Mayo Clinic Cardiovascular CME

Pregnancy-Related and Other Women Specific Cardiovascular Risk Factors

Pregnancy-Related and Other Women Specific Cardiovascular Risk Factors

Guest: Rekha Mankad, M.D. (@RMankadMD)

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

Data supports that women's risk of heart disease has been underrecognized — women are dying of heart disease at increasingly higher rates. Women have the same regular risk factors as men, including high blood pressure, high cholesterol, diabetes and smoking, but there are some additional female-specific risk factors.

Joining us today to discuss pregnancy and cardiovascular risk is Rekha Mankad, M.D., a noninvasive cardiologist at Mayo Clinic in Rochester, Minnesota, with special interest in heart disease in women.

Specific topics discussed:

• Guidelines that address women's risk factors for heart disease
• Complications related to menopause and pregnancy
• Impact of diabetes on heart disease in women
• Preventive screening and risk assessment
• Autoimmune diseases and heart disease in women
• Impact of marriage on women's risk of heart disease

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

No CME credit offered for this episode.

Podcast transcript can be found here.

Atrial Fibrillation and Underestimation of Aortic Stenosis Severity

Atrial Fibrillation and Underestimation of Aortic Stenosis Severity

Guest: Vuyisile T. Nkomo, M.D., M.P.H.

Host: Malcolm R. Bell, M.D.

Aortic valve stenosis is common in the general population. Echocardiography is the primary tool used for assessing the severity of the disease. In patients with atrial fibrillation, however, Doppler echocardiography may underestimate the severity of aortic valve stenosis, resulting in the potential for grave consequences.

Joining us today to discuss optimal diagnoses of the severity of aortic valve stenosis in patients with atrial fibrillation is Vuyisile T. Nkomo, M.D., M.P.H., a professor of medicine with joint appointments in the Structural Heart Disease Program and Division of Cardiovascular Ultrasound at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Echocardiogram Doppler criteria for diagnosing the severity of aortic valve stenosis
• Hierarchy in the guidelines for diagnosis
• Aortic valve stenosis in patients with atrial fibrillation, normal sinus rhythm, or both
• Arrhythmia's impact on Doppler signals
• Next steps when aortic valve stenosis is suspected — and the implications of underestimating disease severity

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

No CME credit offered for this episode.

Podcast episode transcript here.

Cardiac Sarcoidosis - Who To Suspect and How to Diagnose

Cardiac sarcoidosis — When to Suspect and How to Diagnose

Guest: Omar F. Abou Ezzeddine, M.D., C.M., M.S. (@abouezzeddine)

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

Cardiac sarcoidosis is difficult to diagnose. It may present with no symptoms and a coincidental ECG finding or with symptoms that are common to most people, such as fatigue and occasional palpitations. Patients may present with minimal clinical cardiac symptoms. Multimodality imaging, in conjunction with clinical history, is required for diagnosis; other, more common diseases should be ruled out before diagnosing cardiac sarcoidosis.

Joining us today to discuss cardiac sarcoidosis is Omar F. Abou Ezzeddine, M.D., C.M., M.S., director of the Cardiac Sarcoidosis Clinic at Mayo Clinic in Rochester, Minnesota, and a cardiologist with expertise in nuclear imaging.

Specific topics discussed:

• Sarcoidosis and cardiac sarcoid defined
• When to suspect sarcoidosis
• Symptoms and the diagnostic cascade for sarcoid
• FDG-PET, MRI and hybrid PET-MRI
• Treatment options

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

No CME credit offered for this episode.

Podcast transcript can be found here.

The Future of Cardiac Rehabilitation

The Future of Cardiac Rehabilitation

Guest: Randal J. Thomas, M.D. (@DrRandalThomas)

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

Cardiac rehabilitation is a Class 1 recommendation for a number of cardiovascular conditions. The benefits are many — and evidence is mounting that supports improved short- and long-term outcomes for patients, whether they participate in center-based or home-based cardiac rehabilitation programs.

Joining us today to discuss the current benefits and challenges of cardiovascular rehabilitation is Randal J. Thomas, M.D., director of the Cardiovascular Rehabilitation Clinic at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Benefits and challenges of cardiac rehabilitation program participation
• Systematic approaches that improve participation rates
• Provider and patient education required
• Emerging solutions including personalized, home-based programs

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

No CME credit offered for this episode.

Podcast transcript can be found here.

Papillary Fibroelastoma (PFE) 101

Papillary Fibroelastoma (PFE)

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

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

Papillary fibroelastomas (PFEs) are the most common benign neoplasms of the cardiac valvular structures. Although rare and often hard to diagnose accurately, PFEs are being recognized more frequently via high-resolution imaging technology — and by ruling out other possible conditions that can mimic them.

Joining us today to discuss papillary fibroelastomas is Kyle W. Klarich, M.D., a consultant in Cardiovascular Medicine with a joint appointment in the Echocardiography Laboratory here at Mayo  Clinic in Rochester, Minnesota. Dr. Klarich is also Vice Chair for Clinical Practice in the Department of Cardiovascular Medicine, echocardiology specialist, and a professor of medicine at Mayo Clinic College of Medicine and Science.

Specific topics discussed:

• Papillary fibroelastoma (PFE) explained
• Best approaches to PFE identification: echocardiography, physical exam and antinuclear antibody testing
• PFE or nonbacterial thrombotic endocarditis
• Risk assessment and treatment alternatives
• New forms of treatment: a percutaneous solution

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

No CME credit offered for this episode.

Podcast transcript can be found here.

The Role of Genetic Testing in Cardiovascular Disease

Genetic Testing in Cardiovascular Disease

Guest: Iftikhar J. Kullo, M.D. (@iftikhar_kullo)

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

The Framingham risk score and other calculator models have been used to assess patients' risk of cardiovascular disease for more than 60 years. The models help to identify patients as having low risk, intermediate risk or high risk — but unless patients are assessed on the day they have a cardiovascular event, they may not be flagged as having high risk. Genetic risk assessment provides an exciting new avenue to help improve the risk prediction equations.

Joining us today to discuss genetic testing in cardiovascular disease is Iftikhar J. Kullo, M.D., a preventive cardiologist and professor of medicine here at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• Why genetic testing is needed for coronary risk stratification
• How to assess genetic risk of cardiovascular disease
• Genetic and genomewide polygenic risk scores
• Typical patients and a focus on patients at intermediate risk
• Genetic testing for patients with familial hypercholesterolemia

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

No CME credit offered for this episode.

Podcast transcript can be found here.

Myocardial Blood Flow as Assessed with PET Scanning in the Assessment of Patients with Chest Pain

Myocardial Blood Flow Assessed With PET Scanning in the Evaluation of Patients With Chest Pain

Guest: John P. Bois, M.D.

Host: Malcolm R. Bell, M.D. 

What is typically seen in positron emission tomography (PET) imaging is qualitative: Before and after pictures of patients at rest and under stress that are used to identify any kind of relative profusion defects. Quantitative PET takes this technique a step further, quantifying blood flow to the heart tissue in milliliters per minute per gram of myocardial tissue. In essence, traditional PET takes a photo of the heart before and after, but qualitative PET produces a video of the blood flow into the heart over time.

Joining us today to discuss myocardial blood flow and coronary flow reserve as assessed with PET scanning in the evaluation of patients with chest pain is John P. Bois, M.D., a consultant in Ischemic Heart Disease and Critical Care with a joint appointment in Radiology here at Mayo Clinic in Rochester, Minnesota. He's also co-director of our Chest Pain and Coronary Physiology Clinic, a nuclear cardiology specialist and an assistant professor of medicine.

Specific topics discussed:

• Quantitative versus qualitative PET: Quantifying blood flow to the heart tissue
• Automatic quantification via mathematical modeling
• Quantitative PET in patients with obstructive artery disease
• Improved testing accuracy with quantitative PET
• Diagnostic and prognostic evaluation of patients with challenging symptoms
• Future applications: standardization ad studies

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

No CME credit offered for this episode.

Podcast transcript can be found here.

What is New Managing Lipids?

Recent Developments in the Field of Lipid Management

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

Host: Thomas G. Allison, Ph.D., M.P.H. (@DrTAllison)

Statins and lifestyle changes are still the first line choices for the management of low-density lipoprotein (LDL) cholesterol to reduce the risk of heart disease. Recent developments in the field of lipid management, however, provide promising treatment options for patients who are statin intolerant or simply not achieving their LDL goals, or have elevated levels of triglycerides or lipoprotein(a), also called LP(a).

Joining us today to discuss recent developments in the field of lipid management is Stephen L. Kopecky, M.D., a preventive cardiologist here at Mayo Clinic in Rochester, Minnesota.

Specific topics discussed:

• The end of the statin era?
• New treatment options for patients who are statin intolerant
• Triglycerides: fibrates and statins — and fish oil
• LP(a) as a risk marker in patients with atherosclerotic cardiovascular disease or familial hyperlipidemia
• Use of proprotein convertase subtilisin/kexin type 9 serine protease (PCSK9) inhibitors

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

No CME credit offered for this episode.

Podcast transcript can be found here.

Coming Soon: Mayo Clinic Cardiovascular CME Podcast

Featuring Cardiovascular topics for medical professionals from your colleagues at the Mayo Clinic.