Parallax by Ankur Kalra

In this week's episode of Parallax, Dr. Ankur Kalra welcomes Dr. John Mandrola, a cardiac electrophysiologist practicing in Louisville and the host of the popular podcast "This Week in Cardiology" and co-author of Sensible Medicine, among other forums. In this insightful episode, we delve into Dr. Mandrola's career journey. He discusses how the beginnings of his career during a period of significant innovations and the reversal of expert opinions profoundly influenced his perspective on medicine, leading to a more conservative stance. Dr. Kalra then invites Dr. Mandrola to share the motivations that drive his work as a medical journalist and communicator, along with his methods of selecting studies to highlight in his writings and show. Dr. Mandrola emphasizes the importance of bedside medicine and the critical role of translating and interpreting evidence in modern healthcare. Together, Dr. Kalra and Dr. Mandrola explore the complexities of practicing medicine today and ponder the value propositions associ

In the landmark centennial episode of Parallax, Dr Ankur Kalra welcomes a true luminary in the field of cardiology, Dr Valentin Fuster. Dr Valentin Fuster, a renowned cardiologist, currently holds multiple roles. He serves as the Director of the Cardiovascular Institute and as the Physician-in-Chief at the Mount Sinai Medical Center in New York. Additionally, Dr Fuster is the General Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Madrid. Notably, he also holds the position of Editor-in-Chief at the Journal of the American College of Cardiology (JACC). In this candid and rich episode, Dr Fuster delves into his upbringing in Barcelona and reflects on the influential role his family played in providing him with role models and a sense of freedom during his formative years. Dr Fuster invites us to contemplate the concepts of mentorship and trust by recounting pivotal moments from his life, revealing how these principles propelled him towards a life of fulfilment. Dr Kal

In this week's Parallax, Dr. Ankur Kalra's guest is Dr. Mirvat Alasnag. Dr. Alasnag is an interventional cardiologist at King Fahad Armed Forces Hospital (KFAFH) in Saudi Arabia. Additionally, she serves as the Editor-in-Chief at Current Cardiovascular Imaging Reports and is a member of the Board of Trustees at SCAI. Dr. Alasnag and Dr. Kalra provide a comprehensive review of the key highlights from ESC Congress 2023. Dr. Alasnag distills the background and latest evidence from key interventional trials, emphasizing their significance for patient care. Tune in to discover the strategies that Dr. Kalra and Dr. Alasnag are currently employing and gain insights into how these data will shape their future decision-making in the catheterization laboratory. Don't miss this informative discussion at the forefront of interventional cardiology. Trials included: FIRE: Physiology-Guided Complete PCI in Older MI Patients MULTISTARS AMI: MULTivessel Immediate Versus STAged RevaScularization in Acute Myocardial Infarctio

In this week's Parallax, Dr Ankur Kalra welcomes back Dr Jag Singh to discuss Dr Singh's recently published book, "Future Care," which delves into the exciting evolution of medicine over the next 5 to 10 years. Dr Jagmeet Singh is a Cardiac Electrophysiologist and a Professor of Medicine at Harvard Medical School. He is also the Founding Director of the Resynchronization and Advanced Cardiac Therapeutics Program at Massachusetts General Hospital. "Future Care" wasn't written overnight; it had been simmering in Dr Singh's mind for nearly a decade. The catalyst for this book was a convergence of factors, including the COVID-19 pandemic and Dr Singh’s personal health journey. Drawing from his experiences across three different countries, his role in patient care and leadership and his unique perspective as a patient himself, Dr Singh explores the crucial question of how medicine can and should evolve. In this episode, Dr Kalra and Dr Singh delve deeply into the ideation, research, and writing process that brou

In the finale of our series "Conversations about Hypertrophic Cardiomyopathy", Dr Ankur Kalra welcomes, Dr Anjali Tiku Owens, for a dynamic and practical discussion. Dr Owens is Medical Director of the Center for Inherited Cardiac Disease and Associate Professor of Medicine at the Hospital of the University of Pennsylvania. This series is supported by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information. In this week’s episode, Dr Kalra and Dr Owens take us on a journey through the complexities of hypertrophic cardiomyopathy (HCM), with focus on the diagnostic challenges and breakthroughs in this field. Emphasising with the critical importance of making accurate diagnoses, Dr Owens shares her insights into identifying the common mimickers of HCM through a structured approach starting with taking the patients history. As the conversation delves deeper, Dr Owens discusses the various diagnostic tools and tests used to rule out other cond

In the second episode of our series "Conversations about Hypertrophic Cardiomyopathy", Dr Ankur Kalra sat down with Dr Ahmad Masri to have a deep-dive into the management paradigms of hypertrophic cardiomyopathy (HCM), considering the evolution of medical therapy in recent years. Dr Ahmad Masri is a Cardiologist and the Director of OHSU Hypertrophic Cardiomyopathy Center. This series is sponsored by an unrestricted educational grant from Bristol Myers Squibb. Please see www.camzyosrems.com for important safety information. Dr Kalra invites Dr Masri to guide us through his decision-making process in evaluating medical and surgical options in patients with obstructive hypertrophic cardiomyopathy. Dr Masri delves into first and second-line treatment strategies while exploring the significance of FDA-approved cardiac myosin inhibitors in the management of hypertrophic cardiomyopathy. Dr Kalra asks Dr Masri about the practical office-based clinical course for patients deemed suitable candidates to receive mavaca

Join Dr Ankur Kalra in this episode of our mini-series, "Conversations about Hypertrophic Cardiomyopathy," as he engages in an in-depth discussion with Dr Carolyn Yung Ho. Together, they explore the journey from symptoms to diagnosis and management options for hypertrophic cardiomyopathy (HCM). Dr Ho, Medical Director of the Cardiovascular Genetics Center and an Associate Professor at Harvard Medical School. Dr Ho offers a comprehensive examination of HCM, providing valuable insights on diagnosing the condition and distinguishing it from other conditions. The discussion addresses important questions, such as when to refer patients suspected of having HCM. The episode explores the significance of cardiac MRI in diagnosing and distinguishing HCM, with a focus on the distinctive features that aid in assessment. The differentiation between sarcomeric and non-sarcomeric forms of HCM is examined for its clinical relevance, with an emphasis on identifying individuals at risk. Dr Ho sheds light on the diagnostic

“You should neither take the outcome personally nor fall into the trap of thinking that doing nothing better.” In this special episode of Parallax, we bring you Dr Ankur Kalra's thought-provoking lecture delivered at the IU School of Medicine Department of Anaesthesia Grand Rounds and introduced by Dr Nandan Anavekar. In this episode, Dr. Kalra explores the intersection of spirituality and healthcare, encouraging us to reflect on its significance for both patients and providers. Dr. Kalra begins by defining spirituality and highlighting its interconnectedness with patient care and the broader concept of life. He invites us to think about the various mechanisms behind spiritual experiences and practices, sharing his own personal journey with meditation. Examining studies on the impact of meditative practices like yoga and mindfulness on heart outcomes, he sheds light on their place in healthcare. Delving into his experiences as a physician, Dr. Kalra presents two patient cases, illustrating how he navigates

In this week's Parallax, Dr Ankur Kalra is joined by guests, Dr Rama Ellauzi, Dr Nandan Anavekar and Dr Anthony Kashou, also known as The EKG Guy. Together, they delve into cardiovascular education and the Global Cardiology University (GCU). The genesis of GCU traces back to Dr Kashou's time as an intern at Mayo Clinic. Recognizing the challenges of postgraduate education, Dr Kashou embarked on a journey to enhance early-level training. Drawing inspiration from his own struggle to comprehend electrocardiograms (EKGs), he set out to build a comprehensive database. This eventually led to the birth of GCU. Dr Ellauzi, Dr Anavekar and Dr Kashou share their passion for education and the devotion that drew them to the GCU. They explore the vision of GCU, which revolves around creating a community space where knowledge is shared, aligning with educational trends, and empowering learners. Through scientific content evaluation and a commitment to providing premium yet affordable materials, GCU embraces community own

In this final episode of our mini-series on value in academic medicine, Dr Ankur Kalra welcomes back Dr Nandan Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic, who also serves as the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this inspiring conversation, Dr Anavekar and Dr Kalra discuss the education of postgraduate medical students and reflect on Dr Anavekar’s role as a Program Director. Dr Anavekar shares his motivations and the moral framework he uses to approach his responsibility towards his students. The conversation then shifts towards the learning environment provided for medical students. Dr Anavekar contrasts the prevalent competitive culture and draws on Vedic philosophies to outline how we can strive for a student-centric culture that fosters a more collaborative environment and supports autonomous decision-making. Dr Anavekar asks listeners to look at medic

In the second part of our mini-series exploring the concept of value in academic medicine, Dr. Ankur Kalra once again engages in a compelling discussion with Dr. Nandan Anavekar. Dr Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic, also serves as the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this stimulating and thought-provoking episode, Dr. Kalra and Dr. Anavekar delve into the topic of measuring success in medicine. Dr. Anavekar puts forward the argument that the ambiguous definition of academic achievement often results in damaging biases that have long-term repercussions on the medical field. As a program director, Dr. Anavekar believes that the number of published articles should not be the only or most crucial criterion for evaluating early-career faculty. He argues that it's important to also consider the "distance travelled" by candidates. Dr. Kalra raises perti

Bullying is a phenomenon that most of us are familiar with, whether through personal experience or through the stories of friends and colleagues. But what exactly is the impact of bullying on an individual and, in turn, on their community or field of work? In the context of medical science, the consequences can be particularly dire. In the latest episode of Parallax, Dr Ankur Kalra's guests are Dr Susanne Täuber and Dr Morteza Mahmoudi. Dr Täuber, an expert in organisational behaviour, was recently terminated for speaking out against discrimination at her institution. Dr Mahmoudi is a radiologist at Michigan State University and co-founder of @AcademicParity movement. Dr Mahmoudi and Dr Täuber teamed up to explore bullying in academic settings. Together with Dr Kalra they discuss why bullies thrive in such environments and the ways institutions enable such behaviour. Dr Täuber offers solutions and a critical overview of institutional narratives, while Dr Mahmoudi highlights the long-term effects on academic

In 2018, the loss of a friend to suicide compelled Dr Anavekar to embark on a profound journey of contemplative self-exploration. Now, he uses his experience to encourage and guide trainees to pose thought-provoking questions that challenge the status quo of the materialistic approach to medicine, ultimately leading to a more outcome-focused perspective. In this week's episode of Parallax, Dr Ankur Kalra sits down with guest Dr Nandan Anavekar, a Professor of Medicine at Mayo Clinic College of Medicine and Science. Dr Anavekar also serves as a consultant for both the Cardiovascular and Radiology Departments at Mayo Clinic and is the Program Director for the Adult Cardiovascular Diseases Fellowship program. In this episode, Dr Nandan Anavekar emphasizes the importance of inner exploration for physicians. He encourages questions such as "Who am I?" and "What is this world that I reside in?" to foster a deeper understanding of the human condition and patient care. Dr Anavekar also addresses the current cultura

In the latest episode of Parallax, Dr. Ankur Kalra invites Dr. Vijay Rao, the Governor of the Indiana Chapter of the American College of Cardiology, to share his experience and insights with the audience. Dr. Rao, who also serves as the Director of Heart Failure, Cardio-oncology, and Co-Director of Anticoagulation at Franciscan St. Francis Health, discusses what initially drew him to the Indiana State Chapter of ACC. As Dr. Kalra asks Dr. Rao about the ways in which early career faculty members can get involved with the organization at a state level. Dr. Rao shares his insider tips and highlights key events where individuals can further their participation. Dr. Rao also sheds light on the governorship election process and shares his learnings from his new role. He emphasizes the importance of advocacy and describes the chapter’s efforts to amplify the voice of cardiologists in relation to Roe v. Wade. Dr. Rao encourages healthcare professionals to reframe their perspectives and get involved with advocacy. Dr

“We're providing about 20,000 different ingredients in our diet to a gut microbiome that has 4 million genes. And they're processing these 20,000 ingredients at a flood of chemicals.” In this episode of Parallax, Dr Ankur Kalra speaks with Dr. Momchilo Vuyisich, co-founder and chief science officer of Viome Life Sciences. Dr Vuyisich shares his personal journey with rheumatoid arthritis and how it led him to explore the intersection of nutrition and the gut microbiome function. He explains how the complexity of nutrition and the compounds generated by the gut microbiome can impact our health. We learn more about three compounds produced by our gut microbiome that have a strong connection with heart disease. Through this conversation, Dr Vuyisich invites us to reframe our approach to nutrition and prevention as a question of food education and data-driven science. What is the effect of red meat and processed food on our gut biome? What can we learn about prevention through understanding gut biome function?

In this week’s Parallax Dr Kalra welcomes back Dr Nijjer for their annual review of the most impactful and controversial cardiovascular trials of 2022. Dr Sukh Nijjer is a Consultant Cardiologist in the UK, he is President of the Royal Society of Medicine and Honorary Senior Clinical Lecturer at Imperial College of London. The coronary physiology trial FLAVOUR was presented at ACC.22 by Dr Bon Kwon Koo. This South-Korean study compared the safety and efficacy of FFR and IVUS-guided stenting. Dr Nijjer interprets the findings and outlines the take-home messages by describing his practice. Following this, Dr Kalra and Dr Nijjer look at REVIVED-BCIS2 presented at ESC 2022 by Dr Divaka Perera. Dr Nijjer talks about the complexity of running this study that evaluated whether revascularization by PCI can improve outcomes in patients with ischemic left ventricular systolic dysfunction compared with optimal medical therapy. They distill some of the nuances for practice. Dr Nijjer summarises the all-comers PROTECTED

Parallax features a guest episode from the new podcast Neurophilia by Nupur Goel. Do you think and act with your mind or heart? How about both? Neurocardiology refers to the intersection between the fields of neurology and cardiology. The mind and heart are deeply interconnected in terms of anatomy, physiology, and various pathologic states. This episode features a vascular neurologist and an interventional cardiologist who will discuss the relationship between their two fields of medicine. Dr. Blake Buletko is a vascular neurologist at the Cleveland Clinic. He completed his residency and fellowship training at the Cleveland Clinic and was the former medical director of their mobile stroke program. In addition to his clinical responsibilities, Dr. Buletko serves as an Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and is the current Program Director of the Adult Neurology Residency program for the Cleveland Clinic. Dr. Ankur Kalra is an intervent

“Medical school cannot, and should not, feel easy—but it should feel worthwhile” – these are the opening words of Dr Kittleson’s book, Mastering the Art of Patient Care. Dr Kittleson’s book is not only a great resource for patient care, but a heartful companion to early career faculty as well. Dr Kalra’s guest on Parallax this week is Dr Michelle Kittleson, Professor of Medicine at Cedars-Sinai, Director of Education in Heart Failure and Transplantation and Director of Heart Failure Research at the Smidt Heart Institute. Coming from generations of doctors, Dr Kittleson describes herself first and foremost a dedicated clinician. With her new book, Dr Kittleson offers her mentorship and shares her advice on how to make patient care fulfilling for both clinicians and patients. In this rich and insightful discussion, Dr Kittleson talks about the origins of famous #kittlesonrules, a collection of tips for doctors shared on Twitter, and her thoughts on mentorship. We learn more about Mastering the Art of Patient

“The hospitals like things just the way they are. It gives them almost complete immunity for any peer reviews, good faith, or bad faith, that they conduct against a physician.” The Health Care Quality Improvement Act of 1986 considers accused physicians to be guilty of the charges unless and until they can prove their innocence. Over the years many hospitals abused the peer review system to extort and silence competent physicians. Dr Lawrence Huntoon, Editor-in-Chief of the Journal of the Association of American Physicians and Surgeons, returns for a deep dive into the topic of the hospital peer review system. In this second episode of our medico-legal series, Dr Kalra invites Dr Huntoon for an overview of the key terminologies and processes of the hospital peer review system. Dr Huntoon summarises some of key actions you can take as a physician to prepare and defend yourself. We learn more about different sham peer review tactics through recent cases. Dr Huntoon shares his thoughts on what we can do to

“Sham peer review or malicious peer review is defined as the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons.” “Most doctors — warns Dr Kaki — do not understand that ultimately your privileges are not dictated by your colleagues through a fair process, but hospital administration controls our destiny”. In 2018, Dr Kaki was subject to a campaign of retaliation that set out to revoke the well-respected cardiologist’s privileges. Today, Dr Kaki is Director of Mechanical Circulatory Support at Ascension and Clinical Associate Professor at Wayne State University School of Medicine. In this week’s Parallax Dr Kalra’s guests are the team that fought for justice in Dr Kaki’s case: Dr Lawrence R Huntoon, Editor-in-Chief of the Journal of the Association of American Physicians and Surgeons and Deborah Gordon, employment attorney. Dr Kaki walks us through his Kafkaesque experience and the knowledge he acquired during his battle with his former hospital. We get insig