Welcome to CardioNerds, where we bring you in-depth discussions with leading experts, case reports, and updates on the latest advancements in the world of cardiology. Tune in to expand your knowledge, sharpen your skills, and become a true CardioNerd!
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This episode explores a complex case of right ventricular (RV) infarction post-PCI leading to acute RV failure and cardiogenic shock. It delves into the diagnostic challenges, the critical role of invasive hemodynamics using a Swan-Ganz catheter, and the strategic escalation of medical therapy to mechanical circulatory support with a Protek Duo RVAD. The discussion highlights the RV's unique physiology and propensity for recovery with timely, tailored intervention.
This episode features University of Florida cardiology fellows discussing a challenging case of severe peripheral artery disease (PAD) and cerebral hyperperfusion syndrome. They delve into PAD prevalence, physical exam findings, and detailed interpretation of ABIs and advanced imaging. The discussion covers guideline-directed medical therapy, the benefits of supervised exercise, and the complex decision-making for revascularization, ultimately revealing a rare post-procedure complication and its pathophysiology. The episode concludes with fellows sharing their passion for cardiology and the UF program, alongside an expert's insights into subclavian stenosis treatment.
CardioNerds and Johns Hopkins fellows present a challenging case of RV failure and shock following AV graft placement in a patient with pre-existing conditions. They delve into potential causes including protamine reactions, high-output heart failure, and the impact of a diminutive RCA, highlighting the diagnostic utility of echocardiography and the shift from cardiogenic to distributive shock. The episode culminates in a successful intervention via graft ligation, followed by expert perspectives on RV echo assessment and insights into the Johns Hopkins Cardiology Fellowship.
CardioNerds discuss a critical case of a 32-year-old pregnant woman experiencing cardiac arrest due to peripartum cardiomyopathy. The fellows detail the diagnostic challenges, physiological considerations in pregnancy, and the complex, multidisciplinary emergency management including ECMO and emergent C-section. The episode further explores long-term care, guideline-directed medical therapy, and the unique challenges of PPCM, culminating in a successful outcome for both mother and baby.
This episode of CardioNerds features Cedars-Sinai fellows discussing a complex case where a massive pulmonary embolus mimicked a STEMI in a young patient, leading to refractory cardiac arrest. They detail the diagnostic journey, from initial EKG analysis and differential considerations to the critical decision-making for VA-ECMO and pulmonary angiogram. The discussion extends to the pathophysiology of RV injury in PE, various treatment options, and profound reflections on end-of-life care and the unique challenges and rewards of cardiology training at Cedars-Sinai.
CardioNerds explore a challenging case with Mayo Clinic fellows involving a patient with lupus, severe mitral regurgitation, and undiagnosed constrictive pericarditis. The discussion delves into the subtle physical exam findings, advanced echocardiography, and invasive hemodynamics that help differentiate between restrictive and constrictive physiology. Experts emphasize the importance of a holistic diagnostic approach and the unique training environment at Mayo Clinic. The episode concludes with a successful surgical outcome and insights from the program director.
This CardioNerds episode features University of Tennessee fellows presenting a complex case of a patient with recurrent ascites and lower extremity edema, ultimately diagnosed with constrictive pericarditis. The discussion delves into the diagnostic challenges, detailed echocardiographic and hemodynamic findings, and the physiological distinctions between constrictive and restrictive cardiomyopathies. The episode concludes with insights on avoiding diagnostic bias, the successful pericardiectomy, and a message from the program director about the UT cardiology fellowship.
CardioNerds ( Amit Goyal & Daniel Ambinder ) join Penn cardiology fellows ( Brian McCauley , Norrisa Haynes , and Mahesh Vidula ) for a rooftop picnic in sunny Philadelphia ! They discuss an informative case of peripartum cardiomyopathy with cardiogenic shock . Program director Dr. Frank Silvestry provides the E-CPR segment and a message to applicants. Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai. Jump to ...
CardioNerds and Northwestern fellows discuss a fascinating case of a 41-year-old with recurrent ICD shocks and a "weak heart" initially attributed to viral illness, then sarcoid. Advanced imaging and genetic testing ultimately revealed arrhythmogenic desmoplakin cardiomyopathy, emphasizing how genetic variants can mimic inflammatory conditions. The discussion covers high defibrillation thresholds, diagnostic approaches, genetic counseling, and the evolving understanding of arrhythmogenic cardiomyopathies. Experts also share insights into Northwestern's cardiology fellowship training.
This CardioNerds episode delves into a rare yet critical post-TAVR complication known as "Suicide LV," triggered by a protamine reaction and exacerbated by traditional inotropic support. UT Austin fellows meticulously guide through the diagnostic challenges, emphasizing the unique pathophysiology and counterintuitive management strategies required. Expert E-CPR and a message from the program director further illuminate the systematic approach to post-TAVR shock and the comprehensive training environment at UT Austin.
The CardioNerds team and Washington University fellows present a compelling case of wild-type ATTR cardiac amyloidosis in an elderly patient. They meticulously review the diagnostic pathway, emphasizing echocardiographic red flags, advanced imaging, and the critical importance of differentiating ATTR from AL amyloid. The discussion highlights breakthrough therapies like Tafamidis and the evolving landscape of amyloid detection and management. Additionally, the fellows and program director share insights into the supportive and innovative Washington University cardiology fellowship program.
CardioNerds ( Amit Goyal & Daniel Ambinder ) join Temple Cardiology Fellows ( Anika Vaidy and Anne- Sophie LaCharite-Roberge ) in Philadelphia, PA! They discuss a fascinating case of pulmonary hypertension secondary to Chronic Thromboembolic Pulmonary Hypertension (CTEPH) associated with May Thurner syndrome and large uterine fibroids. Dr. Vaidya provides the E-CPR and message to applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorsh...
CardioNerds ( Amit Goyal & Carine Hamo ) discuss the past, present, and future of Women’s Heart Health & Women in Cardiology with Dr. Nanette Wenger , Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine . Dr. Wenger is a true leader in the field of women’s heart health and a strong proponent for women in cardiology and medicine. Her passion, dedication, and advocacy have inspired countless trainees to carry this torch and continue to build on he...
CardioNerds ( Amit Goyal & Dan Ambinder ) join Lankenau Medical Center cardiology fellows ( Gwen McNeill and Shaung Ooi ) for some Philly cheesesteaks! They discuss a fascinating case of Embolic Acute Coronary Syndrome from PFO and Pulmonary Hypertension . Dr. John Clark provides the E-CPR and program director Dr. Jeanine Romanelli provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland ...
This episode from CardioNerds features Duke University fellows and faculty discussing a challenging case of hereditary restrictive cardiomyopathy. They walk through the patient's presentation, extensive diagnostic workup including advanced imaging, blood volume analysis, and genetic testing, ultimately leading to a successful heart transplant. The discussion delves into the nuances of RCM pathophysiology, management, and the unique challenges in securing transplantation for these patients, complemented by insights into Duke's cardiology fellowship program.
CardioNerds ( Amit Goyal & Daniel Ambinder ) join Allegheny Health Network cardiology fellows ( Adnan Khalif , Mahathi Indaram , Kushani Gajjar , and Michael Nestasie ) for a lovely Pittsburgh hike and discuss a fascinating case of platypnea-orthodeoxia secondary to a PFO. Dr. Farhan Katchi provides the E-CPR and Program director Dr. Craig Alpert provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Richard Ferraro with mentorship from Un...
CardioNerds join Vanderbilt fellows to discuss a fascinating case of critical bicuspid aortic valve stenosis in a pregnant transgender man. They explore diagnostic nuances, the physiological impact of pregnancy on valvular disease, and the challenging decisions around the timing and method of intervention and delivery. The discussion highlights the importance of multidisciplinary care and patient-centered decision-making in complex cardiac cases.
CardioNerds ( Amit & Dan ) join UT Southwestern cardiology fellows ( Shreya Rao , Sonia Shah , and Nick Hendren ) for some delicious Dallas Tacos! They discuss a fascinating case of syphilitic aortitis with severe aortic regurgitation presenting as cardiogenic shock . Program director Dr. Gail Peterson provides the E-CPR and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fel...
CardioNerds introduces its Case Reports: Recruitment Edition Series, a collaboration with ACC FIT to help programs showcase their training during virtual recruitment. The episode also launches the CardioNerds Academy, a mentored program for future medical education podcasters. Dr. Nosheen Reza, ACC FIT chair, discusses virtual recruitment challenges, opportunities for fellows to engage with the ACC, and critical initiatives to promote diversity and inclusion in cardiology.
This episode details a fascinating case of a 49-year-old male with severe COVID-19 presenting as isolated cardiogenic shock, despite minimal pulmonary involvement. The discussion covers diagnostic challenges, rationale for VA-ECMO and Impella, and the groundbreaking finding of SARS-CoV-2 virions in the myocardium. An expert guest further elaborates on diverse cardiac manifestations of COVID-19 and the critical role of early mechanical support and targeted anti-inflammatory treatment for recovery.
Dr. Michael Blaha discusses coronary artery calcium (CAC) scoring as a powerful tool for individualized cardiovascular disease prevention. He explains how CAC is generated, its epidemiological insights across populations, and its superiority over other subclinical atherosclerosis tests. The episode delves into applying CAC for personalized risk assessment, guiding treatment decisions for statins and aspirin, and effectively counseling patients with both zero and high scores, emphasizing lifestyle and future interventions.
JACC: Case Reports Editor-in-Chief, Dr. Julia Grapsa joins Cardionerds, Amit and Dan, to introduce a new episode series: CardioNerds Case Reports (#CNCR)! We discuss the value of learning through cases, podcasts and other innovations in education, importance of promoting wellness in medicine, the editorial review process for case reports, and being an editor-in-chief as a woman in medicine.
The CardioNerds discuss Lipid Management with Dr. Ann Marie Navar and Dr. Nishant Shah from Duke Medical Center, Division of Cardiology. Amit, Carine and Dan take a deep dive into the greasy world of lipids and cholesterol, covering lipid metabolism, therapeutic targets, approach across the entire spectrum of predicted risk, and key common management scenarios (statin intolerance, hypertriglyceridemia, elevated LP(a)), and more.
The CardioNerds discuss Women's Cardiovascular Prevention with Dr. Leslie Cho, Interventional Cardiologist and Director of the Cleveland Clinic’s Women’s Cardiovascular Center. She is also Section Head of Preventive Cardiology and Rehabilitation in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic. Amit, Dan and Carine take a deep dive into women's cardiovascular prevention and discuss the epidemiology, unique risk factors, different manifestations of CVD a...
The CardioNerds discuss The 'ABC's of Cardiovascular Prevention with Dr. Roger Blumenthal, Director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease and co-chairperson of the 2019 American College of Cardiology/American Heart Guideline on prevention of cardiovascular disease. Joining the discussion is Dr. David Feldman, Osler housestaff and first author of a beautiful State-of-the-Art review in the American Journal of Preventive Cardiology discussing a comprehen...
CardioNerds Amit Goyal and returning guest Dr. Zach Il'Giovine interview our star patient of this series: Kanak Amin. Mr. Amin tells us about his perspectives on being a heart patient and offers important advice for both patients and providers. He gives us many pearls, but especially highlights the importance of diabetes education, cardiac rehabilitation, engaging loved ones, and getting to know the patient on a deeper level. Special messages from Dr. Wael Jaber and Dr. Nishant Shah, who both kn...
This is the first episode in an important series on cardiovascular prevention. It's no secret that cardiovascular disease is the #1 killer worldwide; the total impact on humanity is just staggering. A focus on preventing CVD is an impetus for every cardionerd. In this episode Dan, Amit, Carine, and Heather discuss an illustrative case discussion and review the Cardionerds 2+4 paradigm of cardiovascular prevention: 2 fundamental principles of management + 4 steps in risk stratification.
The role of palliative care in the management of heart failure is discussed by palliative care expert, Dr. Rab Razzak, clinical associate professor and clinical director of palliative care at University Hospital Cleveland Medical Center. CardioNerds host Amit Goyal is joined by special guest interviewer, Dr. Arsalan Derakhshan, Assistant Program director at Case Western Internal Medicine residency program and the head of the Global Health Pathway as well as co-host of the Clinical Problem Solver...
Dr. Robert Mentz , director of the Heart Failure section in the Duke Division of Cardiology , discusses diuretics , anti-hyperglycemic therapies including SGLT2/GLP1 agents, angiotensin receptor-neprilysin inhibitors (ARNi) , iron as therapies for Heart Failure with Preserved Ejection Fraction (HFpEF). Additionally, study design and ongoing research in HFpEF is discussed. At the end of the episode Dr. Mentz provides an additional update that highlights how the COVID-19 pandemic has influenced cl...
We discuss Heart Failure with Preserved Ejection Fraction (HFpEF) with Dr. Kavita Sharma, director of the Heart Failure with Preserved Ejection Fraction Program and interim director of Advanced Heart Failure Transplant section at The Johns Hopkins Hospital. CardioNerds hosts Carine Hamo and Daniel Ambinder are joined by Dr. Beth Feldman (resident at The Johns Hopkins Hospital). Topics discussed include a definitions, diagnosis, phenotypic presentations, inpatient management of acute decompensate...
