The Curbsiders Internal Medicine Podcast #469 Inpatient Heart Failure
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Feb 3, 2025 Dr. Gurusher Panjrath, a leading cardiologist and director at George Washington University's Heart Failure Program, discusses advanced inpatient heart failure management. He shares insights on effective diuretic therapy and innovative strategies for integrating outpatient care. The conversation highlights essential diagnostics like POCUS and echocardiography, as well as the nuances of managing volume overload. Dr. Panjrath emphasizes the importance of patient education and communication to ensure successful transitions of care, ultimately aiming for improved patient outcomes.
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Differential Diagnosis
- Consider differentials for shortness of breath and leg swelling, even with a suspected heart failure diagnosis.
- Evaluate for conditions like liver disease, thyroid issues, arrhythmias, or systemic illnesses.
POCUS in HF
- Point-of-care ultrasound (POCUS) can provide additional information beyond left ventricular ejection fraction (LVEF) in heart failure patients.
- POCUS helps assess vena cava size, pericardial fluid, and regional wall motion abnormalities.
Echocardiography Timing
- Obtain an echocardiogram for new-onset heart failure to assess structure and guide therapy.
- For known heart failure exacerbations, repeat echo only if it will change management (e.g., valvular insufficiency).