The Clinical Cardiology Service consists of two different services: the Cardiac Intensive Care Unit (CICU) and the Consultation Service. The concept is to provide a strong basis of clinical training for the fellow.
Cardiac Intensive Care Unit
The primary responsibility of the cardiology fellow during a CICU rotation is to train and supervise medical students, interns, and residents while overseeing the care of the patients in the CICU. Our CICU is a 12-bed open unit. The majority of patient admissions to the CICU are done by private attending cardiologists. The remaining patients are admitted to the cardiology fellow and faculty attending service. The CICU fellow cares directly only for the fellow service patients and indirectly for the private cardiology patients by directing the care with house staff. In addition, the fellow helps to insert and troubleshoot ICY catheters (for targeted temperature management), Swan Ganz catheters and temporary transvenous pacemakers. The fellow participates in management of patients with various mechanical support devices in the cardiac intensive care unit including intra-aortic balloon pumps, Impella devices, and ECMO. Lastly, the cardiology fellow is responsible for all cardiac emergencies in the hospital during the CICU rotation, including being the code leader at in hospital at cardiac arrests.
The cardiology fellow consult service at Hartford Hospital is responsible for cardiology consultations requested by in-hospital services for all patients not seen by a private cardiology group. These consult requests generally include preoperative evaluation, management of basic arrhythmias, management of chest pain and acute coronary syndromes, and congestive heart failure. The cardiology fellow, in conjunction with the faculty attending on service, evaluates all patients, performs physical examinations, and develops a diagnostic and management strategy. The cardiology fellow service is exclusively a consult service; patients admitted with cardiac problems are cared for primarily by a hospitalist or advanced practitioner.