Background: Coronary artery calcification (CAC) is a strong predictor of cardiovascular events. We aimed to evaluate the prognostic significance of CAC detected by chest CT scan (CT) in heart failure (HF) with preserved ejection fraction (HFpEF) patients (pts) in the absence of coronary artery disease history (CAD Hx). Methods: In this retrospective cohort, we queried [...]

Background: Subclinical hypothyroidism (SCH) is underdiagnosed in patients with heart disease, however, there has been controversy surrounding whether it is a cardiovascular risk factor or not. To determine the prognostic significance of SCH in Heart Failure (HF) with Preserved Ejection Fraction (HFpEF) we followed a cohort of patients for 9 years. Methods: In this retrospective [...]

Background: Heart failure is a common condition characterized by recurrent exacerbations. Medication and dietary nonadherence are associated with readmissions. Telling smokers their lung age significantly improves the likelihood of successful smoking cessation.  We hypothesized that using hand-carried ultrasound (HCU) to share with patients their own images of inferior vena cava (IVC) measurements would serve as [...]

Background: Diuretic therapy is the mainstay of treatment for heart failure exacerbations but its optimal dosing strategy remains unclear. In 2011, the DOSE trial exhibited a trend toward improvement in patients’ global symptom assessments when utilizing a high-dose diuretic strategy, which used nearly 80mg intravenous furosemide three times daily in the first 72 hours on [...]

Background: Despite recent advancements in the medical management of acute and chronic Heart Failure (HF), smooth transitions of care for patients hospitalized with HF remain elusive for most health care systems. Use of home health services and other ancillary services have been promoted in recent years as a means of reducing readmission rates among HF [...]

Background: Appropriate documentation of Congestive Heart Failure (CHF) specificity is still a major documentation problem in most hospitals in the United States despite the frequent presence of Clinical Documentation Improvement Specialists (CDIs) to assist with chart reviews and appropriate documentation/coding.  We are a large hospitalist division providing care at 2 large tertiary care facilities in [...]

Case Presentation: A 39 year old male with a history of congenital bicuspid aortic valve and ascending aortic aneurysm repair (1 year prior) presented with recurrent bilateral lower extremity edema (LEE). He first presented with LEE 3 months post-surgery.  Transthoracic echocardiogram (TTE) initially showed mild apical and inferior hypokinesis with a mildly dilated left atrium [...]

Case Presentation: A 54-year-old woman presented to the emergency department with a 1-week history of exertional dyspnea and chest heaviness. Review of systems was remarkable for bilateral leg swelling and a 7-lbs weight gain over one week without orthopnea or PND. Physical examination revealed an irregularly irregular heart rhythm with pulse deficit, elevated JVP at [...]