Medscape InDiscussion: Heart Failure

Drs Michelle Kittleson and Carolyn Ho have a delightful discussion about effective diagnosis and management for individuals with hypertrophic cardiomyopathy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982162). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines https://www.ahajournals.org/doi/10.1161/CIR.0000000000000937 Hypertrophic Cardiomyopathy https://www.ahajournals.org/doi/10.1161/circresaha.117.311059 Familial Hypertrophic Cardiomyopathy https://medlineplus.gov/genetics/condition/familial-hypertrophic-cardiomyopathy/

Drs Michelle Kittleson and Mathew Maurer discuss the ins and outs of diagnosing and treating TTR amyloid cardiomyopathy. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982161). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Cardiac Amyloidosis: Evolving Diagnosis and Management: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/32476490/ Tafamidis Treatment for Patients With Transthyretin Amyloid Cardiomyopathy https://www.nejm.org/doi/full/10.1056/NEJMoa1805689 Two Decades of Cardiac Amyloidosis: A Danish Nationwide Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543084/

Drs Michelle Kittleson and James Januzzi discuss must-know intricacies of managing subgroups of patients with HFpEF. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982160). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee https://www.jacc.org/doi/10.1016/j.jacc.2023.03.393 Heart Failure With Preserved Ejection Fraction: JACC Scientific Statement https://www.jacc.org/doi/10.1016/j.jacc.2023.01.049

Jennifer Ho, an associate professor and advanced heart failure specialist researching HFpEF. She breaks down how HFpEF is diagnosed using history, biomarkers, and imaging. She highlights common mimickers like infiltrative and valvular disease. She outlines guideline-directed therapies and practical strategies for tailoring treatment and lifestyle care.

Drs Michelle Kittleson and Jason N. Katz discuss how to navigate uncertain terrain using a few rules to balance choices, risks, and goals in managing device therapy for individuals with heart failure. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982158). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Medical Management of Advanced Heart Failure https://pubmed.ncbi.nlm.nih.gov/11829703/ William Osler https://pubmed.ncbi.nlm.nih.gov/3289809/ Escalating and De-escalating Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/35862152/ Experience With Univentricular Support in Mortally Ill Cardiac Transplant Candidates https://pubmed.ncbi.nlm.nih.gov/2306148/

Drs Michelle Kittleson and Sana Al-Khatib explore the ins and outs of complex clinical decisions regarding device placement for patients who have heart failure with reduced ejection fraction. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982150). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death https://pubmed.ncbi.nlm.nih.gov/29097296/ Optimal CRT Implantation — Where and How to Place the Left-Ventricular Lead? https://pubmed.ncbi.nlm.nih.gov/34495452/ Current Device Therapies for Sudden Cardiac Death Prevention — The ICD, Subcutaneous ICD and Wearable ICD https://pubmed.ncbi.nlm.nih.gov/30389367/

Gregg Fonarow, cardiologist and UCLA heart failure expert, discusses nuanced selection of adjunct HFrEF therapies. He covers ivabradine use and prescribing rules. He reviews hydralazine‑nitrate benefits in select populations. He outlines vericiguat's role after worsening heart failure and the evidence for transcatheter mitral repair. Practical tips on multidisciplinary care and medication optimization are highlighted.

Cutting‑edge discussion of quadruple therapy for heart failure with reduced ejection fraction. Clear talk on timing and dose optimization of ARNI/ACEi/ARB, beta blockers, MRA, and SGLT2 inhibitors. Practical strategies to overcome therapeutic inertia, manage low blood pressure and transient creatinine rises. System solutions like telehealth and rapid uptitration models are highlighted.