SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts Titelbild

SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts

SoCCC Pre-Rounds: Bite-Sized Critical Care Cardiology Topics Delivered By Experts

Von: Dr. Balim Senman Dr. Elliott Miller Dr. Simon Parlow Dr. Anthony Carnicelli
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 SoCCC Pre-Rounds is your go-to for quick, high-yield insights in critical care cardiology, hosted by members of the Society of Critical Care Cardiology (SoCCC). With only 160 specialists in the U.S., mentorship is rare. This podcast bridges the gap with bite-sized episodes featuring clinical pearls, expert tips, and real-world answers on topics like cardiogenic shock, ECMO, and resuscitation. Perfect for pre-rounds, night shifts, or leveling up anytime. Listen in. Level up. Join the SoCCC community.Dr. Balim Senman, Dr. Elliott Miller, Dr. Simon Parlow, Dr. Anthony Carnicelli Hygiene & gesundes Leben
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  • Cardiac Tamponade in the ICU: Diagnosis, Echo, and Management with Dr. Courtney Bennett

    Cardiac Tamponade in the ICU: Diagnosis, Echo, and Management with Dr. Courtney Bennett
    Mar 6 2026
    In this episode of SoCCC Pre-Rounds, Dr. Balim Senman sits down with Dr. Courtney Bennett, a critical care cardiologist and echocardiographer at Mayo Clinic Rochester, to unpack the bedside recognition and management of cardiac tamponade. The conversation emphasizes tamponade as a clinical diagnosis, highlighting key physical exam clues such as tachycardia, hypotension, elevated JVP, pulsus paradoxus, and electrical alternans. Dr. Bennett explains the physiology of ventricular interdependence and why the rate of pericardial fluid accumulation matters more than volume alone.The episode also explores how point-of-care echocardiography supports but does not replace clinical judgment, distinguishing early findings like inflow variation from late signs such as chamber collapse. Management strategies are discussed in real-world terms, including when to urgently drain an effusion, how to stabilize patients with fluids and vasopressors while awaiting intervention, and common pitfalls like inappropriate diuresis. This episode delivers practical, high-yield guidance for clinicians managing undifferentiated shock in the cardiac ICU.Key TakeawaysTamponade is a clinical diagnosis: Pericardial effusion alone does not equal tamponade without hemodynamic compromiseTachycardia often comes first: Hypotension and shock may follow as compensation failsSmall, rapidly accumulating effusions can be fatal, while large chronic effusions may be well toleratedEcho supports, not replaces clinical judgment: Chamber collapse suggests late disease; inflow variation may signal early tamponadeDrain emergently when unstable: Approach and urgency depend on patient trajectory, not imaging aloneIn This Episode[00:00] Introduction[01:11] Definition of cardiac tamponade[01:50] Physical exam findings in tamponade[03:25] Pulsus paradoxus: definition and mechanism[04:57] Etiologies of pericardial effusion[05:43] Volume vs. hemodynamic instability[06:40] Clinical vs. echo diagnosis of tamponade[08:09] Echocardiographic findings in tamponade[10:02] Management: tamponade vs. stable effusion[12:10] Stabilizing the pre-tamponade patient[13:23] Fluid vs. diuretics in tamponadeNotable Quotes[01:28] "This is a diagnosis when a patient has pericardial effusion. So excess fluid around the heart that's causing them to have hypotension, low blood pressure, and part of that actually could be what we would describe as Beck's triad." — Dr. Courtney Bennett[12:38] "So first and foremost, I would start with IV fluid resuscitation bolus. I don't think there's a well-defined amount that we should use. 500 a liter of fluid. You have to use your clinical assessment because many of our patients may also be peripherally volume overloaded as well. But typically in this scenario, fluid is really the upfront management."— Dr. Courtney Bennett[13:48] "Sometimes I work with learners who think that because there's an excess of fluid around the heart, we should be giving diuretics. That's not the case because diuretics will decrease the preload and actually worsen the hypotension."— Dr. Courtney BennettResources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Courtney Bennetthttps://alumniassociation.mayo.edu/colleague-notes/courtney-bennett-d-o/Dr. Balim Senmanhttps://www.linkedin.com/in/balim-senman-7561436b/https://x.com/BalimSenmanMDhttps://www.soccc.org/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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    15 Min.
  • The Basics of the Pulmonary Artery Catheter with Dr. Aniket Rali

    The Basics of the Pulmonary Artery Catheter with Dr. Aniket Rali
    Feb 6 2026
    Did you know that pulmonary artery catheters are crucial for patients with unclear shock etiology? In this episode of SoCCC Pre-Rounds, Dr. Elliot Miller sits down with Dr. Aniket Rali, a dual-trained critical care and heart failure cardiologist at Vanderbilt, for a deep dive into the art and science of pulmonary artery catheterization, also known as the Swan-Ganz catheter.Dr. Rali demystifies the PAC by walking us through the fundamentals of when to use it, who should not get one, and how to interpret and troubleshoot the data it provides. Whether you're a resident inserting your first swan or a fellow refining your hemodynamic assessments, this episode will elevate your bedside practice.From contraindications and waveform recognition to zeroing, troubleshooting, and avoiding wedge-related complications, Dr. Rali shares high-impact pearls grounded in real-world CICU experience.Key TakeawaysUse PACs when shock etiology is unclear; they're diagnostic, not therapeuticAvoid PACs in patients with endocarditis, thrombus, or proximal PEKnow your waveforms; it's your only guide during bedside placementAlways level and zero the transducer for accurate pressuresJustify PAC use daily and remove once it’s no longer neededTroubleshoot waveform loss by checking positioning, clots, or tubingAvoid repeated wedging; use diastolic-to-wedge trends when possibleUse chest X-ray to confirm safe placement and prevent complicationsIn This Episode[00:00] Introduction[01:16] Pulmonary artery catheter basics[02:04] Indications for PA catheter use[06:57] Special considerations: left bundle and pacemaker leads[08:12] Bedside placement preparation and checklist[11:33] Presenting PA catheter data on rounds[12:03] Ensuring data accuracy and daily safety checks[15:17] Sequence for presenting hemodynamic data[16:23] Cardiac output measurement methods[18:31] Choosing between Fick and thermodilution[20:04] Limitations in shunt physiology[20:58] Troubleshooting PA catheter issuesNotable Quotes[02:17] "At the end of the day, a diagnostic tool is not going to treat your patient. But if it provides you with additional information that helps you reach the right diagnosis, then it becomes a valuable tool." — Dr. Aniket Rali[09:07] "I firmly believe that the more you sweat in peace, less you bleed in war. And that holds true of any procedure." — Dr. Aniket Rali[10:07] "You really should not be putting in a bedside swan unless you have mastered the waveforms, because the waveforms are your only guidance as to which cardiac chamber you are in." —Dr. Aniket Rali[12:31] "I encourage trainees, next time they have a patient with a SWAN Ganz catheter in, to just have them move their arm or move the catheter up by a foot and down by a foot and see how the pressure readings change." — Dr. Aniket Rali[27:28] "Long live the swan." — Dr. Aniket RaliDr. Aniket RaliDr. Aniket Rali is a heart failure and critical care cardiologist at Vanderbilt University. She’s known for her expertise in hemodynamics, real-world application of advanced monitoring, and thoughtful mentorship of trainees learning the art of bedside right heart catheterization.Resources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Aniket Ralihttps://medicine.vumc.org/department-directory/Aniket-Ralihttps://www.linkedin.com/in/aniket-rali-md-facc-fccp-69ab15228Dr. Elliot Millerhttps://x.com/ElliottMillerMDhttps://www.soccc.org/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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    28 Min.
  • Navigating the Initial Hours of Cardiogenic Shock with Dr. Rebecca Mathew

    Navigating the Initial Hours of Cardiogenic Shock with Dr. Rebecca Mathew
    Jan 2 2026
    How do you diagnose cardiogenic shock quickly and accurately at the bedside? What should your first therapeutic move be? And how do you know if your resuscitation is working?In this episode of SoCCC Pre-Rounds, Dr. Simon Parlow sits down with Dr. Rebecca Mathew, Director of the Cardiac ICU at the University of Ottawa Heart Institute and co-principal investigator of the CAPITAL Research Group. Together, they break down a clear, real-world approach to diagnosing, stabilizing, and treating cardiogenic shock from the moment the patient arrives.Drawing from frontline CICU experience and landmark trials such as CAPITAL DOREMI, Dr. Mathew discusses why history and physical exam still drive the diagnosis, how to approach congestion and perfusion, when inotropes actually help, and how to integrate invasive hemodynamics when available. The episode offers practical, bedside-ready guidance for clinicians managing shock in any setting.Key TakeawaysCardiogenic shock is best diagnosed through history, exam, and perfusion assessment, not lactate or invasive data alone.SCAI is the most practical framework, but Stage D should be assigned only after a failed therapeutic trial.Use inotropes only if hypoperfusion persists after decongestion; dobutamine quickly shows responsiveness.Swan-Ganz catheters help when available, but most shock worldwide is managed without invasive hemodynamics.Avoid early prognostication in the first 24–48 hours to prevent harmful self-fulfilling assumptions.In This Episode[00:00] Introduction [01:06] Importance of initial medical management in cardiogenic shock[02:53] Defining cardiogenic shock and SCAI classification[05:27] Phenotypes and subtypes of cardiogenic shock[07:23] Caveats in SCAI classification[07:49] Bedside diagnosis and risk stratification[09:53] Physical exam: hyperperfusion and congestion[11:54] Initial management approach: decongestion and inotropes[14:17] Therapeutic targets and monitoring response[15:24] Inotrope selection and individualized therapy[16:55] Ongoing research and future directions[17:55] Therapeutic targets: clinical and biochemical markers[19:47] Mean arterial pressure (MAP) targets[21:01] Prognostic factors and risk scoresNotable Quotes[03:21] “I think in its most basic sense, I think of cardiogenic shock as a clinical syndrome of clinical and biochemical hyper perfusion that’s due to a primary cardiac disorder.” — Dr. Rebecca [15:48] “People often ask me what inotrope I reach for, and despite having done the DoReMi trial and proving there’s no difference, I am anecdotally a big believer in dobutamine.” - Dr. Rebecca [22:10] “Once you’re in the throes of shock, I think we just need to focus on the tsunami in front of us and manage that.”[23:26] “The most exciting thing about cardiac critical care and managing cardiogenic shock is you are basically seeing physiology in real time." — Dr. RebeccaDr. Rebecca MathewDr. Rebecca Mathew is a critical care cardiologist and Director of the Cardiac ICU at the University of Ottawa Heart Institute. She leads major cardiogenic shock research programs, including the CAPITAL DOREMI trial published in the New England Journal of Medicine and the ongoing CAPI2 trial focused on early inotrope strategies. Her work spans clinical care, trial leadership, and translational shock physiology.Resources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Rebecca Mathewhttps://www.ottawaheart.ca/profile/mathew-rebeccaDr. Simon Parlowhttps://www.ottawaheart.ca/profile/parlow-simonhttps://www.soccc.org/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
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    26 Min.
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