31. Fulminant Myocarditis with Cardiogenic Shock: Case Discussion

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.

5 points of maximal impulse in approaching myocarditis

  1. 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.
  2. 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.
  3. Manage the acute cardiac injury, which can range from supportive care to treatment of shock, arrhythmias, and even tamponade.
  4. 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.
  5. Treat the myocarditis: Immunosuppression is often started empirically in fulminant disease, but continuation depends on what you find on pathology.

13. HF part 2: Approach to GDMT with Dr. Randall Starling

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.

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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

11. HF part 0: Preamble and tribute to Dr. David Taylor​

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!

On the CardioNerds Heart Failure topic page you’ll podcast episodes, references, guest experts and contributors, and so much more.

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Acute Decompensated Heart Failure Primer – Youtube

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. 

9. Cardiac Amyloid part 3: Pulse check with Drs. Virginia Hahn and Joban Vaishnav ​

Drs. Joban Vaishnov and Virginia Hahn from Johns Hopkins Cardiology join the Cardionerds Cardiology Podcast

Dan and Carine 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.

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Cardiac 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.

8. Cardiac Amyloid Part 2: Pulse Check with Drs. Paul Cremer and Eoin Donnellan

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.

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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.

7. Cardiac Amyloid part 1: case discussion

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.

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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.

6. Hypertrophic cardiomyopathy part 4: Pulse Check with Drs. Amar Krishnaswamy and Per Wierup

Obstructive hypertrophic cardiomyopathy therapy and septal reduction therapy via alcohol septal ablation and surgical myectomy is discussed by interventional cardiologist Dr. Amar Krishnaswamy and surgical perspective from cardiothoracic surgeon Dr. Per Wierup.  Amit joins Dr. Laura Young to take a pulse check with these great experts. Flutter moment by Crystal Silbak, RN.

On the CardioNerds Hypertrophic Cardiomyopathy Topic Page you will find podcast episodes, infographic, youtube videos, references, guest contributors, flutter stars, and so much more.

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Dr. Amar Krishnaswamy earned his medical degree at Yale University. He completed his internal medicine residency training at the Osler Program at Johns Hopkins where he remained to serve as the assistant chief of service (ACS) of the Barker Firm. His general cardiology and interventional cardiology fellowships were completed at the Cleveland Clinic where he remained as staff. He is the program director of the interventional cardiology training program and the section head of the division of interventional cardiology at the Cleveland Clinic.

Dr. Per Wierup received his graduate education and residency training at Lund University in Sweden and completed his advanced cardiac surgery training at the Cleveland Clinic. He then returned to Europe where he worked hard to become the world class surgeon he is today. He returned to the Cleveland Clinic where he continues to take incredible care of his patients.  Dr. Wierup is a talented pianist and enjoys alpine skiing and show jumping!

In addition to our great discussion on hypertrophic cardiomyopathy  with regards to septal reduction therapy, we are so lucky to have Crystal join the cardionerds podcast to share a flutter moment. Crystal is a cardiac nurse at The Johns Hopkins Hospital.

Cardionerds isa Cardiology Podcast that Brings the high-yield, guideline and evidence-based cardiology educational experience to everyone, everywhere, anytime! Learn more at www.cardionerds.com 

5. Hypertrophic cardiomyopathy part 3: Pulse Check with Dr. Edward Kasper

Dr. Edward Kasper shares a unique historical perspective on how the field evolved as Medicine learned more about hypertrophic cardiomyopathy. He shares so many life lessons and clinical pearls that apply to HCM and the practice of medicine in general. Flutter moment by Dr. Sidney Schechet (ophthalmology).

On the CardioNerds Podcast Hypertrophic Cardiomyopathy Topic Page you will find podcast episodes, an infographic, references, guest contributors and so much more.

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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.

In addition to this unique historical perspective of hypertrophic cardiomyopathy, we are thrilled to have Dr. Sid Schechet join the show and share his cardionerds flutter moment!

Dr. Sid Schechet is an ophthalmologist and retinal specialist in Baltimore, Maryland, at the Elman Retina Group. He received his medical degree from Baylor College of Medicine, and completed residency at The University of Maryland. He pursued an extra two-year fellowship in vitreoretinal surgery at The University of Chicago before joining the Elman Retina Group. Aside from fixing eyeballs and retinas, he enjoys making educational, exciting, and entertaining surgical retina videos catered to both ophthalmologists and non-ophthalmologists alike. He also often can be found dusting off and polishing his- what do you call it again?- old stethoscope from med school.

4. Hypertrophic cardiomyopathy part 2: Pulse Check with Dr. Jose Madrazo

Clinical and echo expert Dr. Jose Madrazo discusses a high yield and practical approach to diagnosis and management of hypertrophic cardiomyopathy. Flutter moment by Dr. Saman Nematollahi (Infectious Disease).

On the CardioNerds Podcast Hypertrophic Cardiomyopathy Topic Page you will find podcast episodes, an infographic, references, guest contributors and so much more.

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Dr. Jose Madrazo is a top notch cardiologist in the Johns Hopkins Hospital, and an assistant professor of medicine at the Johns Hopkins School of Medicine. He received his medical degree from the University of Puerto Rico School of Medicine and completed his residency at the Baylor College of Medicine in Houston, TX. He completed his cardiology and advanced echo fellowship at the Washington University in STL School of Medicine before joining the Hopkins faculty.

In addition to this practical Approach to hypertrophic cardiomyopathy, we have just the cutest Cardionerds Flutter provided by Saman Nematollahi and his son!

Saman 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. He loves to play soccer with his wife and son. He is master educator, appeared on and has authored many important tweetorials (links on the hypertrophic cardiomyopathy series page). He has also appeared on the hit medical podcast, The Clinical Problem Solvers. 

3. Hypertrophic cardiomyopathy part 1: case discussion

Cardionerds Hypertrophic Cardiomyopathy 4 prevention strategyThe CardioNerds discuss a case of hypertrophic cardiomyopathy teaching a comprehensive approach to pathophysiology, diagnosis, imaging, and management of hypertrophic cardiomyopathy. Guest host, Dr. Fatimah Alkhunaizi. Flutter moment by Dr. Virginia Hahn (Cardiology).

On the CardioNerds Podcast Hypertrophic Cardiomyopathy Topic Page you will find podcast episodes, an infographic, references, guest contributors and so much more.

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Dr. Alkhunaizi completed her undergraduate degree in Neuroscience at Johns Hopkins University, medical school at Columbia University and she returned to the Johns Hopkins Hospital for Internal Medicine residency. She enjoys reading and taking long cathartic runs.

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.

Don’t forget to check out the rest of the Hypertrophic Cardiomyopathy series. Episode 4: Hypertrophic cardiomyopathy part 2: Pulse check with Dr. Jose Madrazo​  Clinical and echo expert Dr. Jose Madrazo discusses a high yield and practical approach to diagnosis and management of HCM. Episode 5: Hypertrophic cardiomyopathy part 3: Pulse check with Dr. Edward Kasper​ Dr. Edward Kasper shares a unique historical perspective on how the field evolved as Medicine learned more about HCM. He shares so many life lessons and clinical pearls that apply to HCM and the practice of medicine in general. Episode 6: Hypertrophic cardiomyopathy part 4: Pulse check with Drs. Amar Krishnaswamy & Per Wierup​ Amit joins Dr. Laura Young to take a pulse check with experts, and learn more about the structural management of obstructive HCM. They discuss the interventional perspective with interventional cardiologist Dr. Amar Krishnaswamy and surgical perspective from cardiothoracic surgeon

Hypertrophic Cardiomyopathy Schematic by Carine Hamo, MD