By Konrad Solberg

Structural defects of the heart, known as congenital heart defects (CHD), are the most common form of birth defects. Because these defects can involve many different parts of the heart and present in many different ways, treatment of CHD is one of the most complex subspecialties in cardiology.

Yet, due to technological advances and a better understanding of these defects, children born with CHD are living longer than ever. This has created a greater need for talented cardiologists who can care for patients from birth through adulthood.

Established in 2020, the VCU Health Pauley Heart Center Adult Congenital Heart Disease (ACHD) team has big goals, and Sangeeta Shah, M.D., FACC, FASE, is leading the charge.

As a native of New Orleans, Shah led the adult congenital heart disease program at Ochsner Medical Center before taking up her current role. Her work focuses on caring for a diverse population of adults born with structural defects in the heart who must continue to manage their health throughout their lives.

“In ACHD, you get to take care of patients with a very specific disease process,” Shah said. “But you encounter different ages, different educational backgrounds, and different goals with what they want out of life.”

Making care accessible for all patients

Shah develops each patient’s treatment plan by focusing on the importance of her patients knowing about their heart history. With this knowledge, they can be their own advocates for care. This enables her patients to give feedback about what treatment options best fit their lifestyle and needs. And as Shah describes it, the “basic concept is listening.”

“I spend a lot of time getting to know a patient. Such as where they live or what they’re favorite food is,” Shah said. Devoting this time to each patient gives her an understanding of who her patient is as an individual. “So, when I provide a treatment plan, I can provide one within the context of what works for them.”

Developed through her clinical and research experience, Shah’s method of working with patients to develop their treatment plan has made her a star provider at the Pauley Heart Center. 

 

Janice Price (far left) looks on while her granddaughter Janiyah Price takes a blood pressure reading of Dr. Sangeeta Shah at a Teach BP event at Anna Julia Cooper School in Richmond. Also pictured is Amy Ladd, Ph.D., assistant director of Pauley Heart Center. (Kevin Morley, VCU Enterprise Marketing and Communications)

“Our health system is very fortunate to have the expertise of Dr. Shah and her team,” said Greg Hundley, M.D., director of the Pauley Heart Center. “Her approach to managing these complex patients is well founded in clinical science and incorporates an education perspective grounded in empathy and understanding.”

Discussing how her approach to ACHD treatment fits with Pauley’s mission of improving cardiovascular care for all, Shah highlights the importance of diversity within a given team of providers. To help foster trust throughout health care, Shah and her team make a dedicated effort to bring a wide variety of medical professionals into the cardiology setting.

“As in any health care arena, having the patient be able to find common ground with their provider helps them develop a sense of trust,” she said. “We do a lot of teaching in small groups, to nurses, physician fellows, advanced practice providers and internal medicine residents. We also teach health conferences and provide a lot of patient education, such as our ACHD blog posts.”

Bringing together more skill sets to cardiology 

By supporting diversity through so many different methods of education, Shah and her team help develop treatment plans specific to each patient’s needs, benefiting them by tailoring treatment to their disease and who they are. Jessica Hallam, MSN, FNP-C, cites Shah’s method of “treating the patient as a whole” as one of her reasons for choosing Shah as a mentor.

“The biggest reason is Dr. Shah’s advocacy for the patient,” Hallam said. “The patients are not with us for a short amount of time. We get to know them because we spend a long amount of time with them. We go through a lot of life changes with them. From getting pregnant and having babies, to having end of life discussions, Dr. Shah plays a big part in their lives.”

Prior to working with Shah, Hallam said it was the lifelong connections with patients that attracted her to the ACHD specialty. Seeing Shah’s passion, however, is what led Hallam to work under her leadership as a nurse practitioner. Hallam has worked with Shah for two years now and remains impressed with Shah’s care for their patients. 

“She really loves what she does and loves her patients,” Hallam said. “It made me really want to get involved in our field and get involved with our patients.”

 

Jessica Hallam, FNP; Sangeeta Shah, M.D.,FACC, FASE; and Jordan Balmer, RN, BSN, CCRN (left to right) are members of the VCU Health Pauley Heart Center's Adult Congenital Heart Defects team. (Tom Kojcsich, VCU Enterprise Marketing and Communications)

Shah’s ability to meet people where they are has also filled out into educational programs in the Richmond-area. Recognizing the powerful role children play in a family, she started the Pauley program Teach BP in 2022 as a way to outfit students with tools to educate family members about hypertension and become changemakers in their communities. It’s just one of many ways the cardiologist cares for the whole person. 

Carrying this philosophy into her research, Shah and her team work on optimizing exercise capacity for patients with ACHD, no matter the patient’s ability.

“We’re exploring ways to optimize exercise capacity for patients who are already fit as well as those who may not be as active,” Shah said. “There is a lot of socioeconomic diversity in the ACHD patient population, so we work to bring that diversity into our research. This provides us with a wider range of results and a better understanding of the different needs of our patients.”

 

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