Gina G. Mentzer, MD Cardiologist, Heart Failure & Transplant Advanced Integrated Medicine & Surgery (AIMS) Program for Heart Failure April 18 th,
|
|
- Brianne Lewis
- 6 years ago
- Views:
Transcription
1 Gina G. Mentzer, MD Cardiologist, Heart Failure & Transplant Advanced Integrated Medicine & Surgery (AIMS) Program for Heart Failure April 18 th, 2015
2 Heart Failure (HF) Describe the natural course of HF Identify the HFpEF patient Identify HFpEF phenotypes Describe therapies for HFpEF
3 1 in 5 Americans over 40 years old are at risk for HF In US, ~6 million people have clinical HF >650,000 new cases a year Mortality of 50% within 5 years (even with medical therapy) 30 days post-discharge fatalities reach 10%
4 Classification EF% HF r EF HF with reduced Ejection Fraction HF p EF HF with preserved Ejection Fraction HF p EF, borderline HF p EF, improved to 49 > % ACC/AHA HF Guidelines Yancy et.al.
5 Sarah J. Goodlin, et al. JACC 2009.
6 Symptoms: Dyspnea, LE edema, fatigue, Exercise intolerance Typically older woman with HTN, DMII, CAD, obesity, afib, HLD (HTN is most prominent 60-89%) Chemotherapy High blood pressure (>200/100) Clinical findings: JVD, loud P2, S4, rales, edema Laboratory findings: BNP typically normal
7 Nohria 2005 Circulation
8 Structural and functional evaluation with imaging Complete family history Ischemic evaluation Laboratory assessment (CBC, BNP, LFTs, INR, chem panel, SPEP/UPEP, iron studies, A1C, TSH/FT4) Hemodynamic assessment clinically and invasively if indicated (pulm htn freq found) Endomyocardial biopsies are rarely indicated (amyloid, infiltrative, eos)
9 Clinical signs and symptoms Preserved EF >50% Diastolic dysfunction by Doppler echo or cath (E/A ratio>2; LVEDP >12 mmhg and higher CVP) Diagnosis of exclusion Get a hemodynamic study if clinical presentation does not correlate to therapeutic response.
10 HFpEF 1--Hypertrophic CMP HFpEF 2 Infiltrative CMP HFpEF 3 Idiopathic CMP, non-lvh HFpEF 4 Secondary to other diseases (HTN, ischemic, valvular, obesity, CKD, sleep apnea)
11
12
13
14
15
16 No therapy found to improve morbidity and mortality. Diuretics for symptom control. Be cautious with diuresis. Focus on treatment of co-morbid conditions Don t miss primary pulmonary hypertension
17 Drug Initial Daily dose Max Dose Notes Furosemide (loop) mg 120 mg bid BID~effective; IV >PO due to bioavailability and 2:1potency Torsemide (loop) mg 100 mg bid 1:2 furosemide: torsemide Bumetanide (loop) 0.5 mg-1 mg 5 mg bid 80% absorbed; 1:40 furosemide: bumex potency HCTZ (thiazide) 12.5 mg 50 mg Monitor Na Metolazone (thiazide) Spironolactone (aldosterone antag) Eplerenone (aldosterone antag) Triamterene (K sparing) 2.5 mg 2x/week 5 mg 3-4 x/week Monitor K, Na closely 12.5 mg daily 25 mg daily Monitor K & renal function 25 mg daily 50 mg daily 50 mg daily 100 mg BID Typically in combo
18 JNC-8 guidelines Use medications based off of co-morbid conditions Careful with CCB secondary to fluid retention Always counsel of low Na diet
19 Very sensitive to arrhythmias AHA/ACC/HRS Guidelines Cardiovert or control rates for afib esp with exercise Ablate aflutter over 95% success rate
20 BMI less than 30 is ideal Wt loss alleviates symptoms of HF Refer to cardiac rehabilitation Bariatric Medicine consult Gastric bypass surgical program
21 Get a sleep study Screen with overnight trend ox at home if indicated Helps with HTN, weight loss, dyspnea and fatigue
22 Advanced surgical therapy or transplant Ineffective therapy, unprepared death & readmissions Maximal medical therapy and palliative care
23 Earlier detection of HF exacerbations in the outpatient setting Triage RN HF clinic Monitoring Patient self-monitoring Device monitoring Telemonitoring Increased surveillance with clinic visits Hospital discharge follow-up and surveillance Earlier evaluation for advanced therapies. Partnership of patient and care providers to identify gate-keepers
24
25 Left Atrial Decompression Pump For low cardiac output states especially with exercise High Pulmonary Capillary Wedge Pressures Improves exercise tolerance
26 Gina G. Mentzer, MD Cardiologist, Heart Failure & Transplant Advanced Integrated Medicine & Surgery (AIMS) Program for Heart Failure April 18 th, 2015
Congestive Heart Failure: Outpatient Management
The Chattanooga Heart Institute Cardiovascular Symposium Congestive Heart Failure: Outpatient Management E. Philip Lehman MD, MPP Disclosure No financial disclosures. Objectives Evidence-based therapy
More informationChronic. Outline. Congestive^ Heart Failure: Update on Effective Monitoring and Treatment. Heart Failure Epidemiology. Michael G.
Chronic Congestive^ Heart Failure: Update on Effective Monitoring and Treatment Michael G. Shlipak, MD, MPH Professor of Medicine, UCSF Chief, Division of General Internal Medicine, SFVA Medical Center
More informationEstimated 5.7 million Americans with HF. 915, 000 new HF cases annually, HF incidence approaches
Heart Failure: Management of a Chronic Disease Jenny Bauerly RN, CHFN, APRN-BC Heart Failure (HF) Definition A complex clinical syndrome that can result from any structural or functional cardiac disorder
More informationChronic. Outline. Congestive^ Heart Failure: Update on Effective Monitoring and Treatment. Heart Failure Epidemiology. Michael G.
Chronic Congestive^ Heart Failure: Update on Effective Monitoring and Treatment Michael G. Shlipak, MD, MPH Professor of Medicine, UCSF Chief, Division of General Internal Medicine, SFVA Medical Center
More informationHeart Failure 101 The Basic Principles of Diagnosis & Management
Heart Failure 101 The Basic Principles of Diagnosis & Management Bill Tran, MD Non Invasive Cardiologist February 24, 2018 What the eye does not see and the mind does not know, does not exist. DH Lawrence
More informationHEART FAILURE. Heart Failure in the US. Heart Failure (HF) 10/5/2015. Martina Frost, PA-C Desert Cardiology of Tucson Northwest Medical Center
HEART FAILURE Martina Frost, PA-C Desert Cardiology of Tucson Northwest Medical Center Heart Failure in the US Prevalence - ~5 million 650,000 new cases annually 300,000 deaths annually Leading DRG among
More informationObjectives. Let s start at the beginning 10/28/2014. What is Heart Failure? Understanding Heart Failure with Preserved LV Systolic Function
Understanding Heart Failure with Preserved LV Systolic Function Eric Ernst, MD Medical Director C.O.R.E. Clinic Objectives Clarify the terminology surrounding right heart failure and diastolic heart failure
More informationDiagnosis & Management of Heart Failure. Abena A. Osei-Wusu, M.D. Medical Fiesta
Diagnosis & Management of Heart Failure Abena A. Osei-Wusu, M.D. Medical Fiesta Learning Objectives: 1) Become familiar with pathogenesis of congestive heart failure. 2) Discuss clinical manifestations
More informationChronic. Congestive^ Heart Failure: Update on Effective Monitoring and Treatment. Michael G. Shlipak, MD, MPH
Chronic Congestive^ Heart Failure: Update on Effective Monitoring and Treatment Michael G. Shlipak, MD, MPH Professor of Medicine, UCSF Chief, Division of General Internal Medicine, SFVA Medical Center
More informationHEART FAILURE. Heart Failure in the US. Heart Failure (HF) 3/2/2014
HEART FAILURE Martina Frost, PA-C Desert Cardiology of Tucson Northwest Medical Center March 2014 Heart Failure in the US Prevalence - ~5 million 650,000 new cases annually 300,000 deaths annually Leading
More informationHeart Failure Dr ahmed almutairi Assistant professor internal medicin dept
Heart Failure Dr ahmed almutairi Assistant professor internal medicin dept (MBBS)(SBMD) Introduction Epidemiology Pathophysiology diastolic/systolic Risk factors Signs and symptoms Classification of HF
More information1/4/18. Heart Failure Guideline Review and Update. Disclosure. Pharmacist Objectives. Pharmacy Technician Objectives. What is Heart Failure?
Disclosure Heart Failure Guideline Review and Update I have had no financial relationship over the past 12 months with any commercial sponsor with a vested interest in this presentation. Natalie Beiter,
More informationLITERATURE REVIEW: HEART FAILURE. Chief Residents
LITERATURE REVIEW: HEART FAILURE Chief Residents Heart Failure EF 40% HFrEF Problem with contractility EF 40-50% HFmrEF EF > 50% HFpEF Problem with filling/relaxation RISK FACTORS Post MI HTN DM Obesity
More informationHEART FAILURE. Heart Failure in the US. Heart Failure (HF) 2/20/2017. Martina Frost, PA-C Desert Cardiology of Tucson Northwest Medical Center
HEART FAILURE Martina Frost, PA-C Desert Cardiology of Tucson Northwest Medical Center Heart Failure in the US Prevalence - ~5 million 650,000 new cases annually 300,000 deaths annually Leading DRG among
More informationChronic. Outline. Congestive^ Heart Failure: Update on Effective Monitoring and Treatment. Heart Failure Epidemiology
Chronic Congestive^ Heart Failure: Update on Effective Monitoring and Treatment Michael G. Shlipak, MD, MPH Professor of Medicine, UCSF Chief, Division of General Internal Medicine, SFVA Medical Center
More informationHFpEF. April 26, 2018
HFpEF April 26, 2018 (J Am Coll Cardiol 2017;70:2476 86) HFpEF 50% or more (40-71%) of patients with CHF have preserved LV systolic function. HFpEF is an increasingly frequent hospital discharge. Outcomes
More informationDISCLOSURES ACHIEVING SUCCESS THROUGH FAILURE: UPDATE ON HEART FAILURE WITH PRESERVED EJECTION FRACTION NONE
ACHIEVING SUCCESS THROUGH FAILURE: UPDATE ON HEART FAILURE WITH PRESERVED EJECTION FRACTION Lori M. Tam, MD Providence Heart Institute DISCLOSURES NONE 1 OUTLINE Systolic vs. Diastolic Heart Failure New
More informationUpdates in Congestive Heart Failure
Updates in Congestive Heart Failure GREGORY YOST, DO JOHNSTOWN CARDIOVASCULAR ASSOCIATES 1/28/2018 Disclosures Edwards speaker on Sapien3 valves (TAVR) Stages A-D and NYHA Classes I-IV Stage A: High risk
More informationOutline. Chronic Heart Failure: Update on Effective Monitoring and Treatment. Heart Failure Epidemiology. Michael G.
Chronic Heart Failure: Update on Effective Monitoring and Treatment Michael G. Shlipak, MD, MPH Professor of Medicine, UCSF Chief, Division of General Internal Medicine, SFVA Medical Center Scientific
More informationHeart Failure with Reduced EF. Dino Recchia, MD, FACC, FHFSA
Heart Failure with Reduced EF Dino Recchia, MD, FACC, FHFSA Heart Failure HF is the end phenotype of almost all CV disorders Complex clinical syndrome resulting from any structural or functional impairment
More informationCLINICAL PRACTICE GUIDELINE
CLINICAL PRACTICE GUIDELINE Procedure: Congestive Heart Failure Guideline Review Cycle: Biennial Reviewed By: Amish Purohit, MD, MHA, CPE, FACHE Review Date: November 2014 Committee Approval Date: 11/12/2014
More informationΜαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό
Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling
More informationHeart Failure Management Policy and Procedure Phase 1
1301 Punchbowl Street, Harkness Suite 225 Honolulu, Hawaii 96813 Phone (808) 691-7220 Fax: (808) 691-4099 www.queenscipn.org Policy and Procedure Phase 1 Policy Number: Effective Date: Revised: Approved
More informationHeart Failure. Dr. William Vosik. January, 2012
Heart Failure Dr. William Vosik January, 2012 Questions for clinicians to ask Is this heart failure? What is the underlying cause? What are the associated disease processes? Which evidence-based treatment
More informationUpdates in Diagnosis & Management of CHF
Updates in Diagnosis & Management of CHF N. Goldberg, DO April 30, 2011 CHF CHF is reaching an epidemic level in U.S. and continues to worsen over time Reasons are: HTN Dm with sedentary lifestyle and
More informationYOU will treat patients with heart MANAGING HEART FAILURE: 11/4/2014 ALL DIURETICS ARE NOT CREATED EQUAL. failure.
MANAGING HEART FAILURE: ALL DIURETICS ARE NOT CREATED EQUAL SUZANNE FRAZIER MS, CRNP, NP C, CHFN HEART FAILURE DISEASE MANAGEMENT COORDINATOR PENN STATE HERSHEY MEDICAL CENTER Impact of Heart Failure In
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationAssessment and Diagnosis of Heart Failure
Assessment and Diagnosis of Heart Failure Heart failure (HF) is a complex clinical syndrome resulting from any structural or functional impairment of ventricular filling or ejection of blood and is characterized
More informationHEART FAILURE. Ali Mehr, MD, FACC
HEART FAILURE Ali Mehr, MD, FACC Advanced Heart Failure and Transplant Cardiologist Director, Echocardiography Lab Phoenix VA Health Care System Associate Professor of Medicine University of Arizona, COM,
More informationHeart Failure. Disclosures. Objectives: 8/28/2017. This is not a virus. It doesn t go away. none
Heart Failure This is not a virus. It doesn t go away Shelley Wojtaszczyk, FNP-C, CHFN Heart Failure Program Coordinator Mercy Hospital of Buffalo none Disclosures Objectives: Defining and identifying
More informationNora Goldschlager, M.D. SFGH Division of Cardiology UCSF
CLASSIFICATION OF HEART FAILURE Nora Goldschlager, M.D. SFGH Division of Cardiology UCSF DISCLOSURES: NONE CLASSIFICATION C OF HEART FAILURE NYHA I IV New paradigm Stage A: Pts at high risk of developing
More informationState-of-the-Art Management of Chronic Systolic Heart Failure
State-of-the-Art Management of Chronic Systolic Heart Failure Michael McCulloch, MD 17 th Annual Cardiovascular Update Intermountain Medical Center December 16, 2017 Disclosures: I have no financial disclosures
More informationHeart Failure, Anticoagulants, and Medication Reconciliation
Change in Condition: Heart Failure, Anticoagulants, and Medication Reconciliation Lindsay Holland, MHA Director, Care Transitions Health Services Advisory Group (HSAG) Pouya Afshar, MD, MBA Hospitalist,
More informationTHE PROPER APPROACH TO DIAGNOSING HEART FAILURE WITH PRESERVED EJECTION FRACTION
THE PROPER APPROACH TO DIAGNOSING HEART FAILURE WITH PRESERVED EJECTION FRACTION James C. Fang, MD, FACC Professor and Chief Cardiovascular Division University of Utah School of Medicine Disclosures Data
More informationHeart Failure Background, recognition, diagnosis and management
Heart Failure Background, recognition, diagnosis and management Speaker bureau: Novartis At the conclusion of this activity, participants will be able to: Recognize signs and symptoms of heart failure
More informationHeart Failure A Team Approach Background, recognition, diagnosis and management
Heart Failure A Team Approach Background, recognition, diagnosis and management Speaker bureau: Novartis At the conclusion of this activity, participants will be able to: Recognize signs and symptoms of
More informationTherapeutic Targets and Interventions
Therapeutic Targets and Interventions Ali Valika, MD, FACC Advanced Heart Failure and Pulmonary Hypertension Advocate Medical Group Midwest Heart Foundation Disclosures: 1. Novartis: Speaker Honorarium
More informationSummary/Key Points Introduction
Summary/Key Points Introduction Scope of Heart Failure (HF) o 6.5 million Americans 20 years of age have HF o 960,000 new cases of HF diagnosed annually o 5-year survival rate for HF is ~50% Classification
More informationDiastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018
Diastolic Heart Failure (HFpEF) Felix J. Rogers, DO, FACOI April 29, 2018 Case presentation MSO, an 81 year old woman was admitted to HFWH because of progressive dyspnea and difficult to control hypertension
More informationHeart Failure Clinician Guide JANUARY 2018
Kaiser Permanente National CLINICAL PRACTICE GUIDELINES Heart Failure Clinician Guide JANUARY 2018 Introduction This evidence-based guideline summary is based on the 2018 National Heart Failure Guideline.
More informationIntroduction to Heart Failure. Mauricio Velez, M.D. Transplant Cardiologist APACVS 2018 April 5-7 Miami, FL
Introduction to Heart Failure Mauricio Velez, M.D. Transplant Cardiologist APACVS 2018 April 5-7 Miami, FL Disclosures No relevant financial relationships to disclose Objectives and Outline Define heart
More informationSusan P. D Anna MSN, APRN BC February 14, 2019
Is there Equal Opportunity in Heart Failure?? Susan P. D Anna MSN, APRN BC February 14, 2019 Disclosures: I have no financial disclosures. I am not an expert on this topic, but see a lot of women with
More informationTherapeutics of Diuretics
(Last Updated: 08/22/2018) Created by: Socco, Samantha Therapeutics of Diuretics Thambi, M. (2017). The Clinical Use of Diuretics. Lecture presented at PHAR 503 Lecture in UIC College of Pharmacy, Chicago.
More informationUpdate in Congestive Hear Failure DRAGOS VESBIANU MD
Update in Congestive Hear Failure DRAGOS VESBIANU MD Case 58 yo AAM c/o shortness of breath for 3 weeks. Used to walk one mile per day and now he has noticed that he gets short of breath after 2 blocks.
More informationPulmonary Hypertension: Another Use for Viagra
Pulmonary Hypertension: Another Use for Viagra Kathleen Tong, MD Director, Heart Failure Program Assistant Clinical Professor University of California, Davis Disclosures I have no financial conflicts A
More informationEvaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF<40%
Evaluation and Management of Acute Decompensated Heart Failure (HF) with Reduced Ejection Fraction Systolic Heart Failure (HFrEF)(EF
More informationDiastolic Heart Failure Uri Elkayam, MD
Diastolic Heart Failure Uri Elkayam, MD Professor of Medicine University of Southern California School of Medicine Los Angeles, California elkayam@usc.edu Diastolic Heart Failure Clinical Definition A
More informationHypertensionTreatment Guidelines. Michaelene Urban APRN, MSN, ACNS-BC, ANP-BC
HypertensionTreatment Guidelines Michaelene Urban APRN, MSN, ACNS-BC, ANP-BC Objectives: Review the definition of the different stages of HTN. Review the current guidelines for treatment of HTN. Provided
More informationSara O. Weiss, MD Director, Heart Failure Services Virginia Mason Medical Center September 8, 2012
Sara O. Weiss, MD Director, Heart Failure Services Virginia Mason Medical Center September 8, 2012 Disclosure: Dr. Weiss has no significant financial interest in any of the products or manufacturers mentioned.
More informationHeart Failure Clinician Guide JANUARY 2016
Kaiser Permanente National CLINICAL PRACTICE GUIDELINES Heart Failure Clinician Guide JANUARY 2016 Introduction This evidence-based guideline summary is based on the 2016 National Heart Failure Guideline.
More informationHeart Failure. Cardiac Anatomy. Functions of the Heart. Cardiac Cycle/Hemodynamics. Determinants of Cardiac Output. Cardiac Output
Cardiac Anatomy Heart Failure Professor Qing ZHANG Department of Cardiology, West China Hospital www.blaufuss.org Cardiac Cycle/Hemodynamics Functions of the Heart Essential functions of the heart to cover
More informationHeart Failure with Preserved Ejection Fraction (HFpEF): Natural History and Contemporary Management
Heart Failure with Preserved Ejection Fraction (HFpEF): Natural History and Contemporary Management Jason L. Guichard, MD, PhD Greenville Health System Department of Medicine, Carolina Cardiology Consultants
More informationPathophysiology: Heart Failure
Pathophysiology: Heart Failure Mat Maurer, MD Irving Assistant Professor of Medicine Outline Definitions and Classifications Epidemiology Muscle and Chamber Function Pathophysiology Heart Failure: Definitions
More informationHEART FAILURE KEEPING YOUR PATIENT AT HOME
HEART FAILURE KEEPING YOUR PATIENT AT HOME SUZANNE FRAZIER MS, CRNP, NP-C, CHFN HEART FAILURE DISEASE MANAGEMENT COORDINATOR PENN STATE HERSHEY HEART & VASCULAR INSTITUTE IMPACT OF HEART FAILURE In 2010,
More informationImaging in Heart Failure: A Multimodality Approach. Thomas Ryan, MD
Imaging in Heart Failure: A Multimodality Approach Thomas Ryan, MD Heart Failure HFrEF HFpEF EF50% Lifetime risk 20% Prevalence 6M Americans Societal costs - $30B 50% 5-year survival 1 Systolic
More informationWHAT IS ADVANCED HEART FAILURE? James C. Fang, MD, FACC Professor and Chief Cardiovascular Division University of Utah School of Medicine
WHAT IS ADVANCED HEART FAILURE? James C. Fang, MD, FACC Professor and Chief Cardiovascular Division University of Utah School of Medicine Disclosures Data Safety Monitoring Board SOPRANO (J&J), EVALUATE-HF
More informationCONGESTIVE HEART FAILURE
CONGESTIVE HEART FAILURE ACOI IM BOARD REVIEW 2018 MARTIN C. BURKE, DO, FACOI DISCLOSURES I AM PRINCIPAL INVESTIGATOR AND RECEIVE GRANTS FOR HEART FAILURE TRIALS FROM BOSTON SCIENTIFIC, MEDTRONIC AND ST
More informationHeart Failure Management. Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist
Heart Failure Management Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist Heart failure prevalence is expected to continue to increase¹ 21 MILLION ADULTS WORLDWIDE
More informationWHAT S NEW IN HEART FAILURE
WHAT S NEW IN HEART FAILURE Drugs, Devices and Diagnostics John M. Herre, MD, FACC, FACP Director, Advanced Heart Failure Program Sentara Helathcare Professor of Medicine Eastern Virginia Medical School
More informationCitation. What is New in the 2013 ACC/AHA HF Guideline. Dimensions in Heart and Vascular Care Penn State Heart and Vascular Institute
What is New in the 2013 ACC/AHA HF Guideline Dimensions in Heart and Vascular Care Penn State Heart and Vascular nstitute Friday October 18, 2013 Barry S. Clemson, MD Associate Professor of Medicine Penn
More information2 I. Reduced EF (HFrEF)
HF Classification EF Description 2 I. Reduced EF (HFrEF) 40% 1. Referred to as systolic HF. 2. Randomized trials mainly enrolled patients with HFrEF. 3. Efficacious therapies is shown only in these patients.
More informationOutline. Pathophysiology: Heart Failure. Heart Failure. Heart Failure: Definitions. Etiologies. Etiologies
Outline Pathophysiology: Mat Maurer, MD Irving Assistant Professor of Medicine Definitions and Classifications Epidemiology Muscle and Chamber Function Pathophysiology : Definitions An inability of the
More informationHeart Failure Update John Coyle, M.D.
Heart Failure Update 2011 John Coyle, M.D. Causes of Heart Failure Anderson,B.Am Heart J 1993;126:632-40 It It is now well-established that at least one-half of the patients presenting with symptoms and
More informationHeart failure. Failure? blood supply insufficient for body needs. CHF = congestive heart failure. increased blood volume, interstitial fluid
Failure? blood supply insufficient for body needs CHF = congestive heart failure increased blood volume, interstitial fluid Underlying causes/risk factors Ischemic heart disease (CAD) 70% hypertension
More information2016 Update to Heart Failure Clinical Practice Guidelines
2016 Update to Heart Failure Clinical Practice Guidelines Mitchell T. Saltzberg, MD, FACC, FAHA, FHFSA Medical Director of Advanced Heart Failure Froedtert & Medical College of Wisconsin Stages, Phenotypes
More informationHeart Failure A Disease for the Internist?
Heart Failure A Disease for the Internist? Dr Chris Davidson Sussex Cardiac Centre BRIGHTON UK Hot Topics in Heart Failure Drug treatments Valsartan / neprilysin inhib Investigations BNP and others Devices
More informationPharmacotherapeutic Challenge Diuretic Resistance
Pharmacotherapeutic Challenge Diuretic Resistance Barry E. Bleske, Pharm. D, FCCP Associate Professor University of Michigan, College of Pharmacy Learning Objectives Describe the causes for HF readmission.
More informationHypertension and the 2017 Guidelines Meeting the Targets in Small Groups. Lisa Ivy APRN
Hypertension and the 2017 Guidelines Meeting the Targets in Small Groups Lisa Ivy APRN The 2017 Guideline is an Update to JNC7 New information regarding BP related risk of CVD Ambulatory BP monitoring
More informationObjectives. Outline 4/3/2014
Jessica Litke PGY1 ISHP Spring Meeting April 12, 2014 Objectives Appreciate the significance of heart failure (HF) to a patient and to the health care system Understand 2013 ACCF/AHA guidelines for the
More informationChecklist for Treating Heart Failure. Alan M. Kaneshige MD, FACC, FASE Oklahoma Heart Institute
Checklist for Treating Heart Failure Alan M. Kaneshige MD, FACC, FASE Oklahoma Heart Institute Novartis Disclosure Heart Failure (HF) a complex clinical syndrome that arises secondary to abnormalities
More informationCase 1. Case 2. What do you think about reducing or discontinuing some of the above now that his LVEF has normalized?
Case 1 A primary care colleague inquires what to do with a patient (HFrEF in NSR) who has a digoxin level of 2.8ng/ml. Level was obtained at 10am, patient takes all medications at one time upon arising
More informationNew Advances in the Diagnosis and Management of Acute and Chronic Heart Failure
New Advances in the Diagnosis and Management of Acute and Chronic Heart Failure Deborah Budge, MD Intermountain Healthcare Heart Failure Cardiologist Objectives: State the updates from the ACC 2013 HF
More informationMedical Management of Acutely Decompensated Heart Failure. William T. Abraham, MD Director, Division of Cardiovascular Medicine
Medical Management of Acutely Decompensated Heart Failure William T. Abraham, MD Director, Division of Cardiovascular Medicine Orlando, Florida October 7-9, 2011 Goals of Acute Heart Failure Therapy Alleviate
More informationObjectives. Heart failure and Hypertension. Definition & epidemiology of heart failure HEART FAILURE 3/12/2016. Kirsten Bibbins-Domingo, PhD, MD, MAS
Objectives Heart failure and Hypertension Kirsten Bibbins-Domingo, PhD, MD, MAS Lee Goldman, MD Endowed Chair in Medicine Professor of Medicine and of Epidemiology and Biostatistics University of California,
More informationProtocol Identifier Subject Identifier Visit Description. [Y] Yes [N] No. [Y] Yes [N] N. If Yes, admission date and time: Day Month Year
PAST MEDICAL HISTORY Has the subject had a prior episode of heart failure? o Does the subject have a prior history of exposure to cardiotoxins, such as anthracyclines? URGENT HEART FAILURE VISIT Did heart
More informationVentricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation
Ventricular Assist Device: Are Early Interventions Superior? Hamang Patel, MD Section of Cardiomyopathy & Heart Transplantation Objectives Current rationale behind use of MCS Patient Selection Earlier?
More informationObjectives. Systolic Heart Failure: Definitions. Heart Failure: Historical Perspective 2/7/2009
Objectives Diastolic Heart Failure and Indications for Echocardiography in the Asian Population Damon M. Kwan, MD UCSF Asian Heart & Vascular Symposium 02.07.09 Define diastolic heart failure and differentiate
More informationHeart Failure: Guideline-Directed Management and Therapy
Heart Failure: Guideline-Directed Management and Therapy Guideline-Directed Management and Therapy (GDMT) was developed by the American College of Cardiology and American Heart Association to define the
More informationHFpEF: How to optimise management
HFpEF: How to optimise management Burkert Pieske M.D. Berlin, Germany Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, and Department of Internal
More informationHeart 101. Objectives. Types of Heart Failure How common is HF? Sign/Symptoms, when to see a doctor? Diagnostic testing
EXAMING HEART FAILURE: HOW TO RECOGNIZE AND TREAT THE WEAK HEART What is Heart Failure? Treatment of Heart Failure End Stage Heart Failure Munir S. Janmohamed M.D. FACC Assistant Clinical Professor of
More informationHypertension (JNC-8)
Hypertension (JNC-8) Southern California University of Health Sciences Physician Assistant Program Management and Treatment of Hypertension April 17, 2018, presented by Ezra Levy, Pharm.D.! The 8 th Joint
More informationThe Failing Heart in Primary Care
The Failing Heart in Primary Care Hamid Ikram How fares the Heart Failure Epidemic? 4357 patients, 57% women, mean age 74 years HFSA 2010 Practice Guideline (3.1) Heart Failure Prevention A careful and
More informationIdentification of patients with heart failure and PREserved systolic Function : an Epidemiologic Regional study
Identification of patients with heart failure and PREserved systolic Function : an Epidemiologic Regional study Dr. Antonio Magaña M.D. (on behalf I-PREFER investigators group) Stockholm, Sweden, August
More informationPennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016
Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016 Disclosures: A Swell Talk on Edema Laura Novak, MD Speaker has no disclosures
More informationAdvanced Care for Decompensated Heart Failure
Advanced Care for Decompensated Heart Failure Sara Kalantari MD Assistant Professor of Medicine, University of Chicago Advanced Heart Failure, Mechanical Circulatory Support and Cardiac Transplantation
More informationHeart Failure Guidelines For your Daily Practice
Heart Failure Guidelines For your Daily Practice Juan M. Aranda, Jr., MD, FACC, FHFSA Professor of Medicine Director of Heart Failure and Cardiac Transplantation University of Florida College of Medicine
More informationACUTE HEART FAILURE. Julie Gorchynski MD, MSc, FACEP, FAAEM. Department of Emergency Medicine Emergency Residency Program UTHSC, San Antonio TCEP 2014
ACUTE HEART FAILURE Julie Gorchynski MD, MSc, FACEP, FAAEM Department of Emergency Medicine Emergency Residency Program UTHSC, San Antonio TCEP 2014 No disclosures Objectives Overview Cases Current Therapy
More informationAkash Ghai MD, FACC February 27, No Disclosures
Akash Ghai MD, FACC February 27, 2015 No Disclosures Epidemiology Lifetime risk is > 20% for American s older than 40 years old. > 650,000 new cases diagnosed each year. Incidence increases with age: 2%
More information9/14/2017 HEART FAILURE IN OBS NO RELEVANT DISCLOSURES IRRELEVANT DISCLOSURES OBJECTIVES WHY HEART FAILURE
HEART FAILURE IN OBS Matthew Wheatley MD, FACEP Grady Memorial Hospital Emory University School of Medicine NO RELEVANT DISCLOSURES 52 y.o. female with HTN, DM and CHF presents with DIB. She states she
More informationChapter 21. Diuretic Agents. Mosby items and derived items 2008, 2002 by Mosby, Inc., an affiliate of Elsevier Inc.
Chapter 21 Diuretic Agents Renal Structure and Function Kidneys at level of umbilicus Each weighs 160 to 175 g and is 10 to 12 cm long Most blood flow per gram of weight in body 22% of cardiac output (CO)
More informationDr.Fayez EL Shaer Consultant cardiologist Assistant professor of cardiology KKUH
Pulmonary Hypertension in patients with Heart Failure with Preserved Ejection Fraction Dr.Fayez EL Shaer Consultant cardiologist Assistant professor of cardiology KKUH Recent evaluation of available data
More informationWhy guess when you could know? Gold Standard. Cardiac catheterization (Angiogram) Invasive Risks: Infection, hematoma, death
Why guess when you could know? Gold Standard Cardiac catheterization (Angiogram) Invasive Risks: Infection, hematoma, death PCI decisions Number of vessels involved Surgeon experience level The anatomic
More informationHeart Failure. GP Update Refresher 18 th January 2018
GP Update Refresher 18 th January 2018 Heart Failure Dr. Alexander Lyon Senior Lecturer and Consultant Cardiologist Clinical Lead in Cardio-Oncology Royal Brompton Hospital, London UK President of British
More informationUpdates in Heart Failure - Rx
Updates in Heart Failure - Rx Pragnesh Parikh, M.D. Mayo Clinic Florida 2015 MFMER slide-1 Disclosures None. 2015 MFMER slide-2 Overview Epidemiology of ADHF Goals of acute management Pharmacologic Management:
More informationDiastolic Heart Failure. Edwin Tulloch-Reid MBBS FACC Consultant Cardiologist Heart Institute of the Caribbean December 2012
Diastolic Heart Failure Edwin Tulloch-Reid MBBS FACC Consultant Cardiologist Heart Institute of the Caribbean December 2012 Disclosures Have spoken for Merck, Sharpe and Dohme Sat on a physician advisory
More informationAntialdosterone treatment in heart failure
Update on the Treatment of Chronic Heart Failure 2012 Antialdosterone treatment in heart failure 전남의대윤현주 Chronic Heart Failure Prognosis of Heart failure Cecil, Text book of Internal Medicine, 22 th edition
More informationHeart Failure Pharmacotherapy An Update
Heart Failure Pharmacotherapy An Update Kenneth Mishler, PharmD, MBA Objectives Review the epidemiology of heart failure (HF) Review evidence based guidelines for the use of mediations used to treat HF
More informationCongestive Heart Failure 2015
Definition Congestive Heart Failure 215 JP Mehegan/ Mercy Cardiology n Cardiac failure; Congestive heart failure; Chronic heart failure (synonyms) n When the heart is unable to pump sufficiently and at
More information