My rotation at Epic Heart and Vascular Center and HCA Northwest was a great learning experience. I was able to work as a part of a team, taking patients’ histories, discussing assessments and plans, and writing notes in the EMR under the direct supervision of Dr. Khan. The rotation provided ample clinical exposure and I got to see bread and butter cases of cardiology, such as coronary artery disease, atrial fibrillation, and valvular heart diseases, along with some other very interesting cases. I remember seeing a complicated case of an elderly woman with moderate-severe MR and Secundum ASD, who had developed isolated right heart failure without any pulmonary hypertension or left heart involvement.
Dr. Khan was highly impressed by my pathophysiological explanation behind the patient’s condition, i.e, mitral regurgitation leading to increased left atrial volume which was being transmitted to the right side via the secundum atrial septal defect sparing the LV and pulmonary vasculature. We identified it to be a possible case of atypical Lutembacher syndrome and Dr. Khan guided me in writing it as a case report. I saw 5-6 patients on an average day which provided me with some valuable first-hand insight into the everyday practice of outpatient medicine in the U.S. Dr. Khan appreciated my knowledge base, and clinical acumen and stated that it was comparable to that of a resident.
The observership experience at HCA Northwest also helped me learn more about the dynamics of inpatient medicine in the U.S. I also had the opportunity to observe some of the procedures such as cardiac catheterization, including an interesting case of left-dominant circulation, vein procedures like radiofrequency thermal ablation, Venaseal, and Varithena along with diagnostic tests like stress testing, echocardiography, carotid doppler, arterial and venous duplex scans. Dr. Khan is very enthusiastic about teaching, he spent ample time teaching us the basics of intervention and diagnostic studies, and by the end of my rotation, I could identify major findings on EKGs, and echocardiograms.
A strong emphasis is also placed on scholarly activities. I had the opportunity to present the 2020 ACC/AHA Guideline for the Management of Patients With Aortic Stenosis. I also presented topics such as types of Aortopathies and when to intervene, and the association of hematuria and proteinuria with rosuvastatin versus atorvastatin. Overall, I had a great experience during this rotation with Dr. Khan. I got to learn more about the vast field of cardiology and the most recent advances and trials. Dr. Khan is a great mentor and an amazing teacher. His qualities of teamwork and patient care have influenced me greatly, and I consider myself fortunate to have learned so much from him.