REBOOT #230 Kittleson Rules Heart Failure
The Curbsiders Internal Medicine Podcast
The Curbsiders Internal Medicine Podcast
4.8 • 3.3K Ratings
🗓️ 30 August 2021
⏱️ 75 minutes
🧾️ Download transcript
Summary
- Written and Produced by: Deborah Gorth ScM
- Cover Art and Infographic by: Edison Jyang
- Hosts: Matthew Watto MD, FACP and Paul Williams MD, FACP
- Editor: Cyrus Askin MD (written materials); Clair Morgan of nodderly.com
- Guest: Michelle Kittleson MD, PhD
Sponsor: Ten Thousand tenthousand.cc
Time Stamps*
- 00:00 Intro, disclaimer, guest bio
- 02:40 Guest one-liner; Picks of the Week
- 08:33 Case from Kashlak part 1, Definition of acute decompensated heart failure (ADHF), Factors that lead to ADHF (FAILURE mnemonic)
- 13:39 Historical clues for ADHF; Is salt restriction needed? Fluid restriction?
- 20:42 More on History and Physical exam for ADHF; JVP exam in detail; Crackles are worthless?!
- 28:36 Labs to trend during an ADHF admission
- 33:15 Recap of history, physical exam, and initial approach; Initiating diuresis; Goal urine output; Diuresis in HFrEF vs HFpEF phenotypes
- 45:32 Diuretic resistance and when to use a drip, metolazone; Do K and Mg need to be 4 and 2?
- 49:05 When to hold guideline directed medical therapy (Beta blockers, ARNI, ACEI/ARB)
- 56:05 Who needs a right heart cath?
- 59:30 Endpoints for discharge; Switch to PO diuretics; Approach to discharge and transitions of care
- 64:04 SGLT2i in heart failure
- 68:15 Take home points and outro
Transcript
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| 0:00.0 | The Curbsiders podcast is for entertainment, education, and information purposes only, |
| 0:07.1 | and the topics discussed should not be used solely at Diagnostry, cure, or prevent any diseases |
| 0:09.9 | or conditions. |
| 0:10.9 | For the more the views and statements expressed on this podcast are solely those of those, |
| 0:12.4 | and should not be interpreted to reflect official policy or position of any entity |
| 0:14.6 | of the side-run possible, cash-like moral hospital, and affiliate outreach programs. |
| 0:17.0 | If indeed, there are any, in fact, there are none. |
| 0:18.8 | Pretty much we are responsible if you screw up, you should always do your own homework |
| 0:20.7 | and there's no way we're wrong. |
| 0:32.2 | Alright Paul, so let's take this again. |
| 0:34.8 | As you know, I did not like that first take, so let's take it again. |
| 0:38.4 | Welcome audience, this is the Curbsiders. |
| 0:40.9 | Tonight we'll be talking about inpatient management of Hard Failure with a fantastic guest, Dr. |
| 0:45.8 | Michelle Kittleson. |
| 0:47.2 | Before we tell you about her, Paul, tell the audience, |
| 0:50.6 | what do we do on the show? |
| 0:52.4 | Why are we here and why are we still doing this? |
| 0:55.4 | It's a great question. |
| 0:56.9 | I think we're learning that the more we repeat the same thing over and over again, the |
| 1:00.4 | more natural it becomes. |
| 1:01.5 | So I think this has been a learning exercise that I'm happy listeners get to see in real |
| 1:04.8 | time. |
... |
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