Cardiologist with a Heart

On any given day, Allen J. Taylor, M.D., FACC, FAHA, can be found wearing his trademark bowtie and white coat, moving purposefully through Medstar Georgetown University Hospital from patient consultations to rounds to meetings in his windowed office.

On a recent spring morning as the academic year was winding down, the hospital’s chief of cardiology slipped on his professor of medicine cap to focus on a first-year student from Georgetown’s School of Medicine.

Peter Nguyen (M’15), 23, is seeking Taylor’s guidance to design his independent research project. Nguyen will devote much of the summer to conducting a meta-analysis on numerous studies on the safety of cardiac tests before liver transplant.

Rites of Passage

A renowned cardiologist and clinical researcher, specializing in cardiovascular imaging and prevention, Taylor is warm, funny and generous with his time. Clearly, he believes deeply in mentoring

“I’m mentoring him [Nguyen] because he’s interested. You honor the interest with time whether it’s students, colleagues or junior faculty. It’s a chain of responsibility. We have all gotten where we are because of it,” Taylor says. “It’s a rite of passage, if you will. It’s the mentorship process. It’s the circle of life.”

During a 20-year career in the United States Army at Walter Reed Army Medical Center, Taylor rose to the rank of colonel. He served as the director of cardiovascular research, director of the cardiovascular disease training program, and chief of the cardiology service. He was decorated with the prestigious Legion of Merit for his distinguished body of work and retired from service in 2008. In addition to his faculty appointment at Georgetown, he also is a professor of medicine at the Uniformed University of the Health Sciences in Bethesda.

A Research Revolution

Taylor has accomplished major research breakthroughs during his career, including defining the role of lipid lowering therapy on carotid atherosclerosis, with a particular focus on HDL cholesterol, and the use of niacin.

His pioneering work in the field of cardiac CT – or cat scans — includes conducting long-term prospective outcomes trials, randomized clinical trials on the utility of the technique, and methods to enhance the safety and appropriateness of cardiovascular imaging.

Taylor also has helped foment and witnessed first-hand a revolution in diagnostic imaging techniques that spare the patient physical invasion, pain, risk, scarring and trauma.

“It’s been 15 years of progress and, ultimately, literally reshaped the guidelines for treatment, safety and professional society endorsement,” Taylor says. “The revolution has been the development of (imaging) technology through its application to its validation.”

Non-invasive techniques such as cat scans and sonograms to detect heart and arterial disease have replaced invasive techniques such as catheters and exploratory surgery. “These are really wonderful tests. They are simple tests but they are incredibly powerful to understand peoples’ risks for heart diseases.” Taylor says.

“It’s very much about preventative medicine. The right treatment for the right patient at the right time is personalized medicine,” he says. “All imaging is inexpensive — clearly [the tests] cost less than a dinner out in D.C.”

Taylor has published extensively in the areas of imaging, lipids, prevention, cardiovascular outcomes and quality within blue-ribbon medical journals such as Circulation, the Journal of the American Medical Association, and the New England Journal of Medicine. Ongoing research funding comes from various private and federal sources, including the National Institutes of Health.

Founding editor-in-chief of the Journal of Cardiovascular CT, Taylor serves in various capacities in an array of medical boards and societies. His national work on writing groups and task forces includes multi-society guidelines on cardiac CT training, terminology, and performance, quality standards for imaging performance and radiation protection, appropriate use criteria for diagnostic testing, and national standards on cardiovascular disease management and prevention.

Clinical Compassion

It is at the bedside where Taylor’s compassion is most apparent.
After an exhaustive review of the medical history of a prominent Washingtonian’s symptoms conducted with a nurse practitioner and intern, the trio enters his hospital room. The patient is peppered with a rash of geometric red welts. Perspiration slicks his forehead and discomfort seems to have overtaken him.

The man has endured one episode of heart failure, has a pace maker and takes a variety of medications, which Taylor and his team parse carefully. The rash, an unhealed wound, dizziness and life stresses have combined to bring him to the hospital.

According to the Centers for Disease Control and Prevention, heart disease can be blamed for about a quarter of all deaths in America making it the leading cause of adult death. While heart disease is equally common among men and women, about half all men who die suddenly of heart disease had no previous symptoms. For women, nearly 66 percent do not have symptoms.

High blood pressure, also called hypertension, is a contributing factor to heart disease. It can damage the heart, brain and kidneys as well as the body-wide highways of blood vessels that transport nutrient rich blood to nourish organs. “There is no question that the higher your blood pressure, the bigger the risk of heart attack and stroke,” Taylor says.

Taylor’s approach to the patient is humble, gentle and reassuring, a cardiologist with a heart. The man quickly relaxes under Taylor’s touch.

Later, Taylor says he believes the man will be alright after a thorough review and fine tuning of his medication. This patient, along with his family, is deeply vested in his care, a key component of personalized medicine.

The patient won’t join the ranks of those individuals about whom Taylor worries, the ones who fall through the cracks.

By Victoria Churchville, GUMC Advancement
(Published June 13, 2012)