Cardionerds: A Cardiology Podcast

CardioNerds (Amit Goyal & Daniel Ambinder) join Northwestern University cardiology fellows (Sarah Hale, Sarah Chuzi, and Graham Lohrmann) for burgers and a great case by the Chicago River! They discuss a fascinating case of arrhythmogenic desmoplakin cardiomyopathy. Dr. Lisa Wilsbacher provides the E-CPR and program director Dr. Benjamin Freed provides a message for applicants.  Episode notes were developed by Johns Hopkins internal medicine resident Richard Ferraro with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A male in his early 40s presented for second opinion regarding multiple ICD shocks. 10 years prior he was diagnosed with a “weak heart,” thought secondary to a viral illness and a dual-chamber ICD was placed at that time. He noted shocks occurring for the first time 5 years prior, at which time amiodarone was started. They recurred two years prior, when he was diagnosed with paroxysmal atrial fibrillation. Finally, he was hospitalized one month before presentation with multiple ICD shocks and was found to have high defibrillation thresholds (DFTs) and amiodarone was stopped. He  then presented for a second opinion from the Northwestern CardioNerds!  The patient had been doing well on GDMT and had NYHA Class I symptoms (Enjoy Ep #13 – Approach to GDMT). He did note a family history of a cousin with “cardiac issues” and did not know his father’s family history. Physical exam demonstrated bradycardia and ECG demonstrated an a-paced, v-sensed rhythm at 50 bpm. TTE demonstrated a moderately dilated LV with LVEF 30%, globally reduced LV function and multiple wall motion abnormalities without a vascular distribution.  PET-CT was performed which showed diffuse uptake and high-intensity signal at the inferolateral and basal anterior walls. Cardiac MRI showed diffuse circumferential epicardial delayed enhancement with associated diffuse, enhancing thickening of the pericardium favoring inflammatory versus fibrotic process. Patient was initially diagnosed with cardiac sarcoid and started on prednisone and weekly methotrexate.   On return of genetic testing, patient found to have a pathogenic variant for desmoplakin gene, and it was felt his cardiomyopathy was secondary to desmoplakin Left Dominant Arrhythmogenic Cardiomyopathy (LDAC, or left-dominant ARVC) presenting with inflammatory myocardial injury. On follow up the patient remained listed for transplant, and DFTs improved off amiodarone.   Case Media CXR ECG Cardiac MRI PET CT (Cardiac Sarcoid Protocol) Click to Enlarge Episode Schematics & Teaching Created by Dr. Karan Desai Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case We started the case talking about DFTs. What are DFTs?!  Defibrillation Thresholds (DFTs) are the minimal amount of energy required to return a patient to sinus rhythm that is in a cardiac dysrhythmia.   Most modern ICD leads have thresholds less than 15 joules and typically less than 10 joules with biphasic shocks. High DFT thresholds tend to be defined as >25J or a safety margin of <10J.  DFT testing is not routinely recommended during implantation of left-sided transvenous devices; however, in patients undergoing right-sided transvenous ICD or ICD pulse generator changes, DFT testing is a reasonable approach. Pat

CardioNerds (Amit Goyal & Daniel Ambinder) join UT-Austin cardiology fellows (Priya Kothapali, Sergio Montano, Travis Benzing, and Michael Grzeskowiak) for a speedboat adventure on Lake Travis! They discuss a fascinating case of Suicide LV post-TAVR. Dr. Mark Pirwitz provides the E-CPR and program director Dr. Clay Cauthen provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her early 70s, with a history of CAD s/p PCI to LAD & RCA with DES six months prior, to presentation, paroxysmal atrial fibrillation s/p ablation, type 2 diabetes mellitus, hypertension, prior TIA, and severe symptomatic AS was admitted for elective TAVR. She underwent successful implantation of a 29mm Medtronic Evolut Pro valve via left common femoral artery access. Post-valve deployment and following protamine administration for heparin reversal, course was complicated by hypotension with PEA arrest requiring CPR for 4 minutes. Intra-op TEE and angiogram showed a well-seated prosthetic valve with trace paravalvular leak and no evidence of acute aortic regurgitation, significant paravalvular leak, pericardial effusion, coronary obstruction, aortic dissection, or access site complications. She was treated for suspected Protamine reaction with high dose steroids & epinephrine. However, she remained hypotensive with MAP in the 50s on high dose Epinephrine, Norepinephrine, and Vasopressin. Hemodynamics by pulmonary artery catheter demonstrated CVP 7, mPA 26, PCWP 18 mmHg and CO/CI 2.8 L/min and 1.3 L/min/m2. Her lactate was elevated at 5.92 mmol/L and EKG demonstrated normal sinus rhythm. Bedside TTE in the ICU showed hyperdynamic LV function with LVEF 70% and near-complete mid to distal cavity obliteration with significant intracavitary gradient. She was diagnosed with post-TAVR suicide LV and managed with aggressive volume resuscitation and rapid wean of Epinephrine/Norepinephrine with improvement in her hemodynamics. She was eventually extubated and discharged on beta-blocker therapy. Case Media A. ECG B. CXR Click to Enlarge A. ECG: Normal sinus rhythm, no evidence of AV block, no ST segment elevation or depression.B. CXR: Pulmonary vascular congestion, no pneumothorax, ETT at level of carina, PAC in appropriate position Pre-Aortogram Implantation Post-Dilation Post-Aortogram TEE: Mid-Esophageal Three-Chamber View TEE: Mid-Esophageal Short Axis View Abdominal aortography showed no evidence of vascular access site complication or contrast extravasation. Aortic root angiography showed no evidence of AI, coronary obstruction, or dissection. TTE: PLAX and A4C Episode Schematics & Teaching Created by Dr. Karan Desai Graphic by Dr. Carine Hamo Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case Remind all CardioNerds – how do we define Severe Aortic Stenosis?  By TTE, severe AS is defined as a mean gradient >40 mmHg, a peak velocity >4 m/s, an aortic valve area <1 cm2 and dimensionless index < 0.25. But remember, in HF patients decreased trans-aortic valve flow secondary to LV disease can make the diagnosis challenging!  In HFrEF, patients with severe AS by aortic valve area (AVA) may not meet velocity or gradient criteria in one of four contexts: AVA measurement error, pseudo-severe AS, poor contractile reserve, or true severe Low Flow, Low Gradient AS (LFLG AS).  Similarl

CardioNerd (Amit Goyal) join Washington University in St. Louis cardiology fellows (Adam Lick, Manny Rivera Maza, and Sam Lindner) for some amazing local St. Louis craft brews! They discuss a fascinating case of  wild-type aTTR cardiac amyloid. Prior to meeting up with the group, Amit bumps into Rachita Navara: a Wash U #FIT, aspiring electrophysiologist, & a rock star of the band “The Pacemakers” (be sure to check out their performance at the end of the episode!) who shares thoughts about the program and her cutting edge contributions to the field of EP. Dr. Katie Zhang provides the E-CPR and program director Dr. Andy Kates provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary – Case figures & media – Case teaching – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A man in his early 70s, with a history of hypertension, a bicuspid aortic valve, chronic kidney disease and carpal tunnel syndrome presents with two weeks of worsening dyspnea on exertion. At baseline, he is an avid cyclist and noticed he can now only bike ½ mile when before he could bike extended distances. In addition, he noted abdominal swelling and palpitations. Vitals signs showed mild tachycardia, irregularly irregular rhythm, and no clear evidence of volume overload. Labs demonstrated acute on chronic kidney disease, an elevated NT-proBNP and elevated troponin. ECG demonstrated atrial flutter with variable conduction block. TTE demonstrated marked concentric left ventricular hypertrophy with preserved ejection fraction, biatrial enlargement, reduced global longitudinal strain with apical sparing, and bicuspid aortic valve with moderate aortic stenosis. Further diagnostics revealed normal serum kappa/lambda light chains and PYP scan was positive. Patient underwent EMB which demonstrated ATTR amyloid deposition and genetic screening did not show mutations commonly associated with hereditary ATTR. Case Media A B C D A. CXR: Stable mild enlargement of the cardiac silhouette; mildly tortuous aorta. Lung fields are clear, no pneumonia, pleural effusions, or pneumothorax.B. AV continuous wave DopplerC. Strain ImageD. Tc-99 PYP Scan TTE 1 TTE 4 TTE 2 TTE 5 TTE 3 TC-99 PYP Scan Strain video 1 Strain video 2 Strain video 3 Episode Schematics & Teaching Created by Dr. Karan Desai Created by Dr. Carine Hamo (updated 9.2020) Click to enlarge! The CardioNerds 5! – 5 major takeaways from the #CNCR case Cardiac amyloidosis can have a range of cardiac and extra-cardiac findings as amyloid fibrils can deposit in many different tissues, depending on the amyloid protein involved. The first step in diagnosis is maintaining a high index of suspicion. The presence of prominent right-sided HF symptoms, low voltage on ECG, biatrial enlargement, ventricular hypertrophy, conduction disease, and pericardial effusion should prompt a high suspicion for cardiac amyloid. These are typical features of infiltrative or storage restrictive cardiomyopathies. PEARL: ATTR CM can cause asymmetric LVH and is an important HCM phenocopy! Remember, amyloidosis is a systemic disease and extra-cardiac findings are common. ATTR amyloid has a predilection for the musculoskeletal system (including bilateral carpal tunnel syndrome, lumbar spinal stenosis, and biceps tendon rupture) and peripheral nerves. Conversely, AL amyloid is widely deposited outside the CNS an can result in protean manifestations, including periorbital ecchymoses from vascular fragility, macroglossia, and visceral org

CardioNerds (Amit Goyal & Daniel Ambinder) join Temple Cardiology Fellows (Anika Vaidy and Anne- Sophie LaCharite-Roberge) in Philadelphia, PA! They discuss a fascinating case of pulmonary hypertension secondary to Chronic Thromboembolic Pulmonary Hypertension (CTEPH) associated with May Thurner syndrome and large uterine fibroids. Dr. Vaidya provides the E-CPR and message to applicants. Episode notes were developed by Johns Hopkins internal medicine resident, Eunice Dugan, with mentorship from University of Maryland cardiology fellow Karan Desai. “To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.” – Sir William Osler. CardioNerds thank the patients and their loved ones whose stories teach us the Art of Medicine and support our Mission to Democratize Cardiovascular Medicine. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her late 40s with history of iron deficiency anemia, uterine fibroids, and recurrent DVTs/PEs for the past 6 years despite different anticoagulation regimens, presented with syncope and progressive dyspnea on exertion. Family history was negative for DVT/PE or hypercoagulable states. On exam, she was euvolemic. Labs were significant for anemia, a normal pro-BNP, and a negative extensive hypercoagulable workup. TTE showed interventricular systolic septal flattening, right ventricular outflow tract pulse wave doppler with mid-systolic notch, and shortened acceleration time consistent with elevated pulmonary artery pressure. A VQ scan showed bilateral right greater than left mis-matched perfusion defects. CT angiogram showed right greater than left chronic mural thrombus, correlating with pulmonary angiogram which showed severe proximal and mid-vessel disease on the right and distal disease on the left. RHC corroborated the diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) with mean pulmonary artery pressure of 41 and PVR of 5.2 Woods Units (WU).   To determine the etiology of her recurrent clots, a lower extremity venogram was performed and showed 80% stenosis of her left common iliac vein by the overlying right common iliac artery confirming May-Thurner syndrome. Lower extremity venogram also showed severe proximal stenosis of right iliac vein thought to be due to large uterine fibroids. Given her severe proximal and mid-vessel clot burden, she underwent pulmonary thromboendarterectomy with a subsequent drop in pulmonary vascular resistance to 1 WU.  The etiology of DVTs and CTEPH was determined to be external compression related to both May-Thurner syndrome and uterine fibroids. To prevent future thromboembolic events, she underwent stenting of her left common iliac vein and hysterectomy. With these interventions, RV function returned to normal, and her symptoms completely resolved!  Case Media A B C D E F G H I JClick to enlarge ??? Figue Legend: A. CXRB. ECGC. TTE: Interventricular systolic septal flattening, RVOT pulse wave Doppler with mid-systolic notch and shortened acceleration time, consistent with elevated PVR, RV:LV ratio 1.3, consistent with moderate RV enlargement, The RV is apex-sharing with an open apical angleD. VQ Scan: Multiple b/l perfusion defects, R > L, V scan normalE. CT Angiogram: 1) Enlarged R main PA2) large proximal chronic mural thrombus with minimal vessel cou

CardioNerds (Amit Goyal & Carine Hamo) discuss the past, present, and future of Women’s Heart Health & Women in Cardiology with Dr. Nanette Wenger, Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine. Dr. Wenger is a true leader in the field of women’s heart health and a strong proponent for women in cardiology and medicine. Her passion, dedication, and advocacy have inspired countless trainees to carry this torch and continue to build on her truly impactful work. Special introduction by Dr. Martha Gulati and birthday wishes to Dr. Wenger by the entire CardioNerds Team! Special thanks to Dr. Kimberly Manning for her invaluable mentorship. Episode graphic by Dr. Carine Hamo The Cardionerds CV prevention series  includes in-depth deep dives on so many prevention topics including the ABCs of prevention, approach to obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! CardioNerds Episode PageCardioNerds Prevention PageCardioNerds Women’s Cardiovascular Health PageCardioNerds Academy – Apply now! Subscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron! We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series References and Links 1. Wenger NK (2005) Women in cardiology: The US experience. Heart. 2. Douglas PS, Rzeszut AK, Noel Bairey Merz C, Duvernoy CS, Lewis SJ, Walsh MN, Gillam L (2018) Career preferences and perceptions of cardiology among us internal medicine trainees factors influencing cardiology career choice. JAMA Cardiol. 3. Wenger NK, Speroff L, Packard B (1993) Cardiovascular Health and Disease in Women. N Engl J Med. 4. Burgess S, Shaw E, Zaman S (2019) Women in Cardiology. Circulation. Meet Dr. Wenger! Dr. Nanette Wenger is Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine. Dr. Wenger received her medical degree from Harvard Medical School in 1954 as one of their first female graduates followed by training at Mount Sinai Hospital where she was the first female to be chief resident in the cardiology department. She is among the first physicians to focus on heart disease in women with an expertise in cardiac rehabilitation and geriatric medicine. Dr. Wenger has received numerous awards including the Distinguished Achievement Award from the Scientific Councils of the American Heart Association and its Women in Cardiology Mentoring Award, the James D. Bruce Memorial Award of the American College of Physicians for distinguished contributions in preventive medicine, the Gold Heart Award, the highest award of the American Heart Association, a Lifetime Achievement Award in 2009 and the Inaugural Bernadine Healy Leadership in Women’s CV Disease Distinguished Award, American College of Cardiology. She chaired the U.S. National Heart, Lung, and Blood Institute Conference on Cardiovascular Health and Disease in Women, is a Past President of the Society of Geriatric Cardiology and is past Chair, Board of Directors of the Society for Women’s Health Research. Dr. Wenger serves on the editorial boards of numerous professional journals and is a sought-after lecturer for issues related to heart disease in women, heart disease in the elderly, cardiac rehabilitation, coronary prevention, and contemporary cardiac care. She is listed in Best Doctors in America. Carine Hamo, MD Amit Goyal, MD

CardioNerds (Amit Goyal & Dan Ambinder) join Lankenau Medical Center cardiology fellows (Gwen McNeill and Shaung Ooi) for some Philly cheesesteaks! They discuss a fascinating case of Embolic Acute Coronary Syndrome from PFO and Pulmonary Hypertension. Dr. John Clark provides the E-CPR and program director Dr. Jeanine Romanelli provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A woman in her early 40s with history of tobacco and prior methamphetamine use presented with acute onset chest pain. She was found to have an elevated troponin, anterior T wave inversions, and apical akinesis on TTE. Coronary angiography showed a coronary embolism in the mid-distal LAD. Attempts to wire the lesion led to distal embolization of the clot, and IVUS showed no underlying arteriosclerosis.   To investigate the etiology of the coronary embolus, a repeat TTE with agitated saline was done that suggested a PFO with right to left flow, as well as decreased RV function with an estimated RVSP of 70 mmHg. The clinical picture was that of a paradoxical coronary embolus, arising from the right (venous) side traveling to the left (arterial) side via a PFO. PFO closure was discussed but not performed given severe pulmonary hypertension with Right to Left shunt. In this circumstance, the PFO functions as a “pop-off valve” for the overloaded RV; closing it risks precipitating acute RV overload and failure. A RHC showed a PA pressure of 70/24 mmHg with mPAP of 40 mmHg, PCWP 5 mmHg, and PVR of 11 woods units. Given concern for idiopathic PH, a vasodilator challenge was done which did not show reactivity, and she was started on ambrisentan and sildenafil. Ultimately, the etiology of her pulmonary hypertension was felt to be due to PAH from prior methamphetamine use vs. idiopathic PAH. On follow-up, her PA pressures and RV function had greatly approved, allowing for safe and successful PFO closure in an attempt to prevent future emboli.  Final diagnosis: Embolic Acute Coronary Syndrome from PFO & Pulmonary Hypertension. Case Media Before treatment: short axis Before treatment: apical 4 Before treatment: RVSP After treatment: Short axis After treatment: Apical 4 After treatment: RVSP Click to enlarge ??? https://youtu.be/XpnJKZuNVrM 1. Coronary angio of embolism2. PFO on TEE with R to L shunt by Doppler3. TTE bubble after PFO closure Episode Schematics & Teaching Click to enlarge ??? The CardioNerds 5! – 5 major takeaways from the #CNCR case Coronary emboli are an uncommon cause of myocardial infarction. We can think of the etiology of coronary emboli in three major categories: Direct, Paradoxical, or Iatrogenic.  Direct emboli originate from the left side of the heart: sources include clot (from atrial appendage, apical thrombus), valvular lesion (vegetation, thrombus, fibroelastoma), or left sided cardiac mass (atrial myxoma, rhabdomyosarcoma).  Paradoxical emboli originate from the right side or systemic venous circulation, and pass from right to left through an atrial septal defect, patent foramen ovale, or pulmonary arteriovenous malformation.  Iatrogenic emboli occur following procedures such as valve replacement or PCI. Note that iatrogenic is the most comm

CardioNerds (Amit Goyal & Dan Ambinder) discuss a case of hereditary restrictive cardiomyopathy with Duke University cardiology fellows Navid Nafissi and Sipa Yankey, and Marat Fudim, an advanced heart failure attending. E-CPR is provided by Dr. Richa Agarwal, fellowship program director of advanced heart failure and cardiac transplantation at Duke University with a final message by fellowship director Dr. Anna Lisa Crowley. Episode notes were developed by Johns Hopkins internal medicine resident Colin Blumenthal with mentorship from University of Maryland cardiology fellow Karan Desai.   Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A 69 yo M with history of atrial fibrillation presents with 5 months of progressive HF symptoms, now NYHA class IV. He was found to be grossly volume overloaded, tachycardic in atrial fibrillation, and hypoxic. CXR demonstrated significant cardiomegaly, and labs indicated new normocytic anemia with evidence of hepatic dysfunction and an elevated NT proBNP. TTE demonstrated massive bi-atrial enlargement, preserved ejection fraction, filling pattern consistent with grade III diastolic dysfunction, and torrential TR. The echocardiogram did not have evidence of constrictive pericarditis and agitated saline study showed Right to Left shunt through a likely PFO. MRI to evaluate for infiltrative cardiomyopathy did not show late gadolinium enhancement (LGE). RHC demonstrated findings consistent with restrictive cardiomyopathy including equalization of diastolic pressures, square root sign, and concordance of RV and LV pressures. PYP scan evaluating for TTR amyloid was negative and laboratory workup did not suggest AL amyloid, Fabry’s, Hemochromatosis, or storage disease. Patient’s symptoms remained refractory and thus eventually underwent successful OHT. Genetic testing eventually revealed missense mutation in MYBPC3 – revealing an inherited cause of restrictive CM for the patient!  Case Media Chest X-ray -Rate-controlled A fib with frequent PVCs, LPFB, non-specific ST changes https://youtu.be/LTUaLd2R7js Episode Schematics & Teaching Click to enlarge ??? The CardioNerds 5! – 5 major takeaways from the #CNCR case When thinking about the etiology of a restrictive cardiomyopathy, we can organize the causes into four major categories: Infiltrative (e.g., amyloidosis, sarcoidosis) Storage diseases (e.g., hemochromatosis, Fabry’s) Non-infiltrative (e.g., idiopathic, diabetic cardiomyopathy, genetic causes) Endomyocardial (e.g., endomyocardial fibrosis, hypereosinophilic syndrome) On examination, patients with restrictive cardiomyopathy may have prominent right-sided symptoms, including hepatomegaly, ascites, and significant peripheral edema. On exam, neck veins may demonstrate a steep y descent, and cardiac auscultation may have a +S4, and murmurs of tricuspid and mitral regurgitation. A multimodal imaging workup is recommended for evaluating RCM. TTE: Typically demonstrates normal LVEF, normal chamber volumes, biatrial enlargement, and restrictive diastolic filling patterns (.e.g, E/A > 2, E/e’ > 14, decreased mitral deceleration time < 150 ms). We can see increased wall thickness with infiltrative processes and storage diseases. cMRI: specific patterns of Late Gadolinium Enhancement may indicate certain pathology (e.g., amyloid may demonstrate diffuse subendocardial, heterogeneous, or transmural signal). T2 signal can identify inflammation and quantify iron. PYP scan: It has a >99% sensitivity for cardiac A

CardioNerds (Amit Goyal & Daniel Ambinder)  join Allegheny Health Network cardiology fellows (Adnan Khalif, Mahathi Indaram, Kushani Gajjar, and Michael Nestasie) for a lovely Pittsburgh hike and discuss a fascinating case of platypnea-orthodeoxia secondary to a PFO. Dr. Farhan Katchi provides the E-CPR and Program director Dr. Craig Alpert provides a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Richard Ferraro with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A 64 y/o female with a history of venous and arterial embolism on anticoagulation, known PFO, and obesity presented after a fall. There was no loss consciousness, pre-syncopal symptoms, chest pain, aura, weakness, or palpitations. She had no recent preceding illness. When she arrived in the ED she was hypoxic to 87% on ambulation on room air and required 4L of nasal cannula O2 supplementation. The AGH CardioNerds were consulted!   On examination, the team noted that upon sitting up the patient would desaturate to the mid 80% but when lying down oxygen saturation would improve to 95%! Her ECG demonstrated a RBBB and no acute ST-T changes. TTE was obtained and showed normal LV and RV function and size, no valvular disease, and a likely PFO on an agitated saline study. Cardiac MRI revealed mild RV hypertrophy and Qp:Qs of 0.8 (right/pulm cardiac output < left/systemic cardiac output, indicating right to left shunting).  RHC showed normal right-sided pressures. A right femoral vein bubble study  was done showing torrential right to left shunting! She underwent PFO closure and her platypnea-orthodexia resolved; she was discharged on room air.  Case Media Episode Schematics & Teaching The CardioNerds 5! – 5 major takeaways from the #CNCR case Platypnea-orthodeoxia syndrome (POS) is when dyspnea (Platypnea) and hypoxia (Orthodeoxia) are present in the upright position, but improve upon lying flat. One cause is ARLIAS, or Acute Right-to-Left Inter-Atrial Shunting, which requires an anatomic component (I.e., ASD or PFO) and a functional component (I.e., PH, PE, RV failure) for Right-to-Left shunting to occur  A PFO, or patent foramen ovale is a common congenital defect and typically will not lead to hypoxia unless there is right to left shunting. Typically flow is left to right due to an LA to RA pressure gradient and lower compliance of the RV.   Remember when evaluating for a PFO with agitated saline, the timing of the appearance of bubbles is important!  Early appearance of bubbles (seen in less than 5 beats of the cardiac cycle, think about intra-cardiac shunt. Delayed opacification (> 5 to 6 beats) occurs when the bubbles slowly build in the LV with each successive beat as they circulate to the LV and suggests extra-cardiac shunt.   Cardiac MRI is helpful in quantifying the shunt fraction (Qp:Qs).  This is the ratio of pulmonary flow (Qp) to systemic flow (Qs), where hemodynamically significant Left-to-Right shunt is > 1.5, especially when we see RA/RV dilation. Qp/Qs < 1.1 indicates net R to L shunt. Other ways to measure a Qp:Qs are echocardiogram (less accurate) and right heart catheterization.   If there remains clinical concern for PFO with right to lef

CardioNerds (Amit & Dan)  join Vanderbilt University cardiology fellows (Tara Holder, Majd El-Harasis, and Amar Parikh) for a Sunday morning brunch, Nashville style! They discuss an enthralling case of bicuspid aortic valve with critical aortic stenosis complicating pregnancy. Program director Dr. Julie Damp provides the E-CPR and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Tommy Das with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A 22yo transgender F2M man (G1P0000) at 32w5d was found to have a late-peaking systolic ejection murmur on a regularly scheduled OB visit. He reported recent left-sided exertional chest pain and intermittent lightheadedness, as well as a history of a childhood heart murmur. TTE showed a bicuspid aortic valve (LCC-NCC fusion) with severe aortic stenosis (peak velocity 4.83 m/s, mean gradient of 56 mmHg, AVA at 0.5 cm2 and Dimensionless Index at 0.15). Furthermore, there was preserved ejection fraction and no associated aortopathy.    Following a syncopal episode, the patient was admitted for cardiac optimization prior to delivery. With shared decision making, he ultimately delivered via cesarean section prior to valvular intervention. Post-partum, he underwent balloon aortic valvuloplasty with improvement in mean aortic gradient to 27 mmHg and trace aortic insufficiency. He was asymptomatic at 5 months post-procedure with similar gradients across the aortic valve on TTE.    Case Media Chest – X ray Final gradients: Peak velocity 4.83 m/s Mean >50 (56) mmHg AVA 0.5 (AVAi=0.27) DOI=0.15 https://youtu.be/YF8TrNmsGh4 Episode Schematics & Teaching Click to enlarge ??? The CardioNerds 5! – 5 major takeaways from the #CNCR case Hemodynamics change dramatically during pregnancy. Cardiac output increases by 30-50% during pregnancy due to: ↑ SV, ↑HR, ↓SVR.   Immediately post-partum, patients with existing valvular lesions are at high risk of heart failure! Hemodynamic changes peripartum are unpredictable.   ↑Preload: relief of IVC compression, auto-transfusion of 300-500mL blood from placenta with each uterine contraction, and intravenous fluids and/or blood products.  ↓Preload: hemorrhage  ↑Afterload: SBP & DBP increase with each uterine contraction  ↓Afterload: systemic vasodilation from epidural and spinal analgesia  ↑CO: by up to 30% in the first stage of labor and up to 80% in the immediate post-partum period. 2/2 ↑SV.  Most pregnant patients with symptomatic AS can be managed medically, with balloon aortic valvuloplasty reserved for patients with refractory symptoms. TAVR and SAVR may be considered, ideally reserved for the 2nd trimester. Spontaneous vaginal delivery carries a lower risk than c-section due to smaller shifts in blood volume, decreased bleeding, and avoidance of preload-shifting anesthetic agents.   In a woman of child-bearing age with severe symptomatic AS who is planned for AVR, shared decision making is key in choice of valve! A mechanical valve is more durable than a bioprosthetic valve, but requires anticoagulation that could complicate a future pregnancy. Alternatives include a Ross procedure (replacing the aortic valve using the patient’s own pulmonic valve – “pulmonary autograft” – and a cadaveric pulmonic valve is placed

CardioNerds (Amit & Dan) join UT Southwestern cardiology fellows (Shreya Rao, Sonia Shah, and Nick Hendren) for some delicious Dallas Tacos! They discuss a fascinating case of syphilitic aortitis with severe aortic regurgitation presenting as cardiogenic shock. Program director Dr. Gail Peterson provides the E-CPR and a message for applicants. Episode notes were developed by Johns Hopkins internal medicine resident Evelyn Song with mentorship from University of Maryland cardiology fellow Karan Desai.  Jump to: Patient summary – Case figures & media – Case teaching – Educational video – References – Production team Episode graphic by Dr. Carine Hamo The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. We are teaming up with the ACC FIT Section to use the #CNCR episodes to showcase CV education across the country in the era of virtual recruitment. As part of the recruitment series, each episode features fellows from a given program discussing and teaching about an interesting case as well as sharing what makes their hearts flutter about their fellowship training. The case discussion is followed by both an E-CPR segment and a message from the program director. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Patient Summary A 57 year old male presents with 3 months of progressive dyspnea on exertion, orthopnea and lower extremity edema. However, his symptoms suddenly worsened over the past few days. He has no other known medical history or prior surgeries. Further, he denies tobacco, alcohol or illicit drug use and reports a preference for male sexual partners.   On presentation to the hospital, he had a markedly wide pulse pressure, a decrescendo diastolic murmur at the left upper sternal border and a water hammer pulse readily identifiable. TTE confirmed the clinical findings of severe aortic regurgitation with holodiastolic flow reversal in the thoracic, as well as the thoraco-abdominal aorta. Right heart catheterization was performed and showed equalization of the LVEDP and aortic diastolic pressure at 40 mmHg with Cardiac Output of 1.73 L/min. RPR was positive at a high titer (1:512). He was ultimately diagnosed with syphilitic aortitis with severe aortic regurgitation.   He progressed to cardiogenic shock and was managed with nitroprusside, dobutamine, and furosemide infusion as well as IV penicillin for syphilitic aortitis and presumed neurosyphilis. The patient was stabilized and eventually underwent an uncomplicated prosthetic aortic valve replacement and aortic root resection and reconstruction and has done well post-operatively!   Pathology was consistent with syphilitic aortitis: “lymphoplasmacytic inflammation, large foci of necrosis, and neovascularization”  Case Media CXR: Cardiomegaly, bilateral pleural effusions, evidence of pulmonary congestion Normal sinus rhythm, left atrial enlargement, LVH and possible septal infarct. LV tracing (black), Aortic tracing (red) Apical long view with color Doppler noting marked flow through aortic valve during diastole. Continuous Doppler through trileaflet aortic valve consistent with severe AI (P1/2 92 msec). Pulse wave Doppler of abdominal aorta demonstrating holodiastolic flow reversal consistent with severe AI. Click to enlarge ??? Episode Schematics & Teaching The CardioNerds Five Severe Aortic Regurgitation Pathophysiology of Aortic Regurgitation Click to enlarge ??? The CardioNerds 5! – 5 major takeaways from the #CNCR case When suspecting severe AR, first characterize the AR as either acute or chronic based on clinical evaluation and hemodynamics. From there, AR can further be characterized as primary (valve disorder) or secondary (disorder of the aortic root/aorta). Chronic AR exposes the LV to volume overload (leading to increased LVEDV), afterload, and increased wall stress. Chronic severe AR has two phases: Compensated Phase: Responding to increased wall stress, eccentric hypertrophy occurs. LVEF is maintained during this stage, though LV dilation may begin to occur. Patients are typically asymptomatic. Decompensated Phase: Eventually, compensatory mechanisms are insufficient and significant LV dilation occurs and LVEF decreases. Patients will develop exertional dyspnea and

CardioNerds Amit and Dan are joined by Dr. Nosheen Reza, chair of the ACC FIT section, to announce the launch of the CardioNerds Case Reports: Recruitment Edition Series! In this exciting project, the CardioNerds collaborated with the ACC FIT section to invite every fellowship program to co-produce a case-based episode. Fellows from the program present and discuss a fascinating case and an expert provides the E-CPR editorial, followed by a message to applicants from the program director. We’ve asked every program to help us promote diversity in their fellow ambassadors to the CardioNerds show. We also discuss the value of podcasts and innovations in medical education, Dr. Reza’s perspectives and advice for the upcoming virtual recruitment, getting involved with the ACC as fellows-in-training (#FIT!), promoting diversity and inclusion within cardiology, and Dr. Reza’s advice for thriving during fellowship. We also introduce the brand new CardioNerds Academy! We will be growing the platform by offering a uniquely tailored and mentored experience to several future CardioNerds Fellows. Our goal is to teach our CardioNerds Fellows the ropes of med-ed podcasting through a comprehensive curriculum with dedicated mentorship. We are honored to have recruited Dr. Justin Berk as program director and Dr. Heather Kagan as associate program director. Episode graphic by Dr. Carine Hamo CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademySubscribe to our newsletter- The HeartbeatSupport our educational mission by becoming a Patron!Cardiology Programs Twitter Group created by Dr. Nosheen Reza Key Reference: Reza N, Krishnan S, Adusumalli S. A Model for the Career Advancement of Women Fellows and Cardiologists. J Am Coll Cardiol. 2020;76(8):996 LP – 1000. Nosheen Reza, MD Dr. Nosheen Reza is a cardiologist and translational researcher at the University of Pennsylvania focusing on advanced heart failure and transplant cardiology and cardiovascular genetics, genomics, and phenomics. She obtained her medical degree from the University of Virginia School of Medicine in 2012 and completed her internal medicine residency training at the Massachusetts General Hospital in 2015. She then completed her Cardiovascular Disease fellowship at the University of Pennsylvania in 2018 and served as 2017-2018 Chief Fellow. At Penn, Dr. Reza pursued additional scholarship in genomic medicine as an NIH T32-funded postdoctoral fellow and in healthcare quality as a Penn Benjamin & Mary Siddons Measey Fellow in Quality Improvement and Patient Safety. She completed her final year of clinical training at Penn in Advanced Heart Failure and Transplant Cardiology and joined the faculty at the University of Pennsylvania in July 2020. Dr. Reza is passionate about medical education and has won many distinctions in the field throughout her training. She serves as an editorial board member for JACC: Case Reports, JACC: CardioOncology, and Current Cardiovascular Risk Reports. Dr. Reza is an active leader in the Heart Failure Society of America, American Heart Association, and American College of Cardiology at the local and national levels and volunteers on multiple leadership councils and steering committees within these organizations. CardioNerds Case Reports: Recruitment Edition Series Production Team Daniel Ambinder, MD Amit Goyal, MD Heather Kagan, MD Justin Berk, MD MPH MBA

CardioNerds (Amit Goyal & Daniel Ambinder) discuss a case report of COVID myocarditis and cardiogenic shock with Dr. Travis Howard and Dr. Zach Il’Giovine, cardiology fellows at the Cleveland Clinic. Dr. Nir Uriel, Professor of Medicine at Columbia University and Director of Advanced Heart Failure and Transplant at NewYork-Presbyterian Hospital Network in New York joins to discuss COVID-19 myocarditis and management of cardiogenic shock. The CardioNerds Cardiology Case Reports series shines light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. Check out the Cardionerds Cardiology Case Reports Topic Page Check out the Cardionerds Topics and Episode page for all podcast episodesSupport our educational mission by becoming a Patron! Case Summary Healthy and physically fit incarcerated 49M who presents with 2 weeks of fevers, myalgias, and SOB. His past medical history includes GSW to abdomen, psoriasis not currently on medications, prior tobacco and alcohol abuse. Transferred for undifferentiated shock on norepinephrine, and was found to be in sinus tachycardia to 110 bpm, hypotensive despite vasopressor infusions with labs showing a hyperinflammatory state, multi-organ failure, and eventually found to be COVID+. The patient quickly progressed into refractory cardiogenic shock requiring VA-EMCO, as well as Impella placement for LV unloading. The patient underwent endomyocardial biopsy with electron microscopy which was notable for COVID virions in the myocardium and was diagnosed with COVID myocarditis. Interestingly, his chest CT showed normal lung parenchyma and therefore presented as isolated cardiac involvement of COVID-19. The patient improved with tocilizumab, IVIG, and steroids. Episode Producer: Colin Blumenthal, MDMedical Education Mentor: Karan Desai, MD Episode graphic by Dr. Carine Hamo The CardioNerds 5! – 5 major takeaways from the #CNCR case Diagnose Cardiogenic Shock at the Bedside!   Exam: Narrow Pulse Pressure, Labored Breathing, Cheyne-Stokes Respirations, Abdominal Bloating/Nausea, Cool Extremities, Oliguria, Altered Mental Status  If PAC available, low central (PA) mixed venous saturation (<55-60%) suggestive* of cardiogenic shock  COVID-19 can cause myocardial injury through several mechanisms  Ischemic – Supply/Demand Mismatch, Acute Plaque Rupture  Nonischemic – Stress Cardiomyopathy, Lymphocytic Infiltration, Direct Viral Cardiomyocyte Injury, Bystander Injury from Systemic Inflammation  Different forms of mechanical support give varying levels of cardiac output and pulmonary support  Consider VA-ECMO in refractory cardiogenic shock, especially if there is evidence of biventricular failure +/- pulmonary compromise  VA-ECMO may require “LV unloading” when there is high afterload leading to pulmonary congestion and/or stasis of blood flow in the LV  Myocarditis Infographic https://twitter.com/CBlumenthal2/status/1295043817855475715?s=20 References  Dexamethasone in Hospitalized Patients with COVID-19  Non-invasive imaging in the diagnosis of acute viral myocarditis  Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness: The ESCAPE Trial  Mechanical Circulatory Support Devices for Cardiogenic Shock: State of the Art  Left ventricular distension and venting strategies for patients on venoarterial extracorporeal membrane oxygenation  Remdesivir for the Treatment of Covid-19 – Preliminary Report   Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial   Resources:   CardioNerds Myocarditis page  https://www.cardionerds.com/episodes/myocarditis/  Talking Tall Rounds Epsiode  https://my.clevelandclinic.org/podcasts/cardiac-consult/talking-tall-rounds-covid-19-related-myocarditis  Tall Rounds Conference  http://consultqdlive.mediaspace.kaltura.com/media/0_7llcuh5t  Colin Blumenthal, MD Karan Desai, MD Amit Goyal, MD Daniel Ambinder, MD

The CardioNerds discuss Coronary Artery Calcium Scoring with Dr. Michael Blaha, Director of Clinical Research for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. Joining the discussion is Dr. Gabriel Shaya, cardiology fellow at the Johns Hopkins Hospital and prevention researcher. Carine Hamo, Heather Kagan and Dan Ambinder take a deep dive into the crunchy and calcified world of coronary artery disease discussing the evidence and utility of coronary artery calcium scoring as a powerful tool for individualized risk stratification of cardiovascular disease prevention. Cardionerds Cardiovascular Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! The Cardionerds CV prevention series  includes in-depth deep dives on so many prevention topics including the ABCs of prevention, approach to obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series References and Links https://www.mesa-nhlbi.org/CAC-Tools.aspx Blaha MJ, Blankstein R, Nasir K. Coronary Artery Calcium Scores of Zero and Establishing the Concept of Negative Risk Factors. J Am Coll Cardiol. 2019;74(1):12-14. Peng AW, Mirbolouk M, Orimoloye OA, et al. Long-Term All-Cause and Cause-Specific Mortality in Asymptomatic Patients With CAC ≥1,000: Results From the CAC Consortium. JACC Cardiovasc Imaging. 2020;13(1 Pt 1):83-93. Shaya GE, Al-Mallah MH, Hung RK, et al. High Exercise Capacity Attenuates the Risk of Early Mortality After a First Myocardial Infarction: The Henry Ford Exercise Testing (FIT) Project. Mayo Clin Proc. 2016;91(2):129-139. Dr. Michael Blaha is an Associate Professor of Cardiology and Epidemiology and presently serves as the Director of Clinical Research for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. Dr. Blaha completed both his MD and MPH and Vanderbilt University. He then completed his Internal Medicine residency in the Osler Medical Housestaff Training Program at Johns Hopkins where he also completed fellowship training. He is an Associate Editor for the Journal of Cardiovascular Computed Tomography, Associate Editor for the Diabetes and Cardiometabolic Clinical Community on acc.org and is a standing member of the Endocrinologic and Metabolic Drug Advisory Committee (EMDAC) for the FDA. He is Principal Investigator for the Coronary Artery Calcium Consortium, co-chair of the Cross-Cohort Collaboration, and a Principle Investigator for the American Heart Association (AHA) Tobacco Regulation and Addiction Center. Dr. Gabriel Shaya earned both his Medical Degree and Masters of Public Health at the University of Miami Miller School of Medicine. He went on to complete his residency in Internal Medicine at the New York Presbyterian – Weill Cornell Medical Center. He has returned to his hometown of Baltimore for Cardiology fellowship with the intent of pursuing a career as an academic cardiologist. His clinical and research interests center on the refinement of cardiovascular risk assessment with the goal of tailoring preventive therapies to avert adverse cardiovascular events before they happen. Michael Joseph Blaha, M.D., M.P.H. Gabe Shaya, MD, MPH Carine Hamo, MD Heather Kagan, MD Daniel Ambinder, MD

JACC: Case Reports Editor-in-Chief, Dr. Julia Grapsa joins Cardionerds, Amit and Dan, to introduce a new episode series: CardioNerds Case Reports (#CNCR)! We discuss the value of learning through cases, podcasts and other innovations in education, importance of promoting wellness in medicine, the editorial review process for case reports, and being an editor-in-chief as a woman in medicine. The CardioNerds Case Reports series will shine light on the hidden curriculum of medical storytelling. We learn together while discussing fascinating cases in this fun, engaging, and educational format. Each episode ends with an “Expert CardioNerd Perspectives & Review” (E-CPR) for a nuanced teaching from a content expert. We truly believe that hearing about a patient is the singular theme that unifies everyone at every level, from the student to the professor emeritus. Take me to the Cardionerds Case Report (CNCR) Series PageTake me to the Cardionerds Episode Topics Page Episode graphic created by Dr. Carine Hamo References Grapsa J (2019) Voices in Cardiology. JACC Case Reports. Grapsa J, Fuster V (2019) JACC: Case Reports: New Era of Clinical Cases, Bridging Patients With Guidelines. J Am Coll Cardiol. Grapsa J, Fuster V (2020) JACC: Case Reports: Moving to a Multimedia Educational Vehicle. J Am Coll Cardiol. (2006) Mindset: the new psychology of success. Choice Rev Online. Balasubramanian S, Saberi S, Yu S, Duvernoy CS, Day SM, Agarwal PP (2020) Women representation among cardiology journal editorial boards. Circulation. Dr. Julia Grapsa serves as the Editor-in-Chief of JACC: Case Reports. Dr. Grapsa worked for Cleveland Clinic Abu Dhabi and then she moved to UK as a a consultant cardiologist for Barts Heart Center. In March 2020, Dr. Grapsa started working as consultant cardiologist at Guys and St Thomas NHS Trust. Within the UK’s leading structural valve disease group, Dr. Grapsa is responsible for the valvular heart disease network and echocardiography, a position previously held by Professor John Chambers. Dr. Grapsa has served as chair of the young community for multimodality imaging for the European Association of Cardiovascular Imaging and as a member of the European Society of Cardiology (ESC) education committee, leading the ESC clinical case gallery. She was responsible for ESC social media, since its birth and she has been a member of imaging and online education committees of Heart Failure Association. Prior to her role as JACC: Case Reports editor-in-chief, Dr. Grapsa served as an editorial consultant for JACC: Cardiovascular Imaging. She is a fellow of the ACC, the American Heart Association, the American Society of Echocardiography and the European Society of Cardiology. Julia Grapsa, MD, PhD, FACC Amit Goyal, MD Daniel Ambinder, MD

The CardioNerds discuss Lipid Management with Dr. Ann Marie Navar and Dr. Nishant Shah from Duke Medical Center, Division of Cardiology. Amit, Carine and Dan take a deep dive into the greasy world of lipids and cholesterol, covering lipid metabolism, therapeutic targets, approach across the entire spectrum of predicted risk, and key common management scenarios (statin intolerance, hypertriglyceridemia, elevated LP(a)), and more. Episode 42. Lipids and Cholesterol with Drs. Drs. Ann Marie Navar and Nishant Shah Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page The Cardionerds CV prevention series will include in-depth deep dives on so many topics related to prevention starting with this case discussion. Stay tuned for upcoming episodes on the ABCs of prevention, obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! Key references: Toth, P. P. (2020). Familial Hypercholesterolemia and Lipoprotein(a): Unraveling the Knot That Binds Them. Journal of the American College of Cardiology, 75(21), 2694–2697. Michos, E. D., McEvoy, J. W., & Blumenthal, R. S. (2019). Lipid management for the prevention of atherosclerotic cardiovascular disease. New England Journal of Medicine, 381(16), 1557–1567. AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 73(24), e285–e350. Lloyd-Jones, D. M., Braun, L. T., Ndumele, C. E., Smith, S. C., Sperling, L. S., Virani, S. S., & Blumenthal, R. S. (2019). Use of Risk Assessment Tools to Guide Decision-Making in the Primary Prevention of Atherosclerotic Cardiovascular Disease: A Special Report from the American Heart Association and American College of Cardiology. Circulation, 139(25), E1162–E1177. Laufs, U., Parhofer, K. G., Ginsberg, H. N., & Hegele, R. A. (2020). Clinical review on triglycerides. European Heart Journal, 41(1), 99–109. ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 74(10), 1376–1414. We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series Dr. Ann Marie Navar is a cardiologist and epidemiologist at the Duke Clinical Research Institute focusing on cardiovascular disease prevention. She received an MD from Duke University and a PhD in Global Disease Epidemiology and Control from the Johns Hopkins School of Public Health in 2009 before completing residency in internal medicine and pediatrics and fellowship in cardiology at Duke. Dr. Navar’s research focuses on improving cardiovascular disease prevention through better identification of at-risk populations, targeted interventions to improve quality of care and patient engagement through the electronic health record, and better treatment of hypertension and cholesterol to lower CV risk. She also studies the impact of payer-imposed barriers to novel therapies. Her areas of expertise include risk prediction, patient risk communication, real world data analyses using EHR- and claims-based datasets, and registries. She is an associate editor at JAMA-Cardiology and a board member of the American Society of Preventive Cardiology. Dr. Nishant Shah obtained his medical degree from Wake Forest University School of Medicine. He completed internal medicine residency training at the Johns Hopkins Osler Program as part of the Barker Firm. He completed his cardiology fellowship training at the Cleveland Clinic. He is currently faculty at Duke Medical Center, Division of Cardiology and is an expert in preventive cardiology as well as a member of the cardiometabolic prevention program. Dr. Shah’s research revolves around the clinical manifestations of  genetic lipid biomarkers and advanced dyslipidemias. He is also interested in ways to make impacts at the primary prevention level. Furthermore, Dr. Shah is involved in many epidemiologic and clinical trial based work with several leaders in the field. He also serves as an associate editor for the American Heart Journal. Dr. Shah is very passionate about clinical education and has won many distinctions in education throughou

The CardioNerds discuss Women’s Cardiovascular Prevention with Dr. Leslie Cho, Interventional Cardiologist and Director of the Cleveland Clinic’s Women’s Cardiovascular Center. She is also Section Head of Preventive Cardiology and Rehabilitation in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic. Amit, Dan and Carine take a deep dive into women’s cardiovascular prevention and discuss the epidemiology, unique risk factors, different manifestations of CVD and treatment strategies to lower cardiovascular risk in women. Tune in as we discuss cases from the CardioNerds Women’s Clinic to learn more! Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page Cardiac Consult PodcastTall Rounds Lectures Key Reference: Cho L, Davis M, Elgendy I, et al (2020) Summary of Updated Recommendations for Primary Prevention of Cardiovascular Disease in Women: JACC State-of-the-Art Review. J Am Coll Cardiol 75:2602–2618 We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Cardionerds Cardiovascular Prevention Series Dr. Leslie Cho is a professor of Medicine at Cleveland Clinic Lerner School of Medicine Case Western Reserve Medical School and serves as Director of the Cleveland Clinic’s Women’s Cardiovascular Center. She is also Section Head, Preventive Cardiology and Rehabilitation in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic. Dr. Cho received her undergraduate degree in interdisciplinary studies from the University of California, Los Angeles, graduating cum laude. She received her medical degree from the University of Chicago Pritzker School of Medicine, and took her residency in internal medicine at the University of Washington Medical Center where she received the John Humphrey Award as Most Outstanding Internal Medicine Resident. Her clinical training continued when she accepted a fellowship in cardiology, followed by a fellowship in interventional cardiology and peripheral disease, both from Cleveland Clinic. Leslie Cho, MD Amit Goyal, MD Carine Hamo, MD Daniel Ambinder, MD

The CardioNerds discuss The ‘ABC’s of Cardiovascular Prevention with Dr. Roger Blumenthal, Director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease and co-chairperson of the 2019 American College of Cardiology/American Heart Guideline on prevention of cardiovascular disease. Joining the discussion is Dr. David Feldman, Osler housestaff and first author of a beautiful State-of-the-Art review in the American Journal of Preventive Cardiology discussing a comprehensive ABCs of prevention. A: Assess Risk, Anti-Inflammatory, Aspirin B: Body weight, Blood Pressure C: Cigarette Cessation, Cholesterol D: Dream (sleep), Diet, Digital Health, Diabetes E: Exercise F: Factors of the Environment G: Genetics Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page Key Reference: Summarizing 2019 in Cardiovascular Prevention using the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease’s ‘ABC’s Approach We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Dr. Roger Blumenthal is a Professor of Medicine and the Director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease for which he was the principal developer. He received his medical degree from Cornell Medical College, where he was awarded the Weiss Prize for Excellence in Clinical Medicine. He completed his internal medicine and cardiology fellowship training at The Johns Hopkins Hospital before joining the Johns Hopkins cardiology faculty. Dr. Blumenthal was the most recent recipient of the Landon School Anthony Kupka Distinguished Alumnus Award. He was co-chairperson of the 2019 American College of Cardiology/American Heart Guideline on prevention of cardiovascular disease. Dr. David Feldman is a Junior Assistant Resident in the Osler Medical Residency Program at the Johns Hopkins Hospital. Prior to joining the housestaff, David received his MD and MPH degrees from the University of Miami. David first joined the Ciccarone Center as a pre-doctoral fellow in 2013 under the mentorship of Drs. Roger Blumenthal and Mike Blaha. David is passionate about cardiovascular disease prevention and hopes to pursue a career in academic cardiology, with a particular interest in preventive cardiology. Roger Scott Blumenthal, M.D. David Feldman, MD Cardionerds Cardiovascular Prevention Series Daniel Ambinder, MD Amit Goyal, MD Carine Hamo, MD

CardioNerds Amit Goyal and returning guest Dr. Zach Il’Giovine explore the patient’s perspective on cardiovascular prevention with the star patient of this series: Kanak Amin. to explore the patient perspective on cardiovascular prevention. Mr. Amin tells us about his perspectives on being a heart patient and offers important advice for both patients and providers on the. He gives us many pearls, but especially highlights the importance of diabetes education, cardiac rehabilitation, engaging loved ones, and getting to know the patient on a deeper level. Special messages from Dr. Wael Jaber and Dr. Nishant Shah, who both knew Mr. Amin as a colleague, friend, and patient. Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. Kanak Amin is the Program Manager of the Radiochemistry Nuclear Medicine program at Cleveland Clinic. His hobbies and interests include woodworking, learning Wall Street and the financial world as well as computer web design. We are so appreciative this phenomenal patient perspective on cardiovascular prevention! Dr. Zachary Il’Giovine is a general cardiology fellow at the Cleveland Clinic. He received his medical degree from the Wright State University Boonshoft School of Medicine before completing internal medicine training at Duke University. He has clinical interests in advanced heart failure and cardiac critical care. Outside of the hospital he loves playing soccer and spending time with his wife Clare and son Luca. Kanak Amin Nishant Shah, MD Zachary Il’Giovine, MD Amit Goyal, MD Cardionerds Cardiovascular Prevention Series

This is the first episode in an important series on cardiovascular prevention. It’s no secret that cardiovascular disease is the #1 killer worldwide; the total impact on humanity is just staggering. A focus on preventing CVD is an impetus for every cardionerd. In this episode Dan, Amit, Carine, and Heather discuss an illustrative case discussion and review the Cardionerds 2+4 paradigm of cardiovascular prevention: 2 fundamental principles of management + 4 steps in risk stratification. The Cardionerds CV prevention series will include in-depth deep dives on so many topics related to prevention starting with this case discussion. Stay tuned for upcoming episodes on the ABCs of prevention, obesity, hypertension, diabetes mellitus and anti-diabetes agents, personalized risk and genetic risk assessments, hyperlipidemia, women’s cardiovascular prevention, coronary calcium scoring and so much more! Take me to the Cardionerds Cardiovascular Prevention PageTake me to episode topics page We are truly honored to be producing the Cardionerds CVD Prevention Series in collaboration with the American Society for Preventive Cardiology! The ASPC is an incredible resource for learning, networking, and promoting the ideals of cardiovascular prevention! This series is kicked off by a message from Dr. Amit Khera, President of the American Society for Preventive Cardiology and President of the SouthWest Affiliate of the American Heart Association. TWO principles of management Emphasize healthy lifestyle for everyone regardless of risk Escalate Preventive Measures with ↑ Risk  FOUR steps of risk stratification Qualitative risk approximation – identify major risk factors and start counseling and education.  Quantitative risk estimation – use a validated model to quantify a patient’s future risk of CVD.  Identify Risk Enhancing Factors – personalize risk if patient is in the gray zones after step 2 Measure coronary artery calcium score – selectively if risk remains uncertain Cardiovascular Prevention Amit Goyal, MD Daniel Ambinder, MD Carine Hamo, MD Heather Kagan, MD

The role of palliative care in the management of heart failure is discussed by palliative care expert, Dr. Rab Razzak, clinical associate professor and clinical director of palliative care at University Hospital Cleveland Medical Center. CardioNerds host Amit Goyal is joined by special guest interviewer, Dr. Arsalan Derakhshan, Assistant Program director at Case Western Internal Medicine residency program and the head of the Global Health Pathway as well as co-host of the Clinical Problem Solvers podcast! Take me to the Heart Failure Topic PageTake me to episode topics page Dr. Rab Razzak went to medical school at Bangledesh Medical College and internal medicine residency at St. Joseph Regional Medical Center in Patterson, NJ. He worked initially as a hospitalist at Cedars Sinai and was grandfathered into palliative care.  He moved to Maryland to work at Johns Hopkins, where he practiced for 4.5 years. He is now a clinical associate professor and clinical director of palliative care at University Hospital Cleveland Medical Center. He is also a devoted husband, dedicated father, and a stand-up comedian! We could think of no one better to discuss Palliative Care in Heart Failure than Dr. Razzak. Dr. Arsalan Derakhshan was born in Iran and moved to Atlanta, Georgia as a young child. He loves to travel and considers himself a global citizen. After graduating from Emory University, he attended the Medical College of Georgia and completed internal medicine residency at Johns Hopkins Hospital. He spends his time attending on inpatient team, staffing resident clinic, and working as the global health track director. He enjoys working with medical students and interns to help them discover their passions. His primary interests include clinical reasoning, global health,  and medical innovations. He co-hosts one of the most popular medicine podcast, The Clinical Problem Solvers and has been incredibly instrumental in the launch of The CardioNerds! Rab Razzak, MD Arsalan Derakhshan, MD CardioNerds Heart Failure Series

Dr. Robert Mentz, director of the Heart Failure section in the Duke Division of Cardiology, discusses diuretics, anti-hyperglycemic therapies including SGLT2/GLP1 agents, angiotensin receptor-neprilysin inhibitors (ARNi), iron as therapies for Heart Failure with Preserved Ejection Fraction (HFpEF). Additionally, study design and ongoing research in HFpEF is discussed. At the end of the episode Dr. Mentz provides an additional update that highlights how the COVID-19 pandemic has influenced clinical trials around the world. Special thanks to guest interviewers, Duke cardiology fellows, Dr. Kelly Arps and Dr. Rahul Loungani! On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic PageTake me to episode topics pageAcute Decompensated Heart Failure Primer – Youtube Dr. Robert Mentz completed internal medicine training at Brigham and Women’s Hospital and cardiology fellowship followed by advanced heart failure and transplant cardiology training at Duke University Hospital and the Duke Clinical Research Institute. He is the new director of the Heart Failure section in the Duke Division of Cardiology. His areas of clinical and research focus include treating comorbid diseases in heart failure patients, use of biomarkers and surrogate and non-fatal outcomes in heart failure trials, and novel therapeutic approaches to heart failure. Dr. Mentz is heavily involved in many clinical trials and serves as the associate editor at Circulation: Heart Failure. In addition to his clinical and research endeavors, Dr. Mentz is heavily invested in the cardiology fellowship where he serves as associated program director and renown mentor for which he has won many fellow-nominated awards. Finally, as former director of the Duke University Cooperative Cardiovascular Society, he expanded the network of current and former Duke trainees to be a leading enroller in clinical trials. We are really excited about him joining the show to discuss Diuretics ARNi SGLT2/GLP1 therapies for HFpEF. Dr. Rahul Loungani completed medical school at the medical university of SC and then traveled to Baltimore for internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital. Here he fell in love with the management and hemodynamics of critically ill patients. He is currently a third-year cardiology fellow at Duke University Medical Center where he will also be pursuing fellowship in advanced heart failure and transplant cardiology next year. His current interests are in Cardiac amyloid, in particular it’s arrhythmic manifestations, early diagnosis, and novel therapeutics. He also loves teaching the housestaff and was awarded the Cassell-Saperstein award at Duke, recognizing the fellow who most demonstrates a commitment to teaching and passion for clinical education. Outside of the hospital loves being a new dad to baby Arya. Dr. Kelly Arps completed medical school at Emory University school of medicine and internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital. She is currently is pursuing her cardiology fellowship at Duke University Medical Center. CardioNerds Heart Failure Series

We discuss Heart Failure with Preserved Ejection Fraction (HFpEF) with Dr. Kavita Sharma, director of the Heart Failure with Preserved Ejection Fraction Program and interim director of Advanced Heart Failure Transplant section at The Johns Hopkins Hospital. CardioNerds hosts Carine Hamo and Daniel Ambinder are joined by Dr. Beth Feldman (resident at The Johns Hopkins Hospital). Topics discussed include a definitions, diagnosis, phenotypic presentations, inpatient management of acute decompensated heart failure, role of dopamine, advanced therapies of HFpEF, and the Paraglide trial. References mentioned in this episode can be found here On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic PageTake me to episode topics pageAcute Decompensated Heart Failure Primer – Youtube Dr. Kavita Sharma graduated from the University of Virginia School of Medicine and completed her residency and served as the assistant chief of service, cardiology fellowship and advanced heart failure fellowship at the Johns Hopkins Hospital. She is the Director of the Johns Hopkins Heart Failure with Preserved Ejection Fraction Program and is currently the interim director of Advanced Heart Failure Transplant section at Hopkins. She has a specialized interest in heart failure with preserved ejection fraction (HFpEF), and directs one of the largest programs in the country dedicated to caring for patients with this condition. She is the principal investigator of numerous clinical and translational trials in HFpEF and leads a team of nurses, research coordinators, and fellows-in-training in this multifaceted program. She is an invited speaker at national meetings in topic areas covering advanced heart failure and HFpEF. Dr. Beth Feldman graduated from Temple University School of Medicine and is currently on the Longcope Firm on the Osler Medical Service at Johns Hopkins University Hospital. Before pursuing a career in medicine, she worked in health care consulting focusing in health systems. She is passionate about health policy and health systems research. She is hoping to pursue a career in cardiology, with a particular interest in critical care. Kavita Sharma, MD Beth Feldman, MD CardioNerds Heart Failure Series

Interventional cardiology and structural interventions in heart failure are discussed by Dr. Jeffrey Moses, Director of Interventional Therapeutics at Columbia University Medical Center Director of Advanced Cardiac Interventions at St Francis Hospital and Heart Center in Roslyn, NY. CardioNerds hosts Amit Goyal and Daniel Ambinder are joined by Dr. Jackie Latina (Cardiology fellow at The Johns Hopkins Hospital). Topics discussed include percutaneous intervention and complex and high-risk coronary intervention (CHIP), treatment of functional mitral and tricuspid regurgitation, aortic stenosis, and the utility of interatrial shunt devices for the treatment congestive heart failure. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic PageTake me to episode topics pageAcute Decompensated Heart Failure Primer – Youtube Dr. Jeffrey W. Moses completed medical school at the University of Pennsylvania School of Medicine and his internship, residency and fellowship in Cardiology at the Presbyterian University of Pennsylvania Medical Center. He currently serves as Director of Interventional Cardiovascular Therapeutics at Columbia University Medical Center and as Director of Advanced Cardiac Interventions at St Francis Hospital and Heart Center in Roslyn, NY. Dr. Moses is an Associate Director of the Transcatheter Cardiovascular Therapeutics (TCT) conference. He has served as lead investigator for numerous national and international clinical studies and he has made important contributions in the areas of clinical research and educational activities in interventional vascular therapy. He is also a pioneer in developing approaches involving minimally invasive surgery, angioplasty, gene therapy, novel imaging technologies and various support devices that allow for wider application of interventional cardiovascular procedures. Dr. Jacqueline Latina was born and raised in the suburbs of Boston, MA, but fortunately escaped without a Boston accent. She is a graduate of Princeton University with an A.B. in chemistry. She earned her M.D. at Tufts University School of Medicine. Her internship and internal medicine residency were completed at Mount Sinai Hospital in New York City, where she stayed on for an American Heart Association postdoctoral research fellowship. She completed an M.S. in clinical research methods at the Columbia Mailman School of Public Health during that time. She is currently a cardiology fellow at Johns Hopkins Hospital, and plans to start interventional cardiology fellowship in June 2020.  She chuckles if you ask “Are you Latina?” Jeffrey W. Moses, MD Jacqueline Latina, MD CardioNerds Heart Failure Series

The Cleveland Clinic Director of Cardiac MRI, Dr. Deborah Kwon, discusses the principles and clinical applications of cardiac MRI, taking us from the protons to the bedside with a series of illustrative cases. CardioNerds hosts Amit Goyal, Daniel Ambinder, and Carine Hamo are joined by Dr. Nicole Pristera (Cleveland Clinic cardiology fellow). Flutter moment by student doctor Arooma Shahid. On the CardioNerds Myocarditis page you will find podcast episodes, infographic, youtube videos, references, tweetorials and guest experts & contributors, flutter stars and so much more. CardioNerds Myocarditis PageCardioNerds Multimodality CV Imaging PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Links in this episode: Mental Filter: Matters of the Heart: Part 1 Mental Filter: Matters of the Heart: Part 2 Cardiac Imaging Agorà Dr. Debbie Kwon attended medical school at the University of Michigan and internal medicine residency at the University of Pennsylvania. She completed her general cardiology and cardiovascular imaging fellowships at the Cleveland Clinic. She is the Director of Cardiac MRI At the Cleveland Clinic and serves as the Core Lab MRI director for the Pulmonary Vascular Disease Phenomics (PVDOMICS) multicenter National institution of Health (NIH) Study. Dr. Nicole Pristera is a cardiology fellow at the Cleveland Clinic.  She earned her medical degree at Case Western Reserve University and completed her internal medicine residency training at Duke University. Her clinical interests include interventional cardiology and cardiac critical care. Outside of the hospital, she enjoys traveling, hiking, and learning foreign languages. Dr. Arooma Tahir completed her medical degree from Lahore Medical and Dental college in Lahore Pakistan. She went to medical school to pursue her passion and currently she is studying for USMLEs in Fresno, CA. She enjoys hiking, trying out different cuisines, and podcast by cardionerds.  Interview Questions How would you give a basic intro to cardiac MRI principles to a first year cardiology fellow?  What should we know about the common sequences for cardiac MRI? We all learn about the risks of NSF.  How much of these risks are a reality and when should we truly avoid gadolinium exposure? What are some challenges to MRI? What types of information about the heart can we obtain with a CMR? The role for Cardiac MRI in particular cases discussed with Dr. Kwon CAD: A 45 year old G1P1 woman with prior preeclampsia and anterior STEMI s/p LAD PCI 3 years ago is being seen for chest pain. TTE shows LVEF 45% with mid-apical anterior hypokinesis and apical aneurysm. How does CMR help delineate ischemic heart disease (perfusion, viability, chambers)  Pericarditis: her stress MRI shows an anteroapical perfusion defect and apical aneurysm with mural thrombus, with corresponding LGE. On further review, her chest pain is sharp, pleuritic, and worsens with recumbency. EKG on follow-up shows diffuse ST elevations and PR depressions except for in aVR which shows ST depression and PR elevation. ESR and CRP are moderately elevated.  ARVC: A 35 year old female athlete who is admitted after VF arrest that occurred during a tennis match. Thankfully she received immediate bystander CPR with early defibrillation and prompt ROSC. She has had prior syncope during training and an uncle died suddenly at age 40. Resting EKG shows an incomplete right bundle, right precordial TWIs, and epsilon waves in V1-V3.  On tele she’s had multiple runs of NSVT of LBBB morphology. Echocardiogram shows RV dilation. A heart failure consult is considering EMBx but requests a CMR beforehand.  Role in select other cardiomyopathies: HCM, Amyloid, hemochromatosis etc (if time) Valvular Heart Disease: A 28 year old man with no PMH who presents with progressive dyspnea during his routine morning runs. On exam he has a early diastolic decrescendo murmur best heard at end expiration while leaning forward. While concentrating on the murmur you notice a subtle rhythmic head bobbing. TTE shows eccentric AI and a dilated LV, but further characterization is limited.  (CMR shows bicuspid aortic valve, TAA, LV dilation) Cardiac mass: a 55 year old woman with subacute fevers, chills, and night sweats now presents with acute ischemic left leg pain. Auscultation reveals a mid-diastolic plop.  TTE is limited by poor sonographic windows, but there is a nondescript echodensity in the LA. What is the role of CMR in cardiac masses?  Myocarditis: Chas Miller is our patient from episodes 31 & 32 who had presented with cardiogenic shock and heart block found to have fulminant myocarditis. Now unfortunately he was too sick to undergo a cardiac mri, but how would it have helped? Deborah Kwon, MD Nicole Pristera, MD Arooma Tahir, MBBS CardioNerds Myocardi

What does it feel like to have fulminant myocarditis? How does it feel to see a loved one on ECMO? What impact do healthcare heroes have on their patients’ and their families’? Tune into this remarkable firsthand patient perspective as Chas and Julie Miller recount their experience with fulminant myocarditis. In Episode 31 we discussed the science & medicine of myocarditis. Now in Episode 32 we realize the emotions and human experience on the other side through the lens of a patient and his loving wife. Special messages from CCU nursing, Megan VanName, Alyssa Noonan, and Kelly Norsworthy, as well as Dr. Dan Choi, cardiac surgeon at Johns Hopkins Hospital. On the CardioNerds Myocarditis page you will find podcast episodes, infographic, youtube videos, references, tweetorials and guest experts & contributors, flutter stars and so much more. Take me to the Myocarditis Series PageTake me to the episode topics pagesCheck out Amit Goyal’s Myocarditis Tweetorial 5 points of maximal impulse in approaching myocarditis (review from episode 31) Build the clinical suspicion for myocarditis: You need a high index of suspicion given the variable presentation, and definitely need to keep a differential so you don’t miss things like acute coronary syndromes. Decide if EMBx is necessary: Most often obtained in fulminant presentations to look for pathologic findings of giant cell myocarditis or eosinophilic myocarditis, because these findings will change management. Manage the acute cardiac injury, which can range from supportive care to treatment of shock, arrhythmias, and even tamponade. Manage the chronic cardiac sequelae: Recovering from the acute phase of myocarditis doesn’t necessarily mean smooth sailing — some develop chronic heart failure, warranting GDMT — or guideline directed management and therapy, as defined byDr. Randall Starling in Ep 13. Treat the myocarditis: Immunosuppression is often started empirically in fulminant disease, but continuation depends on what you find on pathology.

The CardioNerds discuss a case of fulminant myocarditis, teaching a comprehensive approach to myocarditis with just 5 foundational principles. Review the myocarditis infographic on the myocarditis topic page. The episode ends with a special message from the true heroes of this episode, Chas and Julie Miller.  This marks our first episode after 100,000 downloads of the show – and this is a benchmark that we are celebrating together with all of you. Since launch, we have had 82 voices on the show and youtube channel. Our website which collates all the podcast episodes, youtube videos, tweetorials, and more has been accessed in 120 countries. We just cannot thank you enough!  On the CardioNerds Myocarditis page you will find podcast episodes, infographic, youtube videos, references, tweetorials and guest experts & contributors, flutter stars and so much more. Take me to the Myocarditis Series PageTake me to the episode topics pagesCheck out Amit Goyal’s Myocarditis Tweetorial 5 points of maximal impulse in approaching myocarditis Build the clinical suspicion for myocarditis: You need a high index of suspicion given the variable presentation, and definitely need to keep a differential so you don’t miss things like acute coronary syndromes. Decide if EMBx is necessary: Most often obtained in fulminant presentations to look for pathologic findings of giant cell myocarditis or eosinophilic myocarditis, because these findings will change management. Manage the acute cardiac injury, which can range from supportive care to treatment of shock, arrhythmias, and even tamponade. Manage the chronic cardiac sequelae: Recovering from the acute phase of myocarditis doesn’t necessarily mean smooth sailing — some develop chronic heart failure, warranting GDMT — or guideline directed management and therapy, as defined by Dr. Randall Starling in Ep 13. Treat the myocarditis: Immunosuppression is often started empirically in fulminant disease, but continuation depends on what you find on pathology.

Cardiovascular experts, Drs. JoAnn Lindenfeld, Javid Moslehi and Richa Gupta from Vanderbilt University Medical Center and Dr. Enrico Ammirati from Milan, Italy join Amit and Dan for a two part discussion about all things to consider for myocarditis in general (part 1) and COVID-19 myocarditis and heart transplantation in the COVID-19 era (part 2). Flutter Moment by Barrie Stanton (RN). On the CardioNerds Myocarditis page you will find podcast episodes, infographic, youtube videos, references, tweetorials and guest experts & contributors, flutter stars and so much more. Take me to the Myocarditis Series Page  Take me to the COVID-19 Series Page Take me to the Episode Topics Page Dr. JoAnn Lindenfeld, is a Professor of Medicine and the Director of Heart Failure and Heart Transplantation Section at Vanderbilt Heart and Vascular Institute.  She is the past president of the Heart Failure Society of America and serves on editorial boards of numerous journals including JACC, JACC Heart Failure and JHLT.  She is also a member of the AHA/ACC/HFSA heart failure guideline writing committee and was previously chair of the HFSA practice guidelines for the 2006 and 2010 guidelines. In addition to this she’s been an investigator in multiple large-scale clinical trials including the COAPT trial and has served on numerous steering committees, end point committees and data and safety monitoring committees. She is the author of a more than 300 original papers, reviews, and book chapters in the field of heart failure and heart transplantation. Dr. Javid Moslehi is an associate professor of medicine at Vanderbilt University Medical Center where he is the director of the cardio-oncology program.  He is a clinical cardiologist and basic/translational biologist interested in cardiovascular complications associated with novel molecular targeted cancer therapies and the implications of these on our knowledge of basic cardiovascular biology. At Vanderbilt he runs an independent basic and translational research laboratory and program with a focus on signal transduction in the myocardium and vasculature as well as establishing pre-clinical models of cardiotoxicity involving novel targeted oncologic therapies. Dr. Enrico Ammirati is an assistant professor of cardiology and advanced heart failure and transplant cardiologist in Milan, Italy at the Niguarda Hospital with a special research interest and expertise in acute myocarditis and acute heart failure.  He is a fellow of the European Society of Cardiology and has won numerous awards, he has also published incredibly important work on the distinction between fulminant and nonfulminant myocarditis and the prognostic implication of histologic subtypes.  His research interests also include the role of adaptive immunity in heart transplantation and atherosclerosis and he is the author of well over 100+ peer reviewed publications.

Cardiovascular experts, Drs. JoAnn Lindenfeld, Javid Moslehi and Richa Gupta from Vanderbilt University Medical Center and Dr. Enrico Ammirati from Milan, Italy join Amit and Dan for a two part discussion about all things to consider for myocarditis in general (part 1) and COVID-19 myocarditis and heart transplantation in the COVID-19 era (part 2). Flutter Moment/Song by Drs. Matt (Internal Medicine) and Beth Faiman (Oncology). On the CardioNerds Myocarditis page you will find podcast episodes, infographic, youtube videos, references, tweetorials and guest experts & contributors, flutter stars and so much more. Take me to the Myocarditis Series Page Take me to the COVID-19 Series PageTake me to the Episode Topics Page Interview Questions What is myocarditis? How do we classify it? How do we diagnose myocarditis? Why don’t we biopsy everyone? When do we think biopsy may change management? Do we really understand the mechanism of myocardial injury in what we call myocarditis? How do we figure mechanisms out and why is this important? Guests and Experts Dr. JoAnn Lindenfeld, is a Professor of Medicine and the Director of Heart Failure and Heart Transplantation Section at Vanderbilt Heart and Vascular Institute.  She is the past president of the Heart Failure Society of America and serves on editorial boards of numerous journals including JACC, JACC Heart Failure and JHLT.  She is also a member of the AHA/ACC/HFSA heart failure guideline writing committee and was previously chair of the HFSA practice guidelines for the 2006 and 2010 guidelines. In addition to this she’s been an investigator in multiple large-scale clinical trials including the COAPT trial and has served on numerous steering committees, end point committees and data and safety monitoring committees. She is the author of a more than 300 original papers, reviews, and book chapters in the field of heart failure and heart transplantation. Dr. Javid Moslehi is an associate professor of medicine at Vanderbilt University Medical Center where he is the director of the cardio-oncology program.  He is a clinical cardiologist and basic/translational biologist interested in cardiovascular complications associated with novel molecular targeted cancer therapies and the implications of these on our knowledge of basic cardiovascular biology. At Vanderbilt he runs an independent basic and translational research laboratory and program with a focus on signal transduction in the myocardium and vasculature as well as establishing pre-clinical models of cardiotoxicity involving novel targeted oncologic therapies. Dr. Enrico Ammirati is an assistant professor of cardiology and advanced heart failure and transplant cardiologist in Milan, Italy at the Niguarda Hospital with a special research interest and expertise in acute myocarditis and acute heart failure. He is a fellow of the European Society of Cardiology and has won numerous awards, he has also published incredibly important work on the distinction between fulminant and nonfulminant myocarditis and the prognostic implication of histologic subtypes. His research interests also include the role of adaptive immunity in heart transplantation and atherosclerosis and he is the author of well over 100+ peer reviewed publications. JoAnn Lindenfeld, MD Enrico Ammirati, MD Javid Moslehi, MD Myocarditis Infographic

In the midst of the COVID-19 pandemic, we take a look at the association between influenza and myocardial infarction with Dr. Steven Schulman, director of the coronary care unit and cardiology fellowship program director at The Johns Hopkins Hospital and Dr. Rhanderson Cardoso, cardiology fellow at the Johns Hopkins Hospital. Flutter moment by Euri Perio (RN). In light of the COVID-19 pandemic, we shifted gears to meet the educational need as we all are learning more about the cardiovascular implications of SARS-CoV-2. On the CardioNerds COVID-19 series page, you will find our collection of podcast episodes, infographic, youtube videos, curated #Tweetorials, references, guest experts & contributors, flutter stars and so much more. Check out the COVID-19 series page!Take me to episode topics pageClick here for Youtube COVID-19 PlaylistClick here for our Youtube CV fundamentals playlistYoutube video on QTc measurement Dr. Steven Schulman graduated from Johns Hopkins University School of Medicine. He fulfilled his training in internal medicine and chief residency, as well as completing his cardiology fellowship at Hopkins. Dr. Schulman is the director of the Coronary Care Unit (CCU) as well as the Cardiology Fellowship Program Director at Johns Hopkins. His main research interests include acute myocardial infarction. He has won numerous teaching awards from Hopkins residents and fellows over the years. While attending the CCU, Dr. Schulman teaches and guides the next generation of residents and fellows about acute cardiac care. Dr. Rhanderson Cardoso graduated from medical school at the University of Goias in his home country Brazil. He then completed Internal Medicine residency and a chief year at the University of Miami-Jackson Memorial Hospital. Rhanderson has diverse interests in cardiovascular diseases, including electrophysiology, imaging, and prevention. He is especially passionate about teaching and hopes to have a career in academic medicine. He is currently earning a Masters degree in Cardiovascular Epidemiology at the Hopkins Bloomberg School of Public health and is planning on pursuing additional imaging training at Brigham and Women’s Hospital in the upcoming academic year.

Infectious disease experts from the Johns Hopkins Hospital, Drs. Natasha Chida and Saman Nematollahi join the CardioNerds for a 4 part COVID-19 infectious disease series. In this final episode, we discuss the virology and epidemiology of SARS-CoV-2 that serves as the underpinnings for the three prior episodes. Flutter Moment by Dr. Sumeet Bahl (Vascular and Interventional Radiology) We are honored to promote the incredible efforts of #GetUsPPE, a nonprofit organization working hard to make sure every healthcare worker is protected. Dr. Seth Trueger, emergency medicine physician and digital media editor @JAMA Network Open shares an earnest request. In light of the COVID-19 pandemic, we shifted gears to meet the educational need as we all are learning more about the cardiovascular implications of SARS-CoV-2. On the CardioNerds COVID-19 series page, you will find our collection of podcast episodes, infographic, youtube videos, curated #Tweetorials, references, guest experts & contributors, flutter stars and so much more. Check out the COVID-19 series page! Take me to episode topics page Click here for Youtube COVID-19 Playlist Click here for our Youtube CV fundamentals playlist Dr. Natasha Chida, an infectious disease expert at Johns Hopkins. Dr Chida received her MD from the University of Miami Miller School of Medicine, where she also earned an MSPH (masters of science in public health). She completed internal medicine residency at Jackson Memorial Hospital and infectious disease fellowship at Johns Hopkins, where we were lucky to keep her on as faculty. She is a truly incredible educator and mentor to all levels of trainees — she serves as assistant director of the infectious disease fellowship program, co-director of the medical education pathway for residents, director of education for the Johns Hopkins Center for Global Health Education, and course director for the ‘Topics in Interdisciplinary Medicine’ course for medical students. Dr. Saman Nematollahi grew up in Tucson, Arizona. He completed his undergrad at the University of Arizona with dual degrees in Physiology and Spanish Literature. He spent some time after undergrad working in a neuroscience lab before starting med school at the University of Arizona. He then moved to NYC where he completed residency at Columbia. His clinical interests include management of immunocompromised hosts, and his research interest is in medical education. More than that he is a teacher at heart and is obtaining a Master’s of Education at the Johns Hopkins School of Education and was recently awarded a grant to develop a fungal diagnostic curriculum for residents. He loves to play soccer with his wife and son. He is master educator, appeared on and has authored many important tweetorials. He has also appeared on the hit medical podcast, The Clinical Problem Solvers.

Infectious disease experts from the Johns Hopkins Hospital, Drs. Natasha Chida and Saman Nematollahi join the CardioNerds for a 4 part COVID-19 infectious disease series. In this third episode, we discuss all things to consider with regards the clinical presentation & diagnosis of COVID-19. Be sure to stay tuned for the remaining part of this mini-series where we will the virology of SARS-CoV-2. Flutter Moment by Dr. Dani Dumitriu from the frontlines of the COVID-19 pandemic in NYC. We are honored to promote the incredible efforts of #GetUsPPE, a nonprofit organization working hard to make sure every healthcare worker is protected. Dr. Michelle Myles, emergency medicine physician shares her PPE story. In light of the COVID-19 pandemic, we shifted gears to meet the educational need as we all are learning more about the cardiovascular implications of SARS-CoV-2. On the CardioNerds COVID-19 series page, you will find our collection of podcast episodes, infographic, youtube videos, curated #Tweetorials, references, guest experts & contributors, flutter stars and so much more. Check out the COVID-19 series page! Take me to episode topics page Click here for Youtube COVID-19 Playlist Click here for our Youtube CV fundamentals playlist Dr. Natasha Chida, an infectious disease expert at Johns Hopkins. Dr Chida received her MD from the University of Miami Miller School of Medicine, where she also earned an MSPH (masters of science in public health). She completed internal medicine residency at Jackson Memorial Hospital and infectious disease fellowship at Johns Hopkins, where we were lucky to keep her on as faculty. She is a truly incredible educator and mentor to all levels of trainees — she serves as assistant director of the infectious disease fellowship program, co-director of the medical education pathway for residents, director of education for the Johns Hopkins Center for Global Health Education, and course director for the ‘Topics in Interdisciplinary Medicine’ course for medical students. Dr. Saman Nematollahi grew up in Tucson, Arizona. He completed his undergrad at the University of Arizona with dual degrees in Physiology and Spanish Literature. He spent some time after undergrad working in a neuroscience lab before starting med school at the University of Arizona. He then moved to NYC where he completed residency at Columbia. His clinical interests include management of immunocompromised hosts, and his research interest is in medical education. More than that he is a teacher at heart and is obtaining a Master’s of Education at the Johns Hopkins School of Education and was recently awarded a grant to develop a fungal diagnostic curriculum for residents. He loves to play soccer with his wife and son. He is master educator, appeared on and has authored many important tweetorials. He has also appeared on the hit medical podcast, The Clinical Problem Solvers.

Infectious disease experts from the Johns Hopkins Hospital, Drs. Natasha Chida and Saman Nematollahi join the CardioNerds for a 4 part COVID-19 infectious disease series. In this second episode, we discuss all things to consider with regards to protecting healthcare workers in COVID-19 as well as their families as they face the pandemic. Be sure to stay tuned for the remaining 2 parts of this mini-series where we will discuss the clinical presentation and diagnosis of COVID-19, and the virology. Flutter Moment by Dr. Meredith Sloan (Internal medicine, University of Mississippi Medical Center). Check out the COVID-19 series page! Take me to episode topics page Click here for Youtube COVID-19 Playlist Dr. Natasha Chida, an infectious disease expert at Johns Hopkins. Dr Chida received her MD from the University of Miami Miller School of Medicine, where she also earned an MSPH (masters of science in public health). She completed internal medicine residency at Jackson Memorial Hospital and infectious disease fellowship at Johns Hopkins, where we were lucky to keep her on as faculty. She is a truly incredible educator and mentor to all levels of trainees — she serves as assistant director of the infectious disease fellowship program, co-director of the medical education pathway for residents, director of education for the Johns Hopkins Center for Global Health Education, and course director for the ‘Topics in Interdisciplinary Medicine’ course for medical students. Dr. Saman Nematollahi grew up in Tucson, Arizona. He completed his undergrad at the University of Arizona with dual degrees in Physiology and Spanish Literature. He spent some time after undergrad working in a neuroscience lab before starting med school at the University of Arizona. He then moved to NYC where he completed residency at Columbia. His clinical interests include management of immunocompromised hosts, and his research interest is in medical education. More than that he is a teacher at heart and is obtaining a Master’s of Education at the Johns Hopkins School of Education and was recently awarded a grant to develop a fungal diagnostic curriculum for residents. He loves to play soccer with his wife and son. He is master educator, appeared on and has authored many important tweetorials. He has also appeared on the hit medical podcast, The Clinical Problem Solvers. Besides for discussing Protecting Healthcare Workers in COVID-19, we are thrilled to have Dr. Meridith Sloan on the Cardionerds podcast for her inspiring flutter moment! Dr. Meredith Sloan is a proud graduate of the University of Virginia (Wahoowa!) and went to the Medical University of South Carolina. She is currently a third year Internal Medicine resident at the University of Mississippi Medical Center, and is looking forward to being a Chief Resident next year.

Infectious disease experts from the Johns Hopkins Hospital, Drs. Natasha Chida and Saman Nematollahi join the CardioNerds for a 4 part COVID-19 infectious disease series. In this first part we discuss the emerging therapies in our armamentarium. Be sure to stay tuned for the remaining 3 parts in which we tackle advice for the health care worker, the clinical presentation & diagnosis, and the virology. Flutter Moment by Dr. Justin Berk (Medicine/Pediatrics). Check out the COVID-19 series page! Take me to episode topics page Dr. Natasha Chida, an infectious disease expert at Johns Hopkins. Dr Chida received her MD from the University of Miami Miller School of Medicine, where she also earned an MSPH (masters of science in public health). She completed internal medicine residency at Jackson Memorial Hospital and infectious disease fellowship at Johns Hopkins, where we were lucky to keep her on as faculty. She is a truly incredible educator and mentor to all levels of trainees — she serves as assistant director of the infectious disease fellowship program, co-director of the medical education pathway for residents, director of education for the Johns Hopkins Center for Global Health Education, and course director for the ‘Topics in Interdisciplinary Medicine’ course for medical students. Dr. Saman Nematollahi grew up in Tucson, Arizona. He completed his undergrad at the University of Arizona with dual degrees in Physiology and Spanish Literature. He spent some time after undergrad working in a neuroscience lab before starting med school at the University of Arizona. He then moved to NYC where he completed residency at Columbia. His clinical interests include management of immunocompromised hosts, and his research interest is in medical education. More than that he is a teacher at heart and is obtaining a Master’s of Education at the Johns Hopkins School of Education and was recently awarded a grant to develop a fungal diagnostic curriculum for residents. He loves to play soccer with his wife and son. He is master educator, appeared on and has authored many important tweetorials. He has also appeared on the hit medical podcast, The Clinical Problem Solvers.

Dr. Dan Grove is a critical care physician who was diagnosed with COVID-19. Join us as we discuss Dr. Grove’s personal journey and reflections while transitioning from physician to patient, the etymology of the word quarantine, tips and tricks to keep family members safe while in self isolation, and a message to our brothers and sisters on the frontlines as well as the general public. Flutter Moment by Dr. Dani Dumitriu (Pediatrics, Neuroscientist and Pediatric environmental health science) Check out the COVID-19 series page! Take me to episode topics page Follow Dr. Grove’s personal Covid-19 Journey Dr. Daniel Grove serves as assistant director of critical care at Medstar Union Memorial Hospital. He earned his medical degree at Emory University School of Medicine where he also completed his residency and fellowship training in internal medicine and pulmonary and critical care medicine. Dr. Grove is a physician leader in his community and is involved in patient advocacy on many levels. Dan Grove, MD

We share with you the Iranian experience with COVID-19, a rare first hand report from ICU doctor, Dr. Reza Hashemian, covering the clinical, the societal, and the personal. Flutter Moment by Edward Nejat (Reproductive Endocrinology). Check out the COVID-19 series page! Take me to episode topics page Ventilation primer for the cardiologist (Youtube) Dr. Reza Hashemian serves as Professor of Critical care medicine at a large academic hospital in the heart of Iran. He in on the frontlines at Masih Daneshvari hospital in Tehran, the country’s top pulmonary public hospital and the main facility overseeing coronavirus patients.

Tune in to hear the Italian perspective from a “COVID A” cardiovascular hospital in Milan, the heart of the country’s epidemic shared by Dr. Gianluca Pontone, who serves as Director of Cardiovascular Imaging Department Centro Cardiologico Monzino IRCCS, University of Milan. We discuss management of COVID-19 patients with underlying cardiovascular disease and cardiac manifestations of COVID-19 including acute coronary syndromes, cardiogenic shock, and myocarditis. Dr. Pontone shares his personal experience in terms of how he prepares himself to take care of patients during this time and his message for all CardioNerds to hear. Flutter Moment by Nino Isakadze (Cardiology). Check out the COVID-19 series page! Take me to episode topics page Ventilation primer for the cardiologist (Youtube) Dr. Gianluca Pontone serves as Director of Cardiovascular Imaging Department Centro Cardiologico Monzino IRCCS, University of Milan, Italy. He graduated with honors in medicine in 1997 followed by post-graduate degree in cardiology and radiology at University of Milan in 2001 and 2006 respectively. He is currently in the board of directors of Society of Cardiovascular Computed Tomography (SCCT), chairman of CT certification committee of European Association of Cardiovascular Imaging (EACVI) and chairman of working group of cardiac magnetic resonance of Italian society of cardiology.

COVID-19 in the ICU: The CardioNerds follow the case of Sara S Covids through her journey with COVID-19 complicated by progressive respiratory failure. Learn how critical care physicians, Drs. David Furfaro and Sam Brusca approach cardiopulmonary mechanics, general ventilator settings, ventilation in patients with cardiac disease, ARDS diagnosis and management algorithms, including VV and VA ECMO support considerations. Importantly, we discuss these issues in the context of the COVID-19 era and how applies to the safety of the healthcare worker and appropriate use of personal protective equipment with a particular emphasis on COVID-19 in the ICU. Both physicians share tips and tricks on coping and staying motivated as they face this crisis. This episode is broadly applicable for anyone taking care of patients with cardiopulmonary disease. In the COVID era, this is every provider. Flutter Moment by Emily (Pediatric RN) Check out the COVID-19 series page! Take me to episode topics page Ventilation primer for the cardiologist (Youtube) Dr. Samuel Brusca received his medical degree from New York University School of Medicine. He went on to complete his internal medicine training in the Osler Residency Program at Johns Hopkins Hospital and is currently a research fellow in the Critical Care Medicine Fellowship at the National Institutes of Health. His current interests include critical care cardiology, pulmonary arterial hypertension, and right ventricular failure. He is thrilled to be joining the Cardiovascular Disease Fellowship at UCSF this coming July. Outside the hospital, Sam and his amazing wife, Becky, were recently joined by their first daughter, the adorable Madeleine. Dr. David Furfaro received a degree in chemistry with a minor in pharmacology from Duke University. After college, he volunteered with Americorps for a year working with patients with HIV. He received his MD from Harvard Medical School. From there he completed his internal medicine training in the Osler Residency at Johns Hopkins. He returned to Johns Hopkins as an Assistant Chief of Service. He is currently a Pulmonary and Critical Care Medicine Fellow at Columbia University Medical Center. He is interested in critical care, pulmonary hypertension, and lung transplantation. He is also a dedicated medical educator  and a huge Cardio Nerds fan!

The CardioNerds explore the cardiovascular implications of COVID-19 caused by the SARS-CoV 2, in patients with and without underlying cardiovascular disease. We discuss a range of important topics such as ACE-I and ARBS and COVID-19, a 4 part ID mini-series on SARs-CoV 2, important perspectives from clinicians on the frontlines of Italy and Iran, a primer on ICU care for COVID-19 positive patients and so much more! The series kicks off with Dr. Oscar Cingolani, Director of the Hypertension Center at the Johns Hopkins Hospital is joined by Drs. Amit Goyal, Carine Hamo, and Daniel Ambinder and discuss what is known about the interplay between ACE-I and ARBS and COVID-19. We also learn tips and tricks from Dr. Cigolani’s experience with telemedicine use with the hypertension clinic. Flutter Moment by Dr. Stephen Lockey (Orthopedic Surgery) Check out the COVID-19 series page! Take me to episode topics page Follow us on Twitter! Dr. Oscar Cingolani earned his medical degree from the National University of La Plata, Argentina, and completed his Internship and Internal Medicine Residency at CEMIC, Buenos Aires, Argentina, and hypertension research post-doctoral fellowship at Henry Ford Hospital, Detroit, Michigan. After completing his Internal Medicine Residency at The Reading Hospital and Medical Center in Pennsylvania, Dr. Cingolani joined The Johns Hopkins Hospital as a Cardiology fellow, where he remained on Faculty after his training. He is currently the Associate Director of The Johns Hopkins Hospital Cardiac Care Unit and the Director of the Hypertension Center. Dr. Cingolani’s research interests focus on hypertensive heart disease and its transition to heart failure. Dr. Stephen Lockey graduated from Georgetown University School of Medicine and obtained an MBA from the McDonough School of Business. He is currently a third-year resident in Orthopaedic Surgery at Georgetown University Hospital. He is interested in pursuing additional training in spine surgery.

Best-selling author Dr. Martha Gulati joins the CardioNerds squad, Carine Hamo, Heather Kagan, Amit Goyal, and Daniel Ambinder for an unbelievable discussion on women’s cardiovascular health relevant to anyone taking care of women. Topics discussed include disparities in diagnosis, treatment, and outcomes in women vs men, sex specific risk factors for cardiovascular disease, special considerations for the evaluation of women presenting with chest pain, and cardiac conditions that have a female predominance, how to be a trailblazer in cardiovascular medicine and so much more! Check out the Women’s Cardiovascular Health Topic Page Take me to episode topics page Dr. Martha Gulati completed medical school at the University of Toronto, Canada and her internship, residency and cardiology fellowship at the University of Chicago. She previously served as the Sarah Ross Soter Chair in Women’s Cardiovascular Health and the section director for Women’s Cardiovascular Health and Preventive Cardiology at Ohio State University. She currently serves as division chief of Cardiology for the UA College of Medicine – Phoenix. She is also editor-in-chief of ACC’s CardioSmart.  Dr. Gulati has made incredible contributions to researching cardiovascular disease in women. She is the principal investigator of the St. James Women Take Heart Project, a co-investigator on the Women Ischemic Syndrome Evaluation (WISE); previously served as a co-investigator on the Women’s Health Initiative (WHI); a member of numerous advisory boards and societies, including the American Heart Association and the American College of Cardiology; and has published articles in The New England Journal of Medicine, Circulation and Journal of the American Medical Association (JAMA). She is also the best-selling author of Saving Women’s Hearts! References Gulati, M., & Merz, C. (2016). Advances in Lipid Therapy: The Role of Lipid Treatment in Women in Primary Prevention. Progress in Cardiovascular Diseases. Gulati, M. (2017). Improving the Cardiovascular Health of Women in the Nation: Moving beyond the Bikini Boundaries. Circulation, 135(6), 495-498. Lippincott Williams and Wilkins. Wenger NK (2005) Women in cardiology: The US experience. Heart. Douglas PS, Rzeszut AK, Noel Bairey Merz C, Duvernoy CS, Lewis SJ, Walsh MN, Gillam L (2018) Career preferences and perceptions of cardiology among us internal medicine trainees factors influencing cardiology career choice. JAMA Cardiol. Wenger NK, Speroff L, Packard B (1993) Cardiovascular Health and Disease in Women. N Engl J Med. Burgess S, Shaw E, Zaman S (2019) Women in Cardiology. Circulation.

Duke cardiology fellow, Rahul Loungani, interviews Dr. Jonathan Piccini, director of the Electrophysiology Clinical Trials Program and Arrhythmia Core Laboratory at Duke University, about atrial fibrillation management in patients with heart failure. They discuss rate vs rhythm control and strategies for both, new onset AF in the context of critical illness, wearable devices in AF, escalation of therapy in AF, ideal patient for catheter ablation, and AF patients with cardiac resynchronization therapy. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Jonathan P. Piccini, MD, MHS is a clinical cardiac electrophysiologist and Associate Professor of Medicine at Duke University Medical Center and the Duke Clinical Research Institute. His research interests include the conduct of clinical trials and the assessment of cardiovascular therapeutics for the care of patients with heart rhythm disorders. At present, he is the Director of the EP Clinical Trials Program and Arrhythmia Core Laboratory at Duke University. He also serves on the Clinical Working Group of the American Heart Association’s Get With The Guidelines – Atrial fibrillation (GWTG-Afib) registry program. He is an associate editor for the American Heart Journal and serves on the editorial board of Heart Rhythm, the European Heart Journal, and the Journal of Cardiac Electrophysiology. He is the Principal Investigator of the data and coordinating center for ORBIT AF, a 25,000 patient registry focused on quality of care and improving outcomes in patients with atrial fibrillation. He is also the PI of the GENETIC AF clinical trial, the first clinical trial to study genotype-directed rhythm control therapy for atrial fibrillation. He also serves on the steering committees of multiple international randomized trials focused on the treatment of atrial fibrillation.  Dr. Piccini has more than 175 publications in the field of heart rhythm medicine. Clinically, his focus is on the care of patients with atrial fibrillation and complex arrhythmias, with particular emphasis on catheter ablation and lead extraction. Dr. Rahul Loungani completed medical school at the medical university of SC and then traveled to Baltimore for internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital.  Here he fell in love with the management and hemodynamics of critically ill patients. He is currently a third-year cardiology fellow at Duke University Medical Center where he will also be pursuing fellowship in advanced heart failure and transplant cardiology next year. His current interests are in Cardiac amyloid, In particular its arrhythmic manifestations, early diagnosis, and novel therapeutics. He also loves teaching the housestaff and was awarded the Cassell-Saperstein award at Duke,  recognizing the fellow who most demonstrates a commitment to teaching and passion for clinical education. Outside of the hospital loves being a new dad to baby Arya

Vanderbilt fellows, Richa Gupta and Jessica Huston, interview past HFSA president Dr. JoAnn Lindenfeld, Director of Heart Failure and Heart Transplantation Section at Vanderbilt Heart and Vascular Institute about the nuts and bolts of cardiac transplantation. Topics discussed include organ allocation, recipient selection, high risk donors, short and long term complications, and what non-transplant physicians should know about immunosuppressive medications. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Dr. JoAnn Lindenfeld, is a Professor of Medicine and the Director of Heart Failure and Heart Transplantation Section at Vanderbilt Heart and Vascular Institute.  She is the past president of the Heart Failure Society of America and serves on editorial boards of numerous journals including JACC, JACC Heart Failure and JHLT.  She is also a member of the AHA/ACC/HFSA heart failure guideline writing committee and was previously chair of the HFSA practice guidelines for the 2006 and 2010 guidelines. In addition to this she’s been an investigator in multiple large-scale clinical trials including the COAPT trial and has served on numerous steering committees, end point committees and data and safety monitoring committees. She is the author of a more than 300 original papers, reviews, and book chapters in the field of heart failure and heart transplantation. Dr. Richa Gupta completed medical school at the Johns Hopkins School of Medicine and stayed on for internal medicine training in the Osler Residency Program at the Johns Hopkins Hospital.  She is currently a third-year cardiology fellow at Vanderbilt University Medical Center where she will also be pursuing fellowship in advanced heart failure and transplant cardiology next year.  Her current interests include post-transplant outcomes, the genetics of tachycardia-induced cardiomyopathy, the sequelae of mechanical circulatory support and applications of cardiac MRI. She also loves teaching the housestaff and medical students and getting them excited about all things heart failure.  Outside of the hospital she loves horror movies, food, travel and good exercise. Dr. Jessica Huston is an Advanced Heart Failure and Cardiac Transplant fellow at Vanderbilt University Medical Center where she also completed her Cardiovascular Medicine fellowship and served as chief fellow. Prior to her time at Vanderbilt she completed residency at the University of Utah. Her clinical and research interests include pulmonary vascular remodeling in heart failure, pulmonary hypertension and right ventricular failure. Outside the hospital she enjoys exploring the outdoors with her son.

Carine and Dan delve into left ventricular assist devices (LVAD) 101 with Dr. Steven Hsu, heart failure specialist at the Johns Hopkins Hospital. We get big picture, we get detail oriented and we hit the highlights for the psycho-social-and medical management of our LVAD patient population. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic PageTake me to episode topics pageAcute Decompensated Heart Failure Primer – Youtube Dr. Steven Hsu received his medical degree from the Johns Hopkins University School of Medicine. He did his medical training on the Osler Medical Service, during which he also served as an Assistant Chief of Service. He then completed cardiology and advanced cardiomyopathy training at Hopkins. Dr. Hsu takes care of patients with advanced cardiomyopathies, Left Ventricular Assist Devices (LVAD), and heart transplants. He serves as the medical director of the MCS program. He is also funded by an NIH/NHLBI K23 and leads a translational research effort studying the physiologic and molecular characteristics of right ventricular failure in the setting of pulmonary hypertension. More about this series:In conjunction with the 2020 Heart Failure Awareness Week, sponsored by the Heart Failure Society of America the CardioNerds are supporting the society’s efforts to promote heart failure awareness, patient education, and heart failure prevention by launching our Heart Failure Awareness CardioNerds Series. This series is a tribute to Dr. David Taylor. Dr. Taylor (aka “DOT”) was a heart failure attending at the Cleveland Clinic.  He died on Wednesday, February 5th 2020. We remember him for the legend he is. A passionate clinician, skilled educator, devoted mentor.  His legacy lives on within us. #foreverDOT

Amit and co-fellow Dr. Kartik Telukuntla discuss advanced heart failure therapies, or salvage therapies, with Dr. Jerry Estep, section head of heart failure at the Cleveland Clinic. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Dr. Jerry Estep earned his bachelor of arts at the University of Texas, Austin and subsequently received his medical degree from Baylor College of Medicine. He completed internal medicine residency training at University of Texas Southwestern Medical Center and went back to Baylor for his cardiology and heart failure fellowship training. Prior to joining Cleveland Clinic in 2018 as our section head for the division of heart failure and transplant, Dr. Estep was the Section Head of Heart Failure at Methodist DeBakey in Houston, Texas. Dr. Estep has been involved in numerous clinical trials and co-authored over a 100 peer reviewed articles. He has a special interest in advanced heart failure strategies that include mechanical circulatory support devices and has published heavily on the percutaneous placement of intra-aortic balloon pump in the axillary artery as a long-term  support option to bridge patients to transplant. We are really appreciative of Dr. Estep’s time, expertise and amazing discussion regarding advanced heart failure therapies for the cardionerds cardiology podcast. Dr. Kartik Telukuntla completed medical school in the University of Miami and internal medicine residency at University of Pennsylvania. He is currently a general cardiology fellow at the Cleveland Clinic and is slated to continue on for advanced heart failure fellowship.

Amit and co-fellow Kartik Telukuntla talk to Dr. Randall Starling, former president of the HSFA about his approach to guideline-directed medical therapy (GDMT) for Heart Failure. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Dr. Randall Starling obtained his Bachelor’s degree and Master’s in Public Health at the University of Pittsburgh and medical degree from Temple University. He went back to University of Pittsburgh for his internal medicine residency training and then went to Ohio State University for his cardiology fellowship. He stayed on as faculty at Ohio State until 2005 at which time he joined the Cleveland Clinic. He is the former section head of the Division of Heart Failure and former Vice Chairman of the Cardiovascular Medicine Department. Dr. Starling has been the principal investigator on numerous clinical trials and most recently completed his tenure as President of the Heart Failure Society of America. We are really appreciative of his time and knowledge as we discuss GDMT for Heart Failure. Dr. Kartik Telukuntla completed medical school in the University of Miami and internal medicine residency at University of Pennsylvania. He is currently a general cardiology fellow at the Cleveland Clinic and is slated to continue on for advanced heart failure fellowship. This series is a tribute to Dr. David Taylor. Dr. Taylor (aka “DOT”) was a heart failure attending at the Cleveland Clinic.  He died on Wednesday, February 5th 2020. We remember him for the legend he is. A passionate clinician, skilled educator, devoted mentor.  His legacy lives on within us. #foreverDOT

Dan and Carine chat with cardiomyopathy expert Dr. Ed Kasper with regards to his approach to the new onset heart failure patient. This episode is dedicated to Dr. Kasper’s mentor and friend, Dr. Kenneth L. Baughman. On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more. Take me to the Heart Failure Topic Page Take me to episode topics page Acute Decompensated Heart Failure Primer – Youtube Dr. Edward K. Kasper, is a graduate of the Johns Hopkins University with a B.A. in Natural Sciences. He earned his M.D. at the University of Connecticut School of Medicine. His internship and residency in Internal Medicine and assistant chief of service (ACS) of the Thayer service as well as his fellowship in Cardiology, were completed at the Johns Hopkins Hospital, where he then joined the faculty in 1993. He is currently the E. Cowles Andrus Professor of Cardiology and Director of Clinical Cardiology at Johns Hopkins Medicine. Dr. Ken Baughman served as director of the cardiology division at Johns Hopkins University School of Medicine in Baltimore, Md., before being recruited to Brigham Hospital in 2002. He was such a hero in cardiology. Dr. Myron Weisfeldt, a cardiology great in his own right, called Dr. Baughman a physician’s physician, and an exemplar of how you can lead and teach as a model to others. His thousands of patients knew him and benefited from his great expertise and his care. Dr. Gary Gottlieb, president of Brigham Hospital at the time,  said His passion for his patients was woven into the fabric of our hospital,” He represented the very best in medicine … He cared so deeply for each and every person he touched. Not only was he an extraordinary clinician, but he was a respected and accomplished researcher and brilliant mentor to dozens of young men and women who benefited from his nurturance and wisdom.” Learn more about Dr. Ken Baughman from a moving tribute authored by Dr. Roger Blumenthal. 

In conjunction with the 2020 Heart Failure Awareness Week, sponsored by the Heart Failure Society of America the CardioNerds are supporting the society’s efforts to promote heart failure awareness, patient education, and heart failure prevention by launching our Heart Failure Awareness CardioNerds Series. This series will include topics that include the evaluation to new onset heart failure, approach to guideline directed medical therapy, approach to advanced heart failure therapies, LVAD 101, heart transplantation 101, atrial fibrillation and heart failure, structural interventions in heart failure, an in-depth discussion on heart failure with preserved ejection fraction, an approach to palliative care in heart failure and so much more! CardioNerds Heart Failure Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! This heart failure series is a tribute to Dr. David Taylor. Dr. Taylor was a heart failure attending at the Cleveland Clinic.  He died early morning of Thursday, February 5th 2020.  We remember him for the legend he is. A passionate clinician, skilled educator, devoted mentor. We also dedicate the series in memory of Dr. Ken Baughman who served as director of the cardiology division at Johns Hopkins University School of Medicine in Baltimore, Md., before being recruited to Brigham Hospital in 2002.  He was such a hero in cardiology. Dr. Myron Weisfeldt, a cardiology great in his own right, called Dr. Baughman a physician’s physician, and an exemplar of how you can lead and teach as a model to others. For more on Dr. Baughman, please visit the heart failure topics page. 

Dr. Ron Witteles from Standford university provides an approach to cardiac amyloid and specifically AL (Light-Chain) Cardiac Amyloidosis. The discussion is lead by Amit and Dr. Ashley Bock. This episode is the fourth and final part of our immersive journey into the jungle of beta-pleated sheets in the heart. We focus on AL amyloidosis in this episode. Flutter moment by Lois Adamski. On the CardioNerds Cardiac Amyloid Topic Page you will find podcast episodes, infographic, references, guest contributors, flutter stars, and so much more. Take me to the Amyloid Topic Page Take me to episode topics page Cardiac imaging for Amyloid – Youtube  Dr. Ronald Witteles is a graduate of Northwestern University where he earned his B.A. in Biology, and of the University of Chicago Pritzker School of Medicine, where he earned his M.D. with Honors.  He then moved west to Stanford University where he completed IM residency and Cardiology fellowship training, serving as both Chief Resident and Chief Fellow. He subsequently joined the faculty at Stanford, and is currently appointed as Professor of Medicine (Cardiovascular Medicine). He has served as Program Director for the Stanford University Internal Medicine Residency Training Program for more than 10 years, where he leads a residency program of approximately 140 residents.  He is Co-Director of the Stanford Amyloid Center – one of the nation’s largest centers in the country which specializes in the treatment of patients with amyloidosis, and he leads an active research program in this area. He also serves as Co-Director of the Stanford Multidisciplinary Sarcoidosis Program, and he is a national leader in Cardio-Oncology, serving as Associate Editor for the country’s premier journal dedicated to the field, JACC: CardioOncology.  Dr. Ashley Bock earned her medical degree at the University of Colorado and completed her internal medicine residency training at Duke University.  From there she came to the Cleveland Clinic for general cardiology fellowship and advanced heart failure training. She joins our team today to discuss AL cardiac amyloidosis with Dr. Witelles.

Cardionerds (Daniel Ambinder and Carine Hamo) chat with Dr. Virginia Hahn about her work profiling HFpEF patients via endomyocardial biopsy only to find a significant proportion of patients with unsuspected cardiac amyloid. This is followed by a high yield discussion with Dr. Joban Vaishnav about ATTR cardiac amyloid treatment and management options. Flutter moment by David Ambinder (MS IV). On the CardioNerds Cardiac Amyloid Topic Page you will find podcast episodes, infographic, references, guest contributors, flutter stars, and so much more. Take me to the Amyloid Topic PageTake me to episode topics pageCardiac imaging for Amyloid – Youtube  Dr. Virginia Shalkey Hahn is a fourth-year Cardiology fellow at Johns Hopkins in Baltimore, MD. She earned her medical degree from the Perelman School of Medicine at the University of Pennsylvania, where she stayed for residency. She moved to Johns Hopkins for Cardiology fellowship (after a 1 year hiatus as an ICU hospitalist). During fellowship, she completed 2 years on the NIH T32 Training grant and one year as chief fellow. She feels passionate about translational heart failure research and mothering her 2 young children. Dr. Joban Vaishnav completed her undergraduate and medical school training at St. Louis University. She has since been at Johns Hopkins for residency, cardiology fellowship, and advanced heart failure fellowship. Her early research pursuits were in heart failure with preserved ejection fraction. From this, and from her advanced heart failure training, she developed a strong clinical interest and research interest in early diagnosis and treatment of cardiac amyloidosis. In addition to the great discussion on Cardiac Amyloid ATTR treatment, we are excited to have Dan’s brother, David, join the Cardionerds cardiology podcast to share a special flutter moment! David Ambinder is a 4th year medical student at the University of Maryland and will be starting urology residency this coming July at Westchester Medical Center. He grew up in New York and graduated from Touro College before heading to Baltimore for medical school. He enjoys spending time with his wife Samantha and 3 lovely children. Carine Hamo, MD Daniel Ambinder, MD

Amit and Dr. Zach Il’Giovine learn about multimodality imaging in amyloid from Dr. Paul Cremer at the Cleveland Clinic. On their way to Dr. Cremer’s office, they run into Dr. Eoin Donnellan and discuss some incredible fellow research related to cardiac amyloid from an electrophysiologic perspective. On the CardioNerds Cardiac Amyloid Topic Page you will find podcast episodes, infographic, references, guest contributors, flutter stars, and so much more. Take me to the Amyloid Topic Page Take me to episode topics page Cardiac imaging for Amyloid – Youtube  Dr. Paul Cremer earned a Bachelor’s degree in molecular biology from Princeton University, Princeton, NJ, and his medical degree from Harvard Medical School, Boston, MA. Following completion of his internal medicine residency at Massachusetts General Hospital, he worked as a physician for two years at the Navajo IHS Chinle Comprehensive Health Care Facility in Chinle, Ariz. He then continued his postdoctoral training with a three-year fellowship in cardiovascular medicine and a subsequent two-year fellowship in advanced cardiovascular imaging, both at Cleveland Clinic. He joined the Cleveland Clinic staff in 2017. He is the director of the Cleveland Clinic CCU.  He enjoys swimming and reading fantasy books with his daughters. He joins the cardionerds cardiology podcast to shed insight on cardiac amyloid imaging. Dr. Eoin Donnellan is a 3rd year Cardiology Fellow at the Cleveland Clinic and all-around nice guy. He received his medical degree from University College Cork in Ireland before heading to the big city to continue his training at the Mater Hospital in Dublin. He completed his Internal Medicine Residency at the Cleveland Clinic and will start EP Fellowship this July. Outside of the hospital he enjoys long nature walks, whispering sweet nothings, searching for the deeper meaning in little things, and watching thought-provoking and highly entertaining television programs such as This is Us and The Bachelor. Dr. Zachary Il’Giovine is a general cardiology fellow at the Cleveland Clinic. He received his medical degree from the Wright State University Boonshoft School of Medicine before completing internal medicine training at Duke University. He has clinical interests in advanced heart failure and cardiac critical care. Outside of the hospital he loves playing soccer and spending time with his wife Clare and son Luca.

A new case of congestive heart failure due to cardiac amyloid is presented by Yuxuan Wang and discussed by Carine, Heather, Dan and Amit. Guest oncology star: Jackie Zimmerman. Flutter moment by Mark Heslin. On the CardioNerds Cardiac Amyloid Topic Page you will find podcast episodes, infographic, references, guest contributors, flutter stars, and so much more. Take me to the Amyloid Topic Page Take me to episode topics page Cardiac imaging for Amyloid – Youtube  Dr. Yuxuan Wang completed her undergraduate studies at the University of Texas at Austin. She then received her MD and PhD degrees through the Medicine Scientist Training Program at Johns Hopkins School of Medicine. She trained under Bert Vogelstein, focusing on the early detection of cancer. She is currently finishing the last year of residency and fast-tracking into fellowship in Hematology-Oncology. Dr. Jackie Zimmerman completed the Medical Scientist Training Program at University of Alabama School of Medicine. She completed her internal medicine training and served as assistant chief resident (ACS) for the Longcope firm at The Johns Hopkins Hospital. She is currently a medical oncology fellow at Johns Hopkins and investigating tumor-stromal interactions in pancreatic cancer in the lab of Dr Elizabeth Jaffee. Mark Heslin is a current 3rd year medical student at Cooper Medical School of Rowan University in Camden, New Jersey. He completed his undergraduate studies at James Madison University with a degree in biology. Mark will be applying to internal medicine residency programs this upcoming fall with the hope of applying for a cardiology fellowship in the future. His clinical interests include clinical reasoning and the management of atherosclerotic cardiovascular disease. Outside of medical school, Mark enjoys spending time on Long Beach Island with his friends and family.