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PODCAST

Hu Said: Cardiology Board Review Series

Ruey Hu, MD, MPH

Welcome to Hu Said, a cardiology #MedEd podcast. Every episode cuts straight to the core of the topic, delivering the high-yield information you need to know for your exams. In this 2nd season of the podcast, new topics have been added, with >100 total topics. Whenever possible, evidence-based statements from the latest ACC/AHA/HRS/HFSA/SCAI guidelines are interwoven. Whether you are a resident, fellow, or re-certifying cardiologist, subscribe for precise, curated pearls. Ensure you get maximum

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All Episodes

00:10:15

8.04 Orthostatic Hypotension

Hu Said: Cardiology Board Review Series ·

2024/09/29

In this episode, we review orthostatic hypotension (OH). What criteria define OH? What is a simple way to distinguish neurogenic OH from volume depletion-related OH? What criteria define postural orthostatic tachycardia syndrome (POTS)? What non-pharmacologic measures should be undertaken as first-line measures for OH? How do fludrocortisone, midodrine, droxidopa, and atomoxetine work, and what are their side effects? How is supine hypertension managed? Tune in for answers to these

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00:12:35

8.03 Renovascular hypertension, aldosteronism, and...

Hu Said: Cardiology Board Review Series ·

2024/09/26

In this episode, we explore the diagnosis and management of three important causes of secondary hypertension: renovascular hypertension, primary aldosteronism, and pheochromocytoma. Which segments of the renal artery are preferentially affected by atherosclerotic renovascular hypertension versus fibromuscular dysplasia, and which is more likely to be accompanied by disease in other arterial beds? What characteristics suggest that a patient may benefit from renal artery revascularization? What next

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00:16:46

8.02 Hypertensive Urgency and Emergency

Hu Said: Cardiology Board Review Series ·

2024/09/25

In this episode, we review hypertensive urgency and emergency. What counts as "end-organ" damage in hypertensive emergency? What neurological signs are consistent with hypertensive encephalopathy? Which acute conditions require bringing systolic blood pressure (SBP) down to ≤160 mmHg in the first hour, and which require bringing SBP down to ≤140 mmHg in the first hour? Which acute conditions require bringing SBP down to ≤120 mmHg in the first 5 minutes? How does the BP threshold change in acute

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00:21:22

8.01 Chronic Hypertension

Hu Said: Cardiology Board Review Series ·

2024/09/24

In this episode, we review chronic hypertension. How did the the definitions of stage 1 and stage 2 hypertension change in the most recent AHA/ACC/ASH guidelines? What happened to "prehypertension"? Which chronic condition needs control of systolic blood pressure (SBP) to <120/80; which conditions need control of SBP to <130/80? What is the natural variation in BP with sleep and with age? What are the most common causes of secondary hypertension? Which outpatient antihypertensives cause reflex

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00:27:14

7.08 Vasculitis

Hu Said: Cardiology Board Review Series ·

2024/09/21

In this episode, we review the large vessel vasculitides, medium-vessel vasculitides, ANCA-associated small-vessel vasculitides, and immune complex associated small-vessel vasculitides. What is the difference in the population of patients affected by Takayasu's arteritis of the aorta and its branches versus giant cell arteritis of the temporal artery? What about subcranial giant cell arteritis, which affects the aorta instead of the temporal artery? Which disease is characterized by corkscrewing,

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00:14:48

7.06 Carotid Artery Stenosis

Hu Said: Cardiology Board Review Series ·

2024/09/19

In this episode, we review carotid artery stenosis (CAS), including its presentation, diagnosis, medical management, and intervention. Do dizziness, presyncope, or syncope count as symptomatic CAS? What is the definition of nondisabling stroke and transient cerebral ischemic symptoms? What risk factors permit ordering a carotid duplex ultrasound before coronary artery bypass graft surgery? What peak systolic velocity on ultrasound correspond to >=50% and >=70% stenosis of a carotid artery

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00:21:22

7.05 Peripheral Artery Disease

Hu Said: Cardiology Board Review Series ·

2024/09/18

In this episode, we review limb peripheral artery disease (PAD). What is the difference in management of a marginally threatened limb vs immediately threatened limb? In whom can you order ankle brachial index (ABI) testing on? When do you reach for toe brachial index (TBI) or exercise ABI? Is there a role for cilostazol or pentoxifylline? Who should be given low-dose rivaroxaban therapy? Tune in for answers to these questions.Difficulty Level: Easy You are listening to Hu Said: Cardiology Board

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00:14:21

7.04 Aortic Intramural Hematoma, Penetrating Aortic...

Hu Said: Cardiology Board Review Series ·

2024/09/17

In this episode, we review aortic intramural hematoma (IMH), penetrating aortic ulcer (PAU), infectious aortitis and aortic atheroemboli. What condition is characterized by a crescentic aortic wall thickening and echolucency within the aortic wall with no intimal flap on transesophageal echocardiogram? What percent of IMH progresses to aortic dissection?What imaging findings distinguish IMH from dissection on non-contrast CT, contrast CT, and TEE? What are the criteria for complicated IMH, and when

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00:20:05

7.03 Aortic Dissection

Hu Said: Cardiology Board Review Series ·

2024/09/16

In this episode, we review aortic dissection, its risk factors, presentation, physical exam findings, imaging findings, and management. Other than aortic dissection, what other cardiovascular conditions can present with unequal arterial pulsations? How do gender and age affect the risk of aortic dissection? What are risks for aortic dissection for women, especially during pregnancy, and for patients with conditions such as Marfan syndrome or a bicuspid aortic valve? How do you distinguish between a

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00:09:41

7.02 Abdominal Aorta Aneurysm

Hu Said: Cardiology Board Review Series ·

2024/09/15

In this episode, we review abdominal aortic aneurysm (AAA), including its diagnosis, screening, and management. What are the current guidelines for screening and surveillance of AAA, and how do they differ for men and women? At what size does the risk of rupture significantly increase, and what surveillance intervals are recommended based on the size of the aneurysm? What does Laplace's Law say about how the rate of expansion of AAA correlates with its size? What are the key differences between

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00:29:32

7.01 Ascending Aorta Dilation + Marfan, Turner,...

Hu Said: Cardiology Board Review Series ·

2024/09/14

In this episode, we review ascending aorta dilation and ascending aorta aneurysm, including the key syndromes associated. What is cystic medial degeneration? Which diseases cause dilation of the aortic root versus dilation of the ascending aorta? In which diseases is ascending aorta dilation defined by diameter (cm) versus body surface area-indexed diameter (cm/m^2) versus aortic root cross sectional area to height ratio (cm^2/m)? In which diseases is the cutoff for surgical intervention ≥5.5cm,

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00:09:25

6.05 Left Ventricular Thrombus

Hu Said: Cardiology Board Review Series ·

2024/09/13

In this episode, we review left ventricular (LV) thrombus, including its pathophysiology, imaging characteristics, and treatment. How are the components of Virchow's triad disrupted by myocardial infarction, predisposing to formation of LV thrombus? What are the echocardiographic features of LV thrombus? How can LV thrombus be distinguished from myxoma on cardiac MRI and angiogram? Can the chronic versus acute nature of LV thrombus be discerned on imaging? Is there a role for transesophageal

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00:11:55

6.04 Deep Venous Thrombosis

Hu Said: Cardiology Board Review Series ·

2024/09/12

In this episode, we review deep vein thrombosis (DVT). What are the ultrasound features of a DVT? What counts as a proximal DVT? Why are patients with proximal DVT at higher risk, and how does this impact management? What are the recommended anticoagulation strategies, including the use of DOACs versus VKAs? How long should anticoagulation continue for provoked versus unprovoked DVT? When is indefinite anticoagulation recommended, and in what situations might aspirin be a reasonable alternative

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00:08:16

6.02 Calculating Pulmonary Artery Pressures

Hu Said: Cardiology Board Review Series ·

2024/09/10

In this episode, we review how to calculate pulmonary artery pressures (PASP) on echocardiography. How does the simplified Bernoulli equation relate the velocity of flow through the tricuspid valve (tricuspid regurgitant velocity, V_TR) to the right ventricular systolic pressure (RVSP)? When is it permissible and not permissible to assume that PASP is equivalent to RVSP? How can the maximal tricuspid regurgitant velocity (V_max TR), maximal pulmonic regurgitant velocity (V_max PR), and end pulmonic

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00:28:26

6.01 Pulmonary Hypertension

Hu Said: Cardiology Board Review Series ·

2024/09/09

In this episode, we review the essentials of pulmonary hypertension (PH), including the five groups. What echocardiographic findings allow you to distinguish between pre-capillary and post-capillary PH without information from right heart catheterization? In patients with PH non-vasoresponsive to nitric oxide, how do you decide whether to use phosphodiesterase-5 inhibitors (PDE-5 inhibitors), prostacyclin analogs, endothelin receptor antagonists (ERAs), or soluble guanylate cyclase stimulators

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00:12:42

5.02 Inflammatory Pericarditis

Hu Said: Cardiology Board Review Series ·

2024/09/05

In this episode, we dive into the pathophysiology, diagnosis, and treatment of inflammatory pericarditis. How do diagnostic criteria differ for first-time pericarditis and recurrent pericarditis? What is the sequence of ECG changes over the course of pericarditis? How many components would you expect to hear in a pericardial friction rub? Is post-MI pericarditis the same thing as Dressler's syndrome? What medications should be avoided? Can athletes who develop pericarditis play in competitive

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00:18:35

5.01 Pericardial Effusion and Tamponade

Hu Said: Cardiology Board Review Series ·

2024/09/04

In this episode, we review pericardial effusion and cardiac tamponade. What is the definition of small, moderate, and large pericardial effusion? What is ventricular interdependence? What is pulsus paradoxus? What conditions can cause a false positive or false negative pulsus paradoxus? What comprises Beck's triad? What are seven cardinal findings of tamponade physiology on echocardiography? What common comorbidity can cause RV collapse to be negative in tamponade? How do you distinguish pericardial

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00:27:35

4.19 Patient Prosthesis Mismatch and Prosthetic Valve...

Hu Said: Cardiology Board Review Series ·

2024/09/02

In this episode, we review patient-prosthesis mismatch (PPM) and prosthetic valve stenosis. What cutoffs for indexed effective orifice area (EOA) suggest severe, moderate, or mild PPM of an aortic valve prosthesis? What about for mitral valve prosthesis? What are the causes of prosthetic valve stenosis? How do you differentiate PPM from prosthetic valve stenosis using Doppler velocity index (DVI), acceleration time, and jet contour? What factors determine whether prosthetic valve stenosis should be

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00:13:57

4.18 Anticoagulation Targets After Valve Replacement

Hu Said: Cardiology Board Review Series ·

2024/09/01

In this episode, we review anticoagulant targets after valve replacement. What are the anticoagulation goals for mechanical and bioprosthetic valves? Why does a mechanical mitral valve have a higher INR target compared to a mechanical aortic valve? What are the risk factors that can increase the target INR for a mechanical aortic valve? How does the On-X mechanical valve’s anticoagulation regimen differ? What antiplatelet regimen is used after transcatheter valve replacement? Can direct oral

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00:09:43

4.17 Infective Endocarditis Part 2

Hu Said: Cardiology Board Review Series ·

2024/08/31

In this episode, we continue our review on infective endocarditis (IE), covering antibiotic prophylaxis, prosthesis-related endocarditis, and device-related infections. Which are the high-risk cardiac conditions and high-risk procedures that warrant antibiotic prophylaxis for IE? How do the pathogens differ between early and late prosthetic valve endocarditis, and how do these impact prognosis and treatment? What are the common pathogens associated with endocarditis after transcatheter aortic valve

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