The Curbsiders Internal Medicine Podcast #469 Inpatient Heart Failure
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Feb 3, 2025 Dr. Gurusher Panjrath, a leading cardiologist and director at George Washington University's Heart Failure Program, discusses advanced inpatient heart failure management. He shares insights on effective diuretic therapy and innovative strategies for integrating outpatient care. The conversation highlights essential diagnostics like POCUS and echocardiography, as well as the nuances of managing volume overload. Dr. Panjrath emphasizes the importance of patient education and communication to ensure successful transitions of care, ultimately aiming for improved patient outcomes.
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Classifying HF
- Classify new-onset heart failure based on ejection fraction (EF), symptoms, and etiology.
- This patient has stage C HFrEF, likely due to hypertensive cardiomyopathy.
HFrEF Therapy
- Start quadruple therapy for HFrEF: beta-blockers, SGLT2 inhibitors, ARNI, and aldosterone antagonists.
- The sequence may vary based on patient factors like kidney function and blood pressure.
HFpEF Therapy
- In HFpEF, use SGLT2 inhibitors across the board, but ARNI and beta-blocker use depends on gender and EF.
- Aldosterone antagonists can help reduce rehospitalization and improve diuresis.