Category Archives: Cardiology

Cardiology

Heart Health is What Keeps This Penn Cardiology Patient Running – Penn Medicine

After finishing his first triathlon, Sanjay Shah celebrated fairly typically by hugging his wife and daughters. He then stepped aside to make a phone call. It was to his cardiologist.

Im alive and I finished the race, Shah told his doctor at the Perelman School of Medicine at the University of Pennsylvania.

Shah was back into racing condition thanks, in part, to guidance and care from sports cardiology professionals at Penn Medicine.

His training started years before with a decision to take charge of his health in a broader way. Earlier in life, he faced a diabetes diagnosis. That later led to Shah becoming more active. He even lost 40 pounds while training for marathons. He then entered the Rock and Roll Half Marathon in 2009.

That race, and Shahs spirit, came to a sudden stop during mile ten of the half marathon.

I had started feeling a tingling in my jaw. I had taken a caffeine gel during the race, and thought maybe that was affecting me somehow. It was more than just a tingling jaw. Shahs friends noticed a change in his color and urged him to stop running. They wanted to call 9-1-1, but Shah insisted he just needed to rest for a minute or two. Then, he started running again, finishing the final three miles of the race. Despite the accomplishment, instead of words of congratulations, his friends had a blunt and clear message for him, They made me promise that I would go to a cardiologist, recalls Shah.

Days later Shah was sitting in a Penn cardiologists office to undergo stress tests. Twelve minutes on the treadmill didnt raise any red flags. After all, Shah was an avid runner. However, more stress tests that day would, indeed, reveal he was having heart issues.

Shah had trouble wrapping his head around this new reality. "I felt pretty depressed just knowing I had a heart issue. I took pride in exercising regularly. I was even training other people for marathons, Shah recalls. His doctors had said with proper recovery time and a healthy diet, he could take up racing once again.

Racing was the least of his worries at the time, however. This sudden health complication left Shah worrying what the future held for family. "I had no will. I had two girls that I needed to put through college, says Shah. As men we dont like to cry, but I came close to it."

Doctors recommended an angioplasty and four stents to clear blockages in multiple arteries.

Before the procedure even took place, Shah decided hed give himself a challenge that hed never attempted: completing that triathlon.

I signed up to do Philadelphia Triathlon before my angioplasty. I told my doctor look, I have so much faith that I signed up to do a triathlon. I will cross that finish line."

Shahs surgery was a success, but he knew that simply completing the surgery and receiving stents wasnt a green light to completing a triathlon. This became alarmingly clear to him when he started having some mild chest pains during training. Shah knew he needed guidance so that he didnt inadvertently create more health problems for himself. Thats when he turned to Neel P. Chokshi, MD, MBA, medical director of the Sports Cardiology and Fitness Program and an associate professor of Cardiology in the Perelman School of Medicine at the University of Pennsylvania. He asked Chokshi about that minor chest pain, and more. He was also interested understanding effective training protocols for a triathlon to optimize his performance, minimize his risk of a heart related event and improve his diabetes via exercise, recalls Chokshi.

While Shah still struggled to wrap his mind around how someone as active as him could have such serious heart issues, Chokshi says although coronary disease in avid exercisers may seem unlikely, its not uncommon to find other risk factors that can raise risk for heart issues. Diet, cholesterol, blood pressure and lifetime exposure to these factors are important contributors to risk. What is often more surprising in these patients, is the presentation or signs of disease. These patients often present with subtler symptoms in light of their high degrees of fitness. Chokshi says even a small change in running pace or mild chest pains during a warm up can often represent a real issue.

Shah underwent several tailored stress tests with Chokshi and his team to ensure his safety at a high intensity of exercise, but a triathlon is difficult to simulate in a doctors office. Additional stressors, according to Chokshi, include heat stress and electrolyte changes from hours of endurance activity, as well as the possibility of heart attacks or irregular heart rhythms triggered by similar competitive situations.

We encouraged him to log more training hours and to participate in shorter events to build up to a triathlon race, says Chokshi. From there, Shah worked with one of Penns exercise physiologists to develop a training program.

Since his first successful triathlon, Shah has completed a total of six Half Ironman races up and down the East Coast. He credits is care team at Penn Medicine for giving him a second chance at life. When his heart issues were discovered back in 2009, Shah chose to view the complications as a way to change course for the better.

I had two options, Shah recalls. I can look at this and be sad and stop doing what Im doing, or I can pick up another challenge and catch the bull from the horns.

Chokshi says that kind of attitude in a heart patient is key to success, Completing a triathlon is a significant feat for any individual given the mental toughness, physical endurance and commitment required. Patients are often discouraged by their conditions and even their age, but Sanjays story demonstrates the possibilities after being diagnosed with a heart issue.

Running has now become a family affair for the Shahs. Sanjays granddaughters, ages 6 and 8, are now taking part in 5ks with their grandfather. Shahs own daughter is now a coach for a girls track team. Shah is eager to share his story with family, friends, and anyone who will listen to spread the message about heart health. He says exercise and a healthy diet are crucial.

"Having fun and enjoying life is in important. But you dont want to pay for it and you lose it all. It's not worth losing it all due to the bad effects it has on your heart. We all like to party, drink, eat what we wantbut we pay the price."

To learn more about Penns Sports Cardiology and Fitness program, or to find a doctor, click here.

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Heart Health is What Keeps This Penn Cardiology Patient Running - Penn Medicine

Cardiology

PVM Cardiologist Anna McManamey Participates in Tuskegee … – Purdue University

Friday, April 7, 2023

For nearly 60 years, the Tuskegee University College of Veterinary Medicine has hosted its annual Veterinary Medical Symposium and this year a Purdue Veterinary Medicine clinician served as a featured speaker.Dr. Anna McManamey, clinical assistant professor of cardiology, gave the Lunch and Learn presentation Friday, March 24, on the topic, Diagnostic and Treatment Strategies for Asymptomatic Heart Disease. The talk was sponsored by Boehringer Ingelheim Animal Health.Board certified in cardiology by the American College of Veterinary Internal Medicine, Dr. McManamey is a 2016 DVM graduate of the University of Missouri College of Veterinary Medicine and completed her residency at North Carolina State University.She joined the Purdue faculty in 2021.

The 57th Annual Tuskegee Veterinary Medical Symposium, which was held March 22-25, focused on the theme Cultivating a Sustainable Future for the Veterinary Profession. This year marked the first time since the pandemic that the event was held in person. This conference brings together veterinarians and Tuskegee alumni from across the country to discuss important issues related to animal health and veterinary medicine.The event also honored Tuskegee University College of Veterinary Medicine reunion classes, including PVM Dean Willie Reeds class, the Class of 1978, which celebrated its 45th reunion.

The Tuskegee University College of Veterinary Medicine is the only veterinary medical professional program located on the campus of a historically black college or university (HBCU) in the United States. The first class graduated in 1945.Today, the total number of Tuskegee veterinary medical graduates is nearly 3,000.

Writer(s): Kevin Doerr | pvmnews@purdue.edu

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PVM Cardiologist Anna McManamey Participates in Tuskegee ... - Purdue University

Cardiology

Peconic Bay Medical Center names new chairs of surgery and … – RiverheadLOCAL

Peconic Bay Medical Center appointed two new department chairs in March.

Dr. Luis Davila Santini was named chair of surgery and Dr. John Kassotis, was named chair of cardiology, the hospital announced in a press release March 21. As department chairs, they will provide senior oversight of hospital-based services at PBMC.

Both doctors have shown the utmost commitment to expanding services and providing the highest quality medical care, thus further expanding our footprint and positive impact on the East End, PBMC Executive Director Amy Loeb said. We are excited about their addition and look forward to working with them.

Before joining PBMC, Santini spent 11 years at South Shore University Hospital, where he was named the director of vascular surgery services for Northwell Healths eastern region. He developed a network of surgeons in this leadership role, providing state-of-the-art emergent and elective vascular services to five regional hospitals.

Im honored to be able to start this new position at Peconic Bay Medical Center, Santini said. As chair I will aim for our department to continue to reach the high standards of patient care that the medical center is known for, as well as grow and expand the services of the department.

Kassotis, PBMCs new cardiology chair, has held numerous roles in his fields of expertise, which include general cardiology, electrophysiology and heart failure. He has served as the director of the clinical cardiac electrophysiology section at New York Methodist Hospital and the clinical professor and director of the clinical cardiac electrophysiology laboratory and section at SUNY Downstate Medical Center.

Im thrilled to be joining the award-winning cardiac services team at Peconic Bay Medical Center, Kassotis said. It is my goal to continue to expand our cardiac footprint and to provide the best possible care in the region to our patients.

Source: Peconic Bay Medical Center press release

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Peconic Bay Medical Center names new chairs of surgery and ... - RiverheadLOCAL

Cardiology

Cardiology suicide report: 6 things to know – Becker’s ASC Review

While 1 percent of cardiologists have attempted suicide, an additional 8 percent have thought about attempting suicide, according to Medscape's 2023 "Cardiologist Suicide Report," which looked at survey results from over 9,100 practicing physicians across 29 specialties.

Here are five additional things to know from the report:

1. Two percent of female cardiologists have attempted suicide, compared to less than 1 percent of male cardiologists.

2. While 12 percent of female cardiologists have considered suicide, that number drops to 7 percent among male cardiologists.

3. Cardiologists between ages 42 and 56 are the most likely to have suicidal ideations, at 12 percent. An additional 2 percent have attempted suicide.

4. While 40 percent of respondents reported telling a family member about suicidal ideations, 5 percent reported calling a suicide hotline.

5. About 18 percent of cardiologists believe that health systems and medical schools should be responsible for student and physician suicide, and 55 percent believe they should not be.

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Cardiology suicide report: 6 things to know - Becker's ASC Review

Cardiology

5 studies that could make a big impact on interventional cardiology – Cardiovascular Business

1.RENOVATE-COMPLEX PCI found intravascular imaging-guided percutaneous coronary intervention (PCI) offered better outcomes compared to angiography-guided PCI procedures. With more than 1,600 patients enrolled, the study found the number of coronary incidents that occurred after PCI procedures guided by optical coherence tomography (OCT) or intravascular ultrasound (IVUS) was about 7.7% vs. 12.3% for angiography-guided procedures.

"It really showed a benefit for use of intracoronary imaging," Rao explained. "The use of intracoronary imaging in the U.S. is still lagging behind that of other countries. For coronary trials, it was one of the more important trials to come out of ACC."

He said SCAI has dedicated resources to help operators who want to learn more about intravascular imaging to help boost the U.S. usage rates. He said this trial should help convince more facilities to adopt it.

2. TheTRILUMINATE Pivotal Trial for the Abbott TriClipexamined transcatheter edge to edge repair (TEER) of the tricuspid valve to reduce or eliminate regurgitation. The device was found to be superior to the current standard of care of using medical therapy alone, and clear improvements were seen in patient quality of life. While the results did not show a major difference in mortality and heart failure hospitalizations were only slightly lower in the device group, the big takeaway was that TEER made the patients feel much bette after treatment with the TriClip."These patients have very, very poor outcomes, and we know they are at high risk for heart failure and mortality. The data is complicated and mixed, but anything that improves the quality of life in our patients is valuable," Rao said.

3.Safety and Efficacy of TEER in Degenerative Mitral Regurgitation: Analysis from the STS/ACC TVT Registry. This review of MitraClip registry data from 19,088 patients treated with TEER confirmed that the device was associated with very good outcomes.. The rate of successful repairs that reduced or eliminated MR was 89%. Successful repairs also resulted in major reductions in mortality, heart failure readmissions and in the need for reinterventions at one year.

"I think this speaks to the fact that people are selecting their patients carefully and the technology continues to mature," Rao said.

4.Five-Year Results of COAPT showed that using TEER to treat heart failure patients with secondary mitral regurgitation continued to show better outcomes across the board, beating the previous standard of care of medications only.

"It showed a percutaneous approach to functional MR is a really durable procedure. At the end of the day, it does appear we now have a good option," Rao said.

5. The FLAMEstudy comparedthe FlowTriever aspiration device for acute massive pulmonary embolism (PE) to anticoagualtion medication alone, showing that the device significantly reduced in-hospital adverse events and had more than a 90% reduction in high-risk PE mortality. Rao said these findings help inform treatment decisions, which are increasingly moving toward a more aggressive, interventional, catheter-based removal of clots. Cardiology is also becoming more involved at the increasing number of hospitals creating PE responses teams (PERT).

"We are sorely in need to randomized trials in this space," Rao explained.

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5 studies that could make a big impact on interventional cardiology - Cardiovascular Business

Cardiology

Low, average and high income for the top 20 most recruited specialties – Becker’s ASC Review

According to the "2022 Review of Physician and Advanced Practitioner Recruiting Incentives" provided by AMN Healthcare's physician recruiting firm Merritt Hawkins, non-invasive cardiology is the highest paying top recruited physician specialty.

The review was created using a representative sample of 2,695 permanent physician and advanced practitioner search engagements that were ongoing or conducted by Merritt Hawkins/AMN Healthcare's staffing companies from April 1, 2021, to March 31, 2022.

Low, average and high income for the top 20 most recruited physician and advanced practice specialties:

Nurse practitioner

Low: $68,000

Average: $138,000

High: $266,000

Family medicine

Low: $185,000

Average: $251,000

High: $322,000

Radiology

Low: $200,000

Average: $455,000

High: $650,000

Psychiatry:

Low: $145,000

Average: $299,000

High: $450,000

OB-GYN:

Low: $138,000

Average: $321,000

High: $520,000

Internal medicine:

Low: $180,000

Average: $255,000

High: $375,000

Anesthesiology:

Low: $260,000

Average: $400,000

High: $500,000

Cardiology (non-invasive)

Low: $300,000

Average: $484,000

High: $1,000,000

Cardiology (interventional)

Low: $425,000

Average: $527,000

High: $668,000

Gastroenterology

Low: $216,000

Average: $474,000

High: $600,000

Hematology/oncology

Low: $215,000

Average: $404,000

High: $590,000

Certified registered nurse anesthesiologists

Low: $163,000

Average: $211,000

High: $270,000

Hospitalist

Low: $203,000

Average: $284,000

High: $376,000

Pulmonology/critical care

Low: $212,000

Average: $412,000

High: $650,000

Pediatrics

Low: $200,000

Average: $232,000

High: $412,000

Orthopedic surgery

Low: $400,000

Average: $565,000

High: $790,000

Urology

Low: $400,000

Average: $510,000

High: $600,000

Neurology

Low: $275,000

Average: $356,000

High: $525,000

Dermatology

Low: $250,000

Average: $351,000

High: $450,000

Rheumatology

Low: $200,000

Average: $258,000

High: $325,000

Oral maxillofacial surgery

Low: $300,000

Average: $368,000

High: $450,000

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Low, average and high income for the top 20 most recruited specialties - Becker's ASC Review

Cardiology

How one cardiologist turns to art to be a better doctor – The Philadelphia Tribune

The life of a doctor isn't easy these days. Many are saddled with massive student loan debt, work long hours and continue to deal with the trauma of treating patients during the pandemic.

Doctors, nurses and other front-line health-care workers bore the brunt of the pandemic. Many contracted covid-19, and some even had to intubate their colleagues. Others developed long covid, and some suffered such intense emotional pain that they died by suicide. Doctors who want to seek mental health support are fearful of retribution from state licensing boards.

National Doctors' Day is celebrated every March 30 to recognize the contributions of physicians. The first Doctors' Day was observed by Eudora Brown Almond, the wife of a Georgia doctor who sent notes and flowers to physicians. She chose March 30 because it's also the date in 1842 when anesthesia was first used, a remarkable milestone in patient care. The day became an official holiday when Congress passed a proclamation in 1991.

To celebrate National Doctors' Day, I wanted to highlight the contributions of Shirlene Obuobi, a cardiologist, cartoonist and author, who writes regularly for The Post. Recently, I had the chance to chat by email with her while she was on a short break at the hospital. Here's our conversation.

Q: Did you always know you would become a doctor?

A: I decided I wanted to be a doctor at a really young age. It was a fairly practical decision; my mom is a neonatologist, I grew up in health-care environments, and I was a high-achieving kid who wanted to make her West African parents proud. My reasons got more complicated and personal with age. I find that medicine has the potential to be inherently fulfilling both intellectually and emotionally. I like that my job allows me to be a part of peoples' family, so to speak. Cardiology was a bit different - I joke that I went into it kicking and screaming near the end of my first year of residency. It's notoriously intense, but I love the physiology, the scope and the constant movement in the field.

Q: How did you get into writing and art while you were also being a doctor?

A: I've been writing and drawing for as long as I can remember! I've been creating stories and processing my experiences through art since I was a kid, and continuing to do so during my journey through medicine was a given.

Q: What's your favorite aspect of creating comics or writing?

A: The daydreaming! When I have an experience, I often attempt to translate it into art in my head, or find ways to figure out how I could portray the scenario to someone who doesn't have my context.

Q: Do you think having this outlet helps you connect with patients or process the experience of being a doctor?

A: Absolutely. Maintaining empathy in health care and especially as a trainee requires active effort. People are our work, and they are our work when we haven't slept for multiple days, when we've skipped meals, when our family members are getting impatient with us because we're so rarely present. By revisiting my experiences in art, I'm able to process my own feelings and put myself in the shoes of not only my patients but my colleagues. I think it keeps me from becoming a complete nightmare.

Q: What's the stress level like now that the intense part of the pandemic - and the 7 p.m. cheering every night - is over?

A: Ha! Honestly, I don't think the cheering ever really felt like it had much substance in the early days of covid. Most of my colleagues would say they'd prefer something concrete, like better pathways to loan forgiveness. It's very stressful and usually thankless. But there are the occasional days and moments that make it worth it. Keep in mind, I'm a cardiology fellow. I have a sleep debt about five years deep!

Q: What do you want patients to take away from your columns?

A: I have a couple of missions. I want to humanize medicine and the people in it. There's a lot of dissatisfaction with the American health-care system that I think is misplaced upon the people who are the faces of it. But doctors and other health-care workers are people, privy to the same tendencies and biases as everyone else, and they also are subjected to a considerable amount of primary and secondary trauma that has been totally normalized, even though it has clear consequences on our mental health.

I also want to give people insight into how health care works from the point of view of health-care workers, so that they can better advocate for themselves.

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How one cardiologist turns to art to be a better doctor - The Philadelphia Tribune