Week 1: Immersing into NYC and Cardiology

My time in NYC has started off in a rapid-fire fashion. After getting settled into the neighborhood on Saturday and Sunday, I started my clinical experience on Monday. I am working with Dr. Jonathan Weinsaft who is a cardiology MRI specialist in Weill Cornell. This week I believe I have already seen four or five different patient cardiac MRIs.

One of Dr. Weinsaft's research focuses is on the imaging of blood flow in the aorta in patients with various pathologies. I have seen patients with Marfan syndrome and aortic aneurysm receiving these MRIs that are able to model the flow of blood through their aortas. The ultimate goal is to be able to compare the flow in their vessels to the flow of patients without aortic pathologies. I have begun to go through the process of understanding the reconstruction of the MRIs in order to map the flow and how we can use this to calculate further biomechanical properties such as wall shear stress. 

I addition to the MRIs that I have seen, I have been able to get a fairly broad introduction to the cardiology department as a whole. On my second day I followed the cardiac ICU residents on their rounds and was able to see the types of more severe cases that end up in the hospital. A lot of these patients had previously diagnosed or treated pathologies and were coming back because of complications due to drug treatment or worsening of their symptoms. This was a unique experience because I don't think I have ever been in an ICU before. Overall, I had expected a much more tense environment, but the mood was fairly relaxed and no one seemed to be under too much stress.

The next day I was able to go to the electrophysiology department where they were doing a procedure on a patient who had supraventricular tachycardia. With this type of arrhythmia, they are not able to pinpoint the location of the faulty electrical pathway without putting multiple catheters in the patient that can track the electrical signals. They placed four catheters in the heart and were able to approximate the location of the electrical signal that was causing the tachycardia, then they inserted a cauterizing catheter that was pushed into the atrium so that they could ablate the point of interest. This often requires fluoroscopy to image, but advanced technology using magnetic locating allows for lower radiation exposure to the patient while still being able to locate the electrodes and the ablator. 

My experiences with the city have been good so far. It's not as intimidating as I thought it would be and I've been able to explore through running around the city and going to new places to eat. The picture below is from Xi'an Famous Foods, which is one of my favorite places I have been to eat so far.