The fellow is expected to participate in this dedicated ACHD rotation for 11 blocks. The outpatient service evaluates approximately 140 patients per month. The fellow is expected to participate in all outpatient clinics with adult congenital faculty members. This outpatient clinic includes outreach sites in the Bay Area and the transition and transfer clinic for adolescents and young adults at LPCH. There will be a dedicated half-day session clinic per week for 20 blocks where the fellow sees his/her own patients independently under the supervision of an adult congenital faculty member. The consultative evaluation will require the review of prior clinic visits, electrocardiogram, imaging studies, invasive testing and operative notes. Subsequent presentation to the faculty at the end of every ACHD clinic provides the opportunity for in-depth discussion of pathophysiology, differential diagnosis, physical examination, and review of pertinent objective data. This also includes review of all outpatient echocardiograms.
The inpatient service cares for approximately 3-6 patients per week. The fellow provides ACHD consultative services to multiple services in SHC and LPCH, including coronary care unit at SHC, medical inpatient unit, obstetrical service, cardiac intensive care unit at LPCH, and post-cardiac surgical patients. Inpatient management will include but not be limited to pregnancy, arrhythmia, heart failure, pulmonary hypertension, and pre and post cardiac surgical and noncardiac surgical management in the adult with CHD. The fellow is responsible for accepting transfers from our network hospitals for acute medical or surgical care. Finally, the fellow will prepare for the weekly inpatient cardiology and cardiac surgical conference.