222. CardioNerds Rounds: Challenging Cases – Nuances in Pulmonary Hypertension Management with Dr. Ryan Tedford | Cardionerds: A Cardiology Podcast

This CardioNerds Rounds episode features Dr. Ryan Tedford discussing complex heart failure cases, emphasizing hemodynamic assessment and advanced therapies. The discussion covers a young woman with dilated non-ischemic cardiomyopathy and a patient with a mechanical mitral valve, addressing challenges in diagnosis and management. Dr. Tedford stresses the importance of waveform analysis in right heart catheterization, highlighting the limitations of relying solely on numerical values. He also cautions against using nitric oxide in patients with left heart disease and using Sidenafil in patients who have had bowel mirror interventions. The episode further explores the nuances of managing pulmonary hypertension in the context of heart transplantation, including the NYPRIDE challenge.

Outlines

Part 1: Introduction, Case 1 Presentation

Part 2: Waveform Analysis, Initial Management

Part 3: Mechanical Support, Transplant Outcome

Part 4: Case 2 Presentation, Diagnostic Challenges

Part 5: Advanced Metrics, Clinical Conclusion

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222. CardioNerds Rounds: Challenging Cases – Nuances in Pulmonary Hypertension Management with Dr. Ryan Tedford

Cardionerds: A Cardiology Podcast

Part 1: Introduction, Case 1 Presentation

Introduction to CardioNerds Rounds and Expert Guest Dr. Ryan Tedford

Case Presentation: A Young Woman with Dilated Non-Ischemic Cardiomyopathy

Echocardiogram and Initial Hemodynamic Assessment Findings

Part 2: Waveform Analysis, Initial Management

Analyzing Waveforms and Identifying Key Hemodynamic Patterns

Treatment Options and Considerations for Advanced Therapies

Addressing Wedge Pressure Measurement and Initial Treatment Attempts

Part 3: Mechanical Support, Transplant Outcome

Hemodynamic Changes on Balloon Pump and Next Steps in Management

Upgrading to Impella and Post-Transplant Hemodynamics

Post-Transplant Management and Introduction to Second Case

Part 4: Case 2 Presentation, Diagnostic Challenges

Second Case: Initial Presentation and Concerns Regarding Vasoreactivity Testing

Echocardiogram Findings and Clinical Presentation of Second Patient

Repeat Right Heart Catheterization and Waveform Analysis

Part 5: Advanced Metrics, Clinical Conclusion

Treatment Options and Considerations for Second Patient

Differentiating Heart Transplant vs. Heart-Lung Transplant and Advanced Hemodynamic Metrics

Management of Heart Failure with Mildly Reduced EF and Session Conclusion

222. CardioNerds Rounds: Challenging Cases – Nuances in Pulmonary Hypertension Management with Dr. Ryan Tedford

Cardionerds: A Cardiology Podcast

Part 1: Introduction, Case 1 Presentation

00:00Introduction to CardioNerds Rounds and Expert Guest Dr. Ryan Tedford

Introduction to CardioNerds Rounds and Expert Guest Dr. Ryan Tedford

03:41Case Presentation: A Young Woman with Dilated Non-Ischemic Cardiomyopathy

Case Presentation: A Young Woman with Dilated Non-Ischemic Cardiomyopathy

07:10Echocardiogram and Initial Hemodynamic Assessment Findings

Echocardiogram and Initial Hemodynamic Assessment Findings

Part 2: Waveform Analysis, Initial Management

10:04Analyzing Waveforms and Identifying Key Hemodynamic Patterns

Analyzing Waveforms and Identifying Key Hemodynamic Patterns

13:12Treatment Options and Considerations for Advanced Therapies

Treatment Options and Considerations for Advanced Therapies

15:17Addressing Wedge Pressure Measurement and Initial Treatment Attempts

Addressing Wedge Pressure Measurement and Initial Treatment Attempts

Part 3: Mechanical Support, Transplant Outcome

17:54Hemodynamic Changes on Balloon Pump and Next Steps in Management

Hemodynamic Changes on Balloon Pump and Next Steps in Management

21:33Upgrading to Impella and Post-Transplant Hemodynamics

Upgrading to Impella and Post-Transplant Hemodynamics

25:23Post-Transplant Management and Introduction to Second Case

Post-Transplant Management and Introduction to Second Case

Part 4: Case 2 Presentation, Diagnostic Challenges

27:34Second Case: Initial Presentation and Concerns Regarding Vasoreactivity Testing

Second Case: Initial Presentation and Concerns Regarding Vasoreactivity Testing

30:40Echocardiogram Findings and Clinical Presentation of Second Patient

Echocardiogram Findings and Clinical Presentation of Second Patient

33:32Repeat Right Heart Catheterization and Waveform Analysis

Repeat Right Heart Catheterization and Waveform Analysis

Part 5: Advanced Metrics, Clinical Conclusion

35:21Treatment Options and Considerations for Second Patient

Treatment Options and Considerations for Second Patient

38:11Differentiating Heart Transplant vs. Heart-Lung Transplant and Advanced Hemodynamic Metrics

Differentiating Heart Transplant vs. Heart-Lung Transplant and Advanced Hemodynamic Metrics

41:30Management of Heart Failure with Mildly Reduced EF and Session Conclusion

Management of Heart Failure with Mildly Reduced EF and Session Conclusion