Cardio-Obstetrics Series Page
Welcome to the CardioNerds Cardio-Obstetrics Series Page!
The CardioNerds Cardio-Obstetrics series is a comprehensive series led by series co-chairs Dr. Natalie Stokes CardioNerds ambassador from UPMC and Dr. Sonia Shah CardioNerds ambassador from UTSW, and produced in collaboration with WomenHeart.
Why Cardio-Obstetrics❓ Because it’s important, and relevant to anyone taking care of women who are, may become, or have been pregnant as cardiovascular disease is the #1 cause of pregnancy-related death.
In order to raise awareness we’ve put together an fun, sometimes sobering, but comprehensive curriculum, so get ready, because this CardioNerds Cardio-Obstetrics cruise will dock at several ports along the way: ✔normal pregnancy physiology, ✔hypertensive disorders, ✔arrhythmia, ✔valvular heart disease, ✔anticoagulation, ✔pulmonary hypertension, ✔congestive heart failure, ✔aortopathies, ✔coronary artery disease, ✔critical care, ✔4th trimester, ✔Racial disparities in care, ✔interventional considerations, ✔patient perspectives including from womenheart champions, and more!
CardioNerd Amit Goyal, cardioobstetrics series co-chair Dr. Natalie Stokes, and episode lead Dr. Daniela Crousillat discuss normal cardiovascular physiology in pregnancy with Dr. Garima Sharma, Director of the Cardio-Obstetrics Program and the Ciccarone Center ‘s Associate Director of Preventive Cardiology Education in the Division of Cardiology. They discuss physiology from conception to post-partum, including the key hemodynamic, hormonal, and structural changes associated with normal pregnancy in the absence of pre-existing cardiovascular disease.
CardioNerds (Amit Goyal and Daniel Ambinder), cardioobstetrics series co-chair Dr. Natalie Stokes, Northwestern University CardioNerds Ambassador Dr. Loie Farina, and episode lead fellow, Dr. Agnes Koczo (University of Pittsburgh) join Dr. Julie Damp of Vanderbilt University Associate Director of the VUMC Cardiovascular Disease Fellowship for a discussion about pregnancy, heart failure, and peripartum cardiomyopathy. Episode introduction by Dr. Luis Calderon. Audio editing by Pace Wetstein.
CardioNerds Amit Goya and Daniel Ambinder, cardioobstetrics series co-chair Dr. Natalie Stokes, and episode lead Dr. Priya Kothapalli (University of Texas at Austin, Dell Medical School) discuss pregnancy and coronary artery disease with Dr. Malissa Wood, co-founder and co-director of the Corrigan Woman’s Heart Health center at Massachusetts General Hospital. They discuss the differential diagnosis of chest pain in the pregnant patient, the diagnostic approach and management of acute coronary syndromes in the patient population, and manifestations and management of SCAD in pregnancy. Episode introduction by Dr. Julie Power.
CardioNerd (Amit Goyal), cardioobstetrics series co-chair Dr. Natalie Stokes, Cardionerds Duke University CardioNerds Ambassador and episode lead fellow, Dr. Kelly Arps, join Dr. Andrea Russo, Director of Electrophysiology and Arrhythmia Services at Cooper Medical School of Rowan University and immediate past president Heart Rhythm Society, for a discussion about pregnancy and arrhythmia. Stay tuned for a message from Dr. Sharonne Hayes about WomenHeart. Audio editing by Gurleen Kaur.
CardioNerd (Amit Goyal), cardioobstetrics series co-chair Dr. Sonia Shah (FIT, UT Southwestern) and episode lead Dr. Kayle Shapero (FIT, UPMC) discuss pregnancy in patients with pulmonary hypertension with Dr. Candice Silversides, Associate Professor of Medicine and the Director of the Pregnancy and Heart Disease program and head of the Obstetric Medicine program at the University of Toronto.
CardioNerd Amit Goyal, Cardio-OB series co-chair and University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah, and episode lead and Johns Hopkins University Cardiology Fellow, Dr. Anum Minhas, discuss pregnancy and aortic disorders with Dr. Nupoor Narula of Weill Cornell Medical College. Special introduction by Sukrit Narula.
In this episode we discuss the presentation and management of aortopathies during pregnancy. We begin by examining the pathophysiology of aortic disease during pregnancy, followed by a review of the heritable aortopathies and their risk of dissection. We then discuss preconception evaluation and antepartum care of women with aortopathies. We end with addressing management at the time of labor and delivery.
CardioNerds (Amit Goyal and Daniel Ambinder), Cardio-OB series co-chair and University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah, and episode lead and Columbia University Cardiology Fellow Dr. Ersilia DeFilippis discuss hypertensive disorders of pregnancy (HDP) with Dr. Jennifer Lewey from the University of Pennsylvania.
In this episode, we cover chronic hypertension, gestational hypertension, and pre-eclampsia—all of which encompass HDP and complicate approximately 5-10% of all pregnancies. We also review risk factors for HDP, diagnostic criteria, peripartum and postpartum management, and much more! Be sure to tune in to hear Dr. Lewey discuss the future impact of HDP on cardiovascular disease for women later in life and strategies that can help improve care.
Finally Dr. DeFilippis shares her perspectives from her ACC.org FIT Section article titled “Shattering the Glass” including strategies to shattering the glass and tackling imposter syndrome in improving the representation of women in medicine.
In this special CardioOB series patient perspective episode, CardioNerds (Amit Goyal and Daniel Ambinder), join three incredible WomenHeart Champions, Ms. Porothea Dennis, Ms. Brandie Taylor, and Ms. Ellen Robin in the presence of two legendary leaders in cardiovascular medicine, Dr. Nanette Wenger and Dr. Sharonne Hayes. In addition to this episode being featured on our Cardio-Obstetrics topic page, you can also find this episode in our Patient and Family Perspective collection which features several moving and meaningful patient and family stories that remind us of why we do what we do. Audio editing by CardioNerds Academy Intern, Leticia Helms.
CardioNerds Cardio-OB series co-chairs University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah (FIT, University of Texas Southwestern) and Dr. Natalie Stokes, (FIT, University of Pittsburgh) join Dr. Nanette Wenger, Professor of Medicine in the Division of Cardiology at the Emory University School of Medicine and a consultant to the Emory Heart and Vascular Center and Dr. Sharonne Hayes, Professor of Internal Medicine and Cardiovascular Diseases and founder of the Women’s Heart Clinic at Mayo Clinic for an in depth discussion about lifelong advocacy for women’s cardiovascular health. Audio editing by CardioNerds Academy Intern, Dr. Leticia Helms.
CardioNerds (Amit Goyal and Daniel Ambinder), Cardio-OB series co-chair and University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah, episode lead fellow, Dr. Kaitlyn Ibrahim (Temple University now practicing with Lankenau Heart Group), join Dr. Afshan Hameed (Maternal-Fetal Medicine, Obstetrics & Gynecology, UC Irvine), Dr. Paul Forfia (Co-Director, Pulmonary Hypertension, Right Heart Failure & CTEPH Program, Temple University Hospital), and Dr. Marie-Louise Meng (Obstetric and Cardiothoracic Anesthesiology, Duke University) to discuss pregnancy and multidisciplinary critical care.
Three experts from varied subspecialties including Cardiology, Pulmonary Hypertension, Maternal Fetal Medicine, Cardiac Anesthesia and Obstetrical Anesthesia guide listeners through a case of a patient with a congenital conotruncal ventricular septal defect, Eisenmenger physiology, and pulmonary hypertension who becomes pregnant. The discussion touches on pre-conception risk assessment, pulmonary hypertension medical therapy in pregnancy, maternal monitoring during pregnancy, development of detailed multidisciplinary delivery plans and accessibility of such plans, and peri- and post-partum multidisciplinary management of high-risk patients.
CardioNerds (Amit Goyal and Daniel Ambinder), Cardio-OB series co-chair and University of Texas Southwestern Cardiology Fellow, Dr. Sonia Shah, and episode FIT lead and UT Southwestern Cardiology Fellow Dr. Laurie Femnou discuss valvular heart disease in pregnancy with cardio-obstetrics expert Dr. Uri Elkayam, Professor of Medicine and OB Gyn at the University of Southern California.
In this pearl-packed episode, we discuss the diagnosis, acute management, and long-term considerations of valvular heart disease in pregnancy. Through a series of cases, we review the physiologic changes in pregnancy that make certain valvular lesions well-tolerated, while others are associated with a much higher risk of peripartum complications. We also discuss which patients to consider referring for valvular intervention, the ideal timing, and which valvular interventions are safest in the peripartum period. We promise, you won’t want to miss this clinically high-yield episode with Dr. Elkayam, the father of cardio-obstetrics and an absolute legend in the field!
Pregnancy is a hypercoagulable state associated with increased risk of thromboembolism. Managing anticoagulation during pregnancy has implications for both the mother and the fetus. CardioNerd Amit Goyal joins Dr. Akanksha Agrawal (Cardiology Fellow at Emory University), Dr. Natalie Stokes (Cardiology Fellow at UPMC and Co-Chair of the Cardionerds Cardio-Ob series), and Dr. Katie Berlacher (Program Director of the Cardiovascular Disease Fellowship and Director of the Women’s Heart Program at UPMC) as they discuss the common indications for anticoagulation and their management before, during, and after pregnancy. In this episode, we focus on management of pregnant patients with mechanical valves and venous thromboembolism.
Cardio-Obstetrics Series Co-Chairs!
Dr. Natalie Stokes is a second year cardiology fellow at the University of Pittsburgh Medical Center. She completed medical school and residency at the University of Pennsylvania, and prior to that completed a graduate degree in Gender Studies at the University of York, UK. She has interest in CVD in pregnancy, gender equity, health systems and medical education. She enjoys deadlifting and mountain biking!
Meet Our Guests!
Dr. Daniella Crousillat is an advanced echocardiography fellow at Massachusetts General Hospital in Boston, MA. She is interested in sex differences in valvular heart disease and pregnancy-associated CVD with a special focus on health disparities and the care of vulnerable patient populations.
Dr. Julie Damp is program director of the cardiology fellowship at Vanderbilt University. She was part of the multicenter Peripartum Cardiomyopathy Network for the Investigations in Pregnancy-Associated Cardiomyopathy (IPAC) Study. In addition to her clinical and research work in cardio-obstetrics, her expertise include medical education, critical care cardiology, and noninvasive cardiac imaging.
Dr. Agnes Koczo is a second year cardiology fellow at the University of Pittsburgh Medical Center. She is interested in cardio-obstetrics and adult congenital heart disease. She plans to pursue a T32 postdoctoral research fellowship studying immune dysregulation in patients with cardiac complications in pregnancy.
Dr. Loie Farina @loiefarina is a cardiology fellow at Northwestern University. After venturing down south for undergrad at Duke (go Blue Devils!), she returned home to Chicago and has since completed both medical school and residency at Northwestern. She hopes to pursue a career in advanced heart failure and transplantation and is passionate about medical education and heart disease in women. Outside the hospital, she enjoys running along Chicago’s Lakefront Trail, cooking, and exploring new restaurants.
Dr. Andrea Russo is Professor of Medicine at Cooper Medical School of Rowan University, where she is also Director of the Clinical Cardiac Electrophysiology Fellowship Program, as well as Director of Electrophysiology and Arrhythmia Services at Cooper University Hospital and Director of Research at Cooper Heart Institute. She is the immediate past president of the Heart Rhythm Society. She’s also had numerous leadership positions in HRS, the American College of Cardiology, American Heart Association, American Board of Internal Medicine, National Quality Forum, and the American Board of Medical Specialties. Dr. Russo is currently serving as a member of the ACC Cardiovascular Disease in Women Committee and the ABIM Cardiovascular Board. She’s written extensively in the field of electrophysiology, with a focus on sex differences in arrhythmias, ICDs and subcutaneous cardiac devices, atrial fibrillation, digital health, and performance improvement activities. She has been on the steering committee for trials including UNTOUCHED and the Apple Heart Study and contributed to multiple guideline and consensus statements including as first author of the 2013 multisociety Appropriate Use Criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy and senior author of the ACC / AHA Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic. In addition to her academic achievements, Dr. Russo has been recognized many times as a “Top Doctor” in Philadelphia and Southern New Jersey.
Kelly completed medical school at Emory University and residency at Johns Hopkins Hospital, where she served as editor-in-chief for the 2018 Osler Medicine Survival Guide. She is currently is a clinical cardiology fellow at Duke University and served on the 2019-2020 ACC FIT website editorial board in the education section. Kelly is planning to pursue a career in cardiac electrophysiology with a focus on ventricular arrhythmias in heart failure and infiltrative cardiomyopathies.
Dr. Candice Silversides is an Associate Professor of Medicine at the University of Toronto. She serves as the Director of the Pregnancy and Heart Disease program and head of the Obstetric Medicine program. Along with her >180 publications and numerous book chapters, she has contributed to a number of international practice guidelines and consensus statements, and she also helped develop the CARPREG II cardiovascular risk prediction score.
Dr. Kayle Shapero is a first year cardiology fellow at the University of Pittsburgh Medical Center. She began her undergraduate training in chemical engineering and completed a PhD in biomedical engineering. She spent her PhD studying tissue engineered heart valves which ultimately piqued her interest in medicine. She went on to complete her medical degree at Tufts Medical School followed by internal medicine residency at Yale. She is currently in her first year of fellowship at UPMC. She is interested cardio-obstetrics and sports cardiology, and is always looking for ways to combine these two clinical and research interests. Outside of the hospital she attempts to keep in shape by training for triathlons and marathons.
Dr. Nupoor Narula earned her medical degree from the Icahn School of Medicine at Mount Sinai, and graduated with Distinction in Research. She then went to the esteemed Mayo Clinic for Internal Medicine residency, followed by a Vascular Medicine fellowship at Mount Sinai Hospital and Cardiology Fellowship at New York Presbyterian Hospital – Weill Cornell Medical College. She has pursued basic and clinical research training in cardiovascular genetics and is currently completing her Masters in Clinical Epidemiology. Dr. Narula is also a superstar researcher and received grant funding for her research during her Fellowship by the Michael Wolk Heart Foundation and is currently a Fund for the Future Grant Kellen Scholar at Weill Cornell Medicine. She is studying aortopathies, such as Marfan syndrome, with special emphasis on pregnancy and dissection risk.
Dr. Anum Minhas went to medical school at Duke University. She had an interest in imaging and spent a year studying radiation dose estimation and radiation safety. She also developed a passion for clinical cardiology and subsequently went to the University of Michigan for internal medicine residency. Here she studied CT reconstruction for transcatheter aortic valve replacement, as well as the incidence of Takotsubo cardiomyopathy. Anum is a fourth year cardiology fellow at Johns Hopkins interested in cardio-OB. In fact, she has designed and is the inaugural Cardio-Obstetrics fellow at Hopkins. In her free time she enjoys drawing, reading, traveling, and spending time with friends and family.
Dr. Afshan Hameed is a Clinical Professor of both Cardiology and Maternal Fetal Medicine at the University of California, Irvine. Dr. Hameed has served on multiple guideline committees on heart disease and pregnancy for the American College of Obstetrics and Gynecology and serves on the California Maternal Quality Care Collaborative (CMQCC) Pregnancy Associated Mortality Review Advisory Committee (PAMR) that reviews all cases of maternal mortality to identify gaps in care for quality improvement opportunities. She also serves on the writing committee for the Heart Rhythm Society’s “Arrhythmias in Pregnancy Guidelines” and as an expert to help create an Obstetrics Basic Life Support curriculum to integrate into the American Heart Association Life Support Program.
Dr. Paul Forfia is a Professor of Medicine at Temple University Hospital and Co-Director of the Pulmonary Hypertension, Right Heart Failure, and CTEPH Program at Temple University Hospital. He is a renowned expert in the management of patients with right heart failure and PH and has grown the program at Temple to one of the largest in the country.
Dr. Marie-Louise Meng is an assistant professor of anesthesiology at Duke University who has completed additional fellowships in both obstetrical anesthesia and cardiothoracic anesthesia. She is also a physician-scientist researching the role of echocardiography and biomarkers in identifying women at risk of cardiovascular complications after pregnancies complicated by preeclampsia.
Dr. Elkayam is an internationally known expert in heart failure and heart disease in pregnancy. Dr. Elkayam did his medical training in Austria and Israel before completing his cardiology fellowships at Albert Einstein College of Medicine and Cedars Sinai Medical Center. He is currently a dual professor of Medicine and OB Gyn at the University of Southern California, Former Chief of Cardiology at USC University Hospital, and Director of the USC Heart Failure Program. He has been involved in more than 100 self-initiated NIH and industry funded research projects, and has authored over 200 peer review articles and 80 book chapters.
Dr. Laurie Femnou Mbuntum is currently a general cardiology fellow at The University of Texas Southwestern. She completed her undergraduate degree at The University of Maryland Baltimore County. She then moved down South to complete residency at The University of Texas Southwestern where she stayed for cardiology fellowship where she is planning to stay for advanced training in interventional cardiology. She has a special interest in cardio obstetrics and figuring out ways to reduce cardiovascular maternal death. When not in the hospital, she loves spending time with her two boys and learning more about makeup artistry.
Katie Berlacher, MD, is a cardiologist and is certified in cardiovascular disease by the American Board of Internal Medicine and adult echocardiography by the National Board of Echo. She is the medical director of the Magee Women’s Heart Program, the program director of cardiovascular fellowship, and is an assistant professor of medicine at the University of Pittsburgh School of Medicine. She received her medical degree from The Ohio State University and completed her residency and fellowship at the University of Pittsburgh Medical Center.
Dr. Berlacher joined the UPMC Heart and Vascular Institute in 2012. Her clinical interests include women’s heart disease, including pregnancy and heart disease risks, as well as medical education. She has published numerous articles in peer-reviewed journals and is a member of the American College of Cardiology and the American Heart Association. She lives in the city and is an avid cyclist, boxer, and hiker.
Dr. Akanksha Agrawal is a cardiology fellow at Emory University. She did her medical school from Maulana Azad Medical College, India, and Internal Medicine Residency at Einstein Medical Center, Philadelphia, where she did a year of chief residency as well. She is interested in cardio-obstetrics and advanced heart failure, and plans to pursue Advanced Heart Failure and Cardiac Transplant fellowship.