Female Clinical Cardiologists Thrive at VCU

Female Clinical Cardiologists Thrive at VCU

Dr. Denlinger attended the VCU School of Medicine for both her residency and fellowship. Today, she is an outreach cardiologist for the Pauley Heart Center. She spends three days each week in South Hill, Va., assessing patients with a wide variety of cardiovascular diseases and performing non-invasive cardiac imaging.

In addition, two days a week she teaches medical students and fellows and sees patients at the Hunter Holmes McGuire V.A. Hospital in Richmond.

“She really is the ultimate clinical and academic modern physician,” said Dr. George Vetrovec, Director of VCU’s Adult Cardiac Catheterization Lab and Associate Chair for Clinical Affairs. “She teaches at the V.A. Hospital and is very accomplished in that regard. But she also has made a very critical contribution by bringing our traditional academic center into the South Hill community and creating a partnership there.”

The busy cardiologist stands among an increasing number of women who are thriving in a field historically dominated by men.

“Having more women in cardiology can bring different perspectives and different priorities in care. For instance, one of my interests is heart disease in women. Women have atypical presentations of heart disease, sometimes ignore their symptoms, and can be more difficult to diagnose,” she said. “I think if more women are in the field of cardiology, then there will be more awareness of these issues.”

Among medical students, a significantly higher percentage of men choose to go into the cardiology field than women. According to the American College of Cardiology, women make up only 20% of the total number of heart doctors.

The Pauley Heart Center has a successful record of recruiting female cardiologists. Like their male colleagues, Pauley’s female cardiologists are drawn to the university’s vibrant clinical and academic setting. Many of them, in fact, served their residency or fellowship at VCU.

“For instance, one of my interests is heart disease in women. Women have atypical presentations of heart disease, sometimes ignore their symptoms, and can be more difficult to diagnose.”

“VCU is world-renowned in cardiovascular medicine. We draw smart, hardworking doctors who want to be at the forefront of cardiac clinical research and advanced patient care,” said Dr. Kenneth Ellenbogen, Chief of the Cardiology Division, Pauley Heart Center.

Dr. Mary Ann Peberdy serves as Director of the VCU’s Advanced Resuscitation, Cooling Therapeutics, and Intensive Care (ARCTIC) program—featured last year on PBS’s NOVA series—and Medical Director of the hospital’s code and rapid response teams.

“Dr. Peberdy has helped build one of the best cardiac resuscitation programs in the world,” said Dr. Ellenbogen.

The patients seen by the ARCTIC team have suffered sudden cardiac arrest. Often confused with a heart attack, cardiac arrest occurs when the heart suddenly and unexpectedly stops beating. The result is that blood stops flowing to the brain and other vital organs.

Dr. Mary Ann Peberdy

ARCTIC’s strategy calls for paramedics to start the cooling efforts in the field, often before the heart can be restarted. Nationally, survival from cardiac arrest that occurs outside of the hospital is around 11%; ARCTIC has a consistent survival rate for these patients of about 50%.

In recent years, “there is a much deeper understanding of what causes the brain and heart injury after cardiac arrest, and new therapies, such as hypothermia and goal-directed care, can now significantly improve outcomes,” said Dr. Peberdy.

She joined the VCU faculty in 1993, after completing her residency and cardiology training at the Medical College of Pennsylvania. In addition to treating patients, she undertakes clinical and translational research in the fields of resuscitation and heart failure and is the author of over 140 research papers. She also maintains an active cardiology practice, specializing in patient care for advanced heart failure and critical care cardiology.

“The last 10 to 15 years have brought dramatic changes in the therapies available to treat patients with both heart failure and cardiac arrest,” she said. “They are probably two areas in cardiology that have seen a rapid advancement in the science that has translated into improved outcomes for both populations.”

Dr. Peberdy enjoys the challenge of caring for acutely and critically ill patients. “The greatest reward is being able to send someone home and back to their family after suffering a cardiac arrest.”

According to the American College of Cardiology, women make up only 20% of the total number of heart doctors. The Pauley Heart Center has a successful record of recruiting female cardiologists.

Originally from Canada, Dr. Evelyne Goudreau completed her medical training, residency, and cardiology fellowship at University of Montreal Faculty of Medicine. She attended VCU for a fellowship in interventional cardiology and then accepted a position on the faculty in 1988. She works as an attending physician in both the Cardiac Catheterization Lab and the Coronary Care Unit (CCU).

“Dr. Goudreau is a critical component of our faculty—a very hardworking, highly talented clinician,” said Dr. Vetrovec.

Dr. Evelyne Goudreau

Her work involves cardiac catheterization and percutaneous interventions. Since she began, one major change in the cath lab has been the implementation of primary angioplasty for patients presenting with acute myocardial infarctions, which has significantly improved their clinical outcome. This has been possible by reducing “time to balloon”—that is, the time it takes for a heart attack victim to receive angioplasty or other revascularization procedures.

“We have been at the frontier of interventional cardiology innovations,” she said. “We have pioneered many new technologies over the years, and the introduction of coronary stenting was truly a revolution in the cath lab, allowing performance of more complex angioplasties with significant improvement in short-term and longterm outcomes.”

Recently, “we have been involved in the clinical evaluation of robotics,” she said.

“Structural heart disease in the adult patient population is a field that will bring new technologies to the cath lab. We also anticipate increasing our involvement in hybrid procedures as we team with the CT surgeons.”

In the CCU, she has noticed a shift in patient population, with a substantial increase in heart failure patients. As a result, she said, “we are offering more aggressive mechanical support with the expansion of the heart failure and transplant program.”

Clinical electrophysiologist Dr. Jordana Kron found her calling while working shifts as a resident in the cardiac ICU of Johns Hopkins Hospital.

“It’s a very intense rotation, and we were on call there every third night. I think what I loved about it most was that the patients would come in so sick but there was such opportunity to help them,” she said.

Dr. Jordana Kron

One patient arrived with complete heart block and a pulse of 20. “The patient was critically ill and couldn’t stand up. The electrophysiology team came in and put a pacemaker in, and the patient went home the next day.”

Dr. Kron went on to receive her cardiology and electrophysiology training at the University of Florida in Gainesville, Fla. She now works at both VCU’s downtown campus and its outreach clinic at Stony Point.

“She is an outstanding clinician, with wide-ranging interests,” said Dr. Ellenbogen.

Her areas of focus include an extensive list of atrial and ventricular arrhythmias as well as device management in patients with heart failure. She has a special interest in cardiac sarcoidosis, a rare form of inflammatory heart disease that can cause both fast and slow rhythms in patients and can lead to sudden death.

“So little is known about cardiac sarcoidosis. It is hard to study these patients because it is so rare,” she said.

To further research, she organized a group of colleagues from 13 medical institutions in the United States, Canada, and India. The physicians studied the data collected in the defibrillators of 235 patients with the disease— the largest sample ever—and presented their findings at the Heart Rhythm Society in May 2012. Dr. Kron also helped to create the Cardiac Sarcoidosis Consortium, a registry to track the patients worldwide.

“The last 10 to 15 years have brought dramatic changes in the therapies available to treat patients with both heart failure and cardiac arrest,” she said.

She enjoys the intellectual, collaborative environment at VCU. “If we have an interesting case going on, we will pull in our partners so that we can work together,” she said. “I think that leads to really good patient care and also to ongoing education, where you continually learn from your partners.”

Dr. Hem Bhardwaj served her residency at University of Virginia Medical Center, and then attended VCU for her fellowship in cardiology. Upon completion of her fellowship, VCU offered her a faculty position.

“I jumped at the chance,” she said. “Working at VCU provides me the opportunity to teach cardiology fellows and interact with physicians who are on the leading edge of not only cardiovascular medicine but other specialties as well.”

Dr. Hem Bhardwa

“Hem Bhardwaj is a general cardiologist— something of a rarity in the field of academic cardiology, where the majority of cardiologists are subspecialized in some fashion. She has a better global view of the patients because of this,” said Dr. Richard Cooke, Interim Medical Director of VCU’s Heart Transplant and Advanced Heart Failure programs.

Dr. Bhardwaj’s special interests include echocardiographic imaging, especially related to heart failure. Most of her time is spent in clinical work, she said, “but I am now starting to participate in research. I am starting to look at the role of echocardiography in patients with heart failure who have mechanical assist devices.”

Additionally, she said, transcatheter aortic valve replacement (TAVR) is being introduced this year to VCU. The TAVR procedure involves replacing the aortic valve with a less invasive approach, as an alternative to openheart surgery.

“I am very excited to have been offered the chance to be involved in the echocardio- graphic portion of this new venture at VCU,” she said. “Having opportunities like this is instrumental to why I chose to work here.”

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