For Referring Physicians

Thank you for trusting Cardiovascular Institute of the South with your patients. Dr. Smith evaluates patients for structural heart, coronary and pulmonary embolism procedures and keeps referring clinicians informed at every step.

How to refer

• CIS Baton Rouge: phone (225) 308-0247, fax (225) 308-0249
• CIS Zachary: phone (225) 654-1559, fax (225) 654-6212

Please mark the referral "Dr. Phillip Smith — structural heart evaluation" (or the relevant procedure) so it reaches the right team.

What to send

• Reason for referral and your clinical question
• Most recent echocardiogram report (and images if available)
• Recent office notes, problem list and medication list, including anticoagulants and antiplatelet agents
• Recent labs, including creatinine and hemoglobin; BNP or NT-proBNP for heart failure referrals
• Prior catheterization, CT, stress test or TEE reports, if any
• History of bleeding, falls, stroke or heart failure admissions, as relevant
• Insurance information and demographics

Patients who may benefit from structural evaluation

• Aortic stenosis: severe aortic stenosis with symptoms (exertional dyspnea, angina, syncope, declining exercise tolerance), or severe aortic stenosis with reduced ejection fraction. Earlier referral of moderate-to-severe disease is welcome. TAVR
• Mitral regurgitation: moderate-to-severe or severe (3–4+) MR with symptoms, particularly in patients at high surgical risk or with heart failure despite guideline-directed medical therapy. MitraClip / TEER
• Tricuspid regurgitation: severe TR with right-sided heart failure symptoms despite diuretics. TriClip
• Atrial fibrillation with bleeding risk: non-valvular AF with an elevated stroke risk and a history of bleeding, high bleeding risk, falls, or poor tolerance of anticoagulation. Watchman
• Heart failure with recurrent admissions: NYHA class II–III heart failure with a heart failure hospitalization in the past year or elevated natriuretic peptides. CardioMEMS
• Cryptogenic stroke with PFO, or ASD with right heart enlargement. PFO and ASD closure
• Intermediate-high or high-risk pulmonary embolism. These are emergencies; call the hospital transfer line or the on-call cardiologist directly. PE thrombectomy

Not sure if a patient qualifies? Refer anyway. A structural heart evaluation includes a review of imaging, symptoms and surgical risk, and patients who are not candidates return to you with a clear plan.

Education for primary care

Dr. Smith presented "Structural Heart 101: Key Insights for PCPs" to the Louisiana Academy of Family Physicians' statewide webinar series in November 2024, covering which patients to refer and when. He is glad to speak with practices and groups in the Baton Rouge and Zachary area. Call the Baton Rouge office to arrange a talk.