Bio

Clinical Focus


  • Internal Medicine
  • Geriatrics

Academic Appointments


Professional Education


  • Board Certification: American Board of Internal Medicine, Geriatric Medicine (2017)
  • Fellowship: Duke University School of Medicine (2017) NC
  • Residency: University of Connecticut Internal Medicine Residency (2016) CT
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2015)
  • Medical Education: St. George's University School of Medicine (2012) NY

Publications

All Publications


  • Preoperative Screening. Clinics in geriatric medicine Marwell, J. G., Heflin, M. T., McDonald, S. R. 2018; 34 (1): 95–105

    Abstract

    Older adults undergoing elective surgical procedures suffer higher rates of morbidity and mortality than younger patients. A geriatric-focused preoperative evaluation can identify risk factors for complications and opportunities for health optimization and care coordination. Key components of a geriatric preoperative evaluation include (1) assessments of function, mobility, cognition, and mental health; (2) reviews of medical conditions and medications; and (3) discussion of risks, preferences, and goals of care. A geriatric-focused, team-based approach can improve surgical outcomes and patient experience.

    View details for DOI 10.1016/j.cger.2017.08.004

    View details for PubMedID 29129220

  • Safety of vasodilator stress myocardial perfusion imaging in patients with elevated cardiac biomarkers. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology Rai, M., Ahlberg, A. W., Marwell, J., Chaudhary, W., Savino, J. A., Alter, E. L., Henzlova, M. J., Duvall, W. L. 2017; 24 (2): 724–34

    Abstract

    While adenosine and dipyridamole as myocardial perfusion imaging (MPI) stress agents have literature supporting their safety in the setting of myocardial infarction (MI), regadenoson does not. Studying a high risk cohort of patients with elevated cardiac biomarkers may shed light on potential safety issues of these agents which might also affect lower risk cohorts.All patients who had undergone a clinically indicated stress MPI study at two academic centers from 1/1/2010 through 12/31/2012 with elevated troponin ≤7 days prior to testing were included. The primary endpoint was a composite of death, non-fatal MI, congestive heart failure (CHF), stroke, ventricular arrhythmias, atrial fibrillation/flutter, or atrioventricular block requiring intervention within 24 h of testing.Of the 703 stress MPI studies that met inclusion criteria, 360 (51.2%), 199 (28.3%), 74 (10.5%), 9 (1.3%), and 61 (8.7%) underwent regadenoson, dipyridamole, adenosine, dobutamine, and exercise stress, respectively. The primary endpoint occurred in 11 (1.6%) patients with an incidence of 1.4% (n = 5), 1.0% (n = 2), 1.4% (n = 1), 11.1% (n = 1), and 3.3% (n = 2) following regadenoson, dipyridamole, adenosine, dobutamine, and exercise stress, respectively (P = 0.137). The adverse events included non-fatal MI in 7 (1.0%) patients, death in 1 (0.1%) patient, CHF in 1 (0.1%) patient, ventricular arrhythmia in 1 (0.1%) patient, and atrial arrhythmia in 1 (0.1%) patient.In the setting of elevated troponin, serious complications associated with either exercise or vasodilator stress testing appear to be relatively rare with no increased risk attributable to a particular vasodilator agent.

    View details for DOI 10.1007/s12350-016-0448-9

    View details for PubMedID 26902485

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