Congenital Heart Disease Awareness: Transitioning ACHD Patients Into Specialty Care

Marion Rae headshotThis article was authored by Marion McRae, ACNP-BC, a nurse practitioner in the Guerin Family Congenital Heart Program at Cedars-Sinai Medical Center in Los Angeles, CA.

Congenital heart disease (CHD) occurs in close to 1 percent of births with over 90 percent living to adulthood. There are now more adults living with CHD than children due to successful surgical and medical treatment over the last six decades. Unfortunately, many adults with CHD have fallen out of congenital heart care either because they were told they were surgically “fixed” or because they were never referred to adult congenital heart disease (AHCD) providers upon reaching adulthood.

It is now known from decades of follow-up that there can be life-long consequences of even the simplest congenital heart surgeries. In addition, we now know that many individuals with complex CHD repairs that have a single ventricle or a systemic right ventricle will experience early heart failure, arrhythmias, and far-reaching manifestations of surgical procedures, such as the Fontan operation, that subject the body to systemic venous hypertension leading to liver cirrhosis, pulmonary hypertension, esophageal varices, protein-losing enteropathy, plastic bronchitis, etc. Many of these individuals will go on to need a heart transplant or multi-organ transplantation in their second to fourth decade of life.  Continue reading

The Role of the Cardiovascular Genetics Counselor

Marion Rae headshotThis article was authored by Marion E. McRae, MScN, ACNP-BC, CCRN-CSC-CMC, a nurse practitioner in the Congenital Heart Program at Cedars-Sinai Heart Institute.

Genetics counselors have specialized training in medical genetics and counseling at either the masters or doctoral level and are certified through the American Board of Genetic Counseling. Many states offer genetic counseling licensure. Genetic counselors working in cardiovascular genetics have additional clinical training and/or continuing education with regard to cardiovascular disease. It is estimated that there are currently about 50 – 60 cardiovascular genetics counselors in the U.S. Continue reading

Happy Nurse Appreciation Month

NancyLundy headshotThis post was authored by Nancy L. Lundy, NP, AACC.

For those of you that practice in the cardiology arena, the ACC can be, and should be, your professional home.

The ACC pours countless resources into services designed just for the “non-physician” members of the College, offering its members opportunities to be involved in the local, state and national levels. With patient resources, instant access to current guidelines, hundreds of hours of CME and an internationally renowned Annual Scientific Session, nurses can be assured that all of our professional needs are met. Continue reading

Pharmacists Involvement in MI Care: Completing the Team

Craig BeaversThis post was authored by Craig J. Beavers, PharmD, AACC, BCPS-AQ Cardiology, CACP, co-chair of the ACC’s Clinical Pharmacist Workgroup.

Myocardial infarction (MI) is a common occurrence, with an approximate annual incidence rate of 525,000 new events and 200,000 recurrent events, and an estimated 30-day mortality rate of 7.8 percent. Therefore, it is no surprise much focus and attention has been devoted to MI management. Great strides have been made in terms of improving morality and reducing morbidity via interventional techniques and advanced pharmacotherapy. However, variation exists amongst hospitals regarding MI mortality rates despite solid evidence for treatment. While geographic locations, number of beds and MI volumes have correlations with mortality rates and may explain some variability; there still remains a substantial proportion of unaccounted variation. In order to address these unknowns, investigators preformed an analysis of hospitals with the lowest 30-day risk standardized mortality rates. They found seven strategies that impacted their morality outcomes with one of the domains including pharmacist care. This analysis has blossomed into the concept of the ACC’s Surviving MI Initiative. Continue reading

How to Talk to Patients About Nutrition

Jane CasselThis post was authored by Jane Cassel, PA-C, cardiovascular team member of the ACC’s Prevention of Cardiovascular Disease Section Leadership Council.

Working in an acute coronary unit exposes me to several situations that cause me to think about the future of heart disease that provides me with a source of employment. Census data show that coronary artery disease and related mortality has decreased significantly in the recent decades, however, heart disease is still the number one killer among men and women in certain age groups in the U.S. Even with that information, fighting the disease from progressing continues to be a goal that I don’t see will ever become a null product. Continue reading

Jane Linderbaum, RN, MS, FNP, AACC: A Distinguished Associate

Serving close to two decades as a cardiology nurse practitioner at Minnesota’s Mayo Clinic, Jane Linderbaum, RN, MS, FNP, AACC, has developed an outstanding ability getting patients from point A to point Z in their care without running the gamut of the entire alphabet. While this particular talent stems from the Mayo Clinic itself – as it is the first and largest medical group practice to implement integrated care – it also derives from Linderbaum’s own team-based clinical expertise. Continue reading

Patient-Centered Care in a Team-Based Environment

This post was authored by Suzanne Hughes, RN, MSN, clinical education project director for the Preventive Cardiovascular Nurses Association, and a member of the ACC’s CV Team Section.

The focus on patient-centered care in medicine has come a long way and over the years, all members of the cardiovascular care team have played an increasingly important role.

A survey from earlier this year from the Preventive Cardiovascular Nurses Association (PCNA) asked members of the cardiovascular care team how much time they spend with their patients during an initial visit. Nearly 25 percent responded that they spend more than an hour; most spend between 20 and 60 minutes. Further, even among those respondents who are not themselves prescribers, many make treatment recommendations, and play a key role in assuring that patients persist with long-term therapy.   Continue reading

Where is my Team? Transitioning to a Team-Based Care Model

This post was authored by the ACC Cardiovascular Team Council*.

A team is often defined as a group of individuals with a full set of complementary skills working together to complete a task, a project, or to achieve a goal. In cardiology the focus is on the patient and to deliver exceptional patient care, we must rely on teamwork. In cardiology, a cardiovascular team is comprised of a skilled, diverse group of professionals including physicians, nurses, nurse practitioners, clinical nurse specialists, physician assistants and pharmacists. Continue reading

ACC.13 Poster Presentations – Better than Ever

This post was authored by Payal Kohli, MD, fellow-in-training at the University of California, San Francisco (UCSF).

With the abundance of science at every meeting, I’ve often wondered why they even have poster sessions, which end up being heavily neglected and sparsely attended, sometimes even by the authors themselves. This year, something about the way the poster session was organized seems to have changed that completely and it was packed.

Maybe it was a theme of the meeting itself. Every room seemed to be overflowing, people lining up to see the science this year. Maybe it’s the gorgeous city of San Francisco, which has drawn people from all over the world. Maybe it was because the posters were centrally located near the free coffee from sponsors. Who knows? All I know is that the well-organized, cozy poster session was a real treat this year.

I spent my time in the prevention track, since my interests are rapidly evolving towards that direction.  I think what struck me the most about the posters that I saw in the prevention track was the sheer number—there were dozens! This was a good sign as the promotion of health is becoming the focus of the science of tomorrow, as Dr. Fuster noted in his opening lecture.

The second thing that really stood out was the formation of Prevention groups across the country, such as the Ciccarone Center at Johns Hopkins University, which is under the supervision of Dr. Roger Blumenthal. These types of groups may be trailblazing the way for groups focused on optimal research and clinical delivery of prevention. And many of my co-fellows who belong to this group are lucky to be in a rich collaborative environment such as this, where their name appears on not just one, not just two but sometimes three or four posters, allowing them to be involved in multiple projects at the same time and delve into their research from many different angles.

What struck you most about the poster sessions?

CCAs: Celebrating 10 Years as Part of the ACC Team

The ACC’s Cardiac Care Associate (CCA) designation and membership group began in 2003 in response to ACC’s focus on team-based cardiovascular care, a decade later this group has grown to include more than 5,000 members of the cardiac care team, including nurse practitioners, registered nurses, clinical nurse specialists, physician assistants and clinical pharmacists.

Among the group’s biggest accomplishments over the last decade:

  • National and state-level committee positions for CCA members, including on the ACC’s Board of Trustees
  • Certificate of Accreditation as a provider of continuing nursing education from the ANCC
  • CCA-specific educational track, and dedicated pharmacology program, at Annual Scientific Sessions
  • Ability to vote in ACC chapter elections
  • Creation of the Associate of the American College of Cardiology (AACC) designation to recognize advanced professional achievement by CCA members. (Ten CCAs will receive this designation at Convocation during ACC.13.)
  • Launch of the Cardiovascular Team Section

New this year, the first Distinguished Associate Award will be given at ACC.13 Convocation to Brenda Garrett. “I am humbly honored and proudly accept this award on behalf of all nurses, PA’s and all those that compose the ‘Cardio Team,’” said Brenda.

Check out the following video from Eileen M. Handberg, PhD, ARNP-BC, FACC, Margo B. Minissian, RN, ACNP-BC, CLS, AACC, and Michael Clark, PA-C, PhD, AACC, for more on the CCA Anniversary. You can also share your thoughts on role of the cardiovascular care team below.