EP 121: OMI/NOMI: A Paradigm Shift in Myocardial Infarction Diagnosis With Dr Stephen Smith

In this compelling episode of Parallax, host Ankur Kalra sits down with Dr Sharonne Hayes, a trailblazing Professor of Cardiovascular Medicine and the vice chair for academic advancement and faculty development at Mayo Clinic. Together, they explore the critical intersections of career flexibility, diversity, and inclusion in modern medicine. Drawing from her extensive experience, Dr Hayes challenges traditional career paradigms in cardiology, offering a nuanced perspective on professional growth that prioritizes personal well-being and systemic change. The conversation delves deep into the complex landscape of medical careers, addressing unconscious biases, workforce equity, and the transformative power of inclusive leadership. Listeners will gain profound insights into strategic career navigation, practical strategies for achieving academic recognition, and the critical importance of health equity in cardiovascular care. Throughout the episode, Dr Hayes provides a masterclass in professional development, sharing her unique approach to career management that balances personal priorities with professional aspirations. From founding the Women's Heart Clinic to her groundbreaking research on academic rankings, she offers a roadmap for cardiologists seeking meaningful and flexible career paths. A must-listen for medical professionals, educators, and anyone passionate about creating more equitable and supportive healthcare environments.

In this thought-provoking episode of Parallax, Host, Dr Ankur Kalra engages in an illuminating conversation with Dr Karen Joynt Maddox, a distinguished cardiologist and health policy researcher at Washington University School of Medicine in St. Louis. Together, they navigate the complex intersection of cardiovascular medicine, health economics, and public health policy. Dr Joynt Maddox shares her unique journey into health economics research, offering valuable insights for cardiologists considering this vital career path. The discussion delves deep into the need for enhanced collaboration between clinicians and policymakers, emphasizing how physicians' frontline experiences can inform more effective healthcare policies. In examining the growing presence of private equity in cardiology practices, Dr Joynt Maddox provides nuanced insights into this transformative trend. Through thoughtful analysis, she explores how this financial model shapes healthcare delivery, innovation, and patient outcomes. The conversation extends to broader economic challenges in cardiovascular medicine, particularly the intricate balance between fostering medical innovation and ensuring accessible, affordable care for patients. Drawing from her extensive research experience, Dr Joynt Maddox emphasizes the role of social determinants in cardiovascular health outcomes. The episode concludes with a compelling discussion on integrating public health principles into medical education, offering a vision for a more holistic approach to cardiovascular care.

In this week's episode of Parallax, host Dr Ankur Kalra engages in a thought-provoking discussion with Dr Stephen Smith, a pioneer in electrocardiography and myocardial infarction diagnosis. They delve into the groundbreaking OMI/NOMI paradigm (Occlusion MI vs Non-Occlusion MI), challenging the traditional STEMI vs non-STEMI terminology that has long been the cornerstone of acute coronary syndrome management. Dr Smith presents compelling evidence highlighting the limitations of ST-elevation as a marker for acute coronary occlusion, discussing his recently published review paper: "From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction". The conversation explores the proposed shift to the OMI/NOMI terminology and the specific ECG criteria for diagnosing occlusion MI. Dr Smith discusses the challenges in disseminating this new paradigm and teaching these refined ECG interpretation skills to clinicians. Dr Kalra and Dr Smith explore exciting developments in AI-assisted OMI detection and ongoing studies aimed at validating the OMI/NOMI approach. How can clinicians effectively implement the OMI/NOMI criteria into daily practice? What challenges exist in teaching these new ECG interpretation skills, and how can they be overcome? What advice does Dr Smith have for our listeners? Full source library for this episode can be found on radcliffecardiology.com.

This week on Parallax, Dr Ankur Kalra welcomes Dr Brooke Aggarwal to dive deep into the fascinating intersection of behavioural science and nutrition education. Dr Brooke Aggarwal, an Assistant Professor at Columbia University Medical Center, focuses her research on how behavioural and psychological factors influence adherence to cardiovascular disease prevention guidelines. In this episode, Dr Aggarwal shares insights from a groundbreaking study she worked on, the Family Intervention Trial for Heart Health (FIT Heart), unveiling the crucial role of social support and caregiver dynamics in maintaining healthy behaviours. Dr Kalra and Dr Aggarwal discuss innovative techniques such as motivational interviewing and cognitive behavioural therapy that are transforming the landscape of nutrition counselling. Dr Aggarwal shares her insights into the practical applications of behavioural science in clinical settings, emphasising the importance of addressing cognitive distortions with evidence-based approaches. The discussion highlights the need for healthcare providers to adapt their language to enhance accessibility, creating a supportive environment for sustainable lifestyle changes within patients. Join us as we explore how combining behavioural science with nutrition knowledge can empower individuals to take control of their health and create meaningful, sustainable improvements in their lives.

In this episode of Parallax, Dr Ankur Kalra reunites with Dr Purvi Parwani for a deep dive into the groundbreaking data unveiled at ESC Congress 2024. Dr Parwani, Director of the Women's Cardiovascular Disease Clinic and a leading expert in her field, serves as Associate Professor of Medicine and Director of the Echocardiography Laboratory for Advanced Cardiovascular Imaging at Loma Linda University Health. Dr Parwani offers a comprehensive analysis of the most impactful trials presented at the congress. She delves beyond the headlines, exploring the practical implications these findings hold for the future of patient care. Dr Kalra and Dr Parwani engage in a stimulating discussion, comparing the new data to prior research and exploring how these insights can be translated into real-world improvements for our patients. Key Trials included: MATTERHORN: Transcatheter versus surgical mitral valve repair in patients with heart failure and secondary mitral regurgitation (NCT02371512) RESHAPE-HF2: Percutaneous repair of moderate-to-severe or severe functional mitral regurgitation in patients with symptomatic heart failure (NCT02444338) TRI FR: Multicentric randomised evaluation of the transcatheter edge-to-edge repair in the treatment of severe isolated secondary tricuspid regurgitation (NCT04646811) RHEIA: Transcatheter versus surgical aortic valve replacement in women with severe aortic stenosis (NCT04160130) SENIOR RITA: Older patients with non-ST segment elevation myocardial infarction randomised interventional treatment trial

In this week's episode, Dr Ankur Kalra welcomes authors Dr Srihari Naidu and Lindsay Davis to discuss their newly published children's book, Lindsay's Big Heart. A leading interventional cardiologist, Dr Naidu, and patient advocate, Ms Davis, have collaborated to bring the complex heart condition hypertrophic cardiomyopathy (HCM) to life for young readers. Lindsay Davis shares her personal journey with HCM, offering a firsthand perspective on the challenges and triumphs of living with the condition. Dr Srihari Naidu discusses the importance of translating complex medical information into a format that children can understand and appreciate. As a parent himself, he was inspired to create a resource that would help families navigate the complexities of HCM. The authors share the challenges and rewards of bringing Lindsay's Big Heart to publication, from securing a publisher to finalising the illustrations. They believe that the book can help children feel more informed and empowered, reducing fear and anxiety associated with HCM. Additionally, they hope the book will raise awareness of the condition and encourage early diagnosis and treatment. Join us as we delve into the inspiration behind the book, the writing process, and the importance of accurate and engaging medical education for children.

This week on Parallax, Dr Ankur Kalra welcomes Dr Marc Gerdisch to discuss a groundbreaking study on reducing opioid use after cardiac surgery. Dr Marc Gerdisch is the Chief of Cardiovascular and Thoracic Surgery and Co-Director of the Heart Valve Center and Atrial Fibrillation Program at Franciscan St. Francis Health. He is a senior partner at Cardiac Surgery Associates and a Clinical Assistant Professor of Thoracic and Cardiovascular Surgery at Loyola University Medical Center in Chicago. Dr Gerdisch shares insights into his research on rigid sternal fixation and enhanced recovery protocols, which have shown promising results in postoperative pain management and patient recovery. In this episode, Dr Kalra and Dr Gerdisch discuss the specifics of the study, including the four-cohort design and the steps taken to expedite opioid-free recovery. Dr Gerdisch also shares valuable advice on overcoming physician inertia and building a strong case for implementing such a programme, including cost-benefit analysis considerations. What motivated the study? How can a holistic approach to cardiac surgery recovery be implemented? What advice does Dr Gerdisch have for our listeners? Sources: Gerdisch MW, et al. Ann Thorax Surg 2024. Rigid Sternal Fixation and Enhanced Recovery for Opioid-Free Analgesia After Cardiac Surgery. DOI: 10.1016/j.athoracsur.2024.06.032 CE Cox. TCTMD 2024. Holistic Approach to Cardiac Surgery Can Sharply Cut Opioid Use. Available at: https://www.tctmd.com/news/holistic-approach-cardiac-surgery-can-sharply-cut-opioid-use. Accessed August 12, 2024.

In this enlightening episode of Parallax, which focuses on guideline directed medical therapy (GDMT), Dr Ankur Kalra is joined by two guests, Dr Georges Chahoud, a Heart Failure Cardiologist at St. Louis Cardiology Consultants in the US, and Dr Carsten Israel, Chief of Cardiology at Bethel-Clinic in Germany. Building on their expertise, they share insights on how they would personally consult colleagues on how to manage patients with new onset acute decompensated heart failure (ADHF) and how to optimise this management in the hospital setting. They cover key topics such as why early initiation of GDMT even before hospital discharge is important, what other imaging modalities can help in better stratifying patients at risk of sudden cardiac death and they address the management and assessment of the risk for sudden cardiac death in patients on quadruple backbone GDMT. This episode is a must-listen for all healthcare professionals dedicated to advancing their understanding and treatment of heart failure. This series is supported by ZOLL and is intended for Health Care Professionals.

In this compelling episode of the Parallax Podcast, host Dr Ankur Kalra sits down with Dr Janarthanan Sathananthan, an interventional and structural cardiologist and the Chief Medical Officer of Interventional Cardiology at Boston Scientific. Dr Sathananthan recounts his life's journey, from being born in Sri Lanka during the civil war, and moving to Zimbabwe, New Zealand, Canada, and finally North America. He shares how his diverse upbringing profoundly shaped his career in cardiology. Together, Dr Kalra and Dr Sathananthan delve into cultural challenges and lessons learned from Dr Sathananthan’s father, a dentist who experienced significant discrimination throughout his career. They explore Dr Sathananthan's decision to pursue interventional cardiology, and his passion for the intersection of technology and medicine. This episode also delves into Dr Sathananthan's role as Chief Medical Officer at Boston Scientific, focusing on global initiatives to expand coronary therapies and the growth of PCI in the Asia-Pacific region. They also touch on the ongoing struggle to balance work and personal life in a demanding field. Listeners are invited to submit questions and comments to [email protected], which may be addressed by Dr Kalra in the next episode. Join us for this insightful conversation with Dr Janarthanan Sathananthan on the Parallax Podcast. Guest: @J_Sathananthan Host: @AnkurKalraMD Produced by: @RadcliffeCARDIO

In this week’s Parallax, Dr Ankur Kalra welcomes back Shelley Wood, best known for her work in the cardiology community as the editor-in-chief of TCTMD and Editorial Director of CRF. They discuss her work as a creative author and her second novel, "The Leap Year Gene of Kit McKinley " set to be published by Harper Collins in Canada and Union Square Press in the US in August 2024. Blending the intrigue of a medical thriller with a sweeping overview of the twentieth century, "The Leap Year Gene of Kit McKinley" tells the story of Kit McKinley, whose rare genetic condition causes her to age one year for every four. In this rich discussion, Ms Wood shares how her extensive experience as a medical writer and editor shaped her approach to crafting the novel. Dr Kalra and Ms Wood also explore one of the book’s central themes: eugenics, tracing its historical roots and examining its long shadow on medicine. Ms Wood, who balances a demanding full-time job with her creative writing, shares candid insights into her routine and the challenges of writing and publishing fiction. Tune in for an inspiring conversation about creativity, the human condition, and balancing responsibilities. To pre-order Shelley Wood new novel search for The Leap Year Gene/ The Leap Year Gene of Kit McKinley in your favourite independent bookshop or click here: https://www.unionsquareandco.com/9781454956297/the-leap-year-gene-of-kit-mckinley-by-shelley-wood/