The Pharm So Hard Emergency Medicine & Hospital Pharmacy Podcast Episode 125. Part 1 – Loop There It Is! Mastering the Foundations of Heart Failure
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Oct 10, 2025 
Cait E. Kulig, a skilled clinical cardiology pharmacist and educator specializing in heart failure, joins host Jimmy Pruitt for an enlightening discussion. They unpack the complexities of heart failure, explaining ejection fraction and the Forrester plot in relatable terms. Cait shares key insights on distinguishing between systolic and diastolic heart failure and the importance of hospitalization in prognosis. Listeners learn practical questions to ask patients and strategies for managing guideline-directed medical therapy effectively.
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Heart Failure Is Pump Failure
- Heart failure means the heart cannot supply sufficient blood to meet the body's needs.
- Different structural problems can cause the same outcome of inadequate output.
Squeeze Versus Fill Explains EF Types
- Systolic (HFrEF) is a squeeze problem and EF ≤40%.
- Diastolic (HFpEF) is a filling/volume problem with preserved EF but reduced chamber size.
EF Is Relative, Not Absolute
- Ejection fraction is stroke volume divided by end-diastolic volume.
- Equal EF percentages can hide large differences in absolute cardiac output.