“Clearly I have a bit of a niche-job,” Lisa Howley, MD, said during a recent Becker’s Healthcare Podcast episode. “I spend my days screening for fetal heart conditions, even before birth.”
From her vantage point of serving as director of fetal cardiology at Minneapolis-based Children’s Minnesota since 2019, Dr. Howley shared with Becker’s what she sees as the biggest issues facing the field of cardiology today, as well as what excited her most about the future.
Editor’s note: Response has been lightly edited for clarity and length.
Question: What is one of the biggest issues in cardiology today?
Dr. Lisa Howley: In the course of my time since training to now, I’ve really seen the biggest growth in the field of pediatric cardiology is fetal cardiology. We’re aiming for as many kids as we can to have prenatal diagnoses because we know that that allows families time to be educated, to make decisions for their family, to deliver at cardiac centers of excellence and to transition them into pediatric cardiac programs.
The other end of the spectrum is adult congenital heart disease. A lot of these kids didn’t survive to adulthood because they had heart disease that we weren’t very good at taking care of. Now with advances in medicine and surgical treatments, we’re affording these kids to have very exciting and long lives that they previously couldn’t have.
We have created a very large adult population that have congenital heart disease, so much so there’s more adults living with congenital heart disease in the United States than children. As these kids are surviving into adulthood they have complex forms of congenital heart disease, often malformations of the heart from the time that the heart was ever created.
We need to improve transitioning those that are cared for in the pediatric system into adult congenital programs, which is now kind of a burgeoning field with specialists in the adult field taking care of these kids.
Adult cardiologists are very good at taking care of normal heart structure with just the wear and tear of life that has affected its function. But now we are talking about malformed hearts that we surgically modify in children who are living to adulthood. It’s requiring an increased need for a new type of cardiologist, adult congenital heart specialists, who are really specialized in these unique surgical procedures and malformations of the heart.
Listen to Becker’s full conversation with Dr. Howley here.
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