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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Appearances
A lot of times, these conversations start in the hospital.
And as much as we would like to live in an ideal world where we didn't have these conversations in the hospital, that is really where I think most patients are really thinking about these.
And most physicians are activated.
And we have the resources to actually deploy
So recurrent hospitalizations is one.
Inability to tolerate guideline-directed medical therapies.
So a lot of our patients run medications for heart failure like beta blockers or ACE inhibitors.
And these patients have had high blood pressures for a long time.
And then sometimes we see that, oh, the blood pressure is getting lower and these patients start to come off their medications.
And sometimes people feel like, oh, that's a good thing.
But a lot of times that's actually a really bad sign.
When a patient with heart failure starts to have low blood pressures and cannot tolerate the medications they used to be able to tolerate, super bad sign, and it's a red flag in my book.
The kidneys are really, really very closely tied to the heart.
So worsening renal function or really any type of worsening end organ function, such as you start developing cirrhosis, you have worsening pulmonary hypertension, worsening renal failure.
The other thing I notice is cardiac cachexia.
So basically, a lot of patients, a lot of these patients, it can come in volume overloaded.
So they'll have big legs, big bellies, and yet they are malnourished.
So they may not look like the classic malnourished patient we think about, but that happens very frequently.
And one of the reasons it happens is because a lot of these patients with heart failure,
their stomach, they're engorged with fluid.
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