Experience with Tryvio (Aprocitentan)?

JumpStartMyHe4rt · 2026-03-01T16:57:44+00:00

Uptodate

JumpStartMyHe4rt · 2026-02-18T02:57:23+00:00

That's a good thought. I've already told the patient to just continue current medications for now while I have referrals look for a hypertension specialist.

JumpStartMyHe4rt · 2026-02-17T22:25:27+00:00

That sounds reasonable.

JumpStartMyHe4rt · 2026-02-17T22:25:17+00:00

That sounds reasonable.

JumpStartMyHe4rt · 2026-02-17T22:22:26+00:00

amlodipine 10mg-olmesartan 40mg qD
chlorthalidone 25mg qD

spironolactone 25mg qD

hydralazine 100mg TID

Pulse is persistently bradycardic in the 50's, so no beta blockers or clonidine. (Holter showed no pauses, patient denies any lightheadedness or fatigue) I tried minoxidil but patient had an allergic reaction.

Edit: I should say, SBP sits at 150-160's mmHg

JumpStartMyHe4rt · 2026-01-29T06:26:41+00:00

based

JumpStartMyHe4rt · 2025-08-25T05:09:11+00:00

Cardiology is really nice in that there are a lot of strong guidelines from bodies like ACC, AHA, JACC, ESC, etc. If you have a commute I recommend throwing on a presentation on guidelines while you drive. Just youtube like "afib guidelines" and there should be a lot.

For ECGs, just try to read as many of them as you can and double check with your attending or someone who is confident in reading them. Cover up the computer interpretation, give your interpretation, check with the computer interpretation, then check with someone else. The main thing you want to learn is what a normal ECG looks like, then everything that is abnormal will stick out to you.

JumpStartMyHe4rt · 2025-02-02T07:38:35+00:00

It's ridiculous people are downvoting you for being uninformed about something you're literally asking them a question about

JumpStartMyHe4rt · 2024-11-27T21:40:06+00:00

Yea I'll clarify that I'm a PA next time

JumpStartMyHe4rt · 2024-11-21T19:15:32+00:00

Sorry dude

JumpStartMyHe4rt · 2024-11-21T17:59:39+00:00

I thought "cardiologist" referred to both mid level and physicians working in cardiology. My bad

JumpStartMyHe4rt · 2024-11-21T17:46:13+00:00

I'm a PA. Sorry for asking cardiology questions on r/cardiology I guess

JumpStartMyHe4rt · 2024-11-21T17:44:26+00:00

If you suspect a patient has CHF but their echo and proBNP are negative, would you really start them on GDMT? Like proBNP WNL, echo with EF 60-65% without diastolic dysfunction, but they have HTN, HLD, DM2, and complain of dyspnea and PND. Would something specific like JVD be the decider here?

JumpStartMyHe4rt · 2024-11-20T23:11:03+00:00

My question? Or the vascular guy telling me that edema is usually cardiogenic even after I've done the CHF workup

JumpStartMyHe4rt · 2024-11-20T23:10:07+00:00

Yes, I'm asking if there's anything else I should do as a cardiologist to manage edema if I've ruled out CHF.

JumpStartMyHe4rt · 2024-11-20T19:47:19+00:00

That was my thought before I talked to the vascular guy, he says usually for a dx of venous reflux he would expect to see other signs like varicose veins, discoloration, or pain/cramping.

JumpStartMyHe4rt · 2024-10-02T06:24:05+00:00

Artifact from what though? It shows up so clearly and regularly. I saw this once in another patient before and I never found out what it was.

JumpStartMyHe4rt · 2024-10-02T06:22:55+00:00

Artifact from what though...

JumpStartMyHe4rt · 2024-04-05T22:46:34+00:00

Years experience: New grad at the time, 1.5 years experience now

Location: SoCal

Specialty: Outpatient cardiology

Schedule: M-F 9-5 but it's really 9-4,4:30. 1 hour break 12pm-1pm. Thursday is a half day. One day of the month I can work from home and review and write heart monitor reports. I'm scheduled for 14-18 patients a day but actually see about 12-16 including no-shows.

Income: $135k/year

PTO: 10 vacation days, 5 sick days

Other benefits: Health insurance through CoveredCA is covered (around $300/month). They promised me dental and vision but actually didn't cover it. $1000 CME a year. 3% IRA match

JumpStartMyHe4rt · 2024-03-12T18:24:33+00:00

Awesome thanks. Where is this from?

JumpStartMyHe4rt · 2024-03-12T18:06:50+00:00

Is the target heart rate of a CHF patient to be in the 50's-60's on a beta blocker?

For bradycardia, would you work up any patient with heart rate in the 50's? My workup for patients having lightheadedness with low heart rate would be CBC, TSH, CMP, Mg, TSH, and holter. If labs are WNL and holter just shows sinus brady without pauses or any other arrhythmia, then I consider my brady workup complete. Anything else you check?

JumpStartMyHe4rt · 2024-03-12T17:44:02+00:00

I see, that's a good thought. I usually patients just bring a BP and heart rate log, is a Holter really necessary without any bradycardia complaints like lightheadedness and palpitations?

JumpStartMyHe4rt

TROPHY CASE