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Dr. Sherry-Ann Brown specializes in non-invasive preventive cardiology and cardio-oncology. She provides comprehensive cardiovascular care, focusing on early detection, prevention, and management of heart disease.

 

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Services Offered:

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• Telehealth Video Visits: Direct virtual consultations with patients.

• Asynchronous Interprofessional Consults: PCP submits a consult request, and Dr. Brown provides cardiology recommendations based on the patient's chart.

• Comprehensive Cardiovascular Risk Assessments: For cancer patients, high-risk individuals, and preventive care.

• Executive & Preventive Heart Health: Custom plans for professionals and individuals prioritizing cardiovascular wellness.

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Reasons for Referral & Who to Refer

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• Specific cardiovascular conditions and abnormal test results warranting referral:

  • Hypertension

  • Hyperlipidemia

  • Breast arterial calcification (seen on mammography)

  • Coronary artery calcification (seen on chest CT)

  • Abnormal ECG (electrocardiogram)

  • Abnormal echocardiogram

  • Abnormal stress test

  • Abnormal heart monitor results

  • Any abnormal heart testing result

  • Baseline cardiovascular risk assessment for anyone newly diagnosed with cancer

  • Cancer survivorship cardiovascular risk assessment for anyone ever diagnosed with cancer

  • Preoperative cardiovascular evaluation

  • Abnormal smartwatch ECG tracings

  • Cardiovascular genetic testing results

  • Executive heart health

  • Preventive heart health

  • Cardiovascular health and wellness

  • Life’s Simple 8 Cardiovascular Health Assessment

    • Includes: Blood pressure, cholesterol, blood sugar, BMI, smoking status, physical activity, diet, and sleep.

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Who to Refer and Reasons for Referral

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Common Cardiovascular Concerns:

• Hypertension (new diagnosis, resistant, difficult-to-control)

• Hyperlipidemia (high cholesterol, high triglycerides, statin intolerance)

• Breast Arterial Calcification (BAC) detected on mammography

• Coronary Artery Calcification (CAC) detected on chest CT

• Abnormal ECG (conduction abnormalities, arrhythmias, ischemic changes)

• Abnormal Echocardiogram (chamber abnormalities, valvular disease, LV dysfunction)

• Abnormal Stress Test (ischemia, abnormal functional capacity)

• Abnormal Heart Monitor Results (arrhythmias, pauses, bradycardia, tachycardia)

• Any Abnormal Heart Testing Result requiring expert interpretation and guidance.

Cancer-Related Cardiovascular Risk:

• Baseline cardiovascular risk assessment for newly diagnosed cancer patients.

• Cancer survivorship cardiovascular risk assessment for anyone previously diagnosed with cancer.

Surgical & Preoperative Evaluations:

• Preoperative cardiovascular evaluation (assess heart health before surgery).

• Evaluation for cardiovascular clearance (elective, urgent, or emergent surgeries).

Technology-Based Cardiovascular Concerns:

• Abnormal Smartwatch ECG Tracings (evaluation of irregular rhythms).

• Cardiovascular Genetic Testing Results (guidance on genetic predispositions).

Preventive & General Cardiology:

• Executive Heart Health (preventive evaluations tailored for professionals).

• Preventive Heart Health (risk reduction and early intervention).

• Cardiovascular Health & Wellness (lifestyle-focused heart care).

• Life’s Simple 8 Cardiovascular Health Assessment:

  • Blood Pressure

  • Cholesterol Levels

  • Blood Sugar Control

  • Body Mass Index (BMI)

  • Smoking Status

  • Physical Activity

  • Diet & Nutrition

  • Sleep Health

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Understanding Breast Arterial Calcification (BAC) and Coronary Artery Calcification (CAC)

 

Breast Arterial Calcification (BAC)

 

Breast Arterial Calcification (BAC) is the presence of medial calcifications in the arteries of the breast, commonly detected incidentally on mammography.

 

While traditionally considered a benign finding, emerging research suggests a strong association with cardiovascular disease (CVD), particularly in women.

 

Key Facts About BAC:

• Marker of Cardiovascular Risk: Women with BAC are at higher risk for coronary artery disease (CAD), stroke, and peripheral artery disease.

• Medial Calcification vs. Intimal Calcification: BAC affects the medial layer of arteries (similar to calcifications seen in diabetes and chronic kidney disease) rather than the intimal layer, which is more common in atherosclerotic plaque.

• Not Associated with Breast Cancer: Unlike microcalcifications, which may suggest malignancy, BAC is considered non-malignant.

• More Common in Certain Populations:

  • Postmenopausal women

  • Diabetics

  • Patients with chronic kidney disease (CKD)

  • Individuals with high blood pressure and metabolic syndrome

 

Clinical Implications of BAC:

• BAC serves as an early warning sign for systemic vascular calcification and can indicate an increased risk of coronary artery disease (CAD), heart failure, and stroke.

• Patients with BAC should undergo cardiovascular risk assessment, including:

  • Lipid panel and glucose screening (for metabolic syndrome and diabetes)

  • Coronary artery calcium (CAC) scoring via chest CT (to quantify cardiac risk)

  • Blood pressure monitoring

  • Lifestyle interventions (diet, exercise, smoking cessation, and statin therapy if indicated)

 

Coronary Artery Calcification (CAC)

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Coronary Artery Calcification (CAC) refers to the deposition of calcium in the coronary arteries, which can be measured using a non-contrast cardiac CT scan. It is an important predictor of cardiovascular events and coronary artery disease (CAD).

 

Key Facts About CAC:

• CAC Score and Cardiovascular Risk:

  • CAC Score 0: No detectable coronary calcium; very low risk of cardiovascular events.

  • CAC Score 1-99: Mild calcification; suggests early CAD with low to moderate risk.

  • CAC Score 100-399: Moderate calcification; higher risk of cardiovascular events.

  • CAC Score 400+: Extensive calcification; very high risk of heart attack or stroke.

• Independently Predicts Future Cardiac Events: A high CAC score correlates with increased all-cause mortality and major adverse cardiovascular events (MACE).

• Unlike BAC, CAC is primarily an indicator of atherosclerotic burden and reflects intimal calcification due to chronic plaque formation.

 

Clinical Implications of CAC:

• CAC scoring is particularly useful in intermediate-risk patients to guide statin therapy and aspirin use.

• A high CAC score (>100) suggests intensive preventive therapy, including:

  • Aggressive lipid-lowering therapy (statins, ezetimibe, PCSK9 inhibitors)

  • Blood pressure control

  • Lifestyle modifications (exercise, dietary changes, and smoking cessation)

  • Possible aspirin therapy (if not contraindicated)

 

Who Should Get a CAC Score?

• Patients with BAC detected on mammography (especially postmenopausal women).

• Individuals at intermediate risk for cardiovascular disease (per ASCVD risk calculator).

• Patients with a strong family history of premature coronary artery disease.

• Diabetics over 40 years old (to determine need for statin therapy).

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Who to Refer and Reasons for Referral

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Common Cardiovascular Concerns:

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• Hypertension (new diagnosis, resistant, difficult-to-control)

• Hyperlipidemia (high cholesterol, high triglycerides, statin intolerance)

• Breast Arterial Calcification (BAC) detected on mammography

• Coronary Artery Calcification (CAC) detected on chest CT

• Abnormal ECG (conduction abnormalities, arrhythmias, ischemic changes)

• Abnormal Echocardiogram (chamber abnormalities, valvular disease, LV dysfunction)

• Abnormal Stress Test (ischemia, abnormal functional capacity)

• Abnormal Heart Monitor Results (arrhythmias, pauses, bradycardia, tachycardia)

• Any Abnormal Heart Testing Result requiring expert interpretation and guidance.

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Referral Process & Protocols

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• How to Refer:

  1. Option 1: Telehealth Video Visit Referral

     • PCP refers the patient for a direct telehealth consultation with Dr. Brown.

     • Patient completes Cardiology Intake Forms before the visit.

     • PCP can order cardiovascular tests beforehand or let Dr. Brown decide.

  2. Option 2: Interprofessional Consult (Asynchronous)

     • PCP submits the patient’s medical record and specific cardiology question.

     • Dr. Brown reviews the chart and provides cardiology recommendations without seeing the patient.

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• Steps for PCPs:

  1. Complete the Referral Request.

  2. Specify the urgency (routine, urgent, or emergent).

  3. Indicate whether testing has already been ordered or if Dr. Brown should decide.

  4. For preoperative evaluations: Include surgery type, date, reason, and urgency (elective, urgent, emergent).

  5. State the specific question for Cardiology to address.

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Referral Tips

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• Direct us to Relevant Medical Records:

  • Date of the last relevant PCP note/visit for the patient.

  • Cardiovascular test results (if available).

  • Key medical history.

  • Specify the urgency of the referral (routine, urgent, emergent).​​​​

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Important Notes

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• Management Approach: Dr. Brown will make recommendations for PCPs to manage the patient’s condition.

  • She will see the patient frequently until their cardiovascular condition is under good control, then transition to less frequent follow-ups and return them to PCP care.

  • Advanced cardiovascular disease patients may remain under Dr. Brown’s long-term management.

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• No POTS Management: PCPs will be provided with resources to manage POTS in primary care, as Dr. Brown does not manage POTS.

 

 

Thank you for trusting us with Cardiology care of your patients.

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We are honored to serve you.

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