Cardiologists, other physicians, and patients writing on KevinMD about heart disease: statins and the cholesterol guidelines argued since 2013, blood pressure thresholds, stroke and the clock, cardiac arrest and what CPR can and cannot do, stents and atrial fibrillation, heart failure drugs that go unprescribed, prevention from salt to calcium scores, and a specialty that became procedural because procedures were paid. One maintained record draws on this archive: Heart disease: what physicians say, in their own words.
Last week, KevinMD published my blog titled "The anticoagulant standard of care nobody tested." This week I'll continue with a discussion of patients who may have been harmed by anticoagulants. In 2001, two co-authors and I initiated a systematic review…
Last week, KevinMD published my blog titled “The anticoagulant standard of care nobody tested.” This week I’ll continue with a discussion of patients who may have been harmed by anticoagulants.
A 32-year-old male is rushed to the ER. An hour ago, he was playing football with his friends, as he does every week. No smoking. Barely drinks. No family history anyone knew about. He is 32 years old, and his…
A 32-year-old male is rushed to the ER. An hour ago, he was playing football with his friends, as he does every week. No smoking. Barely drinks. No family history anyone knew about. He is 32 years old, and his heart is attacking him. He is not an anomaly anymore. He is a pattern. According to an extensive study spanning 16 years, the rate of having a heart attack …
Cardiovascular disease remains the leading cause of death in the United States, yet its burden is not evenly distributed. Black Americans experience higher rates of hypertension, heart failure, and premature cardiovascular mortality. These patterns are often called "health disparities," but…
Cardiovascular disease remains the leading cause of death in the United States, yet its burden is not evenly distributed. Black Americans experience higher rates of hypertension, heart failure, and premature cardiovascular mortality. These patterns are often called “health disparities,” but that language risks understating a central reality. Cardiovascular risk does not arise in isolation. It accumulates along lines of social and structural inequality.
The relationship between social conditions and cardiovascular health …
I am a 94-year-old physician who would like to share a recent experience in which my Apple Watch played a critical role in the detection of a life-threatening event. Over the course of my career, I focused on early detection…
I am a 94-year-old physician who would like to share a recent experience in which my Apple Watch played a critical role in the detection of a life-threatening event.
Over the course of my career, I focused on early detection and prevention in medicine, particularly in colorectal cancer. This made my recent personal experience with early detection of a cardiac event and prevention of its serious consequences through wearable technology especially …
I am a heart transplant recipient. I understand the responsibility that comes with the organ I was given. I take my medications exactly as prescribed. I go to my appointments. I monitor for anything that could signal a problem. I…
I am a heart transplant recipient. I understand the responsibility that comes with the organ I was given. I take my medications exactly as prescribed. I go to my appointments. I monitor for anything that could signal a problem. I do everything I am supposed to do. And I still almost ran out of my transplant medication.
What I was not prepared for was having to fight to get the medication …
Thirty years ago, I ran a cardiac arrest in the operating room. The patient survived. The room eventually quieted down. The nurses began cleaning up. People moved on to the next case. But I remember standing there afterward feeling exhausted…
Thirty years ago, I ran a cardiac arrest in the operating room. The patient survived. The room eventually quieted down. The nurses began cleaning up. People moved on to the next case.
But I remember standing there afterward feeling exhausted and unsettled. It had been several months since my ACLS recertification, and during the code I caught myself mentally reaching for details of the algorithm that had once felt automatic. I …
In New Orleans, shoppers often request "lagniappe," pronounced lan-yap, to express their desire for something extra, the baker's dozen, a 13th donut. Added benefit was a major topic of interest for the 500 participants in the combined International Early Lung…
In New Orleans, shoppers often request “lagniappe,” pronounced lan-yap, to express their desire for something extra, the baker’s dozen, a 13th donut. Added benefit was a major topic of interest for the 500 participants in the combined International Early Lung Cancer Action Program (IELCAP), International Early Lung Cancer and Respiratory Tract (IELCART), and AGILE 3 conferences held March 19 to 21, 2026, in Gdansk, Poland. Although this topic ranged freely …
What if the real driver of aging isn't your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that…
What if the real driver of aging isn’t your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that microvascular decline is the overlooked upstream force behind nearly every disease …
What if one of the most common escalation strategies for acute heart failure doesn't actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the…
What if one of the most common escalation strategies for acute heart failure doesn’t actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the show to break down what the DOSE trial really tells us …
What happens when a physician who spent decades treating patients suddenly finds himself on the other side of the exam table, unable to get a simple answer about his own aneurysm? Jeffrey Junig, a psychiatrist and addiction medicine specialist, shares…
What happens when a physician who spent decades treating patients suddenly finds himself on the other side of the exam table, unable to get a simple answer about his own aneurysm? Jeffrey Junig, a psychiatrist and addiction medicine specialist, shares how a life-saving surgery and a casually dropped diagnosis exposed the …
At the American College of Cardiology meeting, a new trial was shared that might change how we view one of the world's most common heart conditions. At its core, the study asked a simple but disruptive question: Do patients with…
At the American College of Cardiology meeting, a new trial was shared that might change how we view one of the world’s most common heart conditions. At its core, the study asked a simple but disruptive question: Do patients with atrial fibrillation really need to take blood thinners for the rest of their lives to prevent stroke? For decades, the answer has been yes. This trial suggests the answer …
This episode is sponsored by Novartis Pharmaceuticals Corporation. In this sponsored episode from Novartis Pharmaceuticals Corporation, a leading preventive cardiologist walks through the 2026 cholesterol guideline update and what it means in practice. Seth J. Baum, a Columbia-trained preventive cardiologist,…
In this sponsored episode from Novartis Pharmaceuticals Corporation, a leading preventive cardiologist walks through the 2026 cholesterol guideline update and what it means in practice. Seth J. Baum, a Columbia-trained preventive cardiologist, founder of Flourish Research, chairman of the Family Heart Foundation, and past …
A patient arrives in the emergency department vomiting. Not once or twice, but repeatedly, leaning over the bedside basin, pale and sweating, clearly miserable. Between episodes, he tries to explain what happened. Earlier in the day he felt completely fine.…
A patient arrives in the emergency department vomiting. Not once or twice, but repeatedly, leaning over the bedside basin, pale and sweating, clearly miserable. Between episodes, he tries to explain what happened. Earlier in the day he felt completely fine. Then the nausea started suddenly, followed by vomiting, cramping, and a cold sweat that made his shirt cling to his back. By the time he arrived in the emergency room, …
It is 4:50 p.m. on a Thursday. Your last patient is a 67-year-old with heart failure with reduced ejection fraction. He has been hospitalized twice this year. His medications look familiar. A beta-blocker. An ACE inhibitor. A loop diuretic. But…
It is 4:50 p.m. on a Thursday. Your last patient is a 67-year-old with heart failure with reduced ejection fraction. He has been hospitalized twice this year. His medications look familiar. A beta-blocker. An ACE inhibitor. A loop diuretic. But something is missing. You scroll through the chart. No mineralocorticoid receptor antagonist. No SGLT2 inhibitor. No ARNI. You pause. You know the guidelines. You have heard the talks. You …
The morning my mother passed away began like any other. She was getting ready for work. She finished her morning chai and just stepped out of the shower with the sunlight filling the bedroom. There was nothing unusual about that…
The morning my mother passed away began like any other. She was getting ready for work. She finished her morning chai and just stepped out of the shower with the sunlight filling the bedroom. There was nothing unusual about that morning that was particularly alarming. And then, in a moment so small I almost missed it, she paused and pressed a hand to her back. “I don’t feel right,” she …
The treatment of cardiovascular diseases has advanced at an extraordinary pace over the past half-century resulting in an age-adjusted 60 percent reduction in heart disease death rates. This dramatic decline is directly attributable to primary and secondary preventive therapies such…
The treatment of cardiovascular diseases has advanced at an extraordinary pace over the past half-century resulting in an age-adjusted 60 percent reduction in heart disease death rates. This dramatic decline is directly attributable to primary and secondary preventive therapies such as statins and small interfering messenger RNAs along with disruptive technologic advances in procedural techniques. New pharmacologic options for thromboprophylaxis and novel therapies for heart failure …
Modern medicine loves numbers. LDL. A1c. BMI. Tumor diameter. Pounds lost. They are easy to measure, easy to track, and easy to celebrate. But none of them are the disease itself. As GLP-1 prescribing accelerates and insurers increasingly define success…
Modern medicine loves numbers. LDL. A1c. BMI. Tumor diameter. Pounds lost. They are easy to measure, easy to track, and easy to celebrate. But none of them are the disease itself.
As GLP-1 prescribing accelerates and insurers increasingly define success by weight reduction, we are repeating a familiar mistake: Elevating a surrogate marker to the status of a biological endpoint.
BMI was never designed to diagnose disease in individuals. Adolphe Quetelet created …
Are you concerned about statins? In the past two weeks, cold hard statistics have cut through the fog of misinformation surrounding these best-selling drugs, focusing instead on the safety and efficacy of lowering your blood cholesterol level. No emotions or…
Are you concerned about statins? In the past two weeks, cold hard statistics have cut through the fog of misinformation surrounding these best-selling drugs, focusing instead on the safety and efficacy of lowering your blood cholesterol level. No emotions or bias, just numbers. Welcome information for anyone who has enjoyed numerous trips around the sun and is looking forward to many more.
Middle age, that point in life when your invincibility …
As a pediatric cardiologist, I have spent my career watching children grow. During clinic visits, we track their height, weight, and milestones. We also sit with families and ask what makes their children smile. We might send a toddler to…
As a pediatric cardiologist, I have spent my career watching children grow. During clinic visits, we track their height, weight, and milestones. We also sit with families and ask what makes their children smile. We might send a toddler to physical therapy for gross motor delay while we also encourage her love of art or music. Years of listening to parents share what their child enjoys has taught me that …
An excerpt from 50 Studies Every Hospitalist Should Know. Debbie Lin Teodorescu, MD, MEng, a cardiologist, and Hugo Torres, MD, MPH, an endocrinologist, authored this article. The DOSE trial provided good insight into the dosage and frequency for administering loop…
The DOSE trial provided good insight into the dosage and frequency for administering loop diuretics in patients presenting with acute decompensated heart failure. Physicians can prescribe intravenous loop diuretics with confidence that their decision is evidence-based, efficacious, and safe.
