Birmingham VA Medical Center Heart Station & Echo Lab Teaching Service


bvamc_200 The Heart Station & Echocardiography Lab at the Birmingham Veterans Affairs Medical Center (BVAMC) is part of the Division of Cardiovascular Disease of the UAB Medical Center and Department of Medicine. Teaching teams of attendings and fellows treat veterans who present with a full range of cardiovascular disease. Cardiology Fellows have more direct interaction with patients & families and more direct patient care responsibilities than at UAB Hospital. Non-invasive procedures performed in the VA Heart Station include ECG’s, Holters, GXT’s, and Echoes.


Attendings

Massoud Leesar, MD
Gilbert Perry, MD (Director)
José Tallaj, MD

Duration of Rotation

Cardiology Fellows on the UAB Echocardiography rotation spend part of their time at the BVAMC.


Clinical
Responsibilities

1. Interpret all ECGs at the BVAMC

  • Be available for consultation with regard to ECGs.
  • Present interesting or difficult ECG’s at the weekly Friday ECG conference.


2. Interpret Holter Monitors at the BVAMC
    An electrophysiology attending is available to Fellows for consultation.

3. Read all BVAMC Echocardiograms

  • Echos are read with the Echo attending every afternoon from 3-5 PM. Echo Fellows are required to read the echoes on their own prior to this reading session (from 1-3 PM). 
  • Echo Fellows are also encouraged to perform echocardiograms whenever possible. The echo attending is available for consultation if required.


4. Assist with Transesophageal echocardiograms (TEE)

  • See and evaluate all patients referred for TEE
  • Discuss indications, contra-indications, and possible complications with the echo attending
  • Write pre- and post-TEE orders.

      All TEE’s are performed under the direct supervision of the VA echo attending.

5. Interpret and provide consultations for GXTs

  • Regular GXT’s are routinely performed by one of the research nurses or the nurse practitioner.
  • Echo Fellows are responsible for providing consultation when requested by the nurse/nurse practitioner.
  • Interpretations of GXTs are to be done in a timely manner (within 24 hr).
  • The nurse/nurse practitioner will notify the Echo Fellow of any high risk GXTs requiring urgent interpretation.
  • BVAMC attendings are available for consultation with regard to GXT’s.


6. Assist with the performance of Dobutamine or Exercise Stress Echocardiograms

  • If the Echo Fellow is unavailable due to clinical responsibilities at UAB, the BVAMC CCU Fellow will assist with performance and interpretation of these tests.

Emergency Consults

The echo technicians will call the Cardiology Fellow for patients with severe disease on echocardiogram, who need immediate attention or evaluation. The Cardiology Fellow will see these patients, and make appropriate disposition (admission, outpatient follow-up, etc.). If the Echo Fellow cannot see the patient due to other clinical responsibilities, he/she will arrange for the patient to be seen and evaluated by either the BVAMC CCU or BVAMC Cath Fellow.

Essential Skills

Cardiology Fellows successfully completing this teaching service will be proficient in: 

  • Interpreting ECGs
  • Interpreting Holter Monitors
  • Performing & reading Echocardiograms
  • Recognizing the indications for TEEs
  • Performingh TEEs (under direction of an attending)
  • Interpreting GXTs
  • Performingand interpreting dobutamine/exercise stress Echos