Melanie Cole, MS (Host): Welcome to Better Edge, a Northwestern Medicine Podcast for physicians. I'm Melanie Cole. And today, we would like to introduce you to a new Bluhm Cardiovascular Institute Recruit, Dr. Charlie Jain. Dr. Jain is the Associate Medical Director for Adult Congenital Heart Disease at Northwestern Medicine's Bluhm Cardiovascular Institute.

Dr. Jain, welcome. I'm so glad you could join us today. As we get into discussing you and what brought you here, please discuss a little bit about your clinical background, your interest in medicine, and what led you to choose congenital heart disease.

Dr. Charlie Jain: Thank you, Melanie, so much for the introduction and for the opportunity to chat with you today, and I couldn't be more excited to join the Northwestern team. In terms of my background, well, full disclosure, my dad is a cardiologist. So, it was always on my mind, but I always tried to pave my own path. But then, sure enough, time and time again, I found myself drawn to medicine and then ultimately to Cardiology.

And throughout my training, I really found myself drawn to master clinicians. So, I trained at the MGH and then at Mayo Clinic. And at Mayo Clinic, I worked closely with Rick Nishimura, who's really just a master clinician tying exam to echo to catheterization and complex hemodynamics as a core part of my practice in addition to adult congenital heart disease. Then, I also worked with Dr. Carole Warnes, who started our adult congenital heart disease clinic here 30 years ago, and many other master clinicians, including Heidi Connolly and Will Miranda, and I just found myself drawn to them and wanting to be like them. And ACHD just fascinates me in all ways. So, I really love all of Cardiology. But I'm really, really passionate about adult congenital heart disease.

Melanie Cole, MS: Well, thank you for sharing that. And going into the family business is always very cool. So, thanks for telling us about this. Now, what drew you to Northwestern Medicine's Bluhm Cardiovascular Institute?

Dr. Charlie Jain: So in terms of that, you know, and again, full disclosure, I was born and raised in Chicago. My wife is also from Chicago, so it's exciting to come back home to Chicago. And when I think about that being here in Minnesota, practicing at Mayo Clinic currently, I have actually seen many patients who come from Chicago, and that always has just seemed kind of bizarre to me as Chicago is such a big city with so many medical institutions, which are excellent. And in particular in Chicago, for Pediatric Cardiology care, Lurie Children's is really a standout as well. And so then, when I think about serving the underserved adult congenital population in Chicago, Northwestern stood out as a clear choice in that there's a partnership with an excellent Pediatric Cardiology institution, which is attached by a bridge.

And then in addition, Northwestern has excellence in all the different disciplines within Cardiology, be it imaging, interventional rhythm, you name it. Then, also with many other fields outside of cardiology, obviously, we partner closely with Cardiac Surgery, but also non-cardiac specialties, including hepatology, pulmonary hypertension, maternal-fetal medicine, anesthesia. So when I think about it in terms of Chicago, Northwestern has it all under one roof to provide expertise for the complex care that ACHD patients need.

Melanie Cole, MS: Dr. Jain, give us a little bit of an overview of what you plan to do at the Adult Congenital Heart Disease Program at Northwestern Medicines Bluhm Cardiovascular Institute. And you mentioned briefly Lurie Children's Hospital of Chicago. Speak about that partnership a little bit and how you collaborate with them to facilitate transition of care, which we know is so important and optimize the outcome for these adult patients as they transition.

Dr. Charlie Jain: Yes, that's exactly right, Melanie. It really is so important to optimize the transition in particular. As I already alluded to, within Chicago, there is an underserved population of patients with adult congenital heart disease. Currently, there's more adults than children living with adult congenital heart disease in America. And the ACHD physician shortage is real, and that's very present within Chicago. So, really excited to try to serve that need if possible.

Along those lines, when we think about what goals we have for the Northwestern and Lurie Adult Congenital Heart Disease Program. Those goals include obviously providing a seamless transition for the pediatric patients, whether they're coming from Lurie or elsewhere. And then, in addition, really trying to establish Northwestern as a center of excellence for adult congenital heart disease throughout the country, and hopefully a referral center.

We aim to achieve adult Congenital Heart Association Accreditation within the next few years, which includes partnering with all different colleagues in Cardiology, Pediatrics, and then many other disciplines as I had mentioned. And then, we hope to be able to grow to serve the needs of many patients in the Chicagoland region and throughout the Midwest.

Melanie Cole, MS: Tell us about your clinical research interests, Dr. Jain. Do you have any recent publications, things that you would like to focus on?

Dr. Charlie Jain: Yes. And without a doubt, going back to kind of the goals, obviously, I was talking about the clinical goals. But just like you're saying, research is incredibly important as is education. So when thinking about research interests, I have many. I think I've been inspired by my many mentors previously that we need to try to answer the clinical questions, which are very important for our patients to actually improve their lives. And so, many of the studies that I've done previously include trying to find different markers, be it from echo or catheterization or otherwise, to help better identify which patients are most at risk for complications, and then also some work on trying to identify which treatment strategies might be most appropriate for our patients.

You know, one of the other things that really drew me to adult congenital heart disease was that it's somewhat of an uncharted territory for a lot of different research questions. Now, it's grown dramatically in the recent past. But historically, most of the studies were very small kind of case series-like studies. And so, it's really an exciting field to be in from that regard.

Melanie Cole, MS: Now, we get to my favorite questions that we get to ask on these. So, please speak about your philosophy of care. You're speaking to referring physicians and even patients. What would you like them to know about how you approach disease, wellness, and care for the whole person?

Dr. Charlie Jain: So along the lines of what is my approach, well, I think really centered in my approach is to be approachable. The patient is at the center of the care, and they should feel comfortable approaching the clinicians and the remainder of the team to make sure that they get the care that they all deserve.

And my underlying principle is that all of our patients deserve expert level care throughout their entire life. And just as you already mentioned, it should be whole-person care. So for our patients in particular, that includes seamless transitions from pediatric to adulthood or from one institution to another, multidisciplinary collaboration with colleagues that actually talk to each other and work with each other and really care about the patients together. And then, of course, certainly, the care should be convenient for patients from an accessibility and approachability standpoint, as I mentioned.

So, I'm excited that at Northwestern we can provide all of this under one roof with experts, who can also be empathic and innovators who are also accessible. And we'll be able to educate our patients and our community to hopefully lead to empowerment and improve the patient experiences.

Melanie Cole, MS: Dr. Jain, what do you do for fun? I'd like you to tell us a little bit about your family and your life outside of work. What are some things that your colleagues may not know about you as you join the Northwestern Medicine team?

Dr. Charlie Jain: So, my wife and I are lucky to have four beautiful children. They're all quite young still, so seven, five, three, and one year old. So, it's quite busy at home and that's plenty of fun enough. But outside of that, you know, I mean, along with things with the kids, we enjoy playing sports with them and getting out in the neighborhood and enjoying nature. We're excited to move back to Chicago, to a bigger city and, explore a lot of the different things that Chicago has to offer from the museums and everything else. So, really, really excited, for the next busy chapter of our lives as a family.

Melanie Cole, MS: Certainly is busy for kids. How wonderful for you. And as we complete this podcast, as the Associate Medical Director for adult congenital heart disease, what are your goals, Dr. Jain, for the future of Northwestern Medicine Bluhm Cardiovascular Institute? And for referring physicians, which patients would you like to be referred to you?

Dr. Charlie Jain: So, I'm overall really excited about the future of the Bluhm Cardiovascular Institute and what role the adult congenital heart disease population will have in that. Along those lines, I am excited to help try to grow the clinical practice, but also the research endeavors and education with goals to hopefully develop a fellowship in adult congenital heart disease in the coming years.

And then outside of that, within the Bluhm Cardiovascular Institute, I've been excited in my initial conversations with Dr. Sanjiv Shah as we hope to help grow the exercise catheterization practice. I have experience that I've developed with exercise catheterization and complex hemodynamic catheterization. So many of our patients are now coming in with more complex disease than before, and multiple possible contributors to their symptoms and/or decline. And catheterization, be it a complex hemodynamic catheterization at rest and/or with exercise can try to help elucidate which driver from the structural heart disease perspective is the most significant. Is it the tricuspid valve, the mitral valve, the aortic valve, the ventricle, the pericardium, the pulmonary veins? Whatever it may be we need to use all the tools available. And so, I'm excited to try to offer that to our patients as well to help improve the care of our patients if possible.

As far as referring physicians, well, there's many. Well, certainly for adult congenital heart disease, if you're a pediatric cardiologist, and you'd like to transition your patient to adult care, or alternatively, if you're a general cardiologist and you may see a patient perhaps with something simple like a small atrial septal defect, or you intermittently see a patient with something more complex like tetralogy of Fallot or Fontan, we would be more than happy to try to help care for those patients. So, please contact us.

In addition, as I mentioned, I'll be part of the catheterization lab, performing hemodynamic catheterization. So if you have patients with dyspnea, which you cannot explain by your non-invasive tests and/or patients with likely heart failure with preserved ejection fraction, but trying to sort out what the best next step is, or alternatively patients with complex structural heart disease with multivalvular disease, I would be happy to try to help with an invasive assessment to answer the questions and help you tailor the patient's care.

And lastly, the other patients that I also really enjoy caring for, which we haven't had a chance to chat about as much today, the two other populations. One is certainly patients with bicuspid aortic valve disease and associated aortopathy. It's really a passion of mine as well. And in many adult congenital heart disease clinics, those patients are an inherent part of it and we hope to grow that aspect of it here as well.

And then lastly, another incredible population, which is often underserved, are women with cardiovascular disease who are either trying to get pregnant or are pregnant or recently were pregnant. I see many women in the childbearing years, who have these complex questions, which can be really challenging and a scary scenario to navigate through. And I'm honored to try to help care for them throughout that time.

Melanie Cole, MS: Thank you so much, Dr. Jain, for joining us and sharing so much about yourself with us today and about your goals for the Northwestern Medicines Bluhm Cardiovascular Institute Program for adult congenital heart disease. Thank you again. And to refer your patient or for more information, please visit our website at breakthroughsforphysicians.nm.org/cardiovascular to get connected with one of our providers.

That concludes this episode of Better Edge, a Northwestern Medicine Podcast for physicians. I'm Melanie Cole.