and help push the field forward. Enjoyed the conversation? Subscribe, leave a review, and tell us how you monitor chloride in your CHF workflow.JAVMA article: https://doi.org/10.2460/javma.25.08.0526INTERESTED IN SUBMITTING YOUR MANUSCRIPT TO JAVMA ® OR AJVR ® ? JAVMA ® : https://avma.org/JAVMAAuthors AJVR ® : https://avma.org/AJVRAuthorsFOLLOW US:JAVMA ® : Facebook: Journal of the American Veterinary Medical Association - JAVMA | Facebook Instagram: JAVMA (@avma_javma) • Instagram photos and videos Twitter: JAVMA (@AVMAJAVMA) / Twitter AJVR ® : Facebook: American Journal of Veterinary Research - AJVR | Facebook Instagram: AJVR (@ajvroa) • Instagram photos and videos Twitter: AJVR (@AJVROA) / Twitter JAVMA ® and AJVR ® LinkedIn: https://linkedin.com/company/avma-journals

Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrumVICTORIA and VICTOR Clinical Trials

Watch Here : https://www.youtube.com/watch?v=637NmaMJBBA Website: https://vigoroussteve.com/ Consultations: https://vigoroussteve.com/consultations/ eBooks: https://vigoroussteve.com/shop/ YouTube Channel: http://www.youtube.com/user/VigorousSteve/ Workout Clips Channel: https://www.youtube.com/channel/UCWi2zZJwmQ6Mqg92FW2JbiA Instagram: https://instagram.com/vigoroussteve/ TikTok: https://www.tiktok.com/@vigoroussteve Reddit: https://www.reddit.com/r/VigorousSteve/ PodBean: https://vigoroussteve.podbean.com/ Spotify: https://open.spotify.com/show/2wR0XWY00qLq9K7tlvJ000 Patreon: https://www.patreon.com/vigoroussteve

A preliminary American Heart Association (AHA) study linked long-term melatonin use to increased heart failure risk, but a closer analysis shows serious flaws, including lack of peer review and failure to account for confounding variables The study found melatonin users had 90% higher heart failure rates, but data mixed together prescription-only countries with over-the-counter markets, misclassifying many actual users as non-users Moreover, the study failed to account for insomnia severity, psychiatric conditions, other medications, and dosing details, making it impossible to determine if melatonin caused the observed outcomes Decades of peer-reviewed research demonstrates melatonin's cardioprotective effects, including reducing blood pressure, protecting heart tissue, and mitigating oxidative damage, contradicting the study's alarming headlines While supplementation is unlikely to pose serious risks, there are natural ways to optimize your melatonin production, such as getting morning sunlight exposure, keeping a consistent sleep schedule, limiting evening blue light, eating earlier, and practicing stress-reduction techniques

SwoleFam member coming back from heart failure to getting off medication due to his gains, the most insane choice for a breakfast meal ever and great rants from some of the most retarded videos we've seen to date.Reminder that we have the SwoleFam Swole New Year's party on December 29th at 12 Noon ET, so mark your calendars and be there for a look-back on a great 2025, looking forward to 2026 and EPIC releases as we do every year!Join The SwoleFam https://swolenormousx.com/membershipsDownload The Swolenormous App https://swolenormousx.com/swolenormousappMERCH - https://papaswolio.com/Watch the full episodes here: https://rumble.com/thedailyswoleSubmit A Question⁠ For The Show: https://swolenormousx.com/apsGet On Papa Swolio's Email List: https://swolenormousx.com/emailDownload The 7 Pillars Ebook: https://swolenormousx.com/7-Pillars-EbookTry A Swolega Class From Inside Swolenormous X: https://www.swolenormousx.com/swolegaGet Your Free $10 In Bitcoin: https://www.swanbitcoin.com/papaswolio/   Questions? Email Us: Support@Swolenormous.com

Send us a textWelcome back Rounds Table Listeners! In our year-end episode, Drs. Mike and John Fralick discuss five important research studies published in 2025:Apixaban for Extended Treatment of Provoked Venous Thromboembolism (HI-PRO) (0:00 – 4:20)Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity (SUMMIT) (4:21 – 9:30)Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (AQUATIC) (9:31 – 15:03)Liberal fluid intake versus fluid restriction in chronic heart failure: a randomized clinical trial (FRESH-UP) (15:04 – 18:09)Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis (ESSENCE) (18:10 – 23:49)The Good Stuff (23:50 – 25:27):Toronto Star Santa Claus Fund, Calgary Food Bank, The War Amps Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this episode of The Medicine Grand Rounders, we're joined by Dr. Wilson Tang, research director and staff cardiologist in the section of heart failure and cardiac transplantation, who delves into the cardiorenal physiology, decongestion strategies and future therapies. Moderated by: Faysal Massad

Heart failure rarely shows up suddenly. In most cases, it develops quietly through subtle symptoms that are easy to ignore. In this episode, Ben Azadi reveals nine silent warning signs of early heart failure, explains why they occur, and shares practical, natural strategies to support heart and metabolic health before serious damage occurs. Heart failure is the leading threat to longevity, and the body often whispers long before it screams. What You'll Learn in This Episode Why nighttime shortness of breath can be an early heart failure warning How needing extra pillows to sleep signals fluid buildup in the lungs The connection between swollen ankles, rapid weight gain, and fluid retention Why a persistent cough, fatigue, or brain fog may point to heart dysfunction How irregular heartbeats and digestive symptoms relate to cardiac stress Simple prevention strategies to improve circulation, reduce inflammation, and support heart function Key labs and tests to discuss with your doctor for early detection How metabolic health, sleep, nutrition, and movement directly impact heart longevity FREE GUIDE: Better Than Ozempic - https://bit.ly/4pxDyhe 

In this episode of Conversing Over Drinks, Cedric sits down with Nathan Williams to share a powerful story of love, resilience, and survival. At just 32 years old, Nathan was diagnosed with end-stage congestive heart failure after experiencing unexpected symptoms during an ordinary day—news that changed his life and his marriage overnight.Nathan opens up about the shock of hearing he would need a heart transplant, the emotional toll of the diagnosis, and the day-to-day challenges of navigating serious illness. He and his wife, Crystal, reflect on how faith, mental strength, and unwavering support helped them endure their darkest moments and grow closer through the process.The conversation also highlights the importance of preparation, including how a Living Benefits life policy provided crucial financial relief and peace of mind during a medical crisis. This episode is a reminder to take your health seriously, prepare for the unexpected, and hold tight to hope—even when the road ahead feels uncertain.

In this episode, the CardioNerds (Dr. Natalie Tapaskar, Dr. Jenna Skowronski, and Dr. Shazli Khan) discuss the process of heart transplantation from the initial donor selection to the time a patient is discharged with Dr. Dave Kaczorowski and Dr. Jason Katz. We dissect a case where we understand criteria for donor selection, the differences between DBD and DCD organ donors, the choice of vasoactive agents in the post-operative period, complications such as cardiac tamponade, and the choice of immunosuppression in the immediate post-operative period. Most importantly, we highlight the importance of multi-disciplinary teams in the care of transplant patients. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls When thinking about donor selection, you need to consider how much physiologic stress your recipient can tolerate, and this may guide your selection of “higher risk” or “lower risk” donors.   The use of DCD donors has increased the potential donor pool and shortened waitlist times with very similar perioperative outcomes to DBD transplantation.  Post-operative critical care management rests on a fundamental principle to apply as much inotropic/vasoactive therapy as needed to achieve some reasonable physiologic hemostasis, and then getting “the heck out of the way!” There are no standard regimens as practices vary across centers, but rest on providing adequate RV support, maintaining AV synchrony, and early resuscitation.   The RV is fickle and doesn't take a joke too well. RV dysfunction post-transplant is important to watch for, and it can be transient or require aggressive support. Don't miss assessing for cardiac tamponade which can require surgical evacuation- “where there's space, that space can be filled with fluid.”   Induction immunosuppression post-transplant varies across centers, but some considerations for use may include (1) high sensitization of the patient, (2) high risk immunologic donor-recipient matching, and (3) recipient renal dysfunction to provide a calcineurin inhibitor (CNI) sparing regimen long term.  Management of heart transplant patients is a multi-disciplinary effort that requires coordination amongst heart failure/transplant cardiologists, cardiac surgeons, anesthesiologists, pathology/immunologists and a slew of ancillary services. Without a dynamic and collaborative team, successful cardiac transplantation could not be possible.  Notes Notes: Notes drafted by Dr. Natalie Tapaskar  What are the basic components of donor heart selection? In practicality, it can be a very inexact science, but we use some basic selection criteria such as: (1) size matching (2) ischemic time (3) donor graft function (4) immunologic compatibility (5) age of the potential donor and recipient (6) severity of illness of the recipient (7) regional variation in donor availability When thinking about accepting older donors (>50 years old), we ideally would screen for donor coronary disease and try to keep ischemic times as short as possible. We may accept an older donor for a recipient who is highly sensitized, which leaves a smaller potential donor pool. There is no clear consensus on size matching, but the predicted heart mass is most used. We are generally more comfortable oversizing than under-sizing donor hearts. Serial echocardiography is important in potential donors as initially reduced ejection fractions can improve on repeat testing, and these organs should not be disregarded automatically. For recipients who are more surgically complex, (i.e. multiple prior sternotomies or complex anatomy), it's probably preferable to avoid older donors with some graft dysfunction and favor donors with shorter ischemic times. What is the difference between DBD and DCD? DBD is donation after brain death- these donors meet criteria for brain death. Uniform Determination of Death Act 1980: the death of an individual is The irreversible cessation of circulatory and respiratory functions or The irreversible cessation of all functions of the entire brain, including those of the brain stem DCD is donation after circulatory death- donation of the heart after confirming that circulatory function has irreversibly ceased. Only donors in category 3 of the Maastricht Classification of DCD donors are considered for DCD donations: anticipated circulatory arrest (planned withdrawal of life-support treatment). DCD hearts can be procured via direct procurement or normothermic regional perfusion (NRP). The basic difference is the way the hearts are assessed, either on an external circuit or in the donor body. For the most complex recipient, DCD may not be utilized at some centers due to concern for higher rates of delayed graft function, but this is center specific and data is still evolving. What are some features surgeons consider when procuring the donor heart? Visual assessment of the donor heart is key in DBD or NRP cases. LV function may be hard to assess, but visually the RV can be inspected. Palpation of the coronary arteries is important to assess any calcifications or abnormalities. Ventricular arrhythmias at the time of procurement may be concerning. Key considerations in the procurement process: (1) Ensuring the heart remains decompressed at all times and doesn't become distended (2) adequate cardioplegia delivery (3) aorta is cross-clamped properly all the way across the vessel (4) avoiding injury to adjacent structures during procurement What hemodynamic parameters should we monitor and what vasoactive agents are used peri-heart transplant? There is no consensus regarding vasoactive agent use post-transplant and practice varies across institutions. Some commonly seen regimens may include: (1) AAI pacing around 110 bpm to support RV function and preserve AV synchrony (2) inotropic agents such as epinephrine and dobutamine to support RV function (3) pulmonary vasodilators such as inhaled nitric oxide to optimize RV afterload Early post-transplant patients tend to have low cardiac filling pressures and require preload monitoring and resuscitation initially. Slow weaning of inotropes as the patient shows signs of stable graft function and hemodynamics. RV dysfunction may manifest as elevated central venous pressure with low cardiac index or hypotension with reducing urine output. Optimize inotropic support, volume status, metabolic status (acidosis and hypoxia), afterload (pulmonary hypertension), and assess for cardiac tamponade. Tamponade requires urgent take-back to the operating room to evacuate material. Refractory RV failure requires mechanical circulatory support, with early consideration of VA-ECMO. Isolated RV MCS may be used in the right clinical context. Why do pericardial effusions/cardiac tamponade happen after transplant? They are not uncommon after transplant and can be due to: Inherent size differences between the donor and recipient (i.e. if the donor heart is much smaller than the recipient's original heart) Bleeding from suture lines and anastomoses, pacing wires, and cannulation sites Depending on the hemodynamic stability of the patient and the location of the effusion, these effusions may require urgent return to the OR for drainage/clot evacuation via reopening the sternotomy, mini thoracotomy, and possible pericardial windows. What are the basics of immunosuppression post-transplant? Induction immunosuppression is variably used and is center-specific. Considerations for using induction therapy may include: (1) high sensitization of the patient (2) younger patients or multiparous women with theoretically more robust immune systems (3) crossing of recipient antibodies with donor antigens (3) renal function to provide a CNI sparing regimen long term Some considerations for avoiding induction may include: (1) older age of the recipient (2) underlying comorbid conditions such as infections or frailty of the recipient What are expected activity restrictions post-transplant? Sternal precautions are important to maintain sternal wire integrity. Generally avoiding lifting >10 pounds in the first 4-12 weeks, no driving usually in the first 4 weeks, monitoring for signs and symptoms of wound infections, and optimizing nutrition and physical activity. Cardiac rehabilitation is incredibly important as soon as feasible. References Kharawala A , Nagraj S , Seo J , et al. Donation after circulatory death heart transplant: current state and future directions. Circ: Heart Failure. 2024;17(7). doi: 10.1161/circheartfailure.124.011678  Copeland H, Knezevic I, Baran DA, et al. Donor heart selection: Evidence-based guidelines for providers. The Journal of Heart and Lung Transplantation. 2023;42(1):7-29. doi:10.1016/j.healun.2022.08.030  Moayedifar R, Shudo Y, Kawabori M, et al. Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. J Heart Lung Transplant. 2024;43(4):673-680. doi:10.1016/j.healun.2023.12.013  Kharawala A, Nagraj S, Seo J, et al. Donation After Circulatory Death Heart Transplant: Current State and Future Directions. Circ Heart Fail. 2024;17(7):e011678. doi:10.1161/CIRCHEARTFAILURE.124.011678  Copeland H, Hayanga JWA, Neyrinck A, et al. Donor heart and lung procurement: A consensus statement. J Heart Lung Transplant. 2020;39(6):501-517.

Dr. Martin Picard, PhD, is a professor of behavioral medicine at Columbia University and an expert on how our behaviors and psychology shape cellular energy production and rates of aging. He explains that your mitochondria don't just “make energy”; they translate what you do—your mindset and your relationships—into the energy you experience as vitality or lack thereof. He explains how exercise, nutrition, sleep, meditation, and even certain thought patterns and our sense of purpose can charge our cells like batteries. He also shares findings that hair greying is the result of cellular stress and is reversible. This episode links physical and mental ‘energy' with cellular energy and provides science-supported tools to improve your physical and mental health. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Helix: https://helixsleep.com/huberman Lingo: https://hellolingo.com/huberman Function: https://functionhealth.com/huberman Waking Up: https://wakingup.com/huberman Timestamps (00:00:00) Martin Picard (00:03:50) What is Energy?, Energy Flow & Transformation (00:07:53) Energy, Vitality, Emotions, Sensory Perception (00:14:18) Sponsors: Helix Sleep & Lingo (00:17:19) “Mito-Centric” View of World, Mitochondrial Energy & Information Patterns (00:25:26) Organelles, Mitochondria & Energy Transformation; Maternal Genes (00:31:12) Mitotypes & Differentiation, Mitochondria as “Social Organisms” (00:36:52) Food & Dysfunctional Energy Transformation (00:40:02) Lifestyle Choices & Interests, Physiological Growth (00:46:39) Pregnancy, Amenorrhea; Illness & Tiredness (00:51:07) Sponsor: AG1 (00:52:29) Energy Transformation & Distribution; Body's Wisdom, Feeling Sick (00:56:27) Tool: Feel Your Energy; Breath & Energy (01:02:31) Flow of Energy; Trade-Offs, Life Purpose & Enjoyment (01:10:15) Biology, Meaningful Experiences & Energy Flow (01:16:27) Sponsor: Function (00:18:15) Inflammation, Energetic Flow (01:20:43) Child Prodigies, Species Lifespan & Mitochondrial Metabolism; Aging (01:28:56) Lifestyle & Aging: Exercise, Fasting; Inflammation, Sleep, Stimulants (01:37:06) Energetic Stress Signals, GDF-15, Cancer, Heart Failure (01:42:18) Genes, Lifestyle & Aging (01:47:54) Gray Hair Reversal, Stress; Inflammation & Aging (01:57:37) Energy Recovery, Sleep & Mitochondrial Function, Stress, Meditation (02:05:16) Tools: Yoga Nidra, NSDR; Pre-Sleep Relaxation, Energy & Restorative Sleep (02:10:58) Diet & Individualization, Clinical Trials; Mitochondria & Nutrition, Keto (02:20:14) Alcohol & Energy Budget; Stress (02:25:02) Exercise, Increase Mitochondria, Overtraining; Resistance & Growth (02:33:06) Sponsor: Waking Up (02:34:41) Supplements & Mitochondria Health, Deficiencies, SS31, Methylene Blue (02:41:31) Energy Flow & Experiences, Balance (02:49:13) Transform Through Resistance, Energetic Awareness, Connection (02:56:05) Food Overconsumption & Mitochondria Disruption; Tissues & Mitochondria (03:01:02) Mitochondrial Health Test; Tool: Ways to Increase Energy; Meditation (03:06:10) Peptides; Fertility Supplements, Urolithin A; Electromagnetic Fields (03:12:16) Acknowledgements (03:14:15) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

The ACIP voted to replace universal newborn hepatitis B vaccination with shared clinical decision-making for infants of mothers who test negative, a move strongly criticized by major medical and public health groups who warn it could reverse decades of progress in preventing pediatric hepatitis B. A large NEJM trial found that a single dose of HPV vaccine provides protection equivalent to two doses over five years, supporting simplified global vaccination strategies. Real-world evidence from nearly 5,000 patients shows dapagliflozin and empagliflozin deliver similar safety and effectiveness across all forms of heart failure.

In this episode, the CardioNerds (Dr. Rachel Goodman, Dr. Shazli Khan, and Dr. Jenna Skowronski) discuss a case of AMI-shock with a focus on listing for heart transplant with faculty expert Dr. Kelly Schlendorf. We dive into the world of pre-transplant management, discuss the current allocation system, and additional factors that impact transplant timing, such as sensitization. We conclude by discussing efforts to increase the donor pool.  Audio editing for this episode was performed by CardioNerds Intern, Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls The current iteration of heart allocation listing is based on priority, with status 1 being the highest priority.  The are multiple donor and recipient characteristics to consider when listing a patient for heart transplantation and accepting a heart offer.  Desensitization is an option for patients who need heart transplantation but are highly sensitized.  Protocols vary by center.  Acceptance of DCD hearts is one of many efforts to expand the donor pool   Notes Notes: Notes drafted by Dr. Rachel Goodman  Once a patient is determined to be a candidate for heart transplantation, how is priority determined?  The current iteration of heart listing statuses was implemented in 2018.  Priority is determined by acuity, with higher statuses indicating higher acuity and given higher priority.  Status 1 is the highest priority status, and Status 7 is inactive patients. (1,2)  What criteria should be considered in organ selection when listing a patient for heart transplant?  Once it is determined that a patient will be listed for heart transplantation, there are certain criteria that should be assessed.  These factors may impact pre-transplant care and/or donor matching (3).  (1) PVR  (2) Height/weight   (3) Milage listing criteria  (4) Blood typing/cPRA/HLA typing  What is desensitization and why would it be considered?  Desensitization is an attempt to reduce or remove anti-HLA antibodies in the recipient.  It is done to increase the donor pool.  In general, desensitization is reserved for patients who are highly sensitized.  Desensitization protocols vary by transplant center, and some may opt against it.  When considering desensitization, it is important to note two key things: first, there is no promise that it will work, and second desensitization involves the use of immunosuppressive agents, thereby putting patients at increased risk of infection and cytopenia. (4)  Can you explain DCD and DBD transplant?  DBD: donor that have met the requirements for legal definition of brain death.   DCD: donors that have not met the legal definition of brain death but have been determined to have circulatory death.  Because the brain death criteria have not been met, organ recovery can only take place once death is confirmed based on cessation of circulatory and respiratory function. Life support is only withdrawn following declaration of circulatory death—once the heart has stopped beating and spontaneous respirations have stopped. (5,6)  References 1: Maitra NS, Dugger SJ, Balachandran IC, Civitello AB, Khazanie P, Rogers JG. Impact of the 2018 UNOS Heart Transplant Policy Changes on Patient Outcomes. JACC Heart Fail. 2023;11(5):491-503. doi:10.1016/j.jchf.2023.01.009  2:  Shore S, Golbus JR, Aaronson KD, Nallamothu BK. Changes in the United States Adult Heart Allocation Policy: Challenges and Opportunities. Circ Cardiovasc Qual Outcomes. 2020;13(10):e005795. doi:10.1161/CIRCOUTCOMES.119.005795  3:  Copeland H, Knezevic I, Baran DA, et al. Donor heart selection: Evidence-based guidelines for providers. J Heart Lung Transplant. 2023;42(1):7-29. doi:10.1016/j.healun.2022.08.030  4: Kittleson MM. Management of the sensitized heart transplant candidate. Curr Opin Organ Transplant. 2023;28(5):362-369. doi:10.1097/MOT.0000000000001096  5:  Kharawala A, Nagraj S, Seo J, et al. Donation After Circulatory Death Heart Transplant: Current State and Future Directions. Circ Heart Fail. 2024;17(7):e011678. doi:10.1161/CIRCHEARTFAILURE.124.011678  6: Siddiqi HK, Trahanas J, Xu M, et al. Outcomes of Heart Transplant Donation After Circulatory Death. J Am Coll Cardiol. 2023;82(15):1512-1520. doi:10.1016/j.jacc.2023.08.006