logo
episode-header-image
May 2025
1h 3m

REBOOT #458 Heart Failure with Reduced E...

The Curbsiders Internal Medicine Podcast
About this episode
We’re taking a break this week, but we’ll be back next week with a brand-new episode. 

Provide superb outpatient care for your patients with HFrEF. Identify underlying causes of heart failure and titrate medications with ease. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) breaks down the nuances of treating this common cardiac condition. 

Claim CME for this episode at curbsiders.vcuhealth.org!

Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME

Show Segments

  • 00:00 Introduction 
  • 03:22 Case Presentation: Newly Diagnosed Heart Failure
  • 07:26 Using Physical Exam Findings to Guide Diuresis
  • 11:58 The Four Pillars of Guideline-Directed Medical Therapy for Heart Failure
  • 15:07 Optimizing Therapy and Follow-Up in Heart Failure Patients
  • 22:10 The Benefits of High-Intensity Initiation and Titration of Guideline-Directed Medical Therapy
  • 28:02 Consideration of Other Medications
  • 40:02 Referral to Advanced Heart Failure Specialist
  • 49:11 Optimizing Therapy and Follow-Up
  • 55:33 Conclusion and Book Recommendation

Credits

  • Writer and Producer: Deborah Gorth MD, PhD
  • Infographic and Cover Art: Zoya Surani
  • Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP   
  • Reviewer: Emi Okamoto MD
  • Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Technical Production: PodPaste
  • Guest: Michelle Kittleson MD, PhD

Sponsor:
Mint Mobile 

Get your summer savings and shop premium wireless plans at MINTMOBILE. com/CURB.

Sponsor: American College of Physicians

Order ACP MKSAP today at acponline.org. Curbsiders Listeners who use promo code  CORECS will receive a MKSAP gift pack with their subscription.

Sponsor: Panacea Legal

Learn more and schedule your free consultation at Panacea.Legal.
Up next
Yesterday
500th Ep Bonus AMA: Diabetes Meds, AI in Medicine, Thyroid Antibodies, Sleep Meds, Top 5 Lists, Favorite Failures, and More!
In this bonus episode, Matt and Paul answer Patreon listener questions on various topics, including the role of AI in medicine, concerns about antibiotics and their impact on health, insomnia treatments, thyroid health, reflections on career burnout and more. They also share pers ... Show More
49m 22s
Oct 6
#500: COPD Update with Cyrus Askin
GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and bu ... Show More
1h 22m
Sep 29
REBOOT: #460 Heart Failure with Preserved Ejection Fraction
We have a classic episode for you. Preserve your sanity while treating heart failure with preserved ejection fraction. Dr Michelle Kittleson @MKittlesonMD (Cedars Sinai) illuminates this confounding cardiac condition. Sponsors Sponsor: FIGS Curbsiders listeners can get 15% off. J ... Show More
48m 57s
Recommended Episodes
Oct 2
The Lead Episode 121: A Discussion of Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia, LIVE at HRX
Join Digital Education Committee host Jason Jacobson, MD, FHRS, as he discusses this late 2024 article with guests Miguel Valderrabano, MD, PhD, FHRS and J. Peter Weiss, MD, Msci, FHRS, from the HRSTv Studio in Atlanta at HRX 2025. The trial compared two treatment strategies for ... Show More
20m 32s
Sep 2021
Chronic congestive heart failure
Chronic congestive heart failure is a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. It is a major and growing public health problem. In this podcast, Syed Wamique ... Show More
16m 48s
Jun 2025
Jun 27 2025 This Week in Cardiology
FDA approves triple-drug polypill, a change of opinion, a deep dive into invasive pulmonary embolism therapies, heart disease trends, and diabetes care is on fire are the topics John Mandrola, MD, discusses in this week's podcast. This podcast is intended for healthcare professio ... Show More
28m 58s
Oct 2
Clinical Challenges in Surgical Oncology: Pheochromocytomas
Join the Behind the Knife Surgical Oncology Team as we discuss the nuances in the work up and management of patients with pheochromocytomas. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Scien ... Show More
28m 30s
Sep 2024
Episode 116: AML Series, Pt. 2 - MDS/AML Diagnosis and Risk Stratification
In this week’s episode, we discuss the diagnostic criteria and risk stratification for myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), building on our discussion from last week. Also, if you have not done so, please do check out our hemepath series to ensure you ... Show More
31m 56s
Feb 2025
411. Journal Club: The VANISH2 Trial with Dr. Jeff Healey and Dr. Roderick Tung
Join CardioNerds EP Council Chair Dr. Naima Maqsood and Episode Lead Dr. Jeanne De Lavallaz as they discuss the results of the VANISH2 Trial with expert faculty Dr. Jeff Healey and Dr. Roderick Tung. Audio editing by CardioNerds academy intern, Grace Qiu. The VANISH2 trial enroll ... Show More
30m 5s
Sep 12
Sep 12 2025 This Week in Cardiology
More from ESC including: Valvular HD guidelines, a new drug class for HTN, myosin inhibition in HCM, vericiguat, and digoxin are the topic discussed by John Mandrola, MD. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit ... Show More
31m 5s
Jul 28
Epidemiology and Outcomes in HFimpEF | JACC Deep Dive
In this JACC Deep Dive, Editor-in-Chief Harlan M. Krumholz, MD, SM, discusses a large real-world study by Min et al. examining heart failure with improved ejection fraction (HFimpEF) in over 24,000 patients. The study found that while EF improvement is common (30%), true remissio ... Show More
8m 31s
Sep 25
Women's Health Compilation: Leading Experts On All Things Estrogen, Menopause, Fertility, & The Diet That Changes Everything
This Women's Health and Hormones Compilation explores how estrogen regulates brain function, why 86% of mothers lose core strength with no recovery protocol, and the critical timing window for hormone therapy. Featured experts include Dr. Lisa Mosconi (ep. 819), Dr. Robin Berzin ... Show More
1h 3m
Jan 2025
409. Journal Club: The ARREST-AF Trial with Drs. Prashanthan Sanders and Mehak Dhande
Join CardioNerds EP Council Chair Dr. Naima Maqsood and Episode Lead Dr. Jeanne De Lavallaz as they discuss the results of the ARREST-AF Trial with expert faculty Dr. Prashanthan Sanders and Dr. Mehak Dhande. Audio editing by CardioNerds intern Bhavya Shah. The ARREST-AF trial en ... Show More
36m 4s