Dr. Clyde Yancy, CardioNerds on Best Management of Elderly Patients With Heart Failure

CardioNerds correspondents Drs. Akiva Rosenzveig and Jenna Skowronski are joined by expert faculty Dr. Clyde Yancy, Northwestern University, to assess the following scenario pertaining to a hypothetical heart failure case.

Mr. S is an 80 year old man with a history of hypertension, type II diabetes mellitus, and hypothyroidism who had an anterior myocardial infarction (MI) treated with a drug-eluting stent to the left anterior descending artery (LAD) 45 days ago. His course was complicated by a new LVEF reduction to 30%, and left bundle branch block (LBBB) with QRS duration of 152 ms in normal sinus rhythm. He reports he is feeling well and is able to enjoy gardening without symptoms, though he experiences dyspnea while walking to his bedroom on the second floor of his house. Repeat TTE shows persistent LVEF of 30% despite initiation of goal-directed medical therapy (GDMT). What is the best next step in his management?

To answer this question, the group references Section 7.4 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.

This podcast originally appeared on The CardioNerds.