Tyler Locke/Dr. Evelyn Horn

My first week of immersion involved meeting the heart failure clinical team in the hospital. On Wednesday, I met with Dr. Horn and we discussed my research and interests, the organization of the heart failure clinic, and the types of patients they see. With this information, we identified some groups of patients for me to see with the team which were relevant to my interests. We also discussed her research interests in pulmonary hypertension, an interesting disease with some pathological similarities to the subtype of heart failure I study in Ithaca. 

On Thursday morning, I joined Dr. Horn and Dr. Karas (along with Anna) for a day of heart failure clinic visits. I spent some time with the nurse practitioner shadowing her initial exam and history for a few patients, which was very interesting to me. As a relatively young and healthy person, I had never experienced such a thorough and in depth appointment before. I was also incredibly impressed by the patients and caretakers and their ability to organize the massive amount of information/treatments they were involved with and advocate for themselves. 

Dr. Karas took a lot of time answering my questions between appointments, explaining each patient's history and management. There was a great variety of patients, with different ages, causes, and degrees of heart failure. I learned a lot about the diagnostics involved in determining the cause and progression of heart failure in the clinic, as well as the therapies involved in slowing the disease progression. Sadly, most of the underlying causes of heart failure are irreversible, but with proper monitoring and care, a lot of the negative remodeling responsible for disease progression can be controlled.

I also saw this really cool piece of engineering called the CardioMEMS device. It is a tiny capacitor which is placed in the pulmonary artery by catheter. Its capacitance is sensitive to the external pressure, which in turn effects its resonant frequency. When excited with an RF signal, the frequency spectrum of the resonant signal changes with the pressure. This allows external monitoring of the pulmonary arterial pressure. Since it is a passive device, it requires no power and can be left in the patient forever. 

Accurate measurement of this pressure allows for the physician to remotely adjust diuretics more effectively than with traditional methods, preventing hospitalization in many heart failure patients.