Internists

• Internal Medicine
  Abdi Rasekh is an interventional cardiologist and electrophysiologist. He received his doctor of medicine degree from the University of Paris XIII where his thesis won the Bronze Medical Award for Clinical Research. He completed his internship and residency in internal medicine at the Graduate Hospital of University of Pennsylvania in Phi

Radiologist

• Ultrasound
  Heart failure is one of the most common and fastest-growing cardiac problems, especially as more people survive cardiac events that prior to modern therapies would have been fatal and as the population ages. It can be defined as an inability for the heart to supply the needs of the body, and can be present either with depressed contractile ("squeezing") function of the heart, known as systolic heart failure, or with apparently normal contraction of the heart muscle, known as diastolic heart failure. Common symptoms include fatigue, shortness of breath, coughing, swelling (particularly of the legs and feet), abdominal distention, and poor appetite; in around 50% of patients this is associated with coronary artery disease (i.e., blockages in the arteries of the heart) but can also be associated with valve problems, diseases of the heart muscle itself, or systemic medical illnesses. Evaluation will typically start with an echocardiogram (ultrasound of the heart) and in appropriate patients some kind of assessment of the presence or absence of coronary artery disease. If reversible causes of heart failure are found, they will be treated; almost all if not all patients can be significantly helped by a combination of medicines and minimally invasive procedures. An assessment of the risk of life-threatening arrhythmias will inform the decision about whether an implantable device called a defibrillator or ICD is necessary. Finally, in the extreme cases in which severe symptoms persist despite medical management, more advanced therapies such as stem cell transplantation, implantation of left ventricular assist devices, or cardiac transplantation are considered.
• MRI
  There are a total of four valves between various chambers of the heart; the tricuspid valve between the right atrium and right ventricle, the pulmonic valve between the right ventricle and pulmonary artery, the mitral valve between the left atrium and left ventricle, and the aortic valve between the left ventricle and the aorta. All of these valves can be affected by a wide range of congenital, infectious, acquired, and degenerative diseases, resulting in "stenosis" (blockage) and/or "insufficiency" or "regurgitation" of the valve. Depending on which valve is affected and how severely, this can cause a wide variety of symptoms, and in some cases may require medications, minimally invasive procedures with balloons delivered via the blood vessels (valvuloplasty), or surgical repair or replacement. In addition to physical examination for a cardiac murmur (which is a sound heard through a stethoscope), echocardiography is usually the first test to assess the presence and significance of valvular heart disease. In selected cases, transesophageal echocardiography (to look at the heart from behind by placing a small probe down the esophagus), more advanced imaging with cardiac MRI or CT, or invasive heart catheterization to measure pressures inside the heart may be necessary to fully characterize a valve problem and more precisely guide therapy