Adverse pregnancy outcomes (APOs), affecting up to 20% of pregnancies, serve as early indicators of a woman’s future cardiovascular risk and should be treated as critical markers in preventive care. Pregnancy offers a unique opportunity—a “window”—to identify and address cardiovascular vulnerabilities, making routine screening for heart health essential at every clinical encounter. Long-term monitoring beyond the postpartum period is vital, as cardiovascular risks persist and evolve over time. Improving women’s heart health requires a collaborative, lifelong approach across specialties, integrating cardiology with obstetrics and primary care. This comprehensive strategy ensures that prevention remains central during and after reproduction. 

In this interview, Drs. Alison L. Bailey, MD, FACC and Ijeoma Isiadinso, MD, FACC discuss “The Role of Prevention During & After Reproduction”. 

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Cohort studies have provided robust data on cardiovascular risk factors, forming the basis for predictive models like the Pooled Cohort Equations and PREVENT. Clinical trials confirm that treating these risk factors effectively reduces cardiovascular events. Over the past 50 years, age-adjusted mortality from acute myocardial infarction has dropped by 89%, reflecting major progress. To advance further, we must consider integrating imaging to identify those at highest risk, using risk factors to guide treatment decisions. This dual approach could enhance precision and improve outcomes in cardiovascular prevention. 

 In this interview, Drs. Alison L. Bailey and David J. Maron discuss “The Role of Imaging in Cardiovascular Prevention”. 

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The menopause transition marks a pivotal period of cardiometabolic change that significantly elevates cardiovascular (CV) risk in women. Despite its clinical importance, this phase remains underrecognized in CV risk assessment, contributing to a profound knowledge gap. Enhancing clinician education and fostering multidisciplinary collaboration are essential to delivering individualized care that addresses both symptom burden and long-term CV outcomes. By prioritizing this life stage, we can improve prevention strategies and reduce the overall burden of cardiovascular disease in women. 

In this interview, Drs. Alison L. Bailey and Lily Dastmalchi discuss “Improving Cardiovascular Clinical Competencies for Menopausal Transition”. 

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The 2025 ACC/AHA Acute Coronary Syndrome guideline is the first major update since 2013, incorporating a decade of new evidence and clinical insights. The writing committee stayed on track and on time, reaching consensus on key recommendations, including checklist-based Class I and II interventions before discharge. They thoughtfully addressed legacy practices and controversial studies to ensure clarity and relevance. While some emerging data didn’t meet the threshold for formal inclusion, areas like discharge antiplatelet therapy, coronary imaging, and mechanical support devices were flagged as important for clinicians to monitor. The result is a practical, evidence-based tool to guide bedside decision-making. 

In this interview, Drs. Roxana Mehran and Sunil V. Rao take listeners “Behind the 2025 Acute Coronary Syndrome Guidelines.” 

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The 2025 ACC/AHA Acute Coronary Syndrome (ACS) Guideline clarifies diagnostic distinctions using electrocardiogram changes, troponin levels, and imaging tools such as coronary CT angiography and echocardiography in the emergency setting. Updates in lipid-lowering strategies and antiplatelet therapy reflect a more personalized approach to risk reduction and long-term care. These recommendations aim to streamline acute decision-making and improve outcomes across the ACS spectrum. 

In this interview, Drs. Sidney C. Smith Jr. and Michelle L. O'Donoghue discuss “Top Takeaways From the 2025 ACC/AHA Acute Coronary Syndrome Guideline.” 

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Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI) is a procedure used to open coronary arteries that have been completely blocked for an extended period. It offers benefits like reduced angina and improved quality of life but carries risks such as vessel injury, heart attack, and procedural failure. Before considering CTO PCI, physicians typically optimize patients on anti-anginal medications—such as beta-blockers, nitrates, and calcium channel blockers—to manage symptoms and evaluate the need for intervention. 

In this interview, Drs. Anthony N. DeMaria and Lindsey Cilia examine “Risk versus Benefit in Chronic Total Occlusion Revascularization.” 

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While blood thinners like warfarin and direct oral anticoagulants (DOACs) remain the standard for stroke prophylaxis, left atrial appendage occlusion (LAAO) devices offer a non-pharmacologic alternative for patients at high bleeding risk. Recent trials have shown that LAAO can be as effective as anticoagulants in preventing stroke and may be a viable option, especially for patients who cannot tolerate long-term anticoagulation. 

In this interview, Drs. Anthony N. DeMaria and Dhanunjaya Lakkireddy explore the evolving landscape of stroke prevention in patients with atrial fibrillation, focusing on the comparison between traditional blood thinners and LAAO. 

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Persistent symptoms after an acute pulmonary embolism (PE) may indicate post-pulmonary embolism syndrome (PPES), a condition affecting up to 50% of patients. The most important consideration in managing PPES is to carefully evaluate and differentiate it from other potential causes of ongoing shortness of breath, particularly chronic thromboembolic pulmonary hypertension (CTEPH), which requires targeted treatment. How can clinicians best differentiate between PPES and other causes of persistent symptoms following an acute PE? 

In this interview, Drs. Dipti Itchhaporia and Paul R. Forfia discuss “Why Are They Still Dyspneic? Post PE Syndrome Workup and Management.” 

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Palliative care supports heart failure patients by guiding complex medical decisions, managing symptoms, and enhancing quality of life. Despite being a guideline-recommended therapy, it remains underused—referrals are 45% lower for heart failure patients than for cancer patients with similar prognoses. Collaboration between cardiology and palliative care teams ensures that patients and caregivers receive goal-aligned care and the best possible quality of life. 

 In this interview, Dr. Mary Norine Walsh and Ms. Jill A. Patton explore how palliative care can help patients across the span of their illness. 

 Related References: 

 1.  Chuzi S, Saylor MA, Allen LA, et al. Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America. J Card Fail. 2025;31(3):559-573. doi:10.1016/j.cardfail.2024.10.435 

2. Gelfman LP, Blum M, Ogunniyi MO, McIlvennan CK, Kavalieratos D, Allen LA. Palliative Care Across the Spectrum of Heart Failure. JACC Heart Fail. 2024;12(6):973-989. doi:10.1016/j.jchf.2024.01.010 

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Recent clinical trials demonstrate that intensive blood pressure lowering—targeting systolic levels below 120 mm Hg—can significantly reduce cardiovascular events and mortality, even among older adults, individuals with diabetes, and those with chronic kidney disease. This challenges the long-standing belief that looser blood pressure targets are safer for older patients, showing instead that with proper monitoring, tighter control offers substantial net benefits for most high-risk groups. 

 In this interview, Dr. Alison L. Bailey and Dr. Keith C. Ferdinand explore the evolving landscape of hypertension management, highlighting new evidence supporting the benefits of tight blood pressure control across diverse populations. 

Suggested Materials: 

 1. Liu J, Li Y, Ge J, et al. Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial. Lancet. 2024;404(10449):245-255. doi:10.1016/S0140-6736(24)01028-6 

2. Bi Y, Li M, Liu Y, et al. Intensive Blood-Pressure Control in Patients with Type 2 Diabetes. N Engl J Med. 2025;392(12):1155-1167. doi:10.1056/NEJMoa2412006 

3. Reddy TK, Nasser SA, Pulapaka AV, Gistand CM, Ferdinand KC. Tackling the Disproportionate Burden of Resistant Hypertension in US Black Adults. Curr Cardiol Rep. 2024;26(11):1163-1171. doi:10.1007/s11886-024-02115-5 

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