In this educational podcast, Dr. Walker discusses the latest research on a new class of diabetes drugs called SGLT2 inhibitors like Jardiance. He explains how these medications work by blocking glucose reabsorption in the kidneys, causing it to be excreted in urine. While initially developed and approved for diabetes, extensive clinical trials have shown SGLT2 inhibitors provide significant benefits for heart failure, kidney disease, and weight loss. Dr. Walker reviews the evidence demonstrating their ability to reduce mortality, heart failure episodes, and progression to end-stage kidney disease. He also discusses proper hygiene practices for patients experiencing sugar in the urine. If you want to learn more about how SGLT2 inhibitors are revolutionizing treatment of diabetes and related conditions, watch this informative discussion.

Keynotes: This educational podcast discusses how the diabetes medication class called SGLT2 inhibitors such as Jardiance work by blocking glucose reabsorption in the kidneys, causing it to be excreted in urine, and reviews the extensive evidence that they provide significant benefits for heart failure, kidney disease, weight loss, and reducing mortality.

Timestamps:
0:00-4:00 Introduction and how SGLT2 inhibitors work
4:00-8:00 Benefits for heart failure
8:00-12:00 Additional benefits and approvals for kidney disease and weight loss
12:00-14:00 Hygiene considerations and reducing kidney failure risk
14:00-End Q&A and conclusions

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In this episode of the Cardiovascular Matters podcast, host Dr. Craig Walker discusses the growing problem of obesity in America and revolutionary new medication options that are helping people safely and effectively lose weight. Dr. Walker explains how obesity increases the risk of heart disease, diabetes and other serious health conditions. He then outlines several new classes of drugs, including GLP-1 agonists, that work to control hunger and blood sugar levels while promoting weight loss. Medical device sales veteran and patient Terry Roberts shares his own positive experience using these medications. Listeners will learn about treatment options and get insight into safely and successfully managing their weight.


Key points:

• The health risks of obesity like heart disease, diabetes and joint problems
• New classes of drugs for weight loss like GLP-1 agonists
• How the drugs work to control hunger, blood sugar and promote weight loss
• Positive results seen in weight loss and cardiovascular outcomes
• Terry Roberts shares his success with the medication plan

Chapter Markers:
0:00-5:00 - Introduction and overview of topic
5:00-10:00 - Health risks of obesity like heart disease and diabetes
10:00-15:00 - Introduction to new classes of weight loss drugs like GLP-1 agonists
15:00-20:00 - How the drugs work to control hunger and blood sugar
20:00-25:00 - Positive results seen in weight loss and cardiovascular outcomes
25:00-30:00 - Terry Roberts shares his success with the medication plan
30:00-35:00 - Q&A and call to action for listeners considering treatment

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This podcast discusses obesity as a major health problem and explores new medical treatments that are safe, effective and help patients feel better. The host Dr. Craig Walker and guest Terry Roberts discuss causes of obesity, health risks, challenges with past treatments and promising new medications.

Terry Roberts provides context for the episode by noting the rising rates of obesity, especially in children. He introduces Dr. Walker as an expert in treating the whole patient and addressing root causes of health issues like obesity.

Dr. Walker explains obesity has many causes related to lifestyle like eating highly processed foods and lack of exercise, but some patients struggle to lose weight no matter their efforts. Genetic and physiological factors play a role in why weight is difficult for some to lose.

Dr. Walker outlines the various health problems and diseases linked to obesity like heart disease, hypertension, diabetes, sleep apnea and more. Being overweight also increases orthopedic problems and lowers quality of life.

Previous weight loss options had problems. Medications that blocked nutrient absorption caused diarrhea, and amphetamine-like drugs were addictive and unsuitable for long-term use. Invasive surgeries also had high risks and complications.

Terry Roberts shares his own weight loss journey with encouragement from Dr. Walker. Dr. Walker discusses new medications that help the body release fat cells more easily and make patients feel good, unlike past options. When combined with lifestyle changes, these new treatments can safely and effectively help patients lose weight and improve health.

Key points:

• Obesity rates are rising, especially in children and teenagers
• Obesity increases risks of heart disease, hypertension, diabetes and more
• Past weight loss treatments had poor safety profiles or caused unpleasant side effects
• New medications help the body release fat cells more readily and make patients feel good
• When combined with lifestyle changes, new medications can safely and effectively help patients lose weight and improve health

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In this episode of Cardiovascular Matters, Dr. Craig Walker discusses the post-procedure care and follow up for patients who have undergone treatments for venous disease. He covers different types of procedures like stenting of the iliac veins, removal of deep vein clots, and closure of superficial and perforator veins.

Dr. Walker explains the recovery process for each type of procedure. For iliac vein stenting, patients may experience some back pain that typically lasts less than a week. They are also prescribed antiplatelet drugs for at least 3 months. For deep vein clot removal, patients need to take anticoagulants like Xarelto for at least 6 months to a year to prevent clots from returning. Superficial and perforator vein closures have a very short recovery with just pressure applied after the procedure.

He stresses the importance of follow up care, especially for patients who underwent treatment for venous ulcers. Their wounds are checked the following week to ensure proper healing. Various wound dressings and skin substitutes can be used to help large ulcers close. All patients are advised to continue walking and focus on weight loss to prevent recurrence of venous disease.

Dr. Walker and Terry Roberts emphasize that venous disease is more prevalent than other conditions but often ignored. Post-procedure lifestyle changes and medication can help patients finally get relief from debilitating symptoms they may have suffered with for decades.

Key points:

- Recovery timelines for different venous procedures
- Medications prescribed after stenting, clot removal etc
- Importance of follow up checks for ulcer patients
- Ongoing lifestyle measures like compression stockings, exercise
- Impact of venous disease and relief it provides patients

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This episode of Cardiovascular Matters explores perforator veins and their role in non-healing leg ulcers with Dr. Craig Walker. Dr. Walker discusses how perforator veins connect deep and superficial leg veins, and how they can cause high pressure that prevents ulcer healing.

• Perforator veins are connections between deep and superficial leg veins
• They are important not to cause issues like deep vein thrombosis during treatments
• Large perforator veins can apply high pressure to skin and cause ulcer formation

Dr. Walker explains that even with compression stockings, leg elevation and other measures, ulcers may not heal if perforator veins are applying pressure. Historically, perforator veins were difficult to treat due to their small size, but new minimally invasive techniques like laser ablation have revolutionized treatment.

• Perforator veins can cause ulcers to persist even with compression and elevation
• Early treatments were challenging due to size of perforator veins
• Laser ablation uses a thin fiber that can accurately treat perforator veins

Dr. Walker demonstrates how laser ablation of perforator veins is performed using ultrasound guidance, numbing and a laser fiber thinner than a hair. Multiple burns along the vein permanently close it off. This often provides immediate relief and allows ulcers to finally heal.

• Laser ablation is performed with ultrasound guidance for accuracy
• Numbing is given to prevent pain from laser heat treatment
• Multiple burns along the vein length close it off to reduce pressure

If you or a loved one suffers from non-healing leg ulcers, especially if other treatments have failed, perforator vein evaluation and treatment may help. Contact Dr. Walker at Cardiovascular Institute of the South for a consultation.

• Non-healing leg ulcers could be from underlying perforator vein issues
• Evaluation and treatment with Dr. Walker may help ulcers finally heal
• Contact Cardiovascular Institute of the South for a consultation

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www.cardio.com

Welcome to Cardiovascular Matters, a podcast dedicated to discussing all aspects of cardiovascular health and disease. Today we're joined by Dr. Craig Walker, a leading cardiologist and expert in peripheral artery disease. Dr. Walker will help us understand what PAD is, who is affected, and why early detection and treatment is so important for overall health and longevity. For many, PAD presents no symptoms but it serves as an important indicator of systemic atherosclerosis. Let's listen in as Dr. Walker addresses these topics and more.

Keypoints:

• PAD affects over 28 million Americans
• Major risk factors are smoking, diabetes, family history, high cholesterol, high blood pressure
• Even asymptomatic PAD is a marker for increased cardiovascular risk and death
• Sick legs are rarely attached to totally healthy people
• PAD patients have higher risk of heart attack than those who already had one

Dr. Craig Walker begins the discussion by explaining that peripheral artery disease (PAD) is more common than many realize, affecting over 28 million Americans. The major risk factors for PAD are smoking, diabetes, family history of cardiovascular disease, high cholesterol, and high blood pressure. PAD develops as a result of atherosclerosis, or hardening of the arteries due to plaque buildup. This restricts blood flow to the limbs, usually the legs.

While PAD often causes no symptoms, even asymptomatic PAD is an important marker for increased cardiovascular risk. Dr. Walker discusses studies that showed individuals with PAD are at higher risk of heart attack, stroke, and early death. This is because the same atherosclerotic process affecting the legs is also occurring in other arteries of the body. He emphasizes that screening for PAD is important, as a simple pulse check or ankle-brachial index test can identify patients who may be at risk.

Treatment involves lifestyle changes like quitting smoking, improving diet, increasing physical activity, and managing underlying conditions like diabetes and high blood pressure. Medications are also important such as statins to lower cholesterol, aspirin or Plavix for anticoagulation, and cilostazol to improve leg blood flow. For those with critical limb ischemia, procedures may be needed to restore blood flow through angioplasty or surgery. Dr. Walker stresses the need for a multidisciplinary approach involving primary care, cardiology, and vascular surgery.

In closing, Dr. Walker has emphasized that PAD is a widespread yet often overlooked condition that signifies increased risk for other cardiovascular problems. Simple screening can identify those with PAD, even if asymptomatic, so they can make lifestyle changes and receive the medical care and monitoring warranted by their higher risk profile. A multidisciplinary approach is key to properly managing PAD patients and preventing limb loss or other complications down the road. Thank you for joining us today on Cardiovascular Matters. Be sure to subscribe so you don't miss our next episode, where we will delve deeper into PAD treatment options.

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In this informative episode of the Cardiovascular Matters podcast, host Dr. Craig Walker sits down with his colleague Terry Roberts to discuss pulmonary embolisms (PEs) in comprehensive detail. PEs, which occur when blood clots travel to the lungs, are a serious cardiovascular condition that can quickly become life-threatening if not properly diagnosed and treated.

Dr. Walker begins by explaining what a PE is on a physiological level, noting how clots blocking blood flow in the lungs can strain the heart and prevent oxygenation of blood throughout the body. He discusses how PEs originate as clots elsewhere in the body, most commonly the legs, that break off and travel to the lungs. Depending on their size, PEs can range from causing minor breathing issues to sudden cardiac arrest.

The discussion then delves into risk factors for developing PEs. Genetic hypercoagulable conditions that cause easier clotting are highlighted, as are external risk factors like smoking, prolonged immobility, recent surgery or trauma, and certain cancers. Dr. Walker stresses the importance of prophylactic measures for at-risk patients, such as compression stockings and blood thinners.

Some key points:

• PEs are the second leading cause of death from cardiovascular disease and can be fatal if large clots block oxygen from circulating in the blood.
• Risk factors for PEs include hypercoagulability, injury, prolonged immobility, surgery, cancer and smoking.
• Symptoms include shortness of breath, arrhythmias, and potentially sudden death from large clots.
• Diagnosis involves imaging tests like CT scans to detect clots in the lungs.
• Traditional treatments include blood thinners like heparin to prevent further clotting.
• Newer options like thrombolytic drugs and thrombectomy devices can dissolve or remove clots quickly in severe cases.
• Emergency support like ECMO can oxygenate the blood while clots are addressed.

Turning to diagnosis, imaging tests like CT scans that can detect clots in the pulmonary arteries are outlined. Dr. Walker also notes newer diagnostic guidelines that help physicians determine the likelihood a patient is experiencing a PE. Traditional first-line treatments involving blood thinners are explained, along with their limitations in dissolving large clots.

The bulk of the conversation focuses on recent advances in PE treatment. Dr. Walker enthusiastically discusses thrombolytic drugs that break down clots, endovascular thrombectomy devices that physically remove clots, and emergency circulatory support like ECMO. He shares inspiring case studies of how these interventions have saved critically ill patients within minutes of their arrival. The risks of these procedures are also addressed.

Overall, this podcast episode is an invaluable resource for anyone seeking to learn more about pulmonary embolisms, from causes and symptoms to state-of-the-art diagnosis and life-saving therapies. Dr. Walker's expertise and passion for the topic shine through, making complex cardiovascular science easy to understand.

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Have you or a loved one struggled with painful, persistent venous ulcers? In this episode of Cardiovascular Matters, Dr. Craig Walker sheds light on venous disease - a common condition that often goes undiagnosed and untreated.

Dr. Walker's interest in venous issues began early in his career while working to open blocked arteries and access the heart. It was in wound healing centers that he noticed the majority of patients suffered from debilitating venous ulcers, not arterial issues. These ulcers could last decades, constantly weeping and requiring bandage changes day and night.

One key culprit is iliac vein compression - where the large veins in the abdomen become squeezed between the aorta and spine. Dr. Walker explains the anatomy and risk factors for compression, detailing how it raises venous pressures and predisposes people to ulcer formation. But for years, there were no effective treatments.

That changed with pioneering work by Dr. Raju using minimally invasive vein stenting. Dr. Walker was amazed by the rapid ulcer healing he saw in patients. Now newer stents and techniques have made the procedure even safer.

In this episode, Dr. Walker shares real case studies of patients with 20+ year ulcers that fully healed within months of stenting. He stresses the importance of evaluating for compression in anyone with longstanding ulcers or discolored legs. Tune in to learn more about diagnosis and new hope for patients suffering from this debilitating condition.

Here are the key points discussed in the podcast episode:

• Dr. Walker's career path led him to recognize the prevalence of venous disease issues over arterial problems when working in wound healing centers.
• Venous ulcers are one of the most common problems treated, often lasting decades and severely impacting quality of life.
• Iliac vein compression, where the iliac veins in the abdomen become squeezed, is a major underlying cause of venous hypertension and ulcer formation.
• Risk factors for compression include family history, obesity, recurrent leg clots, and discolored skin below the knees.
• Non-invasive testing like ultrasound has limitations - intravascular ultrasound placed in the vein is the gold standard diagnostic test.
• Pioneering work by Dr. Raju in the 1990s demonstrated minimally invasive vein stenting could effectively decompress veins and rapidly heal ulcers.
• Newer stents, balloons and techniques have made the outpatient stenting procedure even safer and more successful.
• Case studies showed ulcers persisting over 20 years could fully heal within 6-8 weeks post-stenting.
• Anyone with longstanding ulcers or symptoms should be evaluated for possible iliac vein compression.