Cardiac Caregiver: Alexander Opotowsky, MD, MPH – Boston Children’s Hospital

Cardiac Caregiver: Alexander Opotowsky, MD, MPH – Boston Children’s Hospital


That’s the left ventricle that pumps out to the body, and compared to the last visit several months ago, the function is better and it’s terrific. The fact that the adult congenital heart disease program is centered in Boston Children’s Hospital reflects the dedication this hospital has to continuing care for patients that they have cared for since birth, and before, in many cases. When is the cough the worst? Adult congenital heart disease, in large part, is an offspring of the success of pediatric cardiology, in that more patients are surviving with excellent function for longer periods of time. What we’ve realized is that the vast majority of these patients aren’t quote unquote cured. They still have ongoing issues and require specific monitoring and understanding, and the field of adult congenital heart disease evolved from that understanding. Exercise testing, while it may seem very scientific and specific, is actually a very large picture of how somebody is functioning. If you think about an ultrasound of the heart, or an MRI of the heart, or a physical examination or an EKG, most of those tests are done at rest. Most patients, though, if they have symptoms, it’s not usually at rest that they’re feeling their symptoms. It’s with exercise. What we’re really looking for is to see in patients who have underlying congenital heart disease, objectively, how much can they do? And we measure that looking at how much work they can do on the cycle, or a treadmill, we also look at how much oxygen they can consume. People with congenital heart disease often are used to a different baseline and may not complain of any symptoms and the exercise testing really allows us to figure out how capable is their cardiovascular pulmonary system. Congratulations on your recent marriage. I know that we did this, in part, to understand how things would go with a pregnancy, and I’m glad to tell you that you did terrifically. One of the most rewarding things about working at Boston Children’s Hospital and also at Brigham and Women’s Hospital is the rich intellectual environment and the support of each institution for compassionate and excellent patient care. Very few of our patients fit a mold. It’s exceptionally rewarding to come up with treatment plans that are best for a given patient, and the ability to take time, and to think about things and to make decisions in a collaborative way is absolutely terrific. Something you should be really proud of is that now you’re 98% of what would be predicted. Okay? And that’s all because of you. You did that. Okay? Keep it up.

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