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Treating Complex Artery Disorders


When Jessica Biggs first met Vanderbilt cardiologist Esther Kim, M.D., the 33-year-old burst into tears.

Jessica said she couldn’t contain her emotions after struggling to find answers for her recurring heart problems.

“Three hospitals, six stents and four heart attacks later, I am finally sitting with the person who can help me,” Jessica said. “I just bawled and hugged her. It had been a very long seven months. I asked her to please help me.”

Jessica was the first patient in the Arteriopathy Clinic, the newest addition at the Vanderbilt Heart and Vascular Institute. The clinic specializes in care for patients with complex arterial disorders including spontaneous coronary artery dissection and fibromuscular dysplasia and aneurysmal disease.

Vanderbilt Heart is one of a few centers in the country with a dedicated arteriopathy clinic and the only such center in Tennessee.

As director of the Arteriopathy Clinic, Kim provides a new dimension of care as a vascular medicine specialist. She joins Josh Beckman, M.D., director of the Section of Vascular Medicine.

“We are unique to Vanderbilt and this entire area,” said Kim, associate professor of Medicine at Vanderbilt. “The purpose of developing a dedicated clinic is to provide up-to-date, literature-based personalized care for patients with uncommon vascular diseases. These patients often have delays in diagnosis and require expert care for treatment and dedicated surveillance.

“Review of prior medical records and an in-depth clinical visit is an essential part of the clinic. When they come in, I have done extensive work on what the next steps will be and identified specialists in many different fields whose expertise we may need.

“I not only want to care for my patients, but I also want to raise awareness among physicians.”

It is that model of care that offered Jessica her first level of comfort. After two visits, she said she could finally take a deep breath.

“She has gotten me to where I feel somewhat human and normal again,” said the eighth-grade English teacher.

SCAD is a rare condition that that occurs when a tear forms in one or more blood vessels, which can slow or block blood flow to the heart and cause a heart attack. It is mostly found in middle-aged women with the average age in the 50s. Fibromuscular dysplasia is another disorder primarily affecting young and otherwise healthy women.

Kim treats patients with a range of cardiovascular disorders but has a special interest in patients with uncommon arterial disorders including FMD and SCAD. She participates in the United States Fibromuscular Dysplasia Registry and is the current chair of the Scientific Advisory Board for SCAD Alliance while serving as the associate editor for the specialty’s premier journal, Vascular Medicine.

“Our clinic provides comprehensive medical management for patients for whom not a lot of expertise exists in the cardiology world,” Kim said. “We will begin taking part in multicenter research projects.

“I not only want to care for my patients, but I also want to raise awareness among physicians. It is so important that they become more familiar with these disorders and know that our clinic is here.”


Written by Jessica Pasley, originally published in the VUMC Reporter