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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

00:19:25

2.13 Percutaneous Coronary Intervention

Hu Said: Cardiology Board Review Series ·

2024/07/18

In this episode, we explore key aspects of percutaneous coronary intervention (PCI) from the generalist’s perspective. What are the comparative risks of death, stroke, and major vascular complications in diagnostic catheterization versus PCI? What are the relative advantages and disadvantages of radial access over femoral access? What are the mandated durations for first medical contact to PCI, ED to PCI, and onset of symptoms to PCI? When and should a non-infarct artery be revascularized? In a

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00:30:59

2.12 Coronary Artery Bypass Grafting

Hu Said: Cardiology Board Review Series ·

2024/07/17

In this episode, we explore key aspects of coronary artery bypass grafting (CABG) revascularization. What are the 10-year patency rates of internal mammary artery (IMA) grafts compared to saphenous venous grafts (SVGs), and what accounts for this difference? Is CABG or PCI a better option for revascularizing patients with left main disease? What about triple-vessel disease with reduced ejection fraction, triple-vessel disease with diabetes, triple-vessel disease with preserved ejection fraction,

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00:21:54

2.11 Preventive and Adjunctive Therapies in CAD

Hu Said: Cardiology Board Review Series ·

2024/07/16

In this episode, we review preventive and adjunctive therapies in the management of coronary artery disease (CAD). Who qualifies for cardiac rehabilitation (CR)? What are the four phases of CR? What is the difference between the DASH and Mediterranean diets? In which situations are pharmacologic therapies such as GLP-1 receptor agonists appropriate for weight loss in patients with CAD? How can exposure to air pollution and extreme environmental conditions impact cardiovascular health? What is PM2.5

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00:24:27

2.09 Post-MI Medications and Anti-Anginal Medications

Hu Said: Cardiology Board Review Series ·

2024/07/14

In this episode, we review long-term medication therapy for CAD, including medications used post-myocardial infarction (MI) and medications used for anginal symptom relief in unrevascularizable CAD. What pathways do colchicine interrupt in the development of CAD? Is dual-antiplatelet therapy (DAPT) primarily for prevention of in-stent thrombosis or in-stent restenosis? How many months should you continue DAPT after percutaneous coronary intervention (PCI) for acute coronary syndrome versus after PCI

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00:17:55

2.08 Antiplatelets and Anticoagulation

Hu Said: Cardiology Board Review Series ·

2024/07/13

In this episode, we explore the role of antiplatelets and anticoagulants in managing acute coronary syndromes (ACS) and during percutaneous coronary intervention (PCI). How many days off clopidogrel, prasugrel, ticagrelor, and cangrelor is advised prior to proceeding to CABG? In patients not undergoing CABG, how does one decide which P2Y12 inhibitor to use? How do glycoprotein IIb/IIIa inhibitors such as abciximab, eptifibatide, and tirofiban prevent platelet aggregation, and in what situations are

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00:10:57

2.07 Hibernation and Stunning

Hu Said: Cardiology Board Review Series ·

2024/07/12

In this episode, we explore the concepts in myocardial hibernation and stunning. What is the difference between myocardial stunning, hibernation, and scar? What is considered viable and what is not? What cellular adaptations occur in the process of hibernation? What pattern of rest perfusion, stress perfusion, and FDG metabolism on FDG PET imaging would indicate hibernation instead of scar? What would a hypokinetic->better->worse response vs a hypokinetic->better->worse response imply on

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00:15:38

2.06 Anatomic Testing

Hu Said: Cardiology Board Review Series ·

2024/07/11

In this episode, we review anatomic testing for coronary artery disease. When can you draw upon coronary artery calcium (CAC) scoring to guide statin therapy? When can you use coronary CT angiography (CCTA) with CT-FFR? What are pitfalls of each? Should you choose anatomic testing or functional stress tests for your patients? Tune in for answers to these questions. Difficulty Level: Easy You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season) Please subscribe, rate, and

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00:29:49

2.05 Stress Testing

Hu Said: Cardiology Board Review Series ·

2024/07/10

In this episode, we review the essentials of stress testing, including indications and contraindications of exercise and pharmacologic stress agents, features and pitfalls of imaging-based stress, and a systematic framework for reporting stress test results. What are normal and abnormal ECG changes in response to stress? What baseline abnormalities render exercise ECG uninterpretable? When should you terminate a stress test prematurely? When should you give aminophylline to reverse the effect of

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00:28:24

2.04 ACS Part 2

Hu Said: Cardiology Board Review Series ·

2024/07/09

In this episode, we review the presentation of acute coronary syndromes (ACS) and the Fourth Universal Definition of Myocardial Infarction (MI). What is the difference between myocardial injury, ischemia, and infarction? Why is the term "Type 2 NSTEMI" no longer appropriate? Why is the term "atypical angina" deprecated? What does the GRACE score and TIMI score contain? Tune in for answers to these questions. Difficulty Level: Easy You are listening to Hu Said: Cardiology Board Review Series

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00:22:09

2.03 ACS Part 1

Hu Said: Cardiology Board Review Series ·

2024/07/08

In this episode, we review ECG changes in acute coronary syndromes (ACS). What constitutes a significant vs a non-significant Q wave? Can the shape of the curve of the ST elevation or depression offer clues about whether the ST change is ischemic or non-ischemic? What types of infarctions would you not see reciprocal changes on in the standard ECG? How do you define Sgarbossa's criteria, Wellen's syndrome, and De Winter's syndrome? Tune in for answers to these questions. Difficulty Level: Easy You

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00:21:34

2.02 Apolipoproteins, Lp(a) and Familial Dyslipidemias

Hu Said: Cardiology Board Review Series ·

2024/07/07

In this episode, we review apolipoproteins, Lp(a), and familial dyslipidemias. What roles do apolipoproteins like ApoB48, ApoB100 and ApoA-I play in lipid transport and cardiovascular risk? Why is measuring Lp(a) in nmol/L more informative than mg/dL? Who should ApoB and Lp(a) level testing be sent on? How do conditions like familial hypercholesterolemia differ from dysbetalipoproteinemia or familial hypertriglyceridemia? Tune in for answers to these questions. Difficulty Level: Intermediate You

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00:34:59

2.01 ASCVD Risk Estimation and Lipid Lowering

Hu Said: Cardiology Board Review Series ·

2024/07/06

In this episode, we review ASCVD risk estimation and lipid-lowering therapies. What low-density lipoprotein cholesterol (LDL-C) level should be targeted for patients who have had an ASCVD event versus those who have not, and how do these target LDL-C levels vary based on the presence of risk factors, diabetes status, and estimated 10-year ASCVD risk? What equation recently replaced the pooled cohort equations for estimating 10-year risk of ASCVD, and what new variables are introduced in the updated

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00:10:28

1.19 Pacemaker and ICD Complications

Hu Said: Cardiology Board Review Series ·

2024/07/04

In this episode, we discuss common complications of pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) implantation, along with considerations at the end of life. What are the risks of pacemaker pocket hematoma, pneumothorax, lead dislodgement, diaphragmatic stimulation, and muscular stimulation post-implantation, and how are these managed? What is twiddler's syndrome? What is the difference between pacemaker syndrome and pacemaker-mediated tachycardia, and how do they occur? When is

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00:19:41

1.18 Pacemaker and ICD Terms

Hu Said: Cardiology Board Review Series ·

2024/07/03

In this episode, we clarify key terms related to pacemakers (PPMs) and implantable cardioverter-defibrillators (ICDs). What do the common two-letter labels AR, VR, AS, VS, AP, VP, FD, TD, TP, CD, RV, and RT mean on EGM of an ICD? What is the relationship between the lower rate limit and the lower rate interval? What is the relationship between the post-ventricular atrial refractory period (PVARP) and the total atrial refractory period (TARP)? What is hysteresis? What is a typical upper tracking

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00:12:58

1.17 Reduction of Ventricular Dyssynchrony

Hu Said: Cardiology Board Review Series ·

2024/07/02

In this episode, we explore the concept of ventricular dyssynchrony and cardiac resynchronization therapy (CRT). What are the eleven scenarios in which CRT is recommended, according to the 2022 heart failure guidelines? What benefits to patients receive when CRT is appropriately used? What factors could contribute to nonresponse to CRT? How can echocardiography be used to find the atrioventricular delay to optimize LV filling? Tune in for answers to these questions. Difficulty Level:

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00:20:36

1.16 Programming ICD Therapies

Hu Said: Cardiology Board Review Series ·

2024/07/01

In this episode, we review the key aspects of ICD therapies. What are typical thresholds for a VT monitor zone, regular VT zone, fast VT zone, and VF zone? How is the number of intervals to detect (NID) defined deterministically vs probabilistically for VT vs VF detection? What is a typical rate and interval decrement for anti-tachycardia pacing (ATP)? What is the difference between a burst and a ramp of ATP? What do the B>AX, B>X, and B>A vectors for ICD shock describe? What are strategies

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00:32:04

1.15 Pacemaker and ICD Interrogation

Hu Said: Cardiology Board Review Series ·

2024/06/30

In this episode, we explore the fundamentals of permanent pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) interrogation. What are the most common pacing modes, and when are they used? What is rate-adaptive pacing, mode switching, and managed ventricular pacing? What mode do you induce when you place a magnet? How do you perform a sensing test and a threshold test? What are the timing cycles in single-chamber pacing and dual-chamber pacing? What mode is induced when the device

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00:19:19

1.14 QT Prolongation

Hu Said: Cardiology Board Review Series ·

2024/06/29

In this episode, we review QT prolongation and QT shortening. What is the QT interval, and how is it corrected (QTc) for heart rate variations? Which arrhythmogenic syndromes are associated with mutations in KCNQ1, KCNH2, and SCN5A? How do the T waves of long QT syndrome types 1, 2, and 3 differ? Which long QT syndrome is suggested by arrhythmia triggered from swimming? Which long QT syndrome is suggested by arrhythmia from noises and auditory triggers? Which long QT syndrome will need addition of

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00:11:28

1.13 ARVC and CPVT

Hu Said: Cardiology Board Review Series ·

2024/06/28

In this episode, we review arrhythmogenic right ventricular cardiomyopathy (ARVC) and catecholaminergic polymorphic VT (CPVT). Other than epsilon waves at the end of QRS complexes, what other features on ECG characterize ARVC? What are the echocardiographic and cardiac MRI findings of ARVC? Is diltiazem used in atrial fibrillation in patients with ARVC? What right ventricular ejection fraction makes an ARVC patient eligible for ICD placement? Can patients with ARVC participate in competitive sports

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00:16:36

1.12 Brugada Syndrome

Hu Said: Cardiology Board Review Series ·

2024/06/27

In this episode, we review Brugada Syndrome, syndrome of syncope and/or sudden death in healthy patients associated with mutations in SCN5A. How is Brugada pattern different from Brugada syndrome? How do you recognize the three main types, and how do they differ in management? Who should receive an implantable cardiac defibrillator, and who should receive antiarrhythmics such as quinidine? Tune in for answers to these questions. Difficulty Level: Easy You are listening to Hu Said: Cardiology Board

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