Friday, October 24, 2008

On October 22, 2008, we flew from Hanoi to Saigon, also known as Ho Chi Minh City. To relate to distances in Vietnam, an extremely long country, this was an 850 mile flight. We were invited to lecture at Hoan Mai General Hospital. The members of the party were Dr. Le, myself, and, to my great pleasure, Dr. Tony N. DeMaria, current Professor of Medicine and Chair of Cardiology of UC San Diego. Dr. DeMaria is also a past president of the American College of Cardiology and, at least as significant, if not more, the current Editor of the Journal of the American College of Cardiology, one of the most supreme cardiovascular journals in the world.

Aside from the lectures, to be discussed later, we visited two hospitals in Saigon. The first one was Cho Ray. This is a truly unbelievable experience because they have 1600 beds and the average patient census is close to 3000. This means that all too often there are two and occasionally three patients in one bed. We met with the directors of the intensive care unit and emergency rooms in both of these hospitals. At Cho Ray Hospital, there is extreme overcrowding, as already mentioned. Additionally, there are frequently several family members for each patient to help inpatient care and also to bring in food and other supplies. The devotion and extremely positive professional manner of the overworked physicians there is inspiring.

At Hoan Mai Hospital, Dr. DeMaria lectured on the translation of cardiovascular research into clinical practice, an extremely scholarly presentation. I lectured on the latest advances in management of lipids in patients both with known coronary artery disease and at high coronary risk. I also reviewed the COURAGE Trial, which pointed out the value of intensive medical therapy versus stent placement in stable patients with coronary artery disease. The audience consisted of approximately 40 cardiologists, internists, and general practitioners who practice at that hospital.

Dr. Le performed angioplasty and stent placement on at least two patients while we were lecturing. The hospital actually integrated live performance of these procedures with out lectures to the audience, and I would say their reaction was quite enthusiastic.

I am always happy to return to the United States after such trips because it makes me feel very thankful for my blessings in my ability to practice here. I remain inspired by the devoted professionalism that the physicians in Vietnam possess.

Sunday, October 19, 2008

Oct 20

The opening session on the second day of the 17th ASEAN Congress of Cardiology was marked by a beautiful dance with ribbons and drums which set the tone for a very positive learning and sharing experience for everyone. Over 1500 cardiologists from Vietnam, Singapore, Hong Kong, Indonesia, Malaysia, Laos, Thailand, Cambodia and Myanmar were in attendance. The main focus of attention relates to the increasing incidence and prevalence of coronary artery disease in these countries.

Representatives from the American College of Cardiology were in attendance and assisted with educational activities by reviewing the latest science in this area.

The brand new National Convention Center provided has the latest scientific meeting technology. This includes the ability to show live cases of coronary interventions being performed at other facility to the conference participants. My associated Dr. Khoi Le participated in a particularly challenging case as he has detailed in his blog.

I had the opportunity to share information with other physicians and lectured on the very latest science in the management of lipid disorders.

We had a most enjoyable faculty dinner where faculty, delegates and their families were treated to Vietnamese music and a wonderful meal.

Saturday, October 18, 2008

Oct 17

When Khoi asked if I would be interested in attending the ASEAN College of Cardiology, I couldn’t resist because it would give an opportunity to see how things had changed since I first went to Viet Nam. Since my wife had other plans, I convinced one of my sons to join me for the trip.

We arrived in Hanoi in the late evening Thursday (10/16) after 20 hours in the air. Friday morning, I woke for an early morning run. While the sun was just coming up, many Vietnamese were out doing morning exercises including Yoga, Tai Chi, and running.

Later that morning, we went walking in the Old Quarter. While we did some shopping, seeing the wide variety of people highlighted the Vietnamese people generally have different risk factors. There are very few, if any, individuals that are overweight or obese, but tobacco use is quite prevalent.

Friday evening, we had the opportunity to see a performance of the Vietnam National Symphony Orchestra at the Hanoi Opera House. Since the Opera House is only open during performances, this was not possible during my prior trips.

Saturday, I participated in a symposium on prevention which lasted all day. I lectured on the effects of tobacco on cardiovascular disease and this stimulated a number of questions from both attending physicians and other meeting faculty. Other lectures I attended covered important risk factors such as hypertension, diabetes, and obesity.

The increasing prevalence of cardiovascular disease in Asia is very alarming from a public health perspective because there is so little funding to address a serious problem that affects so many people. As a result, the physicians and scientists in the region show great interest in learning how to combat these issues.