Nusrat Binta Nizam/Dr Ashley Beecy - Week 06

 07/08/24 - 07/12/24 Week 6:

This week, Dr. Beecy planned some immersion activities for me in Milstein Hospital, focusing primarily on the heart center and the Cardiac Intensive Care Unit (CICU). These activities are designed to provide in-depth exposure to the latest cardiac care practices and technologies. The whole week I shadowed several cardiologists.


On Monday, I shadowed Dr. Sayer in his clinic, where he saw many patients visiting for heart transplant follow-ups. I learned about AlloSure testing, a non-invasive blood test used to monitor organ transplant rejection by measuring donor-derived cell-free DNA (dd-cfDNA) in the recipient's blood. This test helps in early detection of rejection, allowing timely intervention. Dr. Sayer also discussed various immunosuppressive activities necessary to prevent organ rejection, which include medications that suppress the immune system to varying degrees. We saw multiple cancer patients who had undergone heart transplants, highlighting the increased risks associated with these procedures. I learned that heart transplant recipients have a higher risk of developing diabetes, various cancers, increased blood pressure, and kidney disease due to the long-term use of immunosuppressive drugs. Additionally, there are different medication protocols for patients who have undergone multiple transplants, tailored to their specific needs and previous medical history.


On Tuesday, I shadowed Dr. Maurer, who primarily sees patients with cardiac amyloidosis. This rare condition, characterized by the buildup of amyloid proteins in the heart tissue, often requires comprehensive management. Dr. Maurer emphasized the importance of genetic testing for family members to identify hereditary forms of the disease early. We discussed the associated complications, such as kidney issues and knee/patellar tendon problems, which often accompany cardiac amyloidosis. Dr. Maurer explained how the genetic basis of the disease impacts its progression and the importance of ongoing drug experiments aimed at finding more effective treatments. The day provided valuable insights into the diagnosis and treatment strategies for managing amyloid progression and the broader implications of the disease on patients' health.


On Wednesday, Thursday and Friday, I visited the Cardiac Intensive Care Unit (CICU) with Dr. Axsom, Dr. Lotan, and Dr. Yunis. During my time there, I observed the critical care management of patients with advanced heart failure, post-cardiac surgery recovery, and acute myocardial infarction. I gained insights into the intricacies of hemodynamic support, the use of advanced cardiac devices, and the multidisciplinary approach to patient care in a high-acuity setting. Additionally, I shadowed Dr. Uriel in his clinic, where he treated patients with various cardiac diseases such as atrial fibrillation, hypertrophic cardiomyopathy, coronary artery disease, and heart valve disorders. This experience broadened my understanding of both the acute and chronic management of complex cardiac conditions.

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