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Sanjiv Shah

2 Dec, 6 tweets, 2 min read

#HFpEF pearl of the day: HFrEF is failure of the LV, HFpEF is failure of the LA. If you want to successfully manage HFpEF in your patients, you need to know at least as much about the LA as you know about the LV.

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Sanjiv Shah

@HFpEF

28 Nov

#HFpEF pearl of the day: HFpEF patients can have cardiac and extracardiac causes of volume overload. Abnormal LV GLS, reduced TDI velocities, and/or ⬆️⬆️ECG QRST angle (R axis – T axis) are clues to a more cardiac predominant phenotype.

Read 7 tweets

Sanjiv Shah

@HFpEF

27 Nov

Here’s another case: 49 yo woman w/obesity (BMI 46), HTN, OSA on CPAP, schizoaffective with new-onset HFpEF (leg swelling, dyspnea, ⬆️JVP, BNP 226 pg/ml, LVEF 65%). Low H2FPEF score = 4 (obesity, HTN meds, E/e’ = 10). What's the diagnosis? More info....

Hospitalized 6 months ago with psychotic break, treated with uptitration of anti-psychotics, now back to baseline mental status. 60-lb weight gain over past 6 mo. Also +lightheaded/dizzy. Here's the echo:

More info: normal thyroid function, normal hemoglobin, no eosinophilia. She was taking lamotragine, risperidone, and citalopram for her schizoaffective disorder. RHC: RA 13, PA 37/24, PCWP 24, CO 9.2 L/min.

Read 5 tweets

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