How To Treat Heart Failure (High-Yield Guide)
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- Опубліковано 31 лип 2023
- An easy to understand guide for understanding heart failure and how to manage it. An extremely high-yield topic for both medical students and residents!
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Your 'compiled medical knowledge' is truly encyclopedic.
Students are extremely lucky to have you as a Mentor.
I salute you Sir !
The GOAT is HERE!
New intern here! I pray that you continue with your teaching videos on UA-cam!!
Complete mastery my guy. 🔥
Incredible! Thank you!
This is so so helpful. I really appreciate you. Thank you.
great video. thank you so much.
thank you for your videos, very helpful
A great summary of heart failure, very practical 😊
Truly one of the best medical teachers I've come across. I use your videos frequently in residency. Much love
Great tips for doctors
I find you extremely interesting, knowledgeable, and easy to understand. Thank you for sharing. Patty Feltner, RN
Great summary, would love to get a bts for how you prepare the guides
very good. reviewed for my fm block
Incredible source of medical knowledge. I love your teaching! I'm learning so much as a pharmacist. Please continue to include medication management.
Bro you are amazing!!!!
Could you make a vid covering infections we usually see in the floors? Cap, diverticulitis, osteomyelitis, UTI, C.diff etc? Might be straight forward, but as an intern it would be great to see how you approach escenarios such as changing IV to oral, for how long to treat X patient or any pearls in general. You make things extremely clear. Thank you!
Will try to make some of those soon!
Thank you. Going through this with my dad who is at stage 2 HFref so very useful information. Surprised his cardiologist hasn’t started him on an SGLT2 or MRA. He’s been on daily Furosemide but it’s a struggle to prevent his edema plus it causes extreme dehydration and potassium loss. Hoping adding Farxiga will stabilize him more.
What about heart failure with kidney disease especially systolic heart failure.Is the management the same?
We typically use metoprolol over carvedilol because it has less effect on bp leaving more “room” in the blood pressure to maximize the other pillars.
This is a great point! Thank you for clarifying because I think I may have made it seem in the video that carvedilol was a lot better, but yes I feel metoprolol often has a lot of advantages (more BP room, once daily dosing)
Doctor, can you please make a video on how to approach patients complaints?, and what sources do you recommend to us medical interns to read from?
My understanding is that Entresto is a ARB and ARNI combination medical therapy.
Correct!
@@ConanLiuMD Doctor, when a patient is chronically hypotensive because they are taking Entresto for HFrEF (and are subsently having quality of life issues because they're sleeping all the time due to this side effect of Entresto). What medical therapy (or other) would be warranted to reverse or mitigate such symptomology in theory?
Any evidence for giving ivabdridine in patients with hypotension. Angiotensin- and Beta- blockade contraindicated. Boss gave 5mg BD this morning - patient was maybe 95 SBP.
Hi, not sure how to contact you to ask this, but could you make a video on a quick guide for antibiotic use? I find your videos very helpful, as a new intern. Thank you for all your help.
Just made a video on UTI in case that answers some of your questions! Will do one for pneumonia soon too hopefully and some other common infections. ua-cam.com/video/B1PoCcfgROo/v-deo.html
@@ConanLiuMDThank you so much!! Very much appreciated- a very happy intern!
Excellent! TY
Why do we care about diastolic vs systolic hf? TLDr?
3:27 :)
Hi Doctor...
Is diastolic heart failure not as bad as the systolic HF? They say I have Mild DHF but no swollen legs. Say 65% EF
Say my heart walls thick. During My Covid bid. My BP was 135/50 and got lower both numbers.
Does DHF cause low sodum?
I mention it briefly in the video that sometimes we do view systolic heart failure as being a little worse than diastolic heart failure. The chance for dangerous arrhythmias is certainly higher in systolic heart failure (this is less of a concern in diastolic). Both definitely need to be treated appropriately however to make sure patients have good outcomes! Both systolic and diastolic heart failure can cause low sodium due to fluid overload.
@@ConanLiuMDHi. Thx for reply. If I do have Diastolic Heart Failur... Is there such thing as no need to treat at this time? The cardi I seen said it's mild and does not expect it to progress for many years, if that. Is there such a thing? Thanks again. Stay tru Respect! 🙏
I have systolic non-ishemic symptoms of chf but everytime i go to the hospital they cant find a diagnosis. I am 35 years old. What should i do? Systolic non-ishemic symptoms
You may benefit from seeing another cardiologist to see if they have other ideas. They should do a pretty comprehensive/thorough workup to figure out what caused your heart failure
Can you still take a beta blocker if you have afib with with heart rate in the 50s?
When your heart rate is that low we generally avoid beta blockers or give the lowest dose possible - if it is absolutely necessary, some patients need a pacemaker so that they can take beta blockers safely. The good news is that if your heart rate is already in the 50s you might be getting some of the protective effects a beta blocker would give anyways, as a lower heart rate means less stress and negative remodeling problems in the heart
Thank you kindly for taking the time to respond. If a patient is not a candidate for a CRT can they get a pacemaker to accommodate a beta blocker?
What is your opinion of LVAD, specifically the CCM? Is there enough research to believe it reduces mortality in HF pts with high LEF? Thanks.
LVADs are indicated for patients with advanced / end stage heart failure - I believe they would only be indicated in patients with systolic heart failure as they help with forward blood flow in patients with severely reduced cardiac output. Diastolic heart failure is a filling problem and so they would not be candidates for an LVAD (but double check with a cardiologist)
I’ve read blocked arteries can be cause of HF but also read that HF can cause narrowing arteries? With EF 15% could stents help restore function?
but is this for acute or chronic heart failure treatment? or both?
- student
A little confused about the difference in diagnosing and treatment of acute HF, chronic HF, congestive HF, acute on chronic, and also about right sided and left sided are these important to differentiate as well?
Both!
Acute - needs an evaluation for why they developed heart failure, otherwise make sure they are on GDMT
Chronic - make sure they are on GDMT
Acute on chronic - make sure they are on GDMT and increase their diuretic dose until euvolemic
The classic patients you will see have left sided heart failure. The main difference in right sided heart failure is that there is no backup of fluid to the lungs (right ventricle and atrium and proximal to the lungs) so you don’t tend to get pulmonary edema and pleural effusions like with left sided heart failure
*Promosm* 😬