Cancer Patients with Heart Issues Benefit from Advanced Imaging Tech at Miami Cardiac & Vascular Institute's Diagnostic Center

Miami Cardiac & Vascular Institute’s Diagnostic Center has played a vital role during the pandemic, using the most advance cardiac imaging technology to precisely diagnose and monitor heart conditions in cancer patients.

How do you diagnose cancer-related cardiac conditions? The team at the Diagnostic Center utilize advanced echocardiograms that measure how your heart muscle contracts to check your heart health. They use echocardiograms to create 3D models of your heart to see how well it pumps blood.

To say that running the Diagnostic Center has been challenging since the onset of the COVID-19 pandemic is an understatement. Safety protocols to protect patients and healthcare personnel have been in place from the beginning — and throughout the pandemic’s surges

Socrates V. Kakoulides, M.D., a cardiologist with Miami Cardiac & Vascular Institute and medical director of the Institute’s Diagnostic Center.

“We have our routine mix of cardiovascular patients that come from our cardiologists, and on top of that, there’s our cancer patients, which are coming straight from the oncologists,” explains Socrates V. Kakoulides, M.D., a cardiologist with Miami Cardiac & Vascular Institute and medical director of the Institute’s Diagnostic Center, who has training and expertise in echocardiography and nuclear cardiology — advanced tests utilized in the diagnosis, management and follow-up of patients with heart disease.

“Some of these patients are being referred from our physicians who are following them clinically,” he said. “And then throughout the year, depending on whether or not we’re going through a surge here, we have patients who are recovering from COVID or may have been exposed to COVID. And so how do we keep our patients safe while they’re in our space. It’s a challenge – but we are getting it done.”

The advanced echocardiograms at the Institute’s Diagnostic Center deploy a technique known as “strain imaging.” In cardiac imaging, the diagnostic medical sonographer can measure the rate of deformation of the ventricular wall in various dimensions, providing are more precise view of early myocardial (heart’s muscular tissue) dysfunction. Heart failure can be detected, which is when the lower left chamber of the heart (left ventricle) gets bigger (enlarges) and cannot contract sufficiently to pump the right amount of oxygen-rich blood to the rest of the body.

In cancer patients, grueling chemotherapy sessions can have an effect on the heart, especially in those with underlying health issues, such as hypertension, diabetes and atherosclerosis (hardening of the arteries).

The so-called strain echocardiography has functioned so well at the Institute’s Diagnostic Center, that Baptist Health is looking to expand this imaging capability to other diagnostic facilities throughout the system.

“The reason why we do these echo studies on cancer patients is to make sure that they don’t suffer from cardiac dysfunction while getting chemotherapy,” said Dr. Kakoulides. “And, obviously, there are medical therapies that can be used to intervene so that we can keep patients on their chemotherapy should they develop heart dysfunction.”

Echocardiographic imaging is vital for patient monitoring during what is known medically as “cardiotoxic cancer therapy.” Left ventricular ejection fraction (LVEF) is the most commonly used parameter for identifying left ventricular dysfunction. But LVEF may lack sensitivity needed to detect subtle changes in cardiac function caused by early muscle cell damage from cardiotoxic cancer treatment.

Jorge L. Hernandez, a cardiac/vascular sonographer at the Institute, said there’s a particular protocol for cardio-oncology patients.

“Strain echocardiography is particular to patients with cardio-oncology issues because the strain is can pick up changes in their left ventricular function, or left ventricular wall, motion that the blind eye can’t see,” explains Mr. Hernandez. “So, we have state-of-the-art machines that have strain echocardiography and they allow us to provide a superior quality echocardiogram. It requires extra training for the technologists and certain physicians that are trained in understanding strain echocardiography. And that sets us above a lot of facilities that can’t provide this service.”