Without a cardiologist since Dr. Geilan Ismail retired in 2022, any replacement arriving at Holy Cross Medical Center would be newsworthy.

Dr. Tiziano Scarabelli, the hospital's new cardiologist, is introducing heart patients to newer diagnostic methods, which he said not only save lives but will also reduce airlifts out of Taos and improve patient care and their overall quality of life.

By using a top-of-the-line CT scan machine Holy Cross obtained in 2023 in conjunction with software that compiles a detailed 3D image of a patient's heart, Scarabelli said he is able to diagnose patients more accurately and discharge non-emergent patients quicker than ever before at Holy Cross.

"When there was a patient coming to the [emergency department] with chest pain, there was the conventional approach," he said, explaining that echocardiogram stress tests either physical or using nuclear medicine require a patient to stay at the hospital for up to 36 hours.

While he still employs both tests regularly at Holy Cross, he said coronary CT angiograms can be performed without injecting any drug and don't require patients to fast, allowing them to be "discharged in [as few as] six hours," Scarabelli said.The test works by revealing calcified coronary arteries indicating coronary plaques immediately and clearly in the imaging, which can be completed in 20 minutes.

Scarabelli shared a PowerPoint presentation with the Taos News of 3D images of hearts, some in various stages of visible to a layman coronary artery disease. In fact one of the goals of the imaging is to very clearly communicate to patients the consequences of a poor diet, obesity, a lack of physical activity or not taking one's prescribed heart or diabetes medicine, for example.

"It has a very significant impact in terms of changes of behavior," Scarabelli said. "That is very important to provide a pictorial representation of the work done by the patients."

Holy Cross CEO James Kiser agreed the CT angiogram is able to provide imaging of the heart faster and with a high degree of accuracy. He said Scarabelli is an expert in using the technology and interpreting the detailed information it provides.

Scarabelli was born and raised in Vercelli, Italy. He has taught at several universities and is licensed to practice medicine in over a dozen states. As a young man, he graduated with a degree in medicine from the University of Turin, then completed a fellowship in cardiology at the University of Brescia. He subsequently moved to England, where he carried out research projects for several years.

Tizianos subspecialty is cardio-oncology, whose primary goal is to prevent and treat cardiovascular complications of cancer, chemotherapy and/or radiation therapy, according to his hospital bio. Kiser has said that one of his priorities is to bring a cancer treatment clinic to Holy Cross.

"We are blessed to have Dr. Tiziano Scarabelli and his wife, Carol Chen-Scarabelli, NP, staffing the Holy Cross Cardiology Department," Dr. Lucas Schreiber said. "It is unusual to find such well-trained and academically inclined clinicians practicing in such a small community. When Dr. Geilan Ismail retired, I feared we would not find a replacement of her caliber. In Dr. Scarabelli, the Taos community is once again receiving state-of-the-art, highly competent and guideline-driven cardiac care."

Scarabelli's wife, Nurse Practitioner Carol Chen-Scarabelli, came to work at Holy Cross with her husband, and shares his drive to serve the folks who live within the hospital's service area.

"With the multimodality imaging we have, including the coronary CT scanner, in order to rule out any significant blockage in the arteries or your heart, it's making a huge difference," Chen-Scarabelli said. "Before, if someone came in with chest pain and you weren't sure if they were having a heart attack and you had to airlift them out. They're getting a $75,000 bill for airlifting, not counting your hospital bill.

"I told [Christus St. Vincent Hospital in Santa Fe] when they came up to visit, I said, 'Well, if they didn't have a heart attack, then they'll get one when they see that bill,'" Chen-Scarabelli said. "If the coronary CT helps us to diagnose rapidly, if they have significant blockage, they do need to be airlifted; [but] we've had some but they weren't urgent like that, and they were able to drive down or have a family member take them instead of being airlifted."

Scarabelli said just three patients he's seen have had to be airlifted out of Taos for treatment at a larger clinic. All three required surgery.

"The negative predictive value of a negative CT angiogram is 100 percent," Scarabelli said, clapping his hands with finality. "If I say it is negative to the patient, 'Go home,' it is done. It's the power of the procedure that allows this hospital to make big jumps in care."

Scarabelli said that after a quarter-century teaching medicine and heading up departments at learning hospitals or running clinical practices in several larger communities in the United States, Taos feels like the right place to be.

"The reality is, I've been an academician all my life," he said. "I became a professor of medicine at Wayne State University [in Michigan] when I started 22 years ago. I'm a professor of medicine at the Royal College. I continue to do that; I'm still an academician. But they no longer pay me.

"I'm sick and tired of the political thing in academia," Scarabelli added. "Academia is worse than the politics in the White House. Here, I'm surrounded by people who have the most genuine desire to help me to do things well."

After renting for six months in Taos, Scarabelli said he, his wife and 14-year-old daughter Caroline have moved into their own home.

"For my first time ever and I'm very honest with you, not even in Italy, not in England, where I lived many years, not in the U.S., I always felt not accepted I feel part of the community," Scarabelli said.

"I used the term community in the past and it was, like, something up there; I didn't understand what it means," Scarabelli said, gesturing to overhead to something out of reach. "I have become aware of that."

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Cardiologist aims to improve care, reduce costly air transport - The Taos News