Cardiac Auscultation Explored in New Book
Medical technology has made tremendous strides in recent decades, revolutionizing health care and vastly improving and extending lives of millions. Are we in danger of relying too much on these technologies at the expense of traditional face-to-face interaction between doctor and patient?
In Learning Cardiac Auscultation: From Essentials to Expert Clinical Interpretation, editor Allen Taylor, MD, FACC, FAHA, chief of Cardiology at MedStar Washington Hospital Center and MedStar Georgetown University Hospital, uses a case-based approach to explore the search for diagnostic clues within patients’ heart sounds. Stuart Seides, MD, physician executive director, MedStar Heart & Vascular Institute, comments, “Relying on tests alone is like flying a plane solely on instruments; often accurate, but when misleading can be fatal. The physical examination is like looking out the cockpit window—a direct connection between the doctor’s senses and the patient’s heart and circulation.”
The 320-page book represents a three-year collaboration between the Georgetown University School of Medicine and MHVI. Published last fall, Dr. Taylor and a team of 62 medical students compiled 26 lectures, taking a case-based approach to auscultation, centered on the clinical application (diagnosis, management and prognosis) of auscultation findings.
David Pearle, MD, professor of Medicine (Cardiology), MedStar Georgetown University Hospital, says, “Under the leadership of master clinician Dr. W. Proctor Harvey, MedStar Georgetown University Hospital has been synonymous with excellence in the teaching of cardiac auscultation. As one who worked closely with Dr. Harvey, I know he would be pleased that this tradition is continued with this fine book edited by Dr. Taylor. This book is especially valuable as stethoscope skills have eroded in the face of new technologies, and a valuable clinical tool is increasingly underused.”
In his 20-year United States military career at Walter Reed Army Medical Center, Dr. Taylor served as director of cardiovascular research, director of the Cardiovascular Disease Training Program and chief of the Cardiology service.
Miriam L. Cohen, MD, Named Trailblazer in Healthcare
Miriam L. Cohen, MD, a cardiologist at MedStar Heart & Vascular Institute at MedStar Union Memorial Hospital, has been named a Trailblazer in Healthcare by The Center Club’s Women in Business. As the first trained female cardiologist in the state of Maryland, and among the first five in the United States, this award honors Dr. Cohen’s contributions and leadership as a pioneer in the health care industry.
“Dr. Cohen is an extraordinary clinician, physician and person,” said Stuart Bell, MD, vice president of Medical Affairs at MedStar Union Memorial. “There is no one more respected by her colleagues or more beloved by her patients, many of whom consider her a friend.”
With more than 47 years of experience, Dr. Cohen began her career as a cardiologist at Union Memorial in 1969 when the discipline was highly dominated by men. Overcoming discrimination and adversity, Dr. Cohen excelled and was involved in some of the very first trials and research on anti-arrhythmic drugs, beta blockers, and pacemakers. Along the way, Dr. Cohen has paved the way for future female cardiologists, helped thousands of patients, and has had an instrumental role in training the next generation of cardiovascular specialists. Today, she continues her role as a notable cardiologist in the career she began almost half a century ago.
Structural Heart Disease Symposium
An international audience of cardiovascular professionals gathered in April in Chicago for the 65th Annual Scientific Conference of the American College of Cardiology. The conference, Impact Innovation, focused on “cutting-edge advances and practice-changing updates in cardiovascular care.”
At a special dinner symposium, more than 350 attendees joined panel members from MedStar Heart & Vascular Institute (MHVI), Cleveland Clinic and Baylor Heart and Vascular Hospital to discuss state-of-the-art management of valve and structural heart disease, and to put standard guidelines for evaluation, diagnosis and treatment in perspective.
Because of the abundance of research conducted since the 2014 guidelines were established for valvular heart disease, evaluating risk requires thinking out of the box, explains Paul Corso, MD, chair of cardiac surgery at MHVI, who served on the panel faculty.
“Clinicians need to factor in more than the guidelines in their clinical decision making,” he says. “Understanding which patient should be treated medically, and who is a candidate for surgical
intervention, and when intervention should take place, is more grey than it is black and white. I told participants at the symposium that you have to know your own practice, know your data, understand your patient, and always consider quality of life.”
“We’ve learned from experience in conducting hundreds of TAVR procedures that standard risk scores don’t apply,” he adds. “This isn’t cookbook medicine. With new technology under development for both aortic and mitral valve replacement, it’s a rapidly changing landscape. That’s why it’s important to have centers of cardiovascular excellence like MHVI, Cleveland Clinic and Baylor continue to develop, define and disseminate best practices,” Dr. Corso adds.
New Vascular Lab at MedStar Montgomery Medical Center
In January, MedStar Montgomery Medical Center opened its non-invasive vascular lab, the third for MedStar Heart & Vascular Institute; labs opened last year at MedStar Southern Maryland Hospital Center and MedStar St. Mary’s Hospital. The MedStar Montgomery lab is open Tuesday and Thursday from 8 a.m. to 4 p.m., where vascular surgeons Steven Abramowitz, MD, and Tareq Massimi, MD, see patients. Call 301-774-8962.
- Diagnostic evaluations at the lab include:
• Ankle-brachial indices
• Bypass graft interrogation
• Carotid, aortic and renal artery duplex scanning
• Mesenteric/Celiac arterial duplex scanning
• Peripheral arterial duplex scanning
• Segmental pressures and waveforms analysis
• Venous insufficiency assessment
• Venous duplex evaluation
• Venous mapping