Clinical Rotations
Check out the videos below to learn more about our clinical rotations!
Cardiac Care Unit (CCU)
This is truly a flagship clinical experience in our fellowship program. Fellows will acquire expertise in the evaluation and treatment of patients with all types of adult cardiovascular diseases including: acute coronary syndromes, arrhythmias, hypertension, cardiomyopathy, valvular heart disease, pericardial disease, pulmonary hypertension, peripheral vascular disease, adult congenital heart disease, and heart disease in pregnancy. Additionally, fellows will become skilled in the management of temporary circulatory support devices, interpretation of invasive hemodynamics and the management of vasoactive medications.
Echocardiography 1
Fellows acquire fundamental knowledge in performing and interpreting a comprehensive echocardiographic examination. This includes chamber quantification, systolic/diastolic functional evaluation and hemodynamic and valvular functional assessment. Fellows will spend mornings with our amazing echocardiography technicians mastering technique in performing echocardiography and afternoons learning to read echocardiogram studies under the guidance of our expert clinical faculty.
Heart Failure
Our outstanding heart failure training provides fellows with a thorough understanding of the pathophysiology of heart failure, with particular emphasis on appropriate diagnostic and therapeutic options for the patient with moderate-to-severe cardiomyopathy. Fellows will also be trained in aspects of mechanical circulatory support and cardiac transplantation including patient selection and pre-operative evaluation, inpatient management of patients with refractory heart failure and cardiogenic shock, and the management of patients after heart transplantation.
Echocardiography 2
Fellows build on the foundational knowledge and skills acquired during the first year of fellowship. During this rotation, fellows will focus their time on acquiring skills in performing hands-on transesophageal echocardiography (TEE) and apply their understanding of 2D TTE principles for TEE-based valvular and structural cardiac assessment. Fellows will also advance their knowledge and skill in reading transthoracic echocardiograms of increasing complexity and develop an advanced understanding of the applications of color doppler, spectral doppler, tissue doppler and M-mode as part of a comprehensive echocardiographic evaluation and in the evaluation of prosthetic valves.
Cardiac Electrophysiology (EP)
Fellows are an integral part of the entire clinical cardiac electrophysiology team. During this rotation, fellows will acquire knowledge and skill in consultative electrophysiology and participate in device implantation or catheter ablation. Fellows will learn to thoroughly evaluate EP patients and understand the diagnostic and therapeutic options. From a technical standpoint, fellows will learn to perform detailed device interrogations
Non-Invasive Imaging
This advanced imaging rotation for senior fellows is spent at CVTI and Keck Medical Center, affording fellows the opportunity to work in a higher volume stress laboratory and transesophageal echocardiography (TEE) laboratory. As a tertiary and quaternary referral center, training at Keck permits fellows to learn from patients with pathology of increasing complexity as well as the full breadth of prosthetic valve interventions. By the end of their third year, fellows will be able to independently supervise the stress laboratory.
Nuclear Cardiology
During the nuclear cardiology rotation fellows will become familiar with the basic physics principles that underlie nuclear cardiology and the fundamentals of image processing. The fellows will learn a variety of nuclear stress protocols and become comfortable supervising the nuclear lab. With this understanding, fellows should learn to identify various types of artifact and learn maneuvers/techniques to differentiate these findings from true perfusion defects. Fellows will focus their attention on nuclear cardiology as part of an assessment of complex coronary artery disease and cardiomyopathy, but will also gain appreciation for its application in myocardial viability.
Los Angeles General Medical Center Cardiac Consultation
The Los Angeles General Medical Center consultative services is one of the flagship rotations at Los Angeles General Medical Center. Fellows will lead a team of residents and medical students in providing evidence-based recommendations for cardiac patients. Fellows enjoy graduated autonomy in the formulation of recommendations. This is balanced by excellent support and guidance by the cardiology consult attending. During this rotation, fellows will become versed in determining the appropriateness of non-invasive and invasive testing. Fellows will learn the indications, contraindications, risks, and limitations of studies and interventions. Fellows will learn to synthesize relevant data from multimodal diagnostics in effort to provide comprehensive cardiac assessment.
Los Angeles General Medical Center Cardiac Catheterization Lab
This experience is one of the highlights of our clinical training experience. Fellows become versed in diagnostic coronary angiography and cardiac catheterization. General fellows serve as the primary operator in all diagnostic studies and assist the interventional cardiology fellow and attending in interventions. Fellows gain exposure to a wide variety of pathologies including advanced coronary artery disease, complex valvular disease and hemodynamics, cardiomyopathies, pulmonary hypertension, pericardial and adult congenital heart disease, many times not previously diagnosed.
Keck Cardiac Consultation
This service functions as both a consultative service as well as a primary service to some non-ICU cardiology patients at Keck Medical Center. As a consultative service, the team provides assistance in the evaluation and care of a variety of cardiac conditions, including assistance in the pre-operative risk stratification and management of post-operative cardiac complications. As a primary service, the team will supervise the management of patients presenting to Keck Medical Center for both cardiac and occasionally care for more complex cardiac patients presenting with non-cardiac complaints. Fellows learn from the complex cardiac pathologies of patients referred to a cutting edge quaternary referral center.
Keck Cardiac Catheterization Lab
Fellows build on the foundational procedural skills and experience acquired during the first year of fellowship in a high volume cardiac catheterization laboratory setting. Keck Medical Center is a tertiary referral center and many patients have complex cardiac disease with multiple comorbidities. Many patients scheduled for cardiac catheterization have undergone multiple prior coronary interventions and have complex coronary disease anatomy and challenging vascular access. These are excellent learning opportunities to advance one’s procedural skills, understanding of coronary anatomy, cardiac hemodynamics and valvular heart disease.
Come learn more about the CCU rotation at Los Angeles General Medical Center from fellow graduate, Jena Pizula!
Come learn more about the Heart Failure and Transplant Rotation at Keck Medical Center from our fellow, Wesley Ghasem!