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Hi, everyone.

This is John Mandrola from the Heart.org Medscape Cardiology, and this is this week in cardiology for April 11, 2025.

This week, a little more ACC and error review plus a bonus.

The trials include to tap it, stride, fresh up, and single shot champion trials.

I had a lot of fun with these trials. There's some

interesting things to discuss. I am back home and recovered from my week in Vienna and Amsterdam.

Sadly, though, Kentucky is almost underwater. We had biblical rain while I was in Europe,

and today is the first day that the river and lakes are receding.

The first trial is the Tappet trial. PhD candidate Sina Gleggard from Copenhagen led to

Tappet trial. This is a simple, elegant RCT comparing thoracentesis upfront plus medical therapy versus medical therapy alone in patients with heart failure

and plural effusion. If you take care of patients with acute congestion due to heart failure,

you know this dilemma. The patient has obvious congestion. There's dysmia, dima, neck veins, rouse, decreased breast sounds.

The patient has known left ventricular dysfunction and an elevated B&P. Now the chest X ratio is a large

plural effusion in addition to the acute congestion. For decades, my entire career, I have recommended

draining that effusion through a catheter.

Back in the old days, we did it ourselves with a needle in the vacuum bottle.

Now, patients go to radiology and get ultrasound-guided drainage.

In my idea, perhaps it was yours too, was that thoracentesis is a simple procedure that speeds the decongestion,

expands the lung, and patients come back feeling better. Now, our pulmonologist had admonished

...