Aditya Mehta, MBBS

Aditya Mehta, MBBS, is a third-year general cardiology fellow at Inova Schar Heart and Vascular in Fairfax, VA. He grew up in western India and studied medicine at Maulana Azad Medical College in New Delhi, India, eventually coming to the US for training in internal medicine at Western Michigan University Homer Stryker M.D. School of Medicine in Kalamazoo, where he served as chief resident. He has more than 20 peer-reviewed publications and enjoys serving as a community health volunteer. Mehta would like to pursue a career in treating heart failure patients, and this summer he will begin a fellowship in advanced heart failure and transplant at the University of Utah Health in Salt Lake City. He hopes to continue performing research in the field of heart transplantation to help make patients’ lives easier.

 

How did you become interested in medicine?

It’s a funny story. My path to medicine was unexpected. After I finished 10th grade, I was inspired by my eldest brother who was working in the US as an engineer and earning a decent salary at the age of 24. I figured if I did the same, maybe as a computer science engineer, I’d live a happy life. I performed well on the engineering entrance prep exam, but while waiting at a train station afterward, I noticed students in uniform studying biology books and preparing for the medical entrance exam. Curious, I decided to take that exam as well and unexpectedly ranked fourteenth out of 2,000 applicants.

Encouraged by my grandfather and father—both opticians who hoped I’d pursue medicine, specifically ophthalmology—I shifted my focus. After 2 years of preparation, I ranked eighth among 250,000 applicants throughout India and gained admission to one of the top medical schools in the country. It was during clinical rotations in my third year that I discovered a genuine passion for patient care, which only solidified my decision.

When did you decide to pursue a career in cardiology instead of ophthalmology?

Getting into cardiology was also a dichotomous decision in my residency. To my father’s disappointment, I left ophthalmology behind pretty early. But I was confused between going into pulmonary critical care or cardiology. One day, my mentor invited me to listen to a patient’s murmur while we were on rounds. I spent nearly 5 minutes doing so—an unusually long time—but couldn’t nail the diagnosis. With his guidance and a few bedside maneuvers, I was able to distinguish a murmur from hypertrophic cardiomyopathy rather than mitral regurgitation. That moment was transformative as I realized the importance of physical examination in diagnosing complex cardiac conditions.

As I continued my training, I found myself deeply engaged in caring for heart failure patients, many of whom were struggling with fluid overload. Their concerns were often simple yet profound: being able to walk around the house, spend time with their grandkids, or shop for groceries without getting breathless. Helping them regain that quality of life was incredibly meaningful.

I came to Inova for an away rotation, and it completely convinced me to pursue cardiology. I applied to spend a month in the cardiac ICU but got accepted for the heart failure and transplant rotation where there was an opening. I just loved taking care of those patients who came in with really, really end-stage heart failure and working them up for advanced therapies, including transplant.

What has been one of your most meaningful patient interactions?

One patient scenario that stuck with me was treating an FBI agent who got shot in the field. The bullet crossed from the left ventricle, perforating his left anterior descending artery, and into the myocardium. He was on mechanical circulatory support (MCS) and then ECMO. We worked him up for a transplant, which he got, and I took care of him for the 4 weeks I was there. I had daily interaction with his family, and I loved being able to help not just the patient, but also those he loved. It was a very stressful situation, and yet he was able to walk out of the hospital 3 weeks later. That was very gratifying. I even got the opportunity to fly and procure the heart for him, so I was involved from beginning to end. After that, I knew that this was what I wanted to do for the rest of my life.

Over the years, I’ve come to love being a clinician, especially the person at patients’ bedsides. I love interacting with patients—hearing their stories, asking what kind of pets they have and what their names are, and generally providing personalized medicine. It gives a sense of knowing them on a personal level.

What is it about the field of heart failure that really makes you want to devote your career to treating these patients?

I love this field, firstly because there are plenty of patients with heart failure. But we don’t have enough doctors. The reasons for that are multifold. Trainees who go on to spend an additional year doing Advanced Heart Failure and Transplant Cardiology get to learn the skills in MCS and cardiac ICU transplant, but there aren’t many jobs. There are ample opportunities for community heart failure jobs, but many applicants feel that if they were to spend an extra year training in something specific, they would want to practice that. Otherwise, as a general cardiologist, they can still see a majority of the heart failure patients and manage them the same way. Secondly, the pay for these positions is going to be either similar or even lower than general cardiology in some states while the workload is greater. You must review a huge amount of data for the patient and then follow them longitudinally, collaborating with multiple disciplines.

I like spending time in the cardiac ICU, dealing with patients on MCS and getting them to their advanced therapies. There’s gratification for me if a patient is able to get back to their baseline state with treatment. I even have immense pleasure when I’m on the floors, even diuresing patients and putting them on inotropes, if they’re able to feel much better and go back to their lives not huffing and puffing.

How do you see the field changing in 5 years?

We have come to a point where the field is splitting into pre- and post-transplant care. While this makes sense on some level given all the new therapies coming out, I was shocked to learn how one of the hospitals where I interviewed had different sets of physicians for pretransplant workup and post-transplant management. I thought: Why can’t they all work together? However, there’s so much new data coming out, especially regarding shock, and many patients are becoming more and more complex. Having one physician taking care of and staying up to date with every single spectrum of the disease is getting harder. Advanced heart failure and transplant is such a niche within cardiology, and it’s becoming even more nuanced. That’s where I’m seeing the field moving towards more and more physicians getting more specialized within heart failure so that they can take care of the patient with a specific condition. 

Do you foresee yourself undertaking this kind of niche specialty training?

I’ve seen my mentors work on the full spectrum of heart failure patients here at Inova—inpatient, outpatient, MCS, CICU, and transplant—and that’s the kind of doctor I want to become. If I restrict myself to just one niche within heart failure, I may be taking away the opportunity for myself to take care of other subsets of patients.

What’s the best piece of advice that you’ve ever gotten from a mentor?

Palak Shah, MD (Inova Schar Heart and Vascular) is my mentor. My mindset as a fellow was to get involved with as much research as possible, so I said yes to every opportunity. We had a chat one point during my first year and he said: “Adi, at one point, you must start saying no. You only have so many hours in your day. You must spend time with your family. That’s the most important thing. Then if you have some time, you’ll work on research, but don’t sacrifice family and personal time to do work.” He kind of gave me permission to say no. After that, I narrowed my focus and I’ve just been saying yes to projects that I know I can deliver on time.

What do you like to do in your free time to balance out your work life?

I’m an avid Xbox player. I’ve been playing FIFA since 2010, and I have owned every single version of the game. My wife is not as much interested in Xbox, but I like to hike with her, stargaze, and explore our national parks. I’ve visited 13 national parks in the United States, including the Grand Canyon, Death Valley, and Shenandoah.

Do you have any advice for fellows coming up behind you?

Believe in yourself. It’s a simple statement, but a very powerful one. Find the right mentor and surround yourself with the right people. That’s what gets you to where you want to be.

What his nominator, Palak Shah, says:

Clinically, Adi is well respected within the program. He is industrious, collaborative, and communicates well with his team members and patients alike. He has demonstrated the aptitude to handle a complex patient population on mechanical support, after transplant, or undergoing evaluation for advanced therapies. Academically, Adi has been working with our research team to better characterize post-transplant outcomes and how novel genomic biomarkers such as donor-derived, cell-free DNA can better elucidate clinically significant heart transplant rejection. I fully expect that with continued mentorship, he has a promising clinical and academic career in heart failure.

To nominate a stellar cardiology fellow for the Featured Fellow section of TCTMD’s Fellows Forum, click here.