October 21st, 2014 · Leave a Comment

Test Your Knowledge Tuesday #23

By Jennifer O'Hara

We continue our weekly series testing your CV knowledge. Today, Dr. John Bresnahan offers a case study covering mechanical complications of acute myocardial infarction.


A 76-year-old woman is admitted to your service with an acute inferior myocardial infarction. In addition to chest pain, she complains of shortness of breath. On examination, her blood pressure is 96/50, pulse is 94 and she has an elevated jugular venous pressure to the angle of her jaw in the supine position with the head of bed elevation at 30 degrees. Her lungs are clear and her heart sounds demonstrate normal first and second heart sounds with a soft S3 at the left lower sternal border. No murmurs are noted.

Which of the following drugs would be the most appropriate at this time in the management of this patient?

A. IV furosemide
B. IV phenylephrine
C. Bilevel positive airway pressure
D. Inhaled nitric oxide
E. One liter of IV saline

Read the rest of this entry »

View full entry · Comment on this

Tags: acute myocardial infarction, Dr John Bresnahan, Test Your Knowledge Tuesday, TYKT

October 16th, 2014 · Leave a Comment

Mayo Clinic Satellite Educational Symposia at AHA

By Jennifer O'Hara

Mayo Clinic will be hosting three free educational symposia this year at the American Heart Association Scientific Sessions 2014 in Chicago, Nov. 15-19. AMA PRA Category 1 Credits ™ are available for these activities. Registration is available onsite only.

Preventive Cardiology - Trendy Topics in Preventive Cardiology — Saturday, Nov. 15 1:55-4 p.m.

Faculty will discuss topics that are applicable in daily practice.  The talks will be case based and provide practical take-home messages for practitioners.

Genetics and Genomics in Cardiovascular Disease: An Update — Sunday, Nov. 16 7-9 p.m.
Session will explore the important role of genetics in the diagnosis and treatment of diseases affecting the heart and major blood vessels. Complimentary dinner will be served.

Hot Topics in Arrhythmia Management: What the Practitioner Needs to Know — Monday, Nov. 17 7-9 p.m.
Experts will use a case-based approach to provide concise updated information in the management of atrial fibrillation, idiopathic ventricular tachycardias, and non-responders to cardiac resynchronization.

For complete information on Mayo Clinic sessions, see our Educational Symposia Brochure.

AHA Location:
Hyatt Regency McCormick Place
2233 S. Drive Martin Luther King Jr. Drive
Chicago, IL  60616
All Mayo Clinic Symposia take place in the Regency Ballroom CDE.

While at AHA, visit the Mayo Clinic booth #1017.

For more information on AHA 2014, visit: American Heart Association Scientific Sessions 2014.

View full entry · Comment on this

Tags: AHA, AMA PRA credits, American Heart Association, Mayo Clinic CV CME

October 14th, 2014 · Leave a Comment

Test Your Knowledge Tuesday #22

By Jennifer O'Hara

This week Dr. Naveen Pereira uses a case study to highlight treatment of systolic heart failure.


A 56-year-old male with a prior history of myocardial infarction presents with progressively increasing dyspnea and edema of lower extremities. An ICD-CRT was implanted two years prior.

Following is his medication regimen:

  • Lisinopril 5 mg twice daily
  • Carvedilol 3.125 mg twice daily
  • Simvastatin 20 mg daily
  • Aspirin 81 mg daily
  • Spironolactone 25 mg daily
  • Furosemide 80 mg daily

On examination, he is afebrile, his heart rate is 62, blood pressure is 86/60 mm Hg, jugular venous pressures are significantly elevated with prominent v waves. Lungs are clear, 3/6 pan systolic murmur over the precordium, S3 is present, 3+ pitting edema and cool extremities are noted.

Laboratory tests reveal a hemoglobin of 8, sodium 126 mmol/L, potassium 4.5 mmol/L, BUN 42 mg/dl and creatinine 1.6 mg/dl. His ECG shows a 100 percent A-V-paced rhythm. He was admitted to the hospital for further management.

Regarding treatment for this patient, all of the following statements are true except:

A.  Hold or decrease carvedilol until the patient is hemodynamically stable.
B.  Right heart catheterization may be indicated.
C.  Adding metolazone 5 mg orally daily may improve symptoms.
D.  Starting IV low dose dopamine may improve renal blood flow.
E.  IV furosemide as a continuous infusion is superior in diuretic efficacy to 12-hour bolus dosing.

Read the rest of this entry »

View full entry · Comment on this

Tags: Dr Naveen Pereira, systolic heart failure, Test Your Knowledge Tuesday, TYKT

October 9th, 2014 · Leave a Comment

Renal Denervation — The Clues are in the Kidneys

By Amy Beeman

In a video originally posted on Medscape’s TheHeart.org, Dr. Robert Simari and Dr. Rajiv Gulati discuss the innovation of renal denervation, a minimally-invasive catheter-based procedure for treating hypertension.   Dr. Gulati addresses the ongoing Symplicity-HTN3 trial and where interventional cardiology may be headed in the future.


View full entry · Comment on this

Tags: Dr Rajiv Gulati, Dr Robert Simari, Symplicity-HTN3, Renal Denervation

October 7th, 2014 · Leave a Comment

Test Your Knowledge Tuesday #21

By Amy Beeman

Today, Dr. Alfredo Clavell offers us a case study on cardiac device and replacement therapy.


A 45-year-old female was transplanted ninety days ago. Two weeks ago, mycophenolate was discontinued due to diarrhea and anemia. She reports feeling unwell the last 48 hours.

She presents with low-grade fever, fatigue and palpitations. An EKG documents right bundle branch block with intermittent high-grade atrioventricular block. Biopsy confirms severe rejection. At this point you should consider:

A. Plasma exchange
B. Pacemaker
C. Methylprednisolone 1mg/kg IV
D. Coronary angiography
E. Rituxamab

Read the rest of this entry »

View full entry · Comment on this

Tags: cardiac device, Dr Alfredo Clavell, replacement therapy, Test Your Knowledge Tuesday, TYKT

Upcoming Events

Update in Nephrology and Kidney Transplantation
September 19 - 20, 2014

Echo at the Arch: Practical Review of Valvular Heart Disease
September 20 - 21, 2014

Cardiovascular Review for the Cardiology Boards and Recertification - Online
September 22, 2014 - October 9, 2015

Mayo Clinic Interventional Cardiology Board Review
September 26 - 28, 2014

Advances in Cardiovascular Pathophysiology and Emerging Novel Therapeutic Strategies
October 10 - 11, 2014

Echo in Pediatric and Adult Congenital Heart Disease Symposium
October 15 - 19, 2014

Advanced Catheter Ablation: New Tips, Techniques, and Technologies for Complex Arrhythmias
October 18 - 21, 2014

Cases in Echocardiography, Cardiac CT, and MRI
October 22 - 25, 2014

Innovation Summit: Cardiology + Structural Heart Disease
November 5 - 6, 2014

Coronary Artery Disease: Case-Based Learning
November 21 - 23, 2014

Echo on Marco Island: Case-Based Approach
December 4 - 7, 2014

The Heart Beat of Cardiology
December 11 - 13, 2014

Cardiology Update at South Beach: A Focus on Prevention
January 7 - 10, 2015

Hawaii Heart 2015
January 26 - 30, 2015

Arrhythmias & the Heart: A Cardiovascular Update
February 2 - 6, 2015

Cardiovascular Conference at Snowbird
February 13 - 16, 2015

Cardiology at Cancun: Topics in Clinical Cardiology
February 23 - 27, 2015

Echocardiographic Workshop on 2-D and Doppler Echocardiography at Vail
March 9 - 12, 2015

Heart Failure Management for Nurse Practitioners, Physician Assistants, and Primary Care Providers
March 19 - 21, 2015

Innovative Valve and Structural Heart Disease
April 2 - 4, 2015

Case Studies from the Heart of Manhattan: A Mayo Clinic Cardiovascular Update
April 16 - 18, 2015

Imaging in Adult Congenital Heart Disease: Pearls for All Cardiac Providers
April 24 - 26, 2015

Echocardiography in the Nation's Capital
May 8 - 10, 2015