Why avoid phenylephrine in systolic HF

Picking up right where Part 1 left off, this episode zeroes in on the practical, high-stakes side of inpatient heart failure management. Dr. Cait Kulig returns to unpack key adverse effects of diuresis, strategies to overcome diuretic resistance, and how to approach add-ons, IV vasoactive agents, and inotropes.

Jimmy and Cait also dive into the impact of acute decompensated heart failure on pharmacokinetics, diuretic selection, and guideline-directed therapy across HFrEF and HFpEF—including tips for transitioning to ARNIs and remembering what really matters during inpatient optimization.

Whether you're adjusting diuretics or making big-picture decisions, this episode will help you level up your heart failure confidence.