Talking All Things Cardiopulm

As part of the healthcare team, Physical Therapists help investigate what symptoms our patients may be experiencing and help facilitate better motion and positioning to help them find relief from their symptoms.

In this episode, Dr. Burriesci reviews a recent patient case of pericarditis and the possible manifestations of this diagnosis. She explains what symptoms and presentations we may see from this patient population so we can be prepared when we assess our patients.  She educates the patient on positioning to help relieve symptoms, breathing strategies, and exercises that can give us the most bang for our buck. She also walks us through what medical interventions are utilized while inpatient and when we should (and shouldn’t!) see these patients from a readiness perspective.

In this episode:

• Pericarditis
• Pericardial Effusion
• Cardiac Tamponade
• Pericardial drain
• Differential diagnosis (angina vs. non-ischemic chest pain)
• Breathing strategies, positioning and interval training
• Importance of vital sign assessment

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IG: @all_things_cardiopulm

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Website: www.allthingscardiopulm.com

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Linked-In: Rachele Burriesci

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When we think of a cardiac patient, who’s had heart surgery, we think of an older adult. They could be anywhere from slightly deconditioned to very deconditioned, which means it could impact how much physical activity they can handle. But, what if that’s just a stereotype?

In this episode, Dr. Burriesci starts by introducing Dr. Kyle Brunelle and his passion for lifting, hiking, jujitsu and breathwork. In 2020, he started a physical therapy business, Renegade Performance, with his wife. He is the optime of an athlete; yet there’s an invisible illness he’s been dealing with since 2015. He was diagnosed with Hypertrophic Cardiomyopathy and had an Implanted Cardiac Defibrillator in 2016 but has continued to maintain his high level of physical activity throughout his journey. Dr. Kyle brings a unique viewpoint of the healthcare field because of his clinical background and his venture as a patient. He also has a fun fact about an external defibrillator he carried around for months and a fascinating ICD placement that I can bet you’ve never seen before.

Find out more about his diagnosis, symptoms, and exercise routine now in this episode!

In This Episode:
- Dr. Kyle Brunelle's background as a PT and business owner
- Hypertrophic Cardiomyopathy
- Diagnostic findings and symptoms
- Symptom mgmt & treatment of HCM
- S-ICD and Kyle's unique placement
- AED / BLS

Find Dr. Kyle Brunnelle at:
IG: @renegademvmt
website: https://www.renegademovementandperformance.com/

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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Have you been a clinician for a few years and wonder what’s next in your career? Do you think about what more you could be doing or do you have a special interest in a specific population, but you’re unclear what it takes to work with them? A residency is maybe the next step. However, it can feel overwhelming to think about uprooting your life to move, taking a pay cut or even finding the why behind the big life change.

In this episode, Dr Burriesci breaks down the three main roads to becoming a board-certified specialist: residency, mentorship, and self-study. As someone who utilized self-study for her first certification, residency for her second speciality and now mentors people who are sitting for their CCS exam, she explores the pros and cons of each road. She explains that while one lane may not work within your lifestyle, another may be the exact fit for you. She navigates through how to apply, what the interview process looks like (from resident and facility standpoints), what moving across country looks like, tuition vs pay in residency and so much more.

 If you feel like there’s a missing piece in your practice or that you desire more mentorship in a specific topic, check this episode out!

In this episode:

• How to tackle applying for specialty
• Qualifications to sit for a specialty exam in cardiovascular & pulmonary 
• Finding a mentor 
• Pros and cons between self-study vs residency
• Applying to a residency
• Setting yourself up for success
• Is it a good fit for you?

APTA specialist Certification:
https://specialization.apta.org/

American Board of Physical Therapy Residency & Fellowship Education:
https://abptrfe.apta.org/

Mentoring Sessions w Dr. Burriesci
https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494

We hear that words matter, but could the words we say as clinicians be impacting our patient’s results?

It could be!

In this episode, Dr. Burriesci chats about Pursed Lip Breathing (PLB) as an intervention for patients with an Emphysema diagnosis, anxiety or post-exercise. This intervention is extremely popular and easy to perform, but the traditional cue of “blow out the candle” is often misused. We want to give our patients a different cue that is mindful of the 1 second inhale to 2 second exhale, to  prevent air trapping, encourage air to move out of the lungs and pace breathing. But if we stop saying “blow out the candle”, then what do we say? Find out now what phrase we should use to maximize PLB and get the most bang for your buck.

 
In This Episode:

• Mechanism of pursed lip breathing (PLB)
• Pathophys of Emphysema
• Importance of the words we choose in cueing
• Visual feedback techniques of PLB

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494

You get a breathing exercise, you get a breathing exercise, everyone gets breathing exercises (even your orthopedic patients)!

In this episode, Dr. Burriesci educates on the importance of utilizing breathing exercises and how they can be incorporated into patient sessions, across the spectrum. She explains that almost every patient/client can benefit from breathing exercises and that there are specific breathing exercises that can be used to help each diagnosis.  But the benefits of using breathing are endless, even if you are not treating patients with cardiac or pulmonary conditions. Incorporating breathing will help set your patient up for success, it will put them in the driver’s seat, give them control and give them the tools to manage a number of issues: SOA, pain, anxiety, atelectasis, pulmonary edema, mucus, diaphragm strength/endurance, gas exchange, the list goes on.

So, while this may not be your common practice (yet), we have to remember to use interventions that we know will make a difference and to treat the whole person. Let’s individualize care for our patients, maximize function and utilize breathing to do just that.

In this episode:

• Discuss the benefits of breathing exercises
• Discuss how to perform the following breathing exercises:
  • Inspiratory holds
  • Stacked breathing
  • Paired breathing
  • Incentive spirometer
• Discuss which breathing exercises will benefit post-surgical patients
• Post-surgical patient: median sternotomy, thoracotomy, clamshell incision
• Define atelectasis
• Discuss changes that occur in the lung post-general anesthesia

Join my main newsletter:  https://allthingscardiopulm.ck.page/9bb2730421

Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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We know Heart Failure (HF) is a diagnosis that does not occur overnight, rather it occurs due to years and years of stress placed on the heart.  Resulting in years and years of management and likely hospital admissions and readmissions. As clinicians, we have to understand our patient’s diagnoses to help guide their therapy and give them the tools to set them up for success.  We should implement strategies that can help manage the progression of the disease process and better yet let's start earlier to be preventative vs reactive and in time to actually make an impact.

In this episode, Dr. Burriesci walks us through the latest HF Clinical Practice Guidelines (CPG) along with the New York Heart Association classifications. The goal of the CPG is to establish an evidence-based approach for the optimal treatment of HF. Dr. Burriesci dives deep into how we can utilize these recommendations for our patients and explore the research behind the 2020 CPG. She reviews the daily activity, education, neuromuscular electrical stimulation, resistance breathing training and exercise recommendations set in the CPG. She goes on to explain how we can tailor these interventions to our own patients. This episode gives us, as clinicians, the knowledge of what the perfect numbers should look like, but the realistic insight that we must meet our patients where they’re at to reduce their overall risk.

In this episode:

• Unpack the Heart Failure CPG
• Describe ACC stages vs NYHA Classes of HF
• Discuss 9 action statements aka recommendations for treating patient with heart failure
  • Increase physical activity 
  • Educate!
  •  Aerobic training
  • HIITs
  •  Strength training
  •  Inspiratory/respiratory muscle training
  •  NMES

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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What’s an illness that is diagnosed by a cluster of symptoms and can have pink frothy sputum? Heart Failure!

To say heart failure is a complicated diagnosis is an understatement. As clinicians, we have to think about the underlying pathophysiology to understand patient presentation, how to direct treatment (coming next week to your favorite pod) and how we can help our patients navigate this diagnosis that can feel overwhelming, even to us!

 In this episode, Dr. Burriesci goes through the pathophys of heart failure and the subsequent signs and symptoms that result.  She explains that the pressures exerted on the chamber, the afterload, cause the chamber to fail over time and cause a back-up. Follow the back-up and you will find the symptoms.  We flow further into the information by looking into what other systems are impacted when the body begins to compensate for heart failure. This again impacts how we, as clinicians, will chart review, think about testing and how we treat our patients. All of these factors help set our patients up for success over the years.

 
In This Episode:

• Difference between left and right heart failure 
• Difference between systolic and diastolic dysfunction 
• Structural difference between dilated and hypertrophic cardiomyopathy
• Signs and symptoms common in both left and right heart failure
• Discuss the systems compensations in response to failure

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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As physical therapists, we are known to have catchy phrases like “movement is medicine”. We hear it all the time in school, we say it to our patients, but is it more than just a catchy phrase? Would it be the magic pill that solves so many disease management problems? 

In this episode, Dr. Burriesci walks us through how lifestyle modifications may take us down a path of less disease. She reviews how chronic kidney disease, coronary artery disease and diabetes all have similar risk factors that link back to lifestyle modifications of, you guessed it, diet and exercise.

This episode puts in perspective the importance of educating patients on  lifestyle modifications and utilizing adequate exercise prescription to make an impact in our patient’s daily lives and create longterm change . We empower patients with knowledge to increase their aerobic fitness while reducing their BMI, blood pressure, glucose levels and more. Each of these put our patients one step closer to living an overall healthier lifestyle and mitigating disease risk.  Movement really is  medicine.

In This Episode:
- Cardiac risk factor
- Diabetic risk factors
- Chronic kidney disease risk factors
- Metabolic syndrome
- Understanding the link between all four processes
- Identifying the importance of lifestyle modification

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494

In This Episode:
-  Bring awareness of risk of heart disease in women
- Common misconceptions of  heart disease based on gender
- Identify atypical signs of angina
- Cardiac Risk Factors
- Reasons for misdiagnosis of heart attack in women
- Obstructive disease vs. microvascular disease

Ezekowitz J et all. Is There a Sex Gap in Surviving an Acute Coronary Syndrome or Subsequent Development of Heart Failure? Circulation: 2020 (142)23.

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

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How did a 2-week shutdown turn into a 3-year (and counting) battle of the same virus? The virus has taught us about what a spike protein looked like because we saw it everywhere. But yet, we aren’t sure why some people get GI symptoms and others end up in a critical condition in the hospital. 

The novel virus, COVID-19, is unlike any other virus that we have had to deal with in the modern age. It quite literally hits both ends of the spectrum, causing issues with both clotting and bleeding. It hijacks a person’s system and creates chaos for an undetermined amount of time. However, Dr. Burriesci is here to give us a 40,000 feet view of what COVID looks like. She explains what symptoms looked like at the beginning of the pandemic and how that has shifted to what it is being seen today. She also chats about her journey through the start of the pandemic, including the loss of her mentor and coach Joe Lewinger, her wife treating on the front lines, and her family back in NY.

In This Episode:

• Dr. Burriesci’s Journey through the start of the pandemic 
• Defining Acute COVID-19
• Pathophysiology and signs and symptoms of COVID-19
• Making sense of the  moving target
• Understanding the location of ACE 2 receptors systemically 
• Progression of signs and symptoms and change with more recent variants 

Joe Lewinger's Story
https://nypost.com/2020/03/29/mary-louis-ad-joe-lewinger-leaves-behind-everlasting-legacy-through-hardship/
https://www.cnn.com/2020/05/18/us/student-grief-teachers-coronavirus/index.html

Want to learn more about COVID? Purchase my COVID workshop-replay:
https://www.allthingscardiopulm.com/covid-workshop-replay


Join my main newsletter:  https://allthingscardiopulm.ck.page/9bb2730421


Want to sign up for a mentoring call with Dr. Burriesci? Sign up here: https://www.allthingscardiopulm.com/mentoring

Find me on:

IG: @all_things_cardiopulm

Threads: @all_things_cardiopulm

Website: www.allthingscardiopulm.com

Youtube: @allthingscardiopulm

Linked-In: Rachele Burriesci

Text at 913-308-4494