Cardiology Course FM — Cardiology course podcast
Cardiology Course FM is a cardiology course podcast of 45-minute masterclasses for doctors, medical students, residents, fellows, nurses and critical care teams, presented by Senior Interventional Cardiologist Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D., founder of the Academy of Elite Doctors.
Listen on Spotify Apple Podcasts RSS feedUse this cardiology course podcast alongside our online modules: each 45-minute lesson follows a teaching sequence of concepts, guidelines, landmark trials and unfolding clinical cases, ideal for residents, fellows and exam candidates. Topics include ECG and echocardiography, arrhythmias and antiarrhythmic drugs, pacemakers, CRT and leadless pacing, coronary artery disease, cardiogenic shock, heart failure and cardiomyopathies, valvular, rheumatic and congenital heart disease, endocarditis and myocarditis, hypertension, heart disease in pregnancy, cardiac emergencies, cath lab complications, medical ethics and examination preparation.
All 58 episodes
How to Read an ECG — A Systematic Approach for Students, Doctors, Fellows, Nurses and Critical Care Teams
Today we are doing something that every one of you does, probably several times a day, and yet very few of us were ever properly taught: how to read an electrocardiogram. Not just glance at it. Read it.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
How to Face Cardiology Entrance Examinations — Strategy and the Books to Prepare
Today's episode is for every young doctor who dreams of becoming a cardiologist, and who is now standing in front of the biggest hurdle on that road: the cardiology entrance examination. How do you prepare? Which books should you read, and which ones can you leave on the shelf? And how do you stay sane while doing it?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Interpreting Echocardiography Values and Making Clinical Decisions
We've already talked about how to read an ECG. Today we turn to the other test every cardiologist reaches for, many times a day: the echocardiogram. But not how to hold the probe. Today is about the numbers — what the values on an echo report actually mean, which ones matter, and how they translate into a decision at the bedside.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Auscultation Is an Art — Becoming an Expert in Bedside Evaluation
In a world of echocardiograms, CT scans and artificial intelligence, is there still a place for the humble stethoscope? Today's guest believes passionately that there is — and that auscultation is not just a skill, but an art.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Medical Ethics in Cardiology — How an Expert Cardiologist Should Be, and a Role Model for Society
In our previous episodes we talked about skills — reading an ECG, interpreting an echo, the art of auscultation. Today we talk about something that sits underneath all of those skills: character. What does it mean to be an ethical cardiologist? How should an expert behave with patients, with colleagues, with industry, and with society? And why should a cardiologist be a role model, not just a technician?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
ECG Pitfalls — Mistakes in Interpretation and How to Record an ECG in the OPD
In our very first episode, we learned a systematic way to read an ECG. Today we go one step further, into the traps. Why do even experienced doctors misread ECGs? Which mistakes happen most often — in recording, in interpretation, and in the way we think? And how should an ECG be taken properly in a busy outpatient clinic?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Echo Pitfalls — Mistakes in Performing, Interpreting and Reporting Echocardiography, and How to Avoid Them
In an earlier episode, we learned how to turn echocardiography values into clinical decisions. Today we look at the other side of the coin — what goes wrong. Where do mistakes happen when an echo is performed, when it's interpreted, and when it's reported? And how do we prevent them?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Facing Cardiac Emergencies — Ensuring Safety, Quality of Care and Saving Patients' Lives
Today's episode is about the moments every clinician remembers for the rest of their life: cardiac emergencies. The cardiac arrest in the ward at three in the morning. The young man with a heart attack in a small hospital far from a catheterisation laboratory. The patient whose blood pressure suddenly falls after a procedure. How should we face these moments — calmly, safely, and in a way that gives the patient the best chance of life?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Cath Lab Complications — How to Prevent and Manage Them
Today we step inside the catheterisation laboratory — the place where modern cardiology saves lives every hour of every day, and also the place where things can go wrong in seconds. How do expert operators prevent complications? And when a complication does happen — a perforation, a dissection, a sudden drop in blood pressure — what do they do in the first minute?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Preventing Mortality in High-Risk Angioplasty
In our last episode we talked about complications in the cath lab. Today we go deeper into the most demanding situations of all — high-risk angioplasty. The elderly patient with a weak heart and left main disease. The diabetic patient with three-vessel disease who has been turned down for surgery. The patient whose last remaining artery is now narrowing. How do expert operators make these procedures safe, and above all, how do they prevent death?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Cardiac Arrhythmias — Benign and Malignant, How to Diagnose, Acute Treatment and Chronic Care
Today we're talking about cardiac arrhythmias — one of the commonest reasons patients come to the doctor, and one of the commonest reasons for anxiety among doctors themselves. Palpitations, skipped beats, a racing heart, a slow pulse, fainting. Some of these are completely harmless. Others can cause sudden death. How do we tell the difference? How do we diagnose them, and how do we treat them — both in the emergency room and over a lifetime?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Uncontrolled Diabetes in the OPD — Stable Patients, All Medications and Their Side Effects
Today we're talking about a condition that walks into every outpatient clinic, every single day, and that is one of the biggest drivers of heart disease in the world: diabetes. In particular, the patient whose sugar just won't come under control. They're stable, they're not in an emergency, but their HbA1c is nine, ten, eleven percent, visit after visit. How should the doctor approach them? Which medicines should be used, how do they work, and what side effects should we watch for?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Non-Obstructive Coronary Artery Disease with Recurrent Symptoms — ANOCA, INOCA and MINOCA
Today's topic is one of the most frustrating situations in cardiology — for patients and doctors alike. A patient has recurrent chest pain. The stress test is abnormal, or the symptoms are typical of angina. They have a coronary angiogram, and the report says: "No significant blockages" or "non-obstructive coronary artery disease". The patient is told everything is fine — and yet the pain keeps coming back. What's going on, and how should we manage it?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Obstructive Coronary Artery Disease with Occasional Symptoms
In our last episode, we talked about patients with chest pain and no significant blockages. Today we turn to the opposite situation, and one of the commonest in every cardiology clinic: the patient with proven, obstructive coronary artery disease — a known blockage, or a previous stent or bypass — who has only occasional symptoms. Maybe a little chest tightness when climbing stairs quickly, or during a brisk walk in the cold. Does every blockage need a stent? Which medicines really protect the patient? And how should we follow them over the years?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Cardiogenic Shock in the ER and ICCU — Latest Evidence and Guidelines
Today we're tackling the most lethal condition in acute cardiology: cardiogenic shock. A patient arrives in the emergency room grey, cold and confused, with a blood pressure of seventy and a failing heart. Despite all the advances of modern medicine, around four or five in every ten such patients still die in hospital. What can we do in the emergency room and the intensive coronary care unit to change that? What do the latest trials and guidelines tell us?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Sepsis and Septic Shock in the ER and ICCU — Latest Guidelines
In our last episode we discussed cardiogenic shock. Today we turn to the commonest type of shock in emergency rooms and intensive care units across the world: sepsis and septic shock. Sepsis affects tens of millions of people every year and causes around one in five deaths worldwide. And it's a cardiology problem too — infections trigger heart attacks, arrhythmias and heart failure, and patients in our coronary care units are vulnerable to infection. How should we recognise sepsis, resuscitate the patient, and manage them in the ICCU, according to the latest evidence and guidelines?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing STEMI with Cardiogenic Shock — in the ER, the Cath Lab and the ICCU, with the Latest Guidelines
In a recent episode we discussed cardiogenic shock in general. Today we focus on the single most dramatic and time-critical scenario in interventional cardiology: an ST-elevation myocardial infarction complicated by cardiogenic shock. A patient with a blocked coronary artery, a failing heart, a falling blood pressure — and minutes that decide life or death. We'll follow this patient from the emergency room, into the catheterisation laboratory, and on to the intensive coronary care unit, with the latest evidence and guidelines at every step.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Managing Pulmonary Embolism With and Without Shock — ER, ICCU, Latest Guidelines and Interventional Procedures
Today's topic is one of the great masqueraders of medicine — a condition that can look like a heart attack, pneumonia, a panic attack, or simply unexplained breathlessness, and that can kill within hours if missed: acute pulmonary embolism. We'll discuss how to diagnose it, how to stratify the risk, how to manage patients with and without shock, and the growing role of catheter-based interventional procedures — in the emergency room, the ICCU and the catheterisation laboratory.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Mastering Bedside Evaluation in Cardiology
In an earlier episode, we explored the art of auscultation. Today we widen the lens to the complete bedside evaluation in cardiology — from the first words of the history, to the hands, the face, the pulse, the jugular veins, the precordium, the lungs, the abdomen and the legs — and how to put it all together into a confident diagnosis before a single test is ordered. It's a skill that every student, resident, physician, nurse and cardiologist can master.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Antibiotic Resistance: Prevention, Stewardship and Solutions to a Global Menace
Today we step a little beyond cardiology, into a threat that touches every ward, every intensive care unit and every catheterisation laboratory in the world: antibiotic resistance. How did we get here, why is it called a silent pandemic, and most importantly, what can each one of us do to prevent it and stop it?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Medical Negligence: How to Avoid It, Handle It and Face It
Today's topic is one that worries almost every clinician, though few talk about it openly: medical negligence. What exactly is negligence, and how is it different from a complication? How can doctors, nurses and hospitals avoid it, and how should we respond when something goes wrong, when a family is angry, or when a legal notice arrives?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Why Doctors Below 50 Are Dying of Massive Heart Attacks: Causes, Prevention and Self-Protection
Today's episode is personal for everyone in our profession. Again and again, we hear heartbreaking news of young doctors — in their thirties and forties — collapsing with a massive heart attack, sometimes in the hospital, sometimes in the gym, sometimes at home after a night shift. Why is this happening to the very people who treat heart disease? What are the causes, and how can doctors protect themselves?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
The Missed Diagnosis: Why We Miss Important Diagnoses and How to Fix the Blunder
Today we're talking about something every clinician has experienced, but few like to admit: the missed diagnosis. The heart attack labelled as gastritis, the aortic dissection sent home as back pain, the pulmonary embolism treated as anxiety, and the rare disease that went unrecognised for years. Why do good doctors miss important diagnoses, sometimes rarely and sometimes more often than we think, and how can we fix the diagnostic blunder?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
The Secrets Never Told During Internship: Expert Diagnosis in Cardiology
Today's episode has a slightly mysterious title: the secrets nobody told us during internship. Every expert cardiologist carries a set of clinical pearls, habits and small tricks learned over decades at the bedside — things that aren't in the textbooks, rarely taught on ward rounds, and yet make the difference between an ordinary diagnosis and an expert one. Today, we're going to open that box.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
The Heart in Pregnancy: Physiological and Pathological Changes, Diagnosis, Complications and Treatment
Today we're exploring one of the most fascinating and challenging areas of medicine: the heart in pregnancy. Pregnancy places an enormous load on the cardiovascular system. In most women, the heart adapts beautifully. But in women with heart disease, or in those who develop new problems during pregnancy, the consequences can be life-threatening for both mother and baby. Today we'll cover the normal physiological changes, the pathological conditions, how to diagnose them, the complications, and how to treat them safely.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Gestational Diabetes: Diagnosis, Complications, Treatment and Food During Pregnancy
In our last episode, we explored the heart in pregnancy. Today we focus on a condition that affects millions of pregnancies every year, and has lifelong consequences for both mother and child: gestational diabetes. We'll talk about why it happens, how to diagnose it, its complications, how to treat it, and — very importantly — what a pregnant woman should eat.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Gestational Hypertension and Preeclampsia: Diagnosis, Complications, Treatment and Food During Pregnancy
Over the last two episodes, we explored the heart in pregnancy and gestational diabetes. Today we complete the trilogy with one of the most important and dangerous conditions in obstetric medicine: gestational hypertension, and its close relative, preeclampsia. We'll discuss how to diagnose it, its complications, how to treat it, when to deliver, and what a pregnant woman with high blood pressure should eat.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Valvular Heart Disease in Pregnancy: Diagnosis, Complications, Treatment and Food During Pregnancy
In our pregnancy series, we've covered the heart in pregnancy, gestational diabetes and gestational hypertension. Today we go deeper into one of the most challenging situations in cardiac obstetrics: valvular heart disease in pregnancy. We'll talk about how to diagnose it, which valve lesions are dangerous, the complications, how to treat them — including anticoagulation for mechanical valves and procedures during pregnancy — and what a pregnant woman with valve disease should eat.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Congenital Heart Disease in Pregnancy: Diagnosis, Complications, Treatment, Food and Precautions
Our pregnancy series continues today with a topic that reflects one of the great successes of modern medicine: congenital heart disease in pregnancy. Children born with heart defects, who once rarely survived, are now growing up, and many of them are women hoping to become mothers. Today we'll discuss how to assess and diagnose congenital heart disease in pregnancy, which conditions are dangerous, the complications, treatment, and the food and precautions every woman should know.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Peripartum and Postpartum Cardiomyopathy: Diagnosis, Complications, Treatment, Food and Precautions
Our pregnancy series continues with a condition that strikes young, previously healthy women at what should be the happiest time of their lives: peripartum cardiomyopathy, which many people also call postpartum cardiomyopathy. Today we'll explain what it is, why it happens, how to recognise it early, its complications, the latest treatments, and the food and precautions that help these women recover.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Coagulation Disorders in Pregnancy: Diagnosis, Complications, Treatment, Food and Precautions
Our pregnancy series continues with a topic that sits at the crossroads of obstetrics, haematology and cardiology: coagulation disorders in pregnancy. Pregnancy changes the blood's clotting system profoundly, protecting the mother from bleeding at delivery, but also putting her at risk of dangerous clots. And some women have bleeding disorders that make delivery hazardous. Today we'll discuss diagnosis, complications, treatment, and the food and precautions that keep mothers safe.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Coronary Artery Disease in Pregnancy: Complications, Treatment and Precautions
Our pregnancy series continues with a topic that many people find surprising: heart attacks and coronary artery disease in pregnancy. We usually think of heart attacks as a disease of older men, but they do happen in pregnant women and new mothers, often with different causes and very different treatment decisions. Today we'll discuss how coronary disease presents in pregnancy, its causes, complications, treatment in the emergency room and the cath lab, and the precautions and diet that protect these women.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Safe Antiplatelets and Anticoagulants in Pregnancy: Oral to Parenteral Selection
In our pregnancy series, almost every episode has come back to one difficult question: which blood thinners are safe in pregnancy? Today we answer it in depth. We'll go through antiplatelet drugs and anticoagulants, oral and parenteral, how to select the right one for each condition, how to switch between them, how to manage them around delivery and breastfeeding, and how to reverse them in an emergency.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Safe Cardiac Drug Selection During Pregnancy and Breastfeeding
In our last episode, we discussed antiplatelets and anticoagulants in pregnancy. Today we complete the pharmacology picture with a practical guide to selecting safe cardiac drugs during pregnancy — blood pressure medicines, beta-blockers, heart failure drugs, antiarrhythmics, lipid-lowering drugs, pulmonary hypertension therapies and emergency drugs — and how to manage them during breastfeeding.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Samantha
Jugular Venous Pressure: Abnormalities, Related Conditions, Diagnosis and Treatment
Today we're looking at one of the most valuable — and most feared — signs in clinical medicine: the jugular venous pressure. Many students find it difficult to see, many doctors skip it, and yet it can tell us more about a patient's circulation in thirty seconds than many expensive tests. We'll cover how to examine it properly, what the waves mean, the abnormalities and the conditions behind them, how to confirm them with modern tools, and how to treat the underlying problems.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
The Right Ventricle: The Most Ignored Chamber in Cardiology
For decades, cardiology has focused on the left ventricle — its ejection fraction, its arteries, its failure. But there's another ventricle, often called the forgotten chamber, which quietly determines whether patients with heart failure, pulmonary embolism, pulmonary hypertension, valve disease and critical illness live or die: the right ventricle. Today we'll explore why it's so often ignored, how it works, how to assess it, the conditions that damage it, and how to treat right ventricular failure.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Pulmonary Blood Flow and Alveolar Ventilation: Matching, Mismatch, Diagnosis and Treatment
In our last two episodes, we explored haemodynamics and the right ventricle. Today we follow the blood a little further — into the lungs, where the heart and the lungs meet. We'll discuss pulmonary blood flow and alveolar ventilation, how they're matched, what happens when they're mismatched, and how this explains hypoxaemia in heart failure, pulmonary embolism, shunts, pulmonary oedema and critical illness. We'll also cover diagnosis and treatment.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Rheumatic Heart Disease: Diagnosis, Treatment and Prevention
Today we turn to a disease that has largely disappeared from wealthy countries, yet still affects tens of millions of people, mostly children and young adults, in India, Africa, the Pacific and among indigenous communities: rheumatic heart disease. It's entirely preventable, yet it remains one of the leading causes of cardiovascular death in young people worldwide. We'll cover how it develops, how to diagnose acute rheumatic fever and rheumatic heart disease, the latest treatments, and how we can prevent it.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Inflammatory Heart Diseases: Diagnosis, Treatment and Prevention
In our last episode, we discussed rheumatic heart disease, an inflammatory disease of the heart valves. Today we widen the lens to the whole family of inflammatory heart diseases — myocarditis, pericarditis, infective endocarditis, cardiac sarcoidosis, the heart in autoimmune diseases and vasculitis, and the role of inflammation in coronary artery disease itself. We'll talk about diagnosis, treatment and prevention.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiomyopathies: Diagnosis, Treatment and Management
Today's topic covers some of the most fascinating and fast-moving areas in cardiology: the cardiomyopathies — diseases of the heart muscle itself. From the young athlete who collapses on the field, to the elderly man with heart failure and carpal tunnel syndrome, to the woman whose heart balloons after a sudden shock, cardiomyopathies are diverse, often genetic, and increasingly treatable with targeted therapies. We'll cover classification, diagnosis, treatment and long-term management.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Benign and Malignant Arrhythmias: Diagnosis, Treatment and Management
Today we're tackling a topic that every doctor meets, from the casualty department to the outpatient clinic: arrhythmias. Some rhythm disturbances are harmless and simply need reassurance. Others can kill within minutes. The real skill lies in telling them apart — quickly, calmly and correctly. We'll cover benign and malignant arrhythmias, how to diagnose them, and how to treat and manage them in the long term.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Restrictive Cardiomyopathy: Diagnosis, Treatment and Management
Today we're focusing on the least understood member of the cardiomyopathy family: restrictive cardiomyopathy. It's the heart that pumps reasonably well but cannot fill. Patients arrive with swollen legs, a swollen abdomen and breathlessness, and are often treated for liver disease or kidney disease for months before anyone thinks of the heart. We'll cover the causes — from amyloidosis to endomyocardial fibrosis — how to diagnose them, how to separate restriction from constrictive pericarditis, and how modern therapies are changing outcomes.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Constrictive Pericarditis ("Constrictive Cardiomyopathy"): Diagnosis, Treatment and Management
In our last episode we explored restrictive cardiomyopathy — the stiff heart that cannot fill. Today we turn to its great mimic: constriction. Patients with constrictive physiology often arrive with a swollen abdomen, swollen legs and a heart that looks almost normal on the echo — and many are labelled as liver disease or cardiomyopathy for years. Yet this is one of the few causes of heart failure that can be cured. We'll cover the causes, the diagnosis, how to separate it from restrictive cardiomyopathy, and the treatment — from anti-inflammatory drugs to surgery.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Bacterial Infective Endocarditis: Diagnosis, Treatment and Management
Today's topic is one of the most dangerous infections in medicine — bacterial infective endocarditis. It can hide behind a simple fever, present as a stroke, a kidney problem or back pain, and destroy a heart valve within days. Despite modern antibiotics and surgery, around one in five patients still die in hospital. We'll cover who gets it, how to diagnose it, how to choose antibiotics, when to send for surgery, and how to prevent it.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Viral and Other Pathogen-Related Myocarditis: Diagnosis, Treatment and Management
Today we're exploring infectious myocarditis — inflammation of the heart muscle caused by viruses, bacteria, parasites and other pathogens. It can strike a healthy young athlete after a simple cold, follow a bout of dengue or scrub typhus, or present as chest pain that looks exactly like a heart attack. Most patients recover completely, but some develop fulminant shock within hours, and others slowly progress to dilated cardiomyopathy. We'll cover the pathogens, how to make the diagnosis, and how to treat and follow these patients.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Culture-Negative Infective Endocarditis: Diagnosis, Treatment and Management
In a recent episode we covered bacterial infective endocarditis. Today we tackle one of its most frustrating forms: culture-negative endocarditis. The patient has fever, a murmur and a vegetation on the echo — yet every blood culture comes back sterile. Without an organism, how do we choose antibiotics, how long do we treat, and how do we know we've got the right diagnosis at all? We'll cover the causes, a systematic diagnostic approach, targeted and empirical treatment, and the role of surgery.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Collagen Vascular Diseases and the Heart: Diagnosis, Treatment and Management
Today we're exploring an area where cardiology meets rheumatology: the collagen vascular diseases, also called connective tissue diseases — lupus, rheumatoid arthritis, systemic sclerosis, inflammatory myositis, Sjögren's syndrome, the spondyloarthropathies and the vasculitides. These conditions can affect every layer of the heart — the pericardium, the myocardium, the valves, the coronary arteries, the conduction system and the pulmonary circulation — and heart disease is now one of the leading causes of death in these patients. We'll cover how they affect the heart, how to diagnose cardiac involvement, and how to treat and manage it.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
The Coronary Artery Disease Epidemic: Diagnosis, Treatment and Management
Today we're tackling what many experts call the greatest epidemic of our time — the epidemic of coronary artery disease. It is the leading cause of death worldwide, and nowhere is the challenge greater than in South Asia, where heart attacks strike a decade earlier than in the West, often in people in their thirties and forties. We'll also look at how infectious epidemics, such as influenza and COVID-19, interact with coronary disease. And we'll cover diagnosis, treatment and, above all, prevention.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Global Warming, El Nino, Earthquakes, Landslides and the Cardiovascular System: Diagnosis, Treatment and Management
Today we're exploring a topic that is rapidly moving from the margins to the centre of cardiology: how our changing planet affects the heart. Global warming, record-breaking heat waves, El Nino cycles, wildfires and air pollution, and natural disasters such as earthquakes, floods and landslides — all of these place enormous stress on the cardiovascular system. Heart attacks, strokes, heart failure and sudden deaths rise during and after these events. We'll discuss the mechanisms, how to recognise and diagnose cardiovascular problems in these situations, and how to treat, manage and prepare.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Screen Time, Prolonged Sitting and the Heart: Cardiovascular Effects in AI and Software Professionals
Today's topic touches millions of people, and perhaps many of our listeners personally: the health effects of excessive screen time and prolonged sitting. Software engineers, AI developers, data scientists and gamers often sit in front of screens for twelve, sixteen, even twenty hours a day, working through the night to meet deadlines or match time zones on the other side of the world. We'll discuss how this lifestyle affects the heart, the blood vessels and every other system in the body, how to detect problems early, and how to treat and prevent them.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiac Antiarrhythmic Drugs: Classification, Mechanisms, Effects and Side Effects
Today's topic is one that every doctor prescribes, every examiner asks about, and many of us find confusing: the antiarrhythmic drugs. How are they classified? How do they work at the level of the ion channels? When do we use them — and, just as importantly, when can they harm or even kill? From amiodarone and flecainide to beta-blockers, digoxin and adenosine, we'll cover classification, mechanisms, clinical effects and side effects.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiac Atrial Arrhythmias: Diagnosis, Treatment and Management
Today we're focusing on the atrial arrhythmias — the rhythm disturbances that arise in the upper chambers of the heart. They range from harmless atrial ectopic beats to atrial tachycardia, atrial flutter and, most importantly, atrial fibrillation, the commonest sustained arrhythmia in the world and a major cause of stroke and heart failure. We'll cover how to recognise them on the ECG, how to investigate them, and how to treat and manage them using the latest guidelines and trials.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiac Ventricular Arrhythmias: Diagnosis, Treatment and Management
In our last episode we explored the atrial arrhythmias. Today we move down to the ventricles, where arrhythmias can be the difference between life and death. Ventricular arrhythmias range from harmless extra beats to ventricular tachycardia, ventricular fibrillation and sudden cardiac death, which claims millions of lives worldwide every year. We'll cover the mechanisms, how to interpret the ECG, how to investigate the underlying heart, and how to treat — from the emergency department to the cath lab and the electrophysiology suite.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiac Conduction Defects and Pacemaker Mode Selection: Diagnosis, Treatment and Management
Today we're exploring the heart's wiring — the conduction system — and what happens when it fails. Sinus node disease, heart block and bundle branch block can cause dizziness, fainting, heart failure and even sudden death. And the pacemaker, one of the greatest inventions in medicine, can restore a normal life. But which patients need a pacemaker, and which mode should we choose — single chamber, dual chamber, biventricular, conduction system pacing, or the new leadless devices? We'll cover diagnosis, temporary and permanent pacing, mode selection and long-term management.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Cardiac Resynchronisation Therapy (CRT): Treatment and Management
In our last episode we discussed conduction defects and pacemaker modes. Today we focus on one of the most important device therapies for heart failure: cardiac resynchronisation therapy, or CRT. For the right patient, it can transform breathlessness into an active life, shrink a dilated heart and reduce the risk of death. But around a third of patients don't respond as hoped. So who should receive CRT, how is it implanted, how do we make sure it works, and what are the new alternatives, such as conduction system pacing?
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Leadless Pacemaker Implantation: Treatment and Management
In our recent episodes we've explored conduction disease, pacemaker modes and cardiac resynchronisation. Today we focus on one of the most remarkable innovations in device therapy: the leadless pacemaker. Imagine a complete pacemaker — battery, electronics and electrode — about the size of a large vitamin capsule, delivered through a vein in the leg and fixed directly inside the heart, with no wires and no surgical pocket. We'll cover how these devices work, who should receive them, how they are implanted, their complications, and how patients should be managed in the long term.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Hypertension: Diagnosis, Current Guidelines, Treatment and Management
Today's topic is the single most important modifiable risk factor for death worldwide: hypertension, or high blood pressure. It affects over a billion people, causes strokes, heart attacks, heart failure, kidney disease and dementia — and yet most people with it are either undiagnosed, untreated or poorly controlled. In the last two years, new European and American guidelines have changed how we define, measure and treat blood pressure, and exciting new treatments are arriving. We'll cover diagnosis, the current guidelines, treatment and long-term management.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
Resistant and Malignant Hypertension: Diagnosis, Current Guidelines, Treatment and Management
In our last episode we covered hypertension and the current guidelines. Today we go deeper into the two most challenging forms: resistant hypertension, where blood pressure stays high despite multiple medicines, and malignant hypertension, a true medical emergency in which severely raised blood pressure damages the eyes, kidneys, brain and heart, sometimes within days. We'll cover definitions, how to uncover hidden causes, the step-by-step treatment of resistant hypertension including renal denervation and new drugs, and the emergency management of malignant hypertension.
Guest: Dr. A M Thirugnanam, MD, MSICP, FSCAI, Ph.D. · Host: Alexander Wood
For medical education only; not a substitute for individual medical advice. New episodes appear here automatically when they are published.