Pre-Operative Evaluation Prior to Non-Cardiac Surgery

Guest: Michael W. Cullen, M.D. (@mwcullen)

Host: Malcolm R. Bell, M.D.

Cardiovascular preoperative evaluation of patients with known or suspected heart disease who are in need of noncardiac surgery is a common scenario.

Joining us today to discuss cardiovascular preoperative evaluation prior to noncardiac surgery is Michael W. Cullen, M.D., Cardiovascular Ultrasound, at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Five-step algorithm for evaluation of patients in the outpatient clinic

Evaluation of patients with no symptoms receiving high-risk procedures

When additional testing is necessary

Data strength regarding improved outcomes from revascularization prior to noncardiac surgery

Medications to add or remove before surgery

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

Resource(s): Prevention of Complications in the Cardiac Intensive Care Unit: A Scientific Statement From the American Heart Association

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Role of Imaging in Known or Suspected Infective Endocarditis

Guest: Michael W. Cullen, M.D. (@mwcullen)

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

The diagnosis and treatment of patients with infective endocarditis can be complex. Successful outcomes require multidisciplinary support for imaging, management and therapy.

Joining us today to discuss the use of imaging in the initial evaluation and management of infective endocarditis is Michael W. Cullen, M.D., a cardiologist and expert echocardiographer at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Risk factors, signs and symptoms that raise the suspicion of infective endocarditis

Comprehensive physical examinations necessary for diagnosis

Hospitalization, blood cultures and antibiotics required for evaluation

Imaging types and considerations for use

Potential complications and their diagnosis

Role of imaging in the management of infective endocarditis

Surveillance imaging and follow-up

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Why Wide Complex Tachycardia Differentiation Matters

Guest: Adam M. May, M.D. (@A_May_MD)

Host: Anthony H. Kashou, M.D.

Ventricular tachycardia or supraventricular tachycardia? Accurate diagnosis of wide complex tachycardia impacts patient care and outcomes. Conventional algorithms plus automated methods and approaches provide solutions to the challenging issue of differentiation.

Joining us today to discuss wide complex tachycardia differentiation is Adam M. May, M.D., a cardiac intensivist at Washington University in St. Louis. Dr. May completed his residency at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Wide complex tachycardia definition and history

May's experience with wide complex tachycardia differentiation

Clinical implications for misdiagnosis of ventricular tachycardia versus supraventricular tachycardia

Common methods and tools available for diagnosis

Algorithm use challenges and limitations

Typical presentation scenarios

Automated tools and approaches for differentiation

Diagnostic tools help the clinician arrive at correct diagnoses

Performance comparison: automated tools versus manual algorithms

Recommended approach to diagnosis today

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Transcatheter Mitral Edge to Edge Repair

Guest: Mackram F. Eleid, M.D.

Host: Kyle W. Klarich, M.D. (@KyleWKlarich)

Transcatheter mitral valve edge-to-edge repair has proved to be a safe and effective treatment for many patients with secondary (severe) mitral regurgitation.

Joining us today to discuss mitral regurgitation and transcatheter mitral valve repair is Mackram F. Eleid, M.D., Cardiovascular Diseases, at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Differences between primary and secondary mitral regurgitation

Treatment for patients with secondary mitral regurgitation

Assessment of mitral regurgitation to determine use of mitral valve clip

Clinical trial outcomes in edge-to-edge repair for secondary mitral regurgitation

Resynchronization for device pacing in practice at Mayo Clinic

Current role for mitral valve edge-to-edge repair

Alternative clinical trials for patients not eligible for edge-to-edge repairs

Common complications in mitral valve edge-to-edge repair

Patient recovery and improvement

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Echo Guided Pericardiocentesis

Guest: S. Allen Luis, M.B.B.S., Ph.D.

Host: Paul A. Friedman, M.D. (@drpaulfriedman)

Pericardiocentesis is a lifesaving diagnostic that for many physicians can cause some measure of anxiety: It's not commonly done, and there are potential risks.

Joining us today to discuss pericardiocentesis is S. Allen Luis, M.B.B.S., Ph.D., cardiologist and co-director of the Pericardial Disease Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Indications for use of pericardiocentesis

Common diagnoses and labs ordered

Pericardiocentesis techniques and approach with echocardiography-guided imaging

Patient placement (supine position) and bed angulation

Standard care pathways following fusion drainage

Injection of lidocaine into the pericardial space for pain relief

Drain removal considerations

Complications following pericardiocentesis

Follow-up medications and treatment

Issues related to steroid use

Follow-up testing recommendations

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Pull Back the Curtains with Mayo Clinic's Cardiac Monitoring, ECG Laboratory, and Inpatient Team

Guests: Zachery (Zach) D. Linn, M.S., CRAT; Joshua (Josh) T. Krell, CRAT; Chad E. Schmitz, M.H.A., CRAT; Joshua K. Busby, CRAT; Jill M. Culp, CCT, CRAT

Hosts: Anthony H. Kashou, M.D. and Tara A. Gosse, M.S.

Mayo Clinic's cardiac monitoring practice is being transformed — growing quickly and adapting to rapid change in the field to improve patient care. Joining us today to discuss that transformation, from the Heart Rhythm and Physiological Monitoring Laboratory at Mayo Clinic in Rochester, Minnesota, are:

Zachery (Zach) D. Linn, M.S., CRAT, remote cardiac monitoring

Joshua (Josh) T. Krell, CRAT, cardiac monitoring

Chad E. Schmitz, M.H.A., CRAT, electrocardiogram (ECG) laboratory

Joshua K. Busby, CRAT, cardiac monitoring interpretation

Jill M. Culp, CCT, CRAT, retired education specialist

Specific topics discussed:

Remote cardiac monitoring team services

The ideal patient for remote cardiac monitoring

Early detection of rhythm disorders with mobile cardiac telemetry and decreased standard device wear time for patients

ECG Holter monitoring and placement

ECG laboratory scope and services

Inpatient telemetry monitoring

Training and education for staff certification and care of patients in the hospital setting

Remote communication with physicians, nurses and patients

Resources: Heart Rhythm and Physiological Monitoring Laboratory

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Exercise for Cardio-Oncology Patients

Guest: Ray W. Squires, Ph.D.

Host: Stephen L. Kopecky, M.D. (@DrSteveKopecky)

Mayo Clinic launched its cardio-oncology rehabilitation (CORE) program in 2017. In 2019, the American Heart Association, with endorsement from the American Cancer Society, published a rationale supporting partnerships with existing cardiac rehabilitation programs to bring patients with cancer into those programs for supervised exercise training and modification of cardiac risk factors. In 2021, Dr. Squires and fellow researchers published the article, "Cardio-oncology rehabilitation (CORE) exercise prescription and programming: A practical guide in the Journal of Cardiopulmonary Rehabilitation and Prevention."

Joining us today to discuss cardio-oncology rehabilitation is Ray W. Squires, Ph.D., Cardiovascular Medicine and director of the Cardiovascular Rehabilitation Program at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Heightened cardiovascular risk for patients with diverse cancers

Studies supporting exercise training for patients with cancer to improve cardiorespiratory fitness

The No. 1 cause of death for patients with cancer

CORE program individualization to provide motivation and exercise management for patients already exhausted by chemotherapy and radiation therapy

Avoiding long sedentary periods and other considerations for patients with cancer

CORE and the electrocardiogram age of patients with cancer

Reimbursement considerations and CORE programs nationally

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

Resource(s): Cardio-oncology rehabilitation (CORE) exercise prescription and programming: A practical guide in the Journal of Cardiopulmonary Rehabilitation and Prevention

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Prevention of CICU Complications

Guest: Jacob C. Jentzer, M.D.

Host: Malcolm R. Bell, M.D.

The traditional coronary care unit was designed and implemented for patients with ST elevation myocardial infarction (MI). At Mayo Clinic, that model has evolved into a complex, multidisciplinary cardiac intensive care unit (CICU) that cares for patients with an array of both acute and chronic cardiovascular diseases and, often, complex comorbidities.

Joining us today to discuss CICU complications and their prevention is Jacob C. Jentzer, M.D., Cardiovascular Medicine, at Mayo Clinic in Rochester, Minnesota. Dr. Jentzer co-authored Prevention of Complications in the Cardiac Intensive Care Unit: A Scientific Statement from the American Heart Association, published in Circulation in 2020.

Specific topics discussed:

Common and preventable complications treated in the CICU

Common health care-associated infections addressed in the CICU

Key steps to prevent health care-associated infections

Increased complexity of patients' conditions

Best practices for ventilator management, A through F

Pain management practices that prevent complications

CICU multidisciplinary team members

Benefits of a career in cardiac critical care

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

Resource(s):

https://www.ahajournals.org/doi/10.1161/CIR.0000000000000909

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

ECG Interpretation and if the Application of Artificial Intelligence May be Helpful

Guest: Peter A. Noseworthy, M.D. (@noseworthypeter)

Host: Anthony H. Kashou, M.D. and Tara A. Gosse, M.S.

Electrical signals can inscribe valuable information about a patient. The world of ECG is evolving rapidly. Research from Mayo Clinic documents 66 discrete labels — from various rhythms, conduction disturbances, ischemia, hypertrophy — obtained from a standard 12-lead electrocardiogram (ECG).

Joining us today to discuss ECG interpretation and the application of artificial intelligence (AI) is Peter A. Noseworthy, M.D., Cardiovascular Medicine, at Mayo Clinic in Rochester, Minnesota. Dr. Noseworthy is the director of the Mayo Clinic Heart Rhythm and Physiological Monitoring Laboratories.

Specific topics discussed:

Critical ingredients necessary to apply AI to the ECG

AI interpretation versus current interpretation software

Improvements to clinical workflow, benefits to staff and added value for clinicians

Potential applications for resource-limited regions of the U.S.

AI as an adjunct to the clinician

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices.

Facebook: MayoCVservices

LinkedIn: Mayo Clinic Cardiovascular Services

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.

Complicated Recurring Inflammatory Pericarditis: Role of Imaging and How to Treat

Guest: S. Allen Luis, M.B.B.S., Ph.D.

Host: Kyle W. Klarich, M.D. (@KyleWKlarich)

When recurrent chest pain episodes are confirmed to be complicated recurrent pericarditis (CRP)  and resolution is challenging, considerations for choosing a referral center for treatment include the number of pericardiectomies being performed at the center and an understanding of the specific surgeon's recommended approach.

Joining us today to discuss CRP is S. Allen Luis, M.B.B.S., Ph.D., a cardiologist and director of the Pericardial Disease Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

Definition, examples and frequency of CRP

Ideal treatment for first-episode pericarditis

Optimal management of CRP via tapering guided by inflammatory markers

Role of echocardiography and cardiac MRI in the diagnosis of CRP

New therapies and treatment algorithms for patients with CRP

Side effects of interleukin-1 (IL-1) inhibitor therapy and use of azathioprine or intravenous immunoglobulin (IVIG) in the treatment of CRP

How to evaluate centers when referring patients for radical pericardiectomy

Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV.

NEW Cardiovascular Education App:The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today!

No CME credit offered for this episode.

Podcast episode transcript found here.