Haider Warraich
speaker
683 appearances
3 recordings
1 series
first heard Oct 2020
last heard Dec 2021
Haider Warraich’s voice in public audio — every appearance, attributed to the second.
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And I think that it just goes to show how heart failure and cancer are in some ways different.
So if I'm a heart failure cardiologist or any heart failure cardiologist, when you go to a patient's bedside, the first thing you ask them is, well, how are you feeling?
And really, other than, I would say, an ICD, most things that we do in heart failure are focused on helping people both live longer and feel better, which may not be true for other therapeutic areas in which you may get a treatment that may make you feel poorly but may help you live longer.
So there's that one sort of specific difference.
Having said that, if you look at
If you look at most large studies, dyspnea is not the only symptom that many patients with heart failure experience.
Depending on who you ask or what study you look at, patients with heart failure have a wide array of symptoms beyond just, I can't breathe or I feel like an elephant is sitting on my chest.
And I feel like that's where some of our blind spots may in fact lie.
Where even though as a heart failure cardiologist, I might be very focused on the patient's heart failure, I might be very focused on their volume status, but again, that my training may make me very adept at managing those symptoms, but there may be a lot that I may be not even asking my patients, not even addressing and not frankly be trained well to sort of take care of.
But I think what you're indicating and what your question sort of shows is that we still have more to understand about what is the value add of palliative care in a patient with advanced heart failure as opposed to cancer.
And as much as I feel and I truly believe that there's a significant value add, what that specifically means, I think, is an area that we really need to study further.
So I think that that's really an area where we can really make a high impact.
And I think that's where people like myself, people who are passionate about this field but are not necessarily sort of experts in serious illness communication the way palliative care physicians are, I think partnerships there are extremely important.
And there are places that have integrated more palliative care and communication skills into their training.
So again, at Brigham and Women's, for example, all the fellows and I believe all the faculty get dedicated training
by our palliative care specialists in communication.
But if I'm right, I think that's the only program that I know of that specifically mandates that as part of their curriculum.
And I think part of that culture shift is not coming from the top down.
It's coming from the bottom up because now you have a lot of residents who trained in internal medicine and who got just great, fantastic palliative care experiences who are now becoming cardiology fellows, who are now beginning to graduate and become faculty members.
And they're looking at their field and thinking about, geez, this is very different from, this is a field that is really ripe for
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