This post was authored by Colin Phillips, MD, a fellow in the Division of Cardiovascular Disease at Beth Israel Deaconess Medical Center in Boston, MA.

As a fellow in training, the opportunity to spend a weekend with a community of great cardiology minds from around the world is a valuable and memorable experience.  Learning from the giants while reconnecting with old friends and professors made my first ACC meeting last year a blast. From the beginning of the conference, my enthusiasm built. It was impossible to walk through the convention center and not tap into the infectious energy. Every encounter carried the promise of new possibilities, new ideas and new relationships.

This year at ACC.16, I will present a poster in the FIT Clinical Decision Making: Congenital Heart Disease, Valvular Heart Disease, Pulmonary Hypertension session, titled “More Volume Lifts an Anchor: Severe Mitral Regurgitation in Hypovolemic Shock Masquerading as Mitral Valve Perforation.” Working with my mentor, Eli Gelfand, MD, FACC, we detail a case of mistaken identity. We report the story of a patient transferred to our home institution, Beth Israel Deaconess Medical Center in Boston, MA, for operative repair of a perforated mitral valve leaflet secondary to bacterial endocarditis. As we evaluated the patient, pieces of his story, including a dynamic systolic murmur and profound dehydration, did not fit the diagnosis as billed. 

We were able to solve the puzzle and determined that he in fact had volume responsive systolic anterior motion of the mitral valve causing the mitral regurgitation and not endocarditis. We avoided the pitfall of anchoring bias with a simple leg lift to increase preload and reduce the murmur and obstruction. With fluid resuscitation, the patient improved and continues to do well today. As a trainee, this case reinforced the importance of revisiting the history and physical examination.

In addition to sharing this story with the ACC.16 audience, the case has been simultaneously published in JAMA Internal Medicine in the “Less is More: Teachable Moments” section. Preparing the abstract for ACC.16 provided me the foundation to publish the case.

Come by and chat on Saturday, April 2 from 3:45 to 4:30 p.m. CT, at the FIT Clinical Decision Making posters (in the poster area, South Hall A1). I suspect that in addition to my own logistical lessons of submitting the abstract, printing the poster and presenting it, the value of sharing this story will be interacting with the other ACC.16 attendees and engaging at the conference.

As I look forward to building a career in cardiology, I need look no further than the motto of this year’s ACC Annual Scientific Session: “Ignite” to recapture the excitement that carries me into this year’s conference.  See you there!

Search the ACC.16 App for additional poster session and additional Fellows in Training practice focus sessions. Follow @ACCCardioEd on Twitter and use the hashtag #ACC16 to join the conversation during ACC.16.

To stay connected as an FIT, check out the FITs on the GO video blog featuring interviews from ACC.16 presenters and ACC leaders, and use the hashtag #ACCFIT on Twitter. Also check out the FIT Section hub on ACC.org.

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