Session 83 Dr. Renee Rodriguez is a community-based Pediatric Cardiologist. She shares why she loves children’s hearts, a typical day, and whether she has balance in her life. Meanwhile, be sure to check out MedEd Media Network for more helpful resources. [01:25] Interest in Pediatric Cardiology The first time she realized she wanted to do pediatric cardiology was the second she started residency being her first rotation as a pediatric resident. For her, residency was the best thing that ever happened since she wasn't in school anymore. She did another rotation but it wasn't as fun as cardiology. From a physiology standpoint, Renee finds congenital heart disease super interesting. It's like a puzzle where you have to figure out where the blood flows based off of what the anatomy is. So she fell in love with congenital heart disease, to begin with. She also fell in love with the patients. For most kids with heart disease, they're neurologically intact. So Renee got to bond with each of the patients Renee would describe pediatric cardiologists as having a unique personality of being able to not only communicate with kids, but also surgical in nature, are cut to the chase, and have high expectations. And she felt she resonated with it as she wants things to be more hardcore. [05:08] Traits that Lead to Being a Good Pediatric Cardiologist Renee describes a good pediatric cardiologist as being constantly questioning what is happening and trying to evaluate things in multiple different ways. Try to understand how to use those different modalities to answer a good question. You could order all of those tests on every patient but that would not be good care. So you have to be thinking about what you're trying to answer and how you can best answer it in a non-invasive way to get the results you need. And if you need to have invasive testing, what is it going to gain, the timing of it. So you need to be able to decipher how you're going to work a problem up. You have to be able to be collaborative. In pediatric cardiology, you're working with surgeons, EP doctors, transplant, heart failure, pulmonary hypertension -- there's a lot of little subspecs when your patient is getting a little bit more complicated. As a pediatric cardiologist, you're needing to be the conductor in all of this between all of the different specialties when it gets pretty complicated. So be collaborative and be able to deduce how you need to work a patient up and what each test is going to give you. "Be a calming collective presence for families. Patients who come to see a pediatric cardiologist are petrified, even if it's just an innocent murmur or the kid has chest pain." Moreover, you have to be calm to the patients and their families as parents are walking in the door, worried and freaked out that their kids are going to die. Most of the time, the kids are totally fine. It's not going to be anything major. But if it is, it's going to be something they're going to live with. You're going to have to be able to dance that wine and speak with parents as you're trying to give them that information and guide them through it while not totally having them walk out of your office in shambles. [07:35] Types of Patients As an outpatient community pediatric cardiologist, she sees a lot of murmurs that are typically benign, like a small hole or small valve defects, nothing major, that typically doesn't require any procedures or intervention. One of the common ones that present later in life is a large atrial septal defect. You don't necessarily pick up murmurs unless there's a significant blood flow across the hole on top of the heart that it causes some rumbling across the pulmonary valve. A lot of those kids present a little later when you hear that murmur and it can be mistaken a lot for a typical murmur so physicians don't necessarily send them until later. This would be one of the things that would require some intervention like surgery or cath procedure based off of