What's Your Dysfunction?
This lysosomal storage disease is X linked, causes hypertrophic cardiomyopathy, and is due to a deficiency in alpha-galactosidase.
What is Fabry's Disease?
This medication has a 21% risk reduction in hospitalization, 22% risk reduction in need for MCS/transplant, decreased mortality as compared to Enalapril.
What is Sacubitril-Valsartan?
This term, the opposite on inotropy, describes the rate of myocardial relaxation may be the initial signal of an underlying cardiomyopathy.
What is Lusitropy?
Diuresis in acute heart failure must be timely and efficacious. Name the recommended starting dose for inpatient acute heart failure patients on chronic outpatient diuretic therapy?
What is at least 2.5 x home dose?
(Continuous = Intermittent dosing)
The FDA recently approved a booster dose for this brand of the COVID-19 vaccine.
What is Pfizer?
Right ventricular disease is no laughing matter. Name the specific echocardiographic criteria which defines Ebstein's anomaly.
What is apical displacement of the septal tricuspid leaflet > 8 mm/m^2?
In the 2021 ESC guidelines, there are four medications which may be used as a class IIa and class IIb adjuncts for HFrEF despite treatment with ARNI/BB/MRA/SGLT2i.
Vericigualt (guanylate cyclase receptor inhibitor)
Hydral-Isosorbide dinitrate
Digoxin
Ivabridine (sinus rhythm, HR> 70, EF<35)
Chemotherapy induced cardiomyopathy may sneak in sooner than you expect. Next time you are in the echo lab, you will look out for the following clinical echo, pre-clinical strain findings.
What is a reduction in LVEF > 10% to less than 53% and decrease in GLS by > 15%?
Addition of this medication, even 'renally dosed' was not shown to improve inpatient outcomes in acute heart failure.
What is dopamine? (DAD-HF, ROSE-AHF)
Name this cryptocurrency that briefly skyrocketed to the moon in 2020-2021.
What is DOGE coin?
A 2012 JACC update on myocarditis revealed that this virus was the leading cause of viral myocarditis.
What is Parvovirus?
This class of medication has shown improvements in clinical cardiovascular outcomes for patients with HFrEF. Name the class, two medications with doses, and respective trials included in the 2021 iteration of the ESC Guidelines for treatment of HFrEF.
What are SGLT2i?
*Empagliflozin 10 or 25 mg (EMPAREG)
Dapagliflozin 10 mg (DAPA-HF)
Specifically for ATTR cardiac amyloidosis, this finding on nuclear PYP scanning may save you an invasive workup.
Heart to contralateral ratio > 1.5 suggests ATTR cardiac amyloid (97% sensitivity and 100% specificity)
Your patient is going to be discharged. Be on alert for efficacious, alternative loop diuretics. What is the conversion of IV furosemide to torsemide or bumetanide?
40 furosemide = 20 torsemide = 1 bumetanide
This movie trailer broke records for number of views accumulated in one day. Name this movie.
What is spiderman: no way home?
Double Trouble: This cardiomyopathy comes in many flavors. When present, it may be associated with pseudoinfarct pattern, LVH, or low voltage on EKG; bi-atrial enlargement, diastolic dysfunction, and peak systolic strain with apical sparing on echo, and subendocardial LGE in both the atria and the ventricles. Name this disease and the treatment in attracts?
What is restrictive cardiomyopathy due to TTR Amyloidosis and Tafamidis? Mechanism of action: molecular chaperone which stabalizes the amyloid tetramer preventing breakdown and formation of amyloid monomers. Tafamidis improves QOL, functional capacity, and survival (Maurer et al. NEJM. 2018).
A 70 year old male with NYHA III HFrEF 30% on quadruple therapy presents to your clinic. Labs reveal a creatinine of 0.9, hemoglobin of 13, ferritin of 250 ng/mL, and iron saturation of 16%. He is up to date on cancer screening. These two criteria may warrant use of IV Fe to improve his symptoms and QOL.
What is ferritin < 100 ng/mL?
What is ferritin between 100-299 and Fe Sat <20%?
What are the echo and cardiac MRI criteria to establish a diagnosis of left ventricular non compaction?
What is...
Echo: A ratio of noncompacted to compacted myocardium >2:1 at end-systole in the parasternal short-axis view
MRI: A trabeculated LV mass of >20% of global LV mass and ratio of non compacted to compacted myocardium greater than 2.3 during diastole
[sensitivity (94%) and specificity (94%)]
Across the ocean in China, this non-diuretic treatment has shown improved decongestion, decreased creatinine, and decreased 30 day readmission in a few small studies.
What is 1.4-4.5% hypertonic saline?
On September 15th, this company sent a billionaire, a physician assistant, a college professor, and a data engineer on a three day orbit around the earth.
What is SpaceX? (mission: Inspiration4)
Name four indications for implantation of ICD in patients with hypertrophic cardiomyopathy. Bonus 100 points for class of recommendation.
1. Prior death, VF, or VT (class I)
2. FH of SCD, LVH > 30 mm (class 2A)
3. NSVT (Class 2A)
4. Extensive LGE on CMR (Class 2B)
Although not yet approved, this myosin activator showed decrease in CV events and mortality in GALACTIC-HF Trial.
What is Omecamtiv mecarbil?
Name this sensitive and specific form of cardiac imaging that can detect iron deposition and be useful in diagnosing hemochromatosis. Be very specific!
T2* imaging/mapping with decreased myocardial T2* time (normal 50 seconds, abnormal 20 ms)
Besides POCUS, name one validated/studied non-invasive method to assess for euvolemia and one method to assess for efficacious diuretic response.
What are urine sodium and hemoconcentration?
Diuretic response: urine sodium (increase diuretics if <50-70 mEQ/L)
Euvolemia: Hemoconcentration (increase in albumin or Hct) and POCUS
Dr. Abramov loves all things twitter. How many followers does he have?
What is 513?