In Africa, Diagnosing a Heart Condition That’s Rare Here
One in an ongoing series
Gregg Pressman, MD, has returned to Einstein Medical Center Philadelphia after a trip across the ocean and back in time, medically speaking, to help patients in Africa who suffer from a disease that’s been nearly eradicated in the United States.
Dr. Pressman, a cardiologist, is back from Rwanda, where he spent 10 days in September as a medical volunteer evaluating patients with rheumatic heart disease.
The mission was organized by Team Heart, a nonprofit organization founded to help identify and treat patients with rheumatic heart disease in Rwanda, where it is rampant.
Team Heart has been providing surgical intervention to patients with rheumatic heart disease for the last 15 years and working with local partners to identify people earlier in the disease process.
The disease, caused by untreated streptococcal infection such as “strep throat,” can lead to severe damage of heart valves over time. Rheumatic fever has largely disappeared from developed countries, because strep throat is treated with antibiotics, which aren’t as widely available in Rwanda.
Dr. Pressman’s role was to identify individuals with heart disease who qualified for surgery. His medical specialty is using echocardiography, ultrasound imaging of the heart, which provides detailed assessment of the heart valves.
“There were three groups that went to various locations in the country to examine patients and look at their echocardiograms to see if they’d be good candidates for surgery,” Dr. Pressman says. His group was stationed at a district hospital in Ruhengeri, in northern Rwanda.
Dr. Pressman also brought home with him a plan to help a fledgling cardiology fellowship program in the Rwandan capital of Kigali by creating a collaboration between that program and Einstein Medical Center Philadelphia.
“We’re exploring the possibility of broadcasting our academic conferences on the internet so they can participate,” he says, “and at some point we might have an exchange of fellows or we might take another trip there.”
The Rwandan fellowship program just started in April of this year and will, for the first time, train cardiologists in Rwanda. Currently there are only “about seven cardiologists in the entire country,” Dr. Pressman says. Along with this are newly opened programs offering cardiac surgery to adults and children.
The patients who were selected to receive surgery by Team Heart were all successfully operated on during the mission. Volunteer critical care nurses, anesthesiologists, perfusionists, pharmacologists and others from across the US assisted and helped train local staff to support their newly created heart surgery program.
Dr. Pressman has been a staff cardiologist at Einstein for 16 years and is the Associate Program Director for the Cardiology Fellowship Training Program.
He previously volunteered with the American Society of Echocardiography on a mission to the Philippines, where similar work was performed.
Dr. Pressman grew up in a medical family and was groomed to be a physician early in life. His father was on staff at Einstein for many years and served as Chief of Psychiatry for a decade.
Regarding the recent mission to Rwanda, he says, “It’s wonderful to help people here in this country, and I’ve always enjoyed that. But other parts of the world don’t have access to the sophisticated medical care we’re used to. Their health problems are very different from what we see here.
“It was good to go to Rwanda, both to help in the care of patients there and to improve their ability to care for their own.”
The trip also created a pleasant confluence for Dr. Pressman. Rwanda is one of the few places on earth where endangered mountain gorillas thrive. While there, he signed up for a ranger-led trek through Volcanoes National Park.
“I got to see the gorillas in their wild habitat,” he says. “It was really fantastic.”
In the past, he has performed echocardiograms on anesthetized gorillas at the Philadelphia Zoo as part of a health maintenance project. This time he got to see the gorillas awake and active.
He also had the opportunity to appreciate Rwanda as a modern country with well maintained highways and electricity throughout, not as a backward Third World country as it is sometimes perceived.
“It’s a beautiful country,” he says. “They just don’t yet have advanced medical facilities.”