BMJ Best Practice Podcast Comorbidities
12 snips
Feb 2, 2026 
Preethi Pirlamarla, an advanced heart failure and transplant cardiologist at the University of Washington, discusses managing multiple illnesses in hospitalized patients. She covers how common comorbidities are, overlooked issues like frailty and malnutrition, coordinating multidisciplinary care, and balancing treatments when conditions conflict. Practical approaches for assessment and early specialist involvement are highlighted.
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Thorough Exam And Frequent Reassessment
- Do a full, thorough physical exam and review relevant imaging and labs on admission.
- Continuously reassess vitals and electrolytes frequently when treating heart failure with chronic kidney disease.
Adjust Acute Interventions To Baseline Heart Function
- Assess hemodynamic status and severity of the acute condition before applying standard resuscitation.
- Re-evaluate frequently after interventions like fluids to spot decompensation early in patients with baseline heart failure.
Frailty Is A Key Prognostic Factor
- Frailty affects up to half of patients with heart failure and predicts prognosis and therapy tolerance.
- Functional tests like grip strength and get-up-and-go inform decisions about advanced therapies.