Guidelines or Goals in Heart Failure: Parag Goyal, Nicole Superville, and Matthew Shuster
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
48 min
2 speakers
6 chapters
transcribed 9 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the purpose of this episode and who are the expert guests?
Welcome to the Jared Powell podcast. This is Eric Wadera. This
is Alex Smith.
And Alex, who do we have with us today? Cause I I think we have someone special, a guest host.
We have a guest host who was requested this episode, Matt Schuster, who's a geriatrician and palliative care doc. He's in Boston. He's a medical director of Hebrew Senior Life Outpatient Clinic at Newbridge. And also, I was in the HVMA primary care program. That's what it was called at the Brigham way back in the day. And Matt was one of the preceptors of a good friend of mine and classmate, Don Scherling. And Matt brought today's topic to us. Um, Matt, welcome to the Jerry Powell podcast.
Thank you. I'm thrilled to be here.
We also have Parog Goyle, who is a cardiologist and associate professor of medicine at Cornell. He's the director of the program for care and study of the aging heart and director of the heart failure with preserved ejection fraction program. Parag welcome to the Jerry Paul Podcast.
Thank you. Thank you.
And I know Prague from the Beaston meetings where we sing campfire songs at night. Um, it's a lot of fun. And Nicole Superville is a cardiologist and assistant professor at Wake Forest and Associate Director of Heart Failure for the Atrium Health Southern Region. Nicole, welcome to the Jerry Powell podcast.
Glad to be here.
So we got a lot to cover. We're gonna be talking about heart failure in older adults and specifically guidelines or goals when we're thinking about heart failure. But before we go into that topic, Matt, I think you have a song request.
I do and the song is entitled Medication. Pretty obvious reason to pick that. Uh
What was the reason to pick that? Or will we find it in the lyrics?
Well, I actually we will find the lyrics. The band is called The Collection. Um, it's actually a song that uh the lead singer of that group wrote about depression. But if you look closely into lyrics, there's a lot of references to things that have to deal with heart failure. And the effects of treatments for heart failure, orthostasis, falls, dyspia. So uh pay attention to the lyrics. Oh yeah, Alex, give us a little
snippet. Here's a little snippet, and I'm for those watching on YouTube, you're gonna see me with the guitar playing this. For those of you who are listening audio only, Matt sent me the garage band version with like four different p backing tracks. It's awesome. So I'll be singing along to that Feeding the
Beast, Matthew, feeding the beast.
All right, here's a little bit.
I was scared of what it meant. If I needed medicine. Just to feel like me again and keep my demons in. Every now and then Cause I remember when I thrived. Now I'm just trying to survive. It's like I tripped and took a dive into another life. That doesn't feel like mine, but now I'm tired of sitting, aimless and drifting, trying to turn off the lights, and only taking off my clothes far from the windows, keeping away from your sight. So now I drop in the weight of the earth. Just long enough to give me a rebirth, cause I deserve to be well. Yeah, I deserve to be well, I'm climbining up out of this hell.
Think I see it, Matthew. I get the lyrics, yeah.
Yeah. That was actually very fitting in terms of just how patients may feel. I feel like I should steal this and put this as an overhead for a heart failure clinic in
terms of me. Play it in the background. Okay, Matt, I'm gonna start off with you. What motivated you to suggest this podcast?
Well, you know, I I actually have been teaching, doing sessions uh about polypharmacy for many years. And in fact, uh as Alex mentioned in the intro, uh Probably more than twenty years ago, Muriel Gillick asked me to help out with the geriatric modules at the Brigham Women's Hospital primary care medicine uh sort of sessions. And I know one of the topics I did was polypharmacy then. And Alex, you may have actually been in one of those. Probably was, yeah. And so it's been something I've thought about for a long time in pr in practice. And in recent years, you know, the the pace of new drug discovery and release by the FDA, it seems to have quickened.
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Chapters
6 chapters
1
What is the purpose of this episode and who are the expert guests?
0:00–8:44
2
How does polypharmacy affect older adults with heart failure and why is it a concern?
8:44–19:25
3
What is HFpEF (heart failure with preserved ejection fraction) and how has its definition evolved?
19:25–25:02
4
What are the current guideline‑directed medical therapies (GDMT) for HFrEF and HFpEF?
25:02–33:42
5
How can clinicians balance GDMT with the risk of over‑medication in frail older patients?
33:42–41:54
6
What strategies help decide when to add, substitute, or deprescribe heart‑failure drugs for an individual patient?
41:54–48:27
Speakers
2 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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