Expand your idea of ischemic heart disease to include non-obstructive patterns, which as our guest, Dr Noel Bairey Merz, a clinical investigative cardiologist whose multiple roles include Director of the Barbra Streisand Women’s Heart Center and the Preventive Cardiac Center at the Smidt Cedars-Sinai Heart Institute, shares with us, is incredibly common, especially in women. Learn to recognize these women and treat according to guidelines, preventing unnecessary IHD mortality in our female (and some male) patients. We review a variety of non-obstructive pathologies and the best techniques to evaluate them.
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- Written and produced by: Shreya Trivedi MD, Molly Heublein MD
- Hosts: Paul Williams MD, FACP; Shreya Trivedi MD; Molly Heublein MD
- Edited by: Matthew Watto MD, FACP; Emi Okamoto MD
- Graphics by: Hannah Abrams
- Guest: Dr. C Noel Bairey Merz MD, FACC, FAHA
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- 00:00 Intro, disclaimer and guest bio
- 04:36 Guest one-liner; Advice for success in research and clinical practice
- 07:07 A case of shortness of breath and chest tightness; Why the paradigm of obstructive coronary artery disease is flawed.
- 12:04 Why is there a sex difference in ischemic heart disease?
- 14:52 How to recognize ischemic heart disease in women; Are certain symptoms more likely in women; Categorizing angina
- 20:13 Who needs stress testing?; Screening for ischemic heart disease in women
- 24:52 How guidelines make good doctors great doctors
- 27:00 Diagnosis of NSTEMI in a woman without obstructive coronary disease
- 29:33 Medical therapy for non-obstructive ischemic heart disease
- 33:18 Additional testing: Cardiac MRI for myocarditis; perfusion reserve testing; CT coronary angiograms
- 35:48 How current non-invasive techniques fail to identify microvascular ischemic heart disease in women
- 39:10 Antianginal therapy
- 41:40 HFpEF in women
- 47:10 Weight loss for paroxysmal atrial fibrillation
- 48:45 New nomenclature for ischemic heart disease
- 50:18 Take home points
- 52:40 Outro