Cardionerds: A Cardiology Podcast

Discussing the importance of managing obesity to prevent cardiovascular disease, the podcast covers lifestyle recommendations, pharmacologic treatment options, and future therapies. Topics include tailored counseling, policy efforts to address obesity as a public health concern, advances in weight loss medications such as semaglutide, and the intersection of obesity medicine and heart failure.

Topics discussed include diagnosing and classifying heart failure, the diagnostic process for rapidly progressive heart failure in a younger patient, physical exam findings and classification of a heart failure patient, analysis of initial laboratory results and patient triage, evaluation and monitoring, treatment options for rapidly progressive heart failure, and imaging surveillance challenges for cardiac sarcoidosis.

Dr. Javed Butler, an advanced heart failure and transplant cardiologist, discusses the 2022 AHA/ACC/HFSA guideline for the management of heart failure. Topics include the management of cardiogenic shock, the use of intra-aortic balloon pump, and personalized care for patients with cardiogenic shock.

Dr. Juan Lopez-Mattei, an expert in cardio-oncology and director of cardiac imaging, discusses cardiac tumors, differentiating between primary and secondary tumors. They explore symptoms, diagnostic methods, and treatment options. They highlight the importance of imaging modalities and the necessity of tissue diagnosis for primary tumors. The speakers express their appreciation for cardio-oncology and emphasize the importance of collaboration in patient care.

Dr. José Joglar and Dr. Mina Chung discuss the key takeaways from the 2023 ACC/AHA/ACCP/HRS Atrial Fibrillation Guidelines, including the updated staging scheme, the effects of alcohol and caffeine on AF, improving stroke prevention, the evolving importance of rhythm control, shared decision-making, and the process of developing clinical guideline documents.

CardioNerds podcast features Drs. Karishma Rahman, Shu Min Lao, and Constantine Troupes discussing a fascinating case of a 20-year-old woman with hypertension and possible mid-aortic syndrome. They explore the differential diagnosis of early-onset hypertension, imaging for diagnosis and surveillance, and treatment options. They also delve into large vessel vasculitis and the challenges in obtaining tissue diagnosis. Managing hypertension and IgG4-related disease, imaging results, and the importance of considering underlying causes of wall thickening are discussed.

Dr. Jamie Almandoz, an expert in obesity and cardiovascular disease risk, joins the hosts to discuss the impact of obesity on cardiovascular health. They explore the question of whether it is possible to be healthy at any size and highlight the biomechanical and psychosocial challenges of obesity. They also delve into the effects of different types of adipose tissue on metabolic health and organ systems. The speakers analyze the results of a semaglutide trial for obesity and cardiovascular disease, discussing the significant risk reduction in major adverse cardiovascular events. Lastly, they discuss the percentage of body weight reduction needed for cardiovascular disease benefits.

Dr. Ashley Lochman and Dr. Chris Domenico discuss anticoagulation pharmacology and clinical decision-making for atrial fibrillation. They explore topics such as when to use warfarin, choosing appropriate DOAC agents, managing therapy in patients on antiplatelets, and the challenges of clinical pharmacology in cardiology.

CardioNerds (Dr. Amit Goyal) join Dr. Anureet Malhotra, Dr. John Fritzlen, and Dr. Tarun Dalia from the University of Kansas School of Medicine for some of Kansas City’s famous barbeque. They discuss a case of Hydroxychloroquine induced cardiomyopathy. Notes were drafted by Dr. Anureet Malhotra, Dr. John Fritzlen, and Dr. Tarun Dalia. Expert commentary was provided by Dr. Pradeep Mammen. The episode audio was edited by Dr. Akiva Rosenzveig. Drug-induced cardiomyopathy remains an important and under-recognized etiology of cardiomyopathy and heart failure. Hydroxychloroquine is a disease-modifying antirheumatic drug used for various rheumatological conditions, and its long-term use is well-known to have toxic effects on cardiac muscle cells. Multiple cardiac manifestations of these drugs have been identified, the most prominent being electrophysiological disturbances. In this episode, we discuss a biopsy-proven case of hydroxychloroquine-induced cardiotoxicity with detailed histopathological and imaging findings. We develop a roadmap for the diagnosis of hydroxychloroquine-induced cardiomyopathy and discuss the various differentials of drug-induced cardiomyopathy. We highlight the importance of clinical monitoring and early consideration of drug-induced toxicities as a culprit for heart failure. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - Hydroxychloroquine induced cardiomyopathy Pearls - Hydroxychloroquine induced cardiomyopathy Continued decline in left ventricular systolic function despite appropriate guideline directed medical therapy should prompt a thorough evaluation for unrecognized etiologies and warrants an early referral to advanced heart failure specialists. Transthoracic echocardiogram is a valuable non-invasive screening tool for suspected pulmonary hypertension, but right heart catheterization is required for definitive diagnosis. Cardiac MRI can be used for better characterization of myocardial tissue and can aid in the evaluation of patients with non-ischemic cardiomyopathy. Hydroxychloroquine (HCQ) is a commonly used DMARD that remains an underrecognized etiology of cardiomyopathy and heart failure. In addition to ophthalmological screening, annual ECG, as well as echocardiography screening for patients on long-term HCQ therapy, should be considered in patients at risk for cardiovascular toxicity, including those with pre-existing cardiovascular disease, older age, female sex, longer duration of therapy, and renal impairment. Management of hydroxychloroquine-associated cardiomyopathy consists of discontinuing hydroxychloroquine and standard guideline-directed medical therapy for heart failure.  HCQ cardiomyopathy may persist despite medical therapy, and advanced therapy options may have to be considered in those with refractory heart failure. Show Notes - Hydroxychloroquine induced cardiomyopathy What are the various cardiotoxic effects of hydroxychloroquine (HCQ) and the mechanism of HCQ-mediated cardiomyopathy? One of the most frequently prescribed disease-modifying antirheumatic drugs (DMARDs), HCQ is an immunomodulatory and anti-inflammatory agent that remains an integral part of treatment for a myriad of rheumatological conditions. Its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions.8 The known cardiac manifestations of HCQ-induced toxicity include conduction abnormalities, ventricular hypertrophy, hypokinesia, and lastly, cardiomyopathy. Conduction Abnormalities - by binding to and inhibiting the human ether-à-go-go-related gene (hERG) voltage-gated potassium channel,

CardioNerds podcast features Drs. Hanad Bashir, Hyunsoo Chung, and Dalia Aziz discussing a case of angioleiomyoma. They highlight the diagnostic approach to syncope, evaluation of cardiac masses, rare angioleiomyomas, and unique experiences in the Christ Hospital Fellowship Program.