Cardiac Care Unit
During this rotation, fellows take a leadership role in managing patients with complex cardiovascular disease. Fellows partner with a team of attending cardiologists, residents, interns and medical students to care for patients with acute myocardial infarction, refractory cardiogenic shock, complex life-threatening arrhythmias, severe decompensated pulmonary hypertension, among other diagnoses. Fellows in the CCU work seamlessly with faculty to directly supervise and coordinate all aspects of care. The CCU fellow also takes on a primary role in the education of the team in all aspects of cardiovascular disease. Fellows will also supervise residents while performing procedures in the CCU such as temporary pacer placement, right heart catheterization, intravascular hypothermia, or intra-aortic balloon placement.
The Hans Hecht Cardiac Catheterization Laboratory at the University of Chicago, under the leadership of Drs. Atman Shah and Sandeep Nathan, performs nearly 2,500 procedures annually and provides the full spectrum of catheter-based and hybrid treatment options for patients with complex cardiac and vascular disease. General Cardiology Fellows become proficient in the performance of diagnostic coronary angiography (both femoral and radial access), right heart catheterizations, endomyocardial biopsies, mechanical circulatory support devices (ranging from intra-aortic balloon pumps to Impellas to percutaneous LVADs), temporary pacemaker implantation, and the interpretation of coronary and peripheral angiography as well as complex hemodynamics. In addition to complex coronary artery interventions, General Fellows are exposed to peripheral (including carotid, renal, iliac, femoral, and infrapopliteal) and structural (transcatheter aortic valve implantations, aortic/mitral valvuloplasty, mitral clips, and ASD/VSD/PDA/PFO closures) interventions. A significant emphasis is placed on understanding interventional decision-making and judgment in addition to the safe and effective performance of these procedures.
During this rotation, fellows serve as the point person for all inpatient and emergency department cardiovascular consultations. Working closely with a faculty member to help lead a team of residents and medical students, the consult fellow plays the primary role in patient triage, approach to diagnostic testing, and management. The consult fellows also take on a primary role in the education of a consult team comprised of includes medical students, interns, and residents.
In this rotation, fellows spend time with in our nationally renowned Section of Cardiac and Thoracic Surgery, under the direction of Dr. Val Jeevanandam. Fellows scrub in the operating room to observe a full spectrum of cardiac surgeries including valve replacements/repairs, open and minimally invasive coronary artery bypass grafting, congenital heart disease repair, VAD implantations and transplants. In addition, fellows participate in all aspects of inpatient pre and post-operative care.
Congestive Heart Failure and Transplantation
In this rotation fellows play a vital role in Chicago’s leading advanced heart failure, mechanical circulatory support, and cardiac transplant program. Fellows participate in the CHF inpatient and intensive care unit consult service, which addresses all aspects of advanced heart failure care. As one of the country’s largest VAD implant centers, the fellows participate in the LVAD evaluation process (for destination or bridge therapy), VAD management, and have the opportunity to see VAD implantations in the Operating Room. As a large cardiac and multi-organ transplant center, fellows are exposed to all aspects of pre-transplant management/selection, organ procurement, and post-operative management. Fellows also perform right heart catheterizations and right ventricular endomyocardial biopsies, interpret the hemodynamic tracings, and review the biopsy slides at a biweekly pathology review.
The University of Chicago Echocardiography Laboratory, under the Director of Dr. Roberto Lang, annually performs more than 15,000 echo procedures, including TTE, TEE, Stress, 3D, and contrast echocardiography. Fellows on this rotation become skilled in all aspects of the performance and interpretation of transthoracic and transesophageal imaging. Our laboratory is a national leader in 3D echocardiography pioneering many of 3D techniques, and fellows gain unique exposure to the use to 3D in both TTE and TEE. With the election of advanced clinical training in echo in the 3rd year, fellows are eligible to sit for the National Board of Echocardiography.
The Heart Rhythm Center, under the direction of Dr. Roderick Tung, provides comprehensive therapy for arrhythmia patients. We perform over 1800 procedures annually in the 3 electrophysiology laboratories (one with magnetic navigation capability). Aside from a busy AF and VT ablation program, the Heart Rhythm Center is recognized as one of the leading centers in the nation for lead management and extraction. General fellows on this rotation become integral members of the Arrhythmia Service and are exposed to complex ablation, cardiac resynchronization therapy, consultative electrophysiology and interpretation of electrocardiograms. At the end of the rotation fellows become proficient in device interrogation and reprogramming, cardioversion, tilt table testing, understanding arrhythmia mechanisms and guideline based therapy for various arrhythmias.
In this rotation fellows gain exposure to cardiac CTA and cardiac MRI in our world-renowned Cardiac Imaging Center, directed by Dr. Roberto Lang. Fellows participate in all aspects of patient selection, preparation, protocol selection, image manipulation and image analysis and interpretation. General fellows work closely with advanced imaging fellows and faculty from the Cardiology and Radiology. Under the direction of Cardiac CT and MRI Director, Dr. Amit Patel , fellows will gain experience with state of the art imaging techniques and scanners, including an active stress MRI program. Fellows interested in a dedicated career in advanced multi-modality imaging have the option to pursue 4thyear Advanced Imaging Fellowship.
Nuclear Cardiology and Stress Testing
In this rotation, fellows will spend time in the University of Chicago Nuclear Cardiology laboratory, which performs over 3000 nuclear cardiology procedures per year. Fellows supervise exercise and pharmacologic nuclear stress tests and learn contraindications, complications, and all aspects of interpretation of stress testing. Fellows will also become proficient in the performance, interpretation and diagnostic and prognostic implications of SPECT myocardial perfusion imaging as well as equilibrium RNA (MUGA). Fellows also participate in the our Cardiac Positron Emission Tomography (PET) program for evaluation of inflammatory cardiomyopathies such as cardiac sarcoidosis and for myocardial viability assessment. Fellows learn all aspects of radiation safety and by choosing to do advanced rotations in their 3rd year will be eligible to sit for the Certification Board in Nuclear Cardiology.
In this rotation, fellows attend outpatient clinics with Dr. Michael Davidson (advanced lipidology), Dr. Matthew Sorrentino (all aspects of cardiovascular prevention), and Dr. George Bakris from the Section of Endocrinology (advanced hypertension). In addition, fellows participate in outpatient clinics focused on vascular medicine, weight loss/nutrition, sleep medicine, and genetics. Fellows our cardiac rehabilitation program, and gain exposure to outpatient vascular imaging. This is an extremely popular 1-month rotation in which fellows gain an understanding of the pathophysiology as well as the diagnostic and therapeutic approaches to all aspects of the primary and secondary prevention of cardiovascular disease.
Adult Congenital Heart Disease
In this rotation fellows attend an adult congenital heart disease clinic staffed by both adult and pediatric cardiology faculty, participate in interventional procedures to repair congenital heart lesions, attend ACHD conferences, and gain exposure to both pediatric imaging and pediatric electrophysiology clinics and procedures. In addition, adult cardiology imaging, EP and interventional rotations and conferences dedicate specific time for exposure to the care and management of adult congenital heart disease patients.
Outpatient Continuity Clinic
Fellows are assigned to Cardiology Faculty member’s clinics held in the Duchossois Center for Advanced Medicine (DCAM). Our busy outpatient practice provides an ideal training environment including both common cardiovascular conditions among the South Side of Chicago population we serve, as well complex cardiovascular disease as a regional and national secondary and tertiary referral center.