Attila Kardos, a consultant cardiologist and clinical lead at Milton Keynes University Hospital, shares his expertise on stress echocardiography and its role in diagnosing chest pain. He discusses the historical significance of this diagnostic tool and its inclusion in cardiovascular guidelines. The conversation dives into a meta-analysis revealing the long-term prognostic value of stress echo and its effectiveness compared to other cardiac imaging techniques. Attila highlights key findings from studies involving over 16,500 patients, emphasizing the importance of interpreting test results for managing cardiovascular risks.

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Fielder Camm from Oxford. They discuss the current state of cardiology post-graduate training in the UK and why it needs reforming. If you enjoy the show, please leave us a podcast review wherever you get your podcast - it's very helpful to us! Link to published paper: https://heart.bmj.com/content/early/2024/12/03/heartjnl-2024-325037

Kazem Rahimi, a Professor of Cardiovascular Medicine at the University of Oxford, delves into the critical landscape of blood pressure management in type 2 diabetes. The conversation highlights the urgent need for updated guidelines due to the common overlap of hypertension and diabetes. They discuss the importance of lifestyle adjustments alongside pharmacological strategies, emphasizing ACE inhibitors and ARBs. Recent advancements, like SGLT2 inhibitors, are showcased for their cardiac and renal benefits, offering a fresh perspective on comprehensive diabetes care.

Professor Vijay Kunadian, an expert in interventional cardiology, shares insights on improving cardiovascular health for women. He highlights the unique challenges women face in diagnosis and treatment, and the importance of participation in clinical trials. The discussion covers gender disparities in cardiac rehabilitation, emphasizing the need for flexible options that consider family dynamics. Kunadian also addresses regional inequalities in care and the necessity of incorporating sex-specific risk factors for better health outcomes.

Rohan Khera, a cardiologist and data scientist at Yale University, discusses groundbreaking AI applications in interpreting ECGs. He reveals how AI can uncover insights often overlooked in traditional analyses. The conversation dives into innovations in diagnosing rhythm disorders and improving cardiac risk assessments through augmented data. Khera also highlights the transformative potential of AI in low-resource healthcare settings, showcasing how these advancements could revolutionize cardiovascular care globally.

Mark Sarnak, an expert from Tufts University, discusses the intricate relationship between chronic kidney disease (CKD) and cardiovascular risks. He highlights the rising incidence of CKD driven by obesity and diabetes, and the significance of efficient screening. Sarnak delves into the latest guidelines for managing cardiovascular risk in CKD patients, including the use of innovative treatments like SGLT2 inhibitors. He also touches on the complexities of prescribing antiplatelet medications and the future of personalized medicine in cardiovascular care.

In this engaging discussion, Mark R Nelson, a general practitioner and researcher at the Menzies Institute for Medical Research, dives into the multifaceted world of aspirin. He explores its historical significance and current guidelines, shedding light on its evolving role in cardiovascular and cancer treatment. Recent large-scale trials are scrutinized, revealing aspirin's potential benefits and risks—especially for the elderly. With fascinating insights into its possible applications beyond heart health, this conversation offers a fresh perspective on aspirin's future in medicine.

Join Professor Marjan Jahangiri, a leading cardiac surgeon at St George's Hospital, as he unpacks the complexities of managing bicuspid aortic valve disease. He explores the role of Transcatheter Aortic Valve Implantation (TAVI) in treatment, discussing its risks and personalized care approaches. Delve into the genetic factors, clinical features, and post-operative monitoring necessary for optimal outcomes. Jahangiri also shares insights on future advancements and the importance of research in enhancing patient care.

Paul Morris is a senior clinical lecturer and interventional cardiologist, while Hazel Haley is a consultant interventional cardiologist, both hailing from Sheffield. They delve into the innovative world of virtual fractional flow reserve (VFFR) and its clinical implications. Insights from their VIRTU-4 study reveal how VFFR impacts patient management in coronary syndromes, shifting strategies towards enhanced therapies and PCI. They also discuss the limitations of VFFR and the importance of ongoing research in advancing non-invasive assessment tools in cardiology.

Oliver Brown, a cardiology trainee from Leeds, discusses the alarming health trends among UK cardiology trainees. He shares insights from a survey revealing high levels of burnout, anxiety, and depression within the field. The conversation emphasizes the importance of mental health support and community resources. Brown also discusses the evolving training structure and its impact on trainee well-being, advocating for necessary changes to improve their overall health. It's a candid look at the rigorous demands faced by those in cardiology.