Parallax by Ankur Kalra

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-assist

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 her groundbreaking Family Intervention Trial for Heart Health (FIT Heart) study, 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 highli

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 r

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 anxie

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

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. Th

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 Asi

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 rou

This week on Parallax, Dr Ankur Kalra welcomes Eric Radtke, Vice President at Worldwide Innovations & Technologies, Inc, and Barbara Breininger, a cardiovascular radiologic technologist and clinical manager with 26 years of experience. This special episode dives deep into the crucial topic of radiation hygiene, exploring it from the perspectives of both manufacturers and users of radiation safety products. Barbara Breininger shares her experiences traveling nationwide to educate healthcare professionals on radiation safety, emphasizing the need for collective awareness and best practices in cath labs. Eric Radtke discusses the company's evolving focus on radiation safety, the origins of their initiatives, and the concerning impacts of radiation exposure as revealed by recent studies. We'll also explore practical steps to enhance safety and delve into the RADPAD tools that can shield interventional cardiologists and allied professionals from exposure. How can we protect ourselves from radiation in the Cath l

In this week’s Parallax, host Dr Ankur Kalra welcomes back Dr Jonathan Fisher, a cardiologist, organizational well-being leader, and bestselling author of Just One Heart: A Cardiologist’s Guide to Healing, Health, and Happiness. In this compelling conversation, Dr Fisher shares his personal experience with burnout within the US healthcare system. He provides a concise overview of the roots of Western medicine's culture and the current epidemic of physician burnout and depression. Dr Kalra then invites him to explore solutions for reversing these negative trends and enhancing patient care. Dr Fisher discusses the workshops he leads, emphasizing core principles like positive attitude, compassion, connection, and teamwork. He also offers a sneak peek into his new book that extends the discussion to a wider audience. Tune in for a rich discussion on the future of healthcare, well-being, and rediscovering the human connection at the heart of medicine. Just One Heart: A Cardiologist’s Guide to Healing, Health, a

Dr Ankur Kalra’s guest this week is Dr Saraschandra Vallabhajosyula, Interventional and Critical Care Cardiologist, Assistant Professor of Medicine at the Warren Alpert Medical School of Brown University and the Director of the Cardiac Intensive Care Unit at Rhode Island Hospital, the Miriam Hospital and Lifespan Cardiovascular Institute. In this episode of Parallax, they delve into the latest insights from ACC.24 through the lens of five pivotal late-breaking trials. Dr Vallabhajosyula offers a deep dive into the nuances of each study. Together, Dr Kalra and Dr Vallabhajosyula distil the complexities of these trials into key messages for practice, grounded in their own clinical experiences. In the spotlight are five key trials: 1. DanGer Shock: Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock 2. RELIEVE-HF: Safety and effectiveness of the V-Wave® Ventura® Interatrial Shunt for the treatment of heart failure (HF) 3. PREVENT: Preventive PCI or medical therapy alone for vulnerable at

In this week’s episode of Parallax, Dr Ankur Kalra welcomes Dr Shashank Sinha. Dr Sinha is an Advanced Heart Failure, Mechanical Circulatory Support, and Transplant Cardiologist at Inova Fairfax Medical Campus, where he serves as Co-Medical Director of the Cardiac Intensive Care Unit and Director of the Cardiovascular Critical Care Research Program. Additionally, he holds the position of Assistant Professor of Medical Education at the University of Virginia School of Medicine. In this episode, Dr Sinha shares his insights on leadership after participating in the prestigious Presidential Leadership Scholars Programme. This programme, designed for mid-career professionals with 10+ years of experience, aims to foster bipartisan, action-oriented leaders. Dr Sinha discusses what motivated him to apply for the programme and guides us through the practical details of the process. Ankur asks him about his modules and the lessons he derived from this multidisciplinary programme. Dr Sinha and Dr Kalra discuss civic du

In this informative episode of Parallax, Dr Ankur Kalra is joined by Dr Andrew Darlington, an Advanced Heart Failure Cardiologist at Piedmont Heart Institute in Georgia. Together, Dr Kalra and Dr Darlington delve into the significance of assessing volume status in patients with heart failure, highlighting its continued relevance in 2024 despite the availability of other diagnostic tools. They caution that mistakes in evaluating volume status can have significant consequences, potentially resulting in alterations in management and negative outcomes. Dr Kalra asks Dr Darlington about his approach to taking medical history. Dr Darlington shares some of the cues he looks for during a physical exam and the art of assessing neck veins. Together, they explore thoracic impedance, its definition, the technologies available to measure this, including a wearable remote monitor and strategies for effectively communicating this technology to patients with worsening heart failure. Dr Darlington gives a comprehensive ove

In this week's Parallax episode, Dr Ankur Kalra welcomes Dr Haider Warraich, a cardiologist at Brigham and Women's Hospital. Dr Warraich is not only a Senior Advisor for Chronic Disease to the FDA Commissioner but also a prolific author, having written three books, including "Song of Our Scars: The Untold Story of Pain." He is a regular contributor to publications like the New York Times and the Washington Post. During the conversation, we learn more about Dr Warraich's journey into medicine and his current role at the FDA, along with his passion for writing. Dr Kalra asks about how Dr Warraich manages his busy schedule and what it takes to write a book. Dr Warraich openly shares his personal experience grappling with chronic pain, a pivotal event that not only influenced his career trajectory but also inspired his book "Song of Our Scars." Moreover, he discusses his role as a Senior Advisor to Dr Robert M Califf, offering insights into his day-to-day responsibilities within the FDA. The conversation also t

Join Dr Ankur Kalra on Parallax this week as he welcomes Dr Candice K Silversides, the first Editor-in-Chief of JACC: Advances. Dr Silversides, a cardiologist and professor at the University of Toronto, wears many hats. She leads the Obstetric Medicine program and directs the Cardio-Obstetric clinic at Mount Sinai Hospital, while simultaneously steering JACC: Advances in its exciting early stages. Dive into the unique synergy between her clinical practice and editorial leadership as Dr Silversides shares her vision for the journal. Learn how she navigates diverse responsibilities, manages peer reviews, and ensures fair evaluation of the submitted manuscripts. Get insights into launching a journal, from adapting to the needs of the readership and editorial board selection to time management. Dr Silversides joins Dr Kalra in exploring the evolving landscape of academic publishing, discussing the challenges and opportunities presented by AI and other advancements. What does the future of academic publishing l

In the season 6 premiere of Parallax, Dr Ankur Kalra welcomes Dr Alex Carter, a Senior Lecturer at the London School of Economics and Political Science (LSE) Department of Health Policy. As the course director for the executive MSc in Health Economics, Policy & Management, Dr Carter delves into the origins and evolution of LSE's health economics program, showcasing its transformation in response to the challenges facing health systems in 2024. The podcast embarks on an exploration of the program's three fundamental pillars: health economics, outcomes measurement, and management. Dr. Carter underscores the importance of efficiently allocating scarce resources, evaluating health system performance through population outcomes, and translating theoretical knowledge into practical application through leadership. Dr Kalra asks Dr Carter about his work with the HyperMarker project, an EU-funded initiative that leverages big data analytics to optimize the prescription of antihypertensives and generate personalized

In this week's Parallax, Dr Ankur Kalra welcomes back Dr Sukhjinder Nijjer for their much-anticipated annual review of advancements in cardiovascular medicine that defined the year 2023. Dr Nijjer, a Consultant Cardiologist in the UK, serves as the President of the Royal Society of Medicine and is an Honorary Senior Clinical Lecturer at Imperial College London. Drs Kalra and Nijjer share their perspectives and experiences, offering valuable insights, practical tips and considerations when interpreting this year’s most impactful trials: • ORBITA-2 (AHA Scientific Sessions): PCI for stable angina • FIRE (ESC Congress): Functional versus culprit-only revascularization in elderly patients with myocardial infarction and multivessel disease • DAPA-MI (AHA Scientific Sessions): SGLT2i in MI without diabetes or heart failure • ILUMIEN IV (ESC Congress): OCT vs angiography-guided PCI • OCTOBER (ESC Congress): OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions • ARTESIA (ESC Congres

In this thought-provoking episode, Dr Ankur Kalra is joined by Dr Anuradha Lala, assistant professor of medicine at the Zena and Michael A Wiener Cardiovascular Institute and in the Department of Population Health Science and Statistics at Icahn School of Mount Sinai and Mount Sinai Hospital. Dr Lala is also the Deputy Editor of the Journal of Cardiac Failure. Dr Kalra and Dr Lala delve into the critical topic of disparities in care within the healthcare system from a cardiologist's point of view and explore actionable steps towards a more inclusive and fair healthcare landscape. Dr Lala advocates for an approach focused on the patient, valuing the unique needs and preferences of each individual as crucial elements in creating a personalised treatment strategy. In this podcast, she provides insight to her study on 'Acute Heart Failure Presentation to the Emergency Department: National Trends by Race and Ethnicity 2007-2019' and how it shows there are differences based on race and ethnicity in terms of wait

On October 28th, 2023, the Canadian Cardiovascular Society (CCS) released a new classification system for acute atherothrombotic myocardial infarction (MI) based on stages of tissue injury severity (CCS-AMI). This expert consensus is the result of decades of data on acute MI with reperfusion therapy. Dr Ankur Kalra is joined this week on Parallax by Dr Andreas Kumar, Chairperson of the Writing Group of the Expert Consensus Statement, Associate Professor of Medicine at the Northern Ontario School of Medicine, Cardiologist at Health Sciences North, and President of the Canadian Society of Cardiovascular MRI. In this informative episode, Dr Kumar shares what led his team and the CCS to introduce a new classification scheme for acute MI. He discusses how research from the past 15 years highlighted the need to incorporate tissue changes resulting from acute myocardial infarction (MI) into clinical practice. Dr Kumar outlines the four stages of CCS-AMI, and we gain insight into how this novel classification schem

In this week's episode of Parallax, Dr Ankur Kalra's guest is Dr Craig R Smith, Cardiac Surgeon and Chairman of the Department of Surgery at Columbia Presbyterian Hospital. In 2020, The Wall Street Journal called Dr Smith the pandemic's most powerful writer. Each day throughout the COVID-19 crisis, Dr Smith provided the faculty and staff with updates on pandemic response and priorities, offering both vital information and unwavering support. This month, Dr Smith released his book, 'Nobility in Small Things: A Surgeon's Path’. In this inspiring episode, Dr Smith delves into the story behind his book and the motivating circumstances that led him to become an author. Dr Kalra asks Dr Smith about his experience as a leader during the pandemic as a surgeon. Dr Smith shares the story of his unconventional journey into medicine, emphasizing how hard physical labor built his resilience and prepared him for his residency. Dr Kalra also asks about Dr Smith's experience as a surgeon for President Bill Clinton in 2004.