PA-CC & CardioNerds Narratives in Cardiology Archives - Cardionerds

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PA-CC & CardioNerds Narratives in Cardiology Archives - Cardionerds episodes

October 31, 2024398. Narratives in Cardiology: Career Flexibility in Cardiology with Dr. Minnow Walsh
In this episode, Dr. Gurleen Kaur (Cardiology FIT at Brigham and Women’s Hospital and APD of the CardioNerds Academy) and Dr. Diane Masket (Medicine Resident at the University of Chicago Northshore and CardioNerds Academy Intern) discuss with Dr. Minnow Walsh (Medical Director of the Heart Failure and Cardiovascular programs at Ascension St. Vincent Heart Center in Indianapolis) about her personal and professional journey in Cardiology. They discuss Dr. Walsh’s authorship of the recent ACC statement on career flexibility in Cardiology, her involvement with the ACC at both the local and national levels, and her passion for making cardiology a more inclusive and welcoming field for all.
Notes were drafted by Dr. Diane Masket and episode audio was engineered by student Dr. Grace Qiu.
This episode is supported by the 5th Annual Going Back to the Heart of Cardiology (A MedscapeLIVE Conference). Join co-chairs Dr. Robert Harrington and Dr. Fatima Rodriguez January 24-26, 2025 at the Fontainebleau Hotel in Miami Beach, Florida.
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Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
The PA-ACC & CardioNerds Narratives in Cardiology Page
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Video version – Career Flexibility in Cardiology
Quoatables – Career Flexibility in Cardiology
“You have to learn to live with ambivalence. You can’t do everything. You can’t do everything all at one time”
“One of the most important things the College is behind and pushing, is that competency-based evaluation is what should be used in fellowship rather than this sort of cookie cutter approach where you have to do these many months of echo and this much of cath lab. So, I think flexibility moving from volume to competency is one push.”
“Fellowship is daunting, and internal medicine residency is too, but I think culture is how we feel every day. And I think the more we increase flexibility the more that culture is going to shift.
Notes – Career Flexibility in Cardiology
Process of developing ACC Health Policy Statements
These documents address issues that require ACC influence and usually involve a variety of institutions, governing bodies, and other stakeholders. ACC comes to an agreement on how they will approach this topic and shares it broadly.
Most of the existing ACC health policy statements are disease-based instead of profession-based. The ACC Career Flexibility statement grew out of the diversity, equity, and inclusion task force, which is a standing committee.
A variety of authors are included in health policy statements to reflect the perspectives of many different interest groups.
All policy statements, including the one about career flexibility, are available online on JACC.org 1
Major Components of the ACC Career Flexibility Health Policy Statement
There are 18 principles that highlight the most important aspects regarding career flexibility in cardiology.2
Flexibility allows for deceleration (decrease in work hours, responsibilities, etc.) and acceleration based on the needs of the physician. For example, during childbearing and rearing time periods, there could be a deceleration, which could accelerate when parenthood responsibilities have decreased.
It does not only need to be based around parenting; physicians who are not parents also desire flexibility and enjoy spending time on activities other than their careers. These needs will be unique for each person.
Individuals seeking flexibility also must understand that there will be an adjustment in their compensation as they are no longer working full-time.
Career flexibility is beneficial at all stages with a desire for a safe training environment early, ability to decelerate mid-career to focus on other priorities and late career to possibly accelerate and works towards a tenure.
Allowing flexibility in cardiology is a major pathway to increasing diversity in the workforce which ultimately creates a more inclusive and welcoming environment.
Both men and women in cardiology are interested in flexibility. For many years there was a belief that only women wanted this flexibility; however, in recent years it has become apparent that all cardiologists seek the opportunity for a better work-life balance.
References:
https://www.jacc.org/guidelines
2022 ACC Health Policy Statement on Career Flexibility in Cardiology. J Am Coll Cardiol 2022;Oct 13
36 min
July 19, 2024381. Narratives in Cardiology: Advocacy for Refugee Health and Empowering First-Generation Cardiologists with Dr. Heval Kelli
In this episode, Dr. Gurleen Kaur (Cardiology FIT at Brigham and Women’s Hospital and APD of the CardioNerds Academy) and Dr. Chelsea Amo-Tweneboah (Medicine Resident at Stonybrook and CardioNerds Academy Intern) discuss with Dr. Heval Kelli (Cardiologist at Northside Hospital Cardiovascular Institute) about his personal and professional journey in Cardiology. They discuss Dr. Kelli’s lifelong advocacy for serving those in need including refugee and immigrant communities, his character in the documentary Refuge, and fostering inclusivity within Cardiology. Audio editing and show notes were drafted by Dr. Chelsea Amo-Tweneboah.
Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
The PA-ACC & CardioNerds Narratives in Cardiology Page
CardioNerds Episode Page
CardioNerds Academy
Cardionerds Healy Honor Roll
CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
Check out CardioNerds SWAG!
Become a CardioNerds Patron!
Video version – Advocacy for Refugee Health and Empowering First-Generation Cardiologists
Quoatables – Advocacy for Refugee Health and Empowering First-Generation Cardiologists
“I have always believed that if someone opened the door for you, you have to hold the door for the next generation. Because if you just walk through the door and close it, you just close the door for many people behind you.”
“Instead of making luck a matter of luck, just make an opportunity for everyone else.”
“Hate makes us realize that no matter how privileged you are, you are not protected.”
“It is very hard to hate something you know.”
“Compassion starts with the neighbor next to you, and then you go out to the world and show it.”
“Your best intern wasn’t the smartest intern. Your best intern was the person ready to go for rounds, took care of everything, sharp early in the morning, stays late, and gets the work done.”
“Intelligence is relative. Hard work and dedication [are] the most important thing.”
Notes – Advocacy for Refugee Health and Empowering First-Generation Cardiologists
Advocacy for refugee health and empowering first-generation cardiologists
Focusing on creating professionals from a given community can help increase their chances of returning to that community and helping to address health disparities.
Refugees and immigrants come from countries and communities where, by and large, prevention is lacking. Seeing a healthcare provider is more appropriate in dire situations.
When approaching immigrants, it is important to present medical information in ways in which they can understand and absorb properly.
For many refugee families, there exists a language barrier and the children are most often the advocates for the family because they are most likely to understand the language of the community they live in.
The vast number of students in the US medical school system come from privileged backgrounds; however, this same statistic is not true for the populations they end up serving.
It is important to have health professionals reflect the populations they serve, and one of the methods to achieve this is through introducing as many individuals as possible to the field of medicine; one of the ways to overcome a leaky pipeline is to pack the pipeline. Strategies include encouraging medical students to serve as mentors for those junior to them.
It is important to build more sustainable relationships with communities because it leads to more trust and success.
Advocating for mental health in these communities is very important because they face these issues at an increased level. However, it is unfortunately under-addressed.
Resource avenues such as the CDC provide substantial information regarding different refugee and immigrant profiles and the issues most pertinent to these communities.
Inclusivity in Cardiology
It is important to normalize people feeling comfortable in having a discourse about differences and recognizing the challenges individuals face when pursuing a career in medicine or cardiology in order to promote inclusivity in this field. This is a major goal for the CardioNerds Narratives in Cardiology program.
Within Cardiology, structural racism and hate are present.
It is important to place yourself in a challenging environment or one different from what you are used to and attempt to find common ground with other individuals.
The Bridge Between Social Issues and Cardiology
As a physician, it is important to create boundaries and choose what social issues you wish to engage in.
If groups of people do not see eye to eye, steps should be taken to reach out to one another and establish and try to understand what these differences are.
Physicians are the best advocates in the world because, for the most part, they are trusted by their patients. Recognizing the importance of the influence that physicians have and realizing this influence can extend beyond the medical space.
Humor can be another means by which to make it easier to bring up important conversations that may otherwise be difficult.
Technology to Help Bridge the Gap
Technology can serve as a means of being able to communicate with refugee families because they are likely to have access to a smartphone.
Refugee families most often don’t understand the information given to them in paper or pamphlet form, and often important medical advice can be lost that way.
Technology provides increased access to medicine and allows patients more individuality and control in keeping on top of their health.
Artificial intelligence technology is the direction that health and medicine are heading in; thus, health professionals and patients must learn how to use this technology to their advantage.
21 min
May 30, 2024373. Narratives in Cardiology: Becoming a “Big E” Medical Educator as a Cardiologist with Dr. James Arrighi
In this episode, Dr. Katie Fell (General Cardiology Fellow at University of Michigan and CardioNerds Academy Fellow) and Dr. Gurleen Kaur (incoming General Cardiology fellow at Brigham and Women’s Hospital and Director of CardioNerds Internship) discuss with Dr. James Arrighi (General Cardiologist and CEO of ACGME-International) about developing as a clinician educator and the concept of competency-based education.
Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
The PA-ACC & CardioNerds Narratives in Cardiology Page
CardioNerds Episode Page
CardioNerds Academy
Cardionerds Healy Honor Roll
CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
Check out CardioNerds SWAG!
Become a CardioNerds Patron!
Video version – Becoming a “Big E” Medical Educator as a Cardiologist with Dr. James Arrighi
Quoatables – Becoming a “Big E” Medical Educator as a Cardiologist with Dr. James Arrighi
“You really have to have a passion or a love for what you do…that’s probably responsible for most of the success one has in life” (time 4:43)
“Sub-subspecialty societies in Cardiology represent [a] great opportunity for junior faculty or even trainees to get involved, even before getting involved in ACC.” (time 5:30)
“Competency-based medical education and time variable training are not synonymous.” (time 16:43)
“As Cardiology evolves into more and more subspecialties…it begs the question… ‘Is Cardiology a primary specialty?’” (time 27:30)
“We need to think about [a] more efficient ways for training.” (time 31:55)
“As a clinician educator, there’s variety, there’s innovation!” (time 41:22)
Notes – Becoming a “Big E” Medical Educator as a Cardiologist with Dr. James Arrighi
How might one develop as a clinician educator on a national level?
Junior faculty and trainees should consider taking advantage of education opportunities in various Cardiology sub-specialty societies (ex: American Society of Nuclear Cardiology, ASNC). This may include involvement in different committees. These opportunities are great ways to build connections and establish a reputation on a national level. This can help lead to other opportunities with larger national organizations (ex: ACC, AHA).
Cardiology Training Oversight
The Accreditation Council for Graduate Medical Education (ACGME) and American Board of Internal Medicine (ABIM) both have regulatory power over Cardiology training, providing the minimum clinical experience standards for Cardiology fellowship training programs.
The ACGME oversees accreditation for Cardiology fellowships.
The ABIM defines the requirements for eligibility for certification of individuals.
Over time, the ACGME has transitioned to placing an emphasis on quality improvement, with a particular focus on continuous programmatic improvement.
The American College of Cardiology (ACC) helps define more granular recommendations for Cardiology training programs and their curriculum.
Periodically the ACC releases training guidelines for Cardiology fellowship programs, called Core Cardiovascular Training Statements, or COCATS. This document provides more contemporary, detailed, and specialty-specific recommendations for Cardiology training as compared to ACGME.
While ACC has no regulatory authority over Cardiology training programs, COCATS documents provide a roadmap for program directors on how to structure training.
The most recent version of the document, COCATS 4, incorporated in the concept of competency-based education (CBME).
What is Competency-Based Education (CBME)?
Medical education has evolved to focus more on outcome-based assessments of trainees structured around competency evaluations.
In 2002, the ACGME defined competencies by which training programs should evaluate their trainees. As a result, training shifted from a time-based structure to one in which trainees must demonstrate specific competencies within a specific time frame.
ACC further defined competencies for Cardiology training in the Core Cardiovascular Training Statement 4 (COCATS 4). This is the first COCATs document introducing aspects of CBME, including defining competencies, milestones, and tools to assess a Cardiology trainee’s performance.
Each of these documents focuses on optimizing fellow time while in training, targeting education to the learner’s goals and their future career trajectory.
Moving to a competency-based, time-variable training program in the U.S. would be challenging and would require significant restructuring of our current GME training system, including Medicare funding.
What is ACGME-International (ACGME-I)?
Group within the ACGME dedicated to improving health care internationally by assessing and advancing the quality of resident physicians’ education through accreditation.
The organization is currently present in 12 countries at 23 sponsoring institutions (as of April 2024).
ACGME-I provides postgraduate medical education programs with standardized frameworks on how to improve the quality of teaching, learning, research, and clinical practice for their trainees.
References
Weissman G, Auseon AJ, Arrighi JA, et al. Perceptions and Utilization of the U.S. Core Cardiovascular Training Statement. J Am Coll Cardiol. 2019;73(22):2896-2899.
Halperin JL, Williams ES, Fuster V. COCATS 4 Introduction. J Am Coll Cardiol. 2015;65(17):1724-1733.
Arrighi JA, Kilic S, Haines PG. Perspectives on Current Training Guidelines for Cardiac Imaging and Recommendations for the Future. Curr Cardiol Rep. 2018;20(6):43. Published 2018 Apr 23.
ACGME Program Requirements for Graduate Medical Education in Cardiovascular Disease. Accessed February 2, 2024.
Mendes LA, Weissman G, Berlacher K, et al. Competency-Based Alternative Training Pathway in Cardiovascular Disease and Clinical Cardiac Electrophysiology. J Am Coll Cardiol. 2022;79(25):2540-2542.
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
22 min
September 23, 2022234. Narratives in Cardiology: Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero – Minnesota Chapter
In this episode, Daniel Ambinder and Amit Goyal (CardioNerds co-founders), Dr. Gurleen Kaur (medicine resident at Brigham and Women’s Hospital and Director of CardioNerds Internship), student doctor Adriana Mares (medical student at the University of Texas El Paso/Texas Tech University Health Sciences Center El Paso, CardioNerds Academy Intern), and Dr. Teodora Donisan (general cardiology fellow at the Mayo Clinic and CardioNerds Academy Chief) discuss with Dr. Mayra Guerrero (Interventional Cardiologist and Professor of Medicine at the Mayo Clinic) about challenges with diagnosing and treating valve disease in women, as well as ideas on how to increase recruitment for women in cardiology including interventional and structural cardiology. Dr. Guerrero shares her inspiring personal journey and advice for how to navigate becoming a structural cardiologist as an international medical graduate, woman, and mother. Audio editing by CardioNerds Academy Intern, student doctor Adriana Mares.
Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
The PA-ACC & CardioNerds Narratives in Cardiology Page
CardioNerds Episode Page
CardioNerds Academy
Cardionerds Healy Honor Roll
CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
Check out CardioNerds SWAG!
Become a CardioNerds Patron!
Video version – Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero
Quoatables – Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero
“Work hard, give it your best, and your work will speak for itself. Don’t be afraid to work hard and you’ll be able to achieve anything you want.”
“I’m very fortunate to have had the opportunities that I’ve had, but now it’s my responsibility and the responsibility of many to make sure that we create those opportunities and that we provide mentorship for others who may want to follow the same steps into this field.”
“I get angry, it’s normal to have emotions, but what I’ve learned is to transform my anger into something good – think of a project, find a paper, do something good for your career…channel that energy to do something good.”
“It’s important that even at young ages you start thinking about how to pay it forward.”
“Don’t wait too long to have kids. There’s never a perfect time to be a parent. Once you decide to have a family don’t put a pause on your personal life for your career.”
Notes – Structural Heart Disease and LatinX Representation in Cardiology with Dr. Mayra Guerrero
Notes (by Dr. Teodora Donisan)
Structural valve disease in women and valve care in the global setting
Heart disease is the leading cause of death for women. However, the awareness regarding this major public health concern has been declining over the past decade. Valve disease awareness is one of the lowest, at less than 3%.
Women have higher mortality than men when they undergo surgical aortic or mitral interventions, mainly because of a higher risk profile. For example, women with severe aortic stenosis usually present at older ages and have many associated comorbidities, however the outcomes are good when they are treated with transcatheter aortic valve replacement (TAVR). Despite this, women are less likely to be referred for aortic valve replacement (AVR) than men. Once women are referred for therapy, they are more likely to be treated with TAVR than surgical aortic valve replacement (SAVR).
There is a deficiency in trial enrollment for women which we need to address in order to generate the knowledge we require with regards to treatment. We also need to identify whether there are referral biases when it comes to AVR.
Another hypothesis for the disparities in valve disease treatment for women when compared with men might be the decreased number of women in cardiology, especially in interventional cardiology (<10% of interventional cardiologists are women). Of note, <3% of TAVR operators are women (1.5% are surgeons and 1.5% are interventional cardiologists).
Diversity and inclusion in interventional cardiology
About 8% of interventional cardiologists are women and only 4.2% of cardiologists are Latinx.
In order to increase recruitment for WIC, the problem needs to be addressed on multiple levels.
Mentorship should be provided to cardiology fellows, and they should be supported in their choice for interventional cardiology. This should be equally offered and tailored to women and underrepresented minorities. Support should be given even earlier in their careers and lives, at school and even with the education they receive at home. Career goals can be achieved with hard work and determination, and this should be an integral part of the education and upbringing from an early age.
There is an institutional responsibility to help address this problem. It can start with training to decrease unconscious bias, improvements in workplace conditions (e.g., schedule flexibility, provide maternity/paternity leave, lactation rooms), opening leadership opportunities for women and URiMs, establishing diversity and inclusion committees.
The FDA, industry, and societies should have DE&I committees to ensure inclusive representation in clinical trial leadership and to ensure recruitment of women and minorities.
Work life harmony as an interventional cardiologist
You must choose your life partner well, caring for your family is teamwork.
You might miss moments, but if you work together with your partner and children, it works out.
It’s important to provide a strong role model for your family.
References
Vogel B, Acevedo M, Appelman Y, et al. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. Lancet. 2021;397(10292):2385-2438.
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
40 min
August 17, 2022228. Narratives in Cardiology: Radiation Safety & Women in Interventional Cardiology with Dr. Sheila Sahni – New Jersey Chapter
In this episode, Daniel Ambinder (CardioNerds Co-Founder), Dr. Gurleen Kaur (Director of CardioNerds Internship and medicine resident at Brigham and Women’s Hospital), Dr. Eunice Dugan (Cardiology fellow at Cleveland Clinic) and Dr. Zarina Sharalaya (Interventional and Structural Cardiologist at North Texas Heart) learn from the Dr. Sheila Sahni (Interventional Cardiologist and Director of The Women’s Heart Program at The Sahni Heart Center) regarding radiation safety in the cath lab and methods of reducing radiation exposure to the operator. She also discusses radiation safety for the pregnant interventional cardiologist and how to safely manage pregnancy during the gestational period. We hear her inspirational journey as a female interventional cardiologist and her experience in starting the Women’s Heart Program at Sahni Heart Center. Special message by Dr. Jeff Lander, New Jersey ACC Chapter Governor. Audio editing by CardioNerds Academy Intern, Pace Wetstein.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode.
The PA-ACC & CardioNerds Narratives in Cardiology Page
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Cardionerds Healy Honor Roll
CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
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Become a CardioNerds Patron!
Video version – Radiation Safety & Women in Interventional Cardiology with Dr. Sheila Sahni
Tweetorial – Radiation Safety & Women in Interventional Cardiology with Dr. Sheila Sahni
1/ Episode 228: @PaChapterACC & @CardioNerds Narratives in Cardiology episode featured a discussion w/ @DrSheilaSahni, @ZSharalayaMD, @EuniceDuganMD, & @Dr_DanMD

Follow this #CardsNarratives🧵on Radiation Safety & Women in Interventional Cardiology pic.twitter.com/YounyfIl8a
— Gurleen Kaur, MD (@Gurleen_Kaur96) August 27, 2022
Quoatables – Radiation Safety & Women in Interventional Cardiology with Dr. Sheila Sahni
“Having anyone who can believe in you when you are really passionate about something is really all you need… the passion is what’s going to carry you through. It’s not about being male or female or pregnant or not pregnant, it’s about what you love to do and how can you master it.”
“Our careers can wait, but family planning cannot. If you are fortunate enough to have the opportunity to start a family even if it’s during your training, you should”.
Notes – Radiation Safety & Women in Interventional Cardiology with Dr. Sheila Sahni
What are procedural techniques to utilize during a heart catheterization to reduce radiation exposure to the operator?
Decrease number and length of cine acquisitions and fluoroscopy time
Decrease the frame rate – halving the frame rate reduces radiation dose by 50%
Decrease the distance between the image intensifier and the patient
Limit steep LAO angulations
Apply collimation as much as possible which reduces overall patient dose and scatter radiation
Limit digital magnification which can increase skin dose exposure by 50%
What are the important dose limits to consider for a pregnant female and her fetus in the cath lab?
The US Nuclear Regulatory Commission (NRC) regulatory equivalent dose limit is 5mSv during the entire pregnancy of the declared pregnant woman.
The annual natural background radiation dose in the US is 3mSv.
The average under-lead dose to a working pregnant interventionalist over the entire gestation is ~0.3mSv.
The fetus of a working pregnant interventionalist is estimated to receive ~0.09mSv over an entire gestation.
What are the ways in which pregnant women can protect themselves and the fetus from radiation exposure in the cath lab?
Disclose (confidentially if desired) pregnancy to the radiation safety office to ensure fetal protection
Wear an additional dosimeter underneath the lead apron at waist level to track fetal radiation dose
Decrease occupational exposure via radiation protection measures as summarized below
What are important considerations for lead apron use in the cath lab to maximize radiation protection?
Make sure your lead fits!
Do not sit in your lead- sitting in lead can lead to cracks which can decrease protection
Hang up your lead when not being used
Consider shoulder pads/arm sleeve addition to lead apron to protect breast tissue
Ensure that your lead apron is undergoing periodic screening to monitor for defects
Consider lead thickness – 0.5mm thickness attenuates 98-99.5% of scattered radiation, 0.35mm thickness attenuates 95-96% of scattered radiation
References
Sahni S, Chieffo A, Balter S. Women as one. Radiation Safety in the Practice of Cardiology. https://rad.womenasone.org/. Accessed March 31, 2022.
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
55 min
June 03, 2022212. Narratives in Cardiology: Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp – Tennessee Chapter
CardioNerds (Amit Goyal and Daniel Ambinder), join Dr. Gurleen Kaur (Director of CardioNerds Internship and medicine resident at Brigham and Women’s Hospital), Dr. Victoria Thomas (Cardionerds Ambassador, Vanderbilt University Medical Center) Dr. Katie Berlacher (Cardiology program director, University of Pittsburgh Medical Center), and Dr. Julie Damp (Vanderbilt University Medical Center Cardiovascular disease fellowship program director) to discuss becoming & thriving as a fellowship program director and more in this installment of the Narratives in Cardiology Series. Special message by Tennessee ACC State Chapter Governor, Dr. John L Jefferies. Audio editing by CardioNerds Academy Intern, student doctor Akiva Rosenzveig.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode.
The PA-ACC & CardioNerds Narratives in Cardiology Page
CardioNerds Episode Page
CardioNerds Academy
Cardionerds Healy Honor Roll
CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
Check out CardioNerds SWAG!
Become a CardioNerds Patron!
Tweetorial – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp
1/ Episode 212, @PaChapterACC & @CardioNerds Narratives in Cardiology episode featured a discussion w/ @Drvic_thomas, @KBerlacher, & @BoydDamp

Follow this #CardsNarratives🧵on the discussion about Becoming and Thriving as a Fellowship Program Director pic.twitter.com/HgF1GPyqWT
— Gurleen Kaur, MD (@Gurleen_Kaur96) June 30, 2022
Video version – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp
Notes – Becoming & Thriving as a Fellowship Program Director with Dr. Katie Berlacher and Dr. Julie Damp
Drafted by Dr. Victoria Thomas.
1. What does it mean to be a big “E” when people say they are a clinician Educator?
It can mean teaching students directly at bedside. However, it is also a sacrifice of daily mentoring and listening to students’ challenges and difficulties.
Being a clinician educator is just as much of a calling as is serving in medicine.
Clinician Educators focus on medicine but also the science and best practices of teaching the art of doctoring.
2. What is physician burnout? Why is this important for to CardioNerds?
Physician burnout is a syndrome of chronic workplace stress that leads to emotional exhaustion and a sense of dissatisfaction and disconnection personally and professionally.
30-45% of cardiologists have reported physician burnout.
3. What factors affect physician burnout?
Emotional and physical exhaustion often lead to physician burnout. First year of training as an intern or fellow and first year of serving as an attending are particularly high-risk periods. This is largely due to learning a new system and responsibilities mixed with a sense of decreased accomplishment.
The sense of decreased accomplishment can lead to physicians suffering from impostor syndrome.
Grit can be defined as a perseverance for long-term goals. The level of grit was not associated with burnout among first-year Internal Medicine residents.
4. What are some of the solutions to prevent or address physician burnout?
Physicians need to feel a sense of belonging and should be supported and celebrated when they have accomplished something by their colleagues and administrators. Fellows and attendings want to feel listened to and supported.
Destigmatizing this idea of “perfection in medicine”. Physician should share with each other their accomplishments but also their mistakes to create a community of personal and professional connection and acceptance.
Practicing mini acts of gratitude such as exercise or therapy can help with burnout.
Delegation of work tasks and taking breaks have been shown to improve mental well-being.
5. What support do program directors have to help prevent burnout for themselves?
Many local graduate medical education (GME) offices will have some resources for program directors depending on the size and funding.
The Accreditation Council for Graduate medical Education (ACGME) had developed an on-line series to help new program directors understand their new roles.
It is also recommended to network and create community of program directors to work with and bounce ideas from.
6. What are some of the differences found among cardiology program directors regarding support from leadership?
45% of men versus 29% of women program directors felt adequate support from leadership. 56% of late-career versus 35% mid-career and early-career program directors felt adequate support from leadership.
There is no evidence to support this, however, but contributing factors may include the documented history of gender bias, wage inequality, and program size.
References Team
Cullen, M. W., Damp, J. B., Soukoulis, V., Keating, F. K., Abudayyeh, I., Auseon, A., … & Weissman, G. (2021). Burnout and well-being among cardiology fellowship program directors. Journal of the American College of Cardiology, 78(17), 1717-1726.
Mehta, L. S., Lewis, S. J., Duvernoy, C. S., Rzeszut, A. K., Walsh, M. N., Harrington, R. A., … & American College of Cardiology Women in Cardiology Leadership Council. (2019). Burnout and career satisfaction among US cardiologists. Journal of the American College of Cardiology, 73(25), 3345-3348.Peckham C. Physician burnout: it just keeps getting worse. Medscape; 2015.
Klein, A. J., Grau, T., Spagnoletti, C. L., Rothenberger, S. D., & Berlacher, K. (2021). Grit Does Not Predict Burnout among First-Year Internal Medicine Residents. Southern Medical Journal, 114(5), 272-276.
Edwards, S. T., Helfrich, C. D., Grembowski, D., Hulen, E., Clinton, W. L., Wood, G. B., … & Stewart, G. (2018). Task delegation and burnout trade-offs among primary care providers and nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs). The Journal of the American Board of Family Medicine, 31(1), 83-93.
Shanafelt, T. D., & Noseworthy, J. H. (2017, January). Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. In Mayo Clinic Proceedings (Vol. 92, No. 1, pp. 129-146). Elsevier.
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
56 min
April 27, 2022 197. Narratives in Cardiology: Empowering the LGBTQIA+ Community of Cardiovascular Patients & Professionals with Dr. Stephen Cook & Dr. Katie Berlacher – Indiana Chapter
CardioNerds (Amit Goyal and Daniel Ambinder), join Dr. Kara Denby (Interventional cardiology fellow, Cleveland Clinic), Dr. Tony Pastor (ACHD fellow, Harvard Medical School), Dr. Katie Berlacher (Cardiology program director, UPMC), and Dr. Stephen Cook (ACHD cardiologist, Indiana University) to discuss empowering the LGBTQIA+ community of cardiovascular patients & professionals and more in this installment of the Narratives in Cardiology Series. This episode features the Indiana ACC Chapter. Episode introduction and audio editing by CardioNerds Academy Intern, Pace Wetstein.
This discussion was inspired by this perspective piece on ACC.org titled: Finding Our Voices: Building an LGBTQIA+ Community Within Cardiology. To learn more about diversity and equity among the LGBTQIA+ population, check out this webinar organized by the ACC.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
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1/ Episode 197, @PaChapterACC & @CardioNerds Narratives in Cardiology episode featured a discussion w/ @KaraDenbyMD, @DrTonyPastor, @KBerlacher, @stephencookmd

Follow this #CardsNarratives🧵on the discussion about Empowering the LGBTQIA+ Community of CV Patients & Professionals pic.twitter.com/CiYZYFcWA9
— Gurleen Kaur (@Gurleen_Kaur96) May 16, 2022
Video version – Empowering the LGBTQIA+ Community of Cardiovascular Patients & Professionals
Coming soon
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
59 min
February 17, 2022180. Narratives in Cardiology: Raising Women Leaders in Academic Cardiology with Dr. Anu Lala
CardioNerds (Amit Goyal and Daniel Ambinder), Dr. Leticia Helms (Internal medicine resident at Columbia University), Dr. Silia DeFilippis (AHFT FIT at Columbia University), and Dr. Anu Lala (AHFT faculty and program director at Mount Sinai Hospital) to discuss diversity and inclusion in academic cardiology and more in this installment of the Narratives in Cardiology Series. The President of the New York ACC Chapter Dr. Hima Vidula discusses D&I initiatives at her chapter. Episode introduction and audio editing by CardioNerds Academy Intern, Shivani Reddy.
Although women compose 50% of medical students in the United States, cardiology remains a male dominated field. Gender disparity is even more prominent when we look at leadership positions. In this episode we discuss why and how cardiology (and advanced heart failure) can be such a rewarding field for women. The episode reflects on the significant contributions women have made to the field in the past and how they continue to move the field with respect to clinical care and research.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode.
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Tweetorial – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala
1/ In Episode 180 @PaChapterACC & @CardioNerds Narratives in Cardiology episode, @PrettiPimentaMD, @ersied727, @AmitGoyalMD, & @Dr_DanMD talk with @dranulala

Follow this #CardsNarratives🧵on the discussion about Raising Women Leaders in Academic Cardiology pic.twitter.com/meza3170Pa
— Gurleen Kaur (@Gurleen_Kaur96) March 30, 2022
Video version – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala
Quotables – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala
“We all have multiple roles – and those roles don’t always have to be completely distinct and separate from one another. You know, our ability in one role, maybe it makes us better at another.”
“I felt like being there was like in medical Disneyland for research.” – Anu Lala
“Heart failure is unique in that it truly requires that cross disciplinary collaboration at the precipice of what is often life and death.” – Anu Lala
“It points to the importance of seeing people do things before you who look like you.” – Anu Lala
“All human beings want to feel heard. They want to feel seen and they want to feel like their voice matters.” – Anu Lala
“consciously deliberately disruptive”
“I like the idea of calling it work-life harmony.”
Show notes – Raising Women Leaders in Academic Cardiology with Dr. Anu Lala
How do women compare to men in cardiology in 2022?
Although nearly 50% of US medical graduates and more than 40% of internal medicine graduates are women, the field of cardiology remains male dominated.
Approximately 20% of general cardiology fellows are women, which is comparable to women in surgical subspecialties like neurosurgery (17%), thoracic surgery (21%), and orthopedic surgery (15%) (Reza 2021).
Additionally, women hold significantly fewer leadership positions and are less likely to be promoted to senior academic ranks.
Out of LBCT presented at ACC 2021, zero had a female first author and zero were presented by women (Kaur 2021).
What may make heart failure unique with respect to the recruitment of women?
Heart failure is the only subspecialty of cardiology that was founded by a woman. Dr. Sharon Hunt is often described as the founder of the subspecialty.
She posited a few reasons why heart failure may attract a higher proportion of women including presence of models and mentors for women, women have been included since the inception of the field, and one that requires collaboration (Hunt 2019).
The number of women in HF training programs ranges between 26 to 36% which is much higher than that of women in other subspecialties like EP and interventional cardiology (Reza 2021).
How can we increase diversity in clinical trial leadership?
Women only represent 1 in 10 authors of cardiovascular trials in high impact journals (Van Spall 2021).
Build diverse research team.
Hold stakeholders accountable including academic institutions, professional societies, industry sponsors, funding agencies, and scientific journals (Van Spall 2021).
Be deliberate about editorial authorship as well as equal representation of women on manuscripts.
How can we increase the diversity of participants in clinical trials?
We know that increasing the diversity of women investigators in clinical trials is associated with increased enrollment of women participants (Reza 2020).
Increased enrollment of diverse populations is key to increasing the generalizability of findings (Van Spall 2021).
Build partnerships with the community and community-level providers.
Meet social and cultural needs such as family and child care responsibilities; socioeconomic and financial barriers; as well as absenteeism from work (Reza 2022).
Provide sex-specific materials to encourage enrollment.
For a related discussion, enjoy Ep #135. Underrepresentation in Clinical Trials & Guidelines with Dr. Clyde Yancy.
How has the COVID-19 pandemic affected women in academic medicine?
Women often bear disproportionate demands of personal life including schooling and caregiving duties and affected by school closures (Reza 2021).
Data have suggested that female academic productivity has been affected as measured by decreased publication authorship which may translate into decreased research support (DeFilippis 2021).
The decreased submission of manuscripts has been particularly pronounced among junior cohorts of women in academics (Squazzoni 2021).
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
55 min
February 04, 2022176. Narratives in Cardiology: Interventional Cardiology, Cardioobstetrics, & Work Life Integration with Dr. Ki Park – Florida Chapter
CardioNerd (Amit Goyal), Dr. Zarina Sharalaya (Interventional cardiology fellow at the Cleveland Clinic), Dr. Ashley Mohadjer (Interventional cardiology fellow, Vanderbuilt Heart and Vascular Institute), and Dr. Laurie Mbuntum (Cardiology fellow, UTSW) join Dr. Ki Park (Associate professor of medicine and an interventional cardiologist at the University of Florida and Malcom Randall VA Medical Center in Gainesville, FL.) for a a well-rounded discussion on all things ‘Women-in-Cardiology’ #WIC . Dr. Ki Park discusses how she nurtured her interest in interventional cardiology, and further shares her thoughts and passion for cardio-obsetrics. She shares her advice for trainees thinking about interventional or cardioobetrics and anecdotes from her training as a successful woman in the field. We discuss the need for education on pregnancy outcomes and long-term cardiovascular risk, ideas to lower maternal mortality, how to start a women’s cardiovascular clinic, and her thoughts on how the field may look in the future. Special message by Florida ACC State Chapter Governor, Dr. David Perloff. Episode introduction and audio editing by CardioNerds Academy Intern, Shivani Reddy.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • Production Team
Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode.
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Video version – Interventional Cardiology, Cardioobstetrics, & Work Life Integration with Dr. Ki Park
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1/ Episode #176: @PaChapterACC & @CardioNerds Narratives in Cardiology featured @LMbuntum, @AMohadjer, and @ZarinaSharalaya in discussion with Dr. Park (@cardioPCImom)

Follow this #CardsNarratives🧵on the discussion on #CardioObstetrics pic.twitter.com/xpeHwVwz37
— Gurleen Kaur (@Gurleen_Kaur96) February 22, 2022
Quotables – Interventional Cardiology, Cardioobstetrics, & Work Life Integration with Dr. Ki Park
“I like the work life integration as opposed to work life balance. Balance just implies that you always have everything aligned perfectly at all times and that is just not doable.”
Dr. Ki Park
Show notes – Interventional Cardiology, Cardioobstetrics, & Work Life Integration with Dr. Ki Park
Why is screening for OB-GYN history for cardiovascular risk is important, and who should be responsible?
Pregnancy is nature’s stress test and in some women can unmask someone’s predisposition to cardiac disease
Yearly screening for diabetes, hypertension, dyslipidemia
Big interdisciplinary effort in attempt to try to capture all women at risk, as many will not present with manifestation of disease initially
How did you nurture your interest in cardioobsetrics? In interventional cardiology?
Meetings and societies
Connect with those who work in the field, social media
Regarding interventional cardiology – having interest in procedures, do as many cases “hands on” as possible, learning from mistakes
What advise do you have to achieve work and life balance?
It’s important to understand the various occupational hazards of radiation exposure which include but are not limited to brain tumors, cataracts, thyroid disease, cardiovascular diseases, musculosketal problems and reproductive side effects.
Have grace, one can’t be 100% at every single thing all the time
Its more work life integration as opposed to a balance
Prioritize different things on different days, be honest with children and explain why you do what you do in age appropriate terms
Maternal mortality is high in this country with cardiovascular disease as a leading cause. What are important factors to improve maternal mortality?
Education
Improving access to care in the peripartum stage for mothers, particularly since the focus in that period is on baby
Legislature to improve insurance coverage
Where do you see cardioobsetrics field going in the next few years?
Make the knowledge more mainstream
Education of subspecialty fellows within cardiovascular education
Collaboration with ACOG and maternal fetal medicine societies
More registries of patients to continue to learn more about these women
What was involved to create the women’s heart clinic in your institution?
Start small – there are plenty of women who want to seek specialized care
Having an MFM and congenital faculty at the same institution was helpful
Seek advice from those at expert centers
What advise do you have for trainees looking to pursue a career in interventional cardiology who are worried about work-life integration?
Understand what you’re getting into, particularly for that year
Don’t be afraid to ask for help from friends or family at home to allow for more quality time with significant others, kids, friends, etc — this isn’t a sign of weakness
You don’t have to be perfect
Physicians have been found to delay childbearing compared to peers in other professions. What are your thoughts on this?
Progress has been made and overall there is increased awareness and support
Leave for trainees should be more flexible
More societal and institutional support
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
49 min
January 07, 2022171. Narratives in Cardiology: Innovation, Excellence and Leadership in Interventional Cardiology with Dr. Samir Kapadia – Ohio Chapter
CardioNerds (Amit Goyal and Daniel Ambinder), Dr. Zarina Sharalaya (Interventional Cardiology Fellow at the Cleveland Clinic), and Dr. Simrat Kaur (General Cardiology Fellow at the Cleveland Clinic) join Dr. Samir Kapadia, the Chair of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic. They discuss future advancements in the field of structural interventional cardiology. Dr. Kapadia sheds light on his journey starting as an international medical graduate from India and speaks about his mentors that helped shape his career and his life. We later delve into several advancements in the field of structural and interventional cardiology, along with the amalgamation of different sub-specialities with intervention such as heart failure and critical care cardiology. We also discuss the measures being taken to reduce the occupational hazards associated with interventional cardiology and how to make this field more appealing to women in cardiology. Special message by Ohio ACC State Chapter Governor, Dr. Kanny Grewal.
The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza.
Video Version • Notes • References • Production Team
Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode.
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Tweetorial on Innovation, Excellence and Leadership in Interventional Cardiology with by Dr. Gurleen Kaur
1/ In the latest @PaChapterACC & @CardioNerds Narratives in Cardiology episode, @AmitGoyalMD, @Dr_DanMD, @ZSharalayaMD, & @SimratKaurMD talk with @tavrkapadia

Follow this #CardsNarratives🧵on the discussion about IMGs & Innovation, Excellence, Leadership in IC pic.twitter.com/hkCuMF4UPB
— Gurleen Kaur (@Gurleen_Kaur96) January 20, 2022
Video version – Innovation, Excellence and Leadership in Interventional Cardiology with Dr. Samir Kapadia
Quotables – Innovation, Excellence and Leadership in Interventional Cardiology with Dr. Samir Kapadia
“A very important thing for all international medical graduates and for everybody, for that matter – it is important to recognize that the opportunities are what you perceive and not what others perceive.”
Dr. Samir Kapadia
Show notes – Innovation, Excellence and Leadership in Interventional Cardiology with Dr. Samir Kapadia
How do international medical graduates contribute to the work force in medicine across the United States of America?
International medical graduates account for 25% of the physician work force, with over 85% being involved in direct patient care.
IMGs are usually accomplished, consummate and highly motivated physicians who often have to overcome challenges such as language proficiency, acculturation and difficulties with obtaining a visa status in the United States.
IMGs also help fill gaps in health care by working in geographical areas that are otherwise not desirable by US or Canadian medical graduates.
IMGs contribute to diversity of the field which provides a richer training environment, improved access to health care for underrepresented minorities, as well as better patient outcomes.
What are key qualities of a good mentor?
A good mentor is responsible for enhancing the education of his or her mentees along with motivating them to challenge their limits.
Qualities of a good mentor extend beyond mere mentorship to sponsorship, where the mentor opens up his or her network for the mentee allowing them to pursue a path of success.
A mentor serves as an advisor and a counselor, helping his or her mentees navigate difficult paths teaching them to become resilient physicians.
A mentor also serves as a confidante for the trainee with whom mentees can share their dreams, aspirations and vulnerabilities knowing not only will this be kept in confidence but will also provide a catalyst for their growth.
What are the recent advancements in minimizing radiation exposures for structural cardiologists?
It’s important to understand the various occupational hazards of radiation exposure which include but are not limited to brain tumors, cataracts, thyroid disease, cardiovascular diseases, musculosketal problems and reproductive side effects.
When dealing with possible occupational radiation exposure, we should strive for the ALARA (as low as reasonably achievable) principle of radioprotection.
The RADPAD (RADPAD 5100A-O; Worldwide Innovations & Technologies, Inc, Lenexa, KS) is a new development that is a lead field shield that is placed between the patient and the operator to reduce scatter radiation and significantly reduce operator radiation exposure.
The use of Zero gravity lead is a novel suspension shield which has also been shown to significantly reduce the operator radiation exposure and potentially decrease orthopedic injuries particularly spinal injuries secondary to the protective lead garments.
What are the future directions for structural interventions and how is the field of structural cardiology going to evolve in the next few years?
The future of structural cardiology provides great promise. After the success of transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve edge to edge repair (TEER), there has been increasing development in tricuspid interventions as well as interventions for severe mitral stenosis due to mitral annular calcification.
The amalgamation of structural interventional cardiology and heart failure as well as with critical care are also exciting fields that is still developing. Advancements in left ventricular restoration devices such as the Revivant TC system may help several patients with end stage congestive heart failure due to ischemic heart disease.
References
Steward DE. The internal medicine workforce, international medical graduates, and medical school departments of medicine. Am J Med 2003;115(1):80–4. Doi: 10.1016/s0002-9343(03)00307-3.
Kostis JB., Ahmad B. International medical graduates and the cardiology workforce. J Am Coll Cardiol 2004;44(6):1172–4. Doi: 10.1016/j.jacc.2004.05.081.
Al Hussein Al Awamlh B. Alien J-1 Physicians in a Pandemic. JAMA Intern Med 2021;181(6):743–4. Doi: 10.1001/jamainternmed.2021.0730.
David YN., Issaka RB. Advancing diversity: the role of international medical graduates. Lancet Gastroenterol Hepatol 2021;6(12):980–1. Doi: 10.1016/S2468-1253(21)00376-9.
Shikhar A. Mentorship During Fellowship. J Am Coll Cardiol 2014;64(15):1637–8. Doi: 10.1016/j.jacc.2014.08.017.
Tobin MJ. Mentoring: seven roles and some specifics. Am J Respir Crit Care Med 2004;170(2):114–7. Doi: 10.1164/rccm.2405004.
Picano E., Vano E. The Radiation Issue in Cardiology: the time for action is now. Cardiovasc Ultrasound 2011;9(1):35. Doi: 10.1186/1476-7120-9-35.
Vlastra W., Delewi R., Sjauw KD., et al. Efficacy of the RADPAD Protection Drape in Reducing Operators’ Radiation Exposure in the Catheterization Laboratory: A Sham-Controlled Randomized Trial. Circ Cardiovasc Interv 2017;10(11). Doi: 10.1161/CIRCINTERVENTIONS.117.006058.
Zanca F., Dabin J., Collard C., et al. Evaluation of a suspended radiation protection system to reduce operator exposure in cardiology interventional procedures. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 2021;98(5):E687–94. Doi: 10.1002/ccd.29894.
GP., Y.S. C. Continuing Advances and Challenges of Structural Heart Imaging. JACC Cardiovasc Imaging 2021;14(1):128–30. Doi: 10.1016/j.jcmg.2020.12.002.
Klein P., Anker SD., Wechsler A., et al. Less invasive ventricular reconstruction for ischaemic heart failure. Eur J Heart Fail 2019;21(12):1638–50. Doi: 10.1002/ejhf.1669.
Production Team
Dr. Gurleen Kaur
Amit Goyal, MD
Daniel Ambinder, MD
44 min

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