Faculty Spotlight: Ada Ip, MD

 

Finding the Right Solution for Each Patient

As an interventional cardiologist, Ada Ip, MD, uses her engineering background to solve problems in the heart without surgery. She inserts a catheter – a thin, flexible tube – through a small cut in the groin or wrist, then threads it up into the heart. By passing tiny cameras, tools and devices through the catheter, she can diagnose different forms of heart disease, open blockages in the blood vessels that feed the heart, and perform other vital procedures.

“As someone trained as an engineer, I’m very focused on finding solutions,” said Dr. Ip. “If I see a problem that hasn’t been figured out, I’ll spend a lot of time poring through all the data and talking with the patient to diagnose the problem and find a solution."

Dr. Ip grew up in San Ramon, Calif., and enjoyed physics and math in high school. While earning her bachelor’s degree in bioengineering from UC San Diego, one of her first engineering classes was taught by a cardiac biomechanics professor. “He focused a lot on the heart, and I loved it and stuck with it,” she said. “We made circuits like the kind used in wearable sensors and devices. We also looked at how cardiac tissue works and how it reacts to various interventions. The heart makes a lot of sense to me – it’s very mechanical, and it was a good fit for the way my brain works.”

While she enjoyed her classes, she also felt drawn to medicine. “I was missing the human connection, so I started shadowing doctors and volunteering in hospitals,” said Dr. Ip. “As I became more immersed, I realized that I really like the patient aspect as well as the side that’s focused on hard science and numbers.”

Dr. Ip earned her medical degree from the Geisel School of Medicine at Dartmouth in Hanover, N.H., then completed her internal medicine residency from Icahn School of Medicine at Mount Sinai in New York, followed by her general cardiology fellowship at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and her interventional cardiology fellowship at UCSF.

“In cardiology, I liked caring for patients who were very ill,” said Dr. Ip. “There’s a different type of bond that you have when they are so sick, and I like being part of people’s lives when it’s the most intense. I feel like I can have the most impact at that time. When I got into the cath lab during my general cardiology fellowship, I discovered that I also like working with my hands. I saw how that can make a big change in a patient’s life, like when they are having an acute heart attack. That led me to become an interventional cardiologist.”

During training, she contributed to several research projects, including the use of a non-invasive ultrasound modality called pulse wave imaging to look at arterial stiffness. She and her colleagues also used this technique to distinguish between calcified and lipid plaques in the carotid artery; other researchers have found that lipid-rich plaques are more likely than calcified plaques to rupture and increase the risk of stroke. This concept is similar to what occurs in the coronary arteries of the heart, which is where she now focuses. Dr. Ip also helped study an interventional procedure to treat blockages in the blood vessels that carry blood from the heart to the lungs, finding that adverse outcomes were more prevalent at low-volume centers.

‘Not Just a Proceduralist’

Over the years, Dr. Ip has developed a quiet confidence that helps her during high-stakes procedures. “When I led Code Blues as a resident, people said that I was cool as a cucumber,” she said. “That experience helps in the cath lab, when the patient is very ill or something goes wrong. At the most crucial moments, you need to command the room, delegate tasks, and have each person on the team read back those tasks. I might say, ‘Peter, please draw bloodwork, including a CBC [complete blood count] and BMP [basic metabolic panel],’ and it’s helpful for Peter to then say, ‘Okay, I’m now drawing the CBC and the BMP,’ so there is a closed-loop communication. If you are calm, everyone else is a tad calmer.”

That centeredness also helps her connect with patients. “I care about people and am a good listener, which helps me bond with them,” said Dr. Ip. “During residency, I also learned that I’m not just caring for the patient in isolation, but also for their family members.”

She recalled taking care of a single mother with metastatic cancer who was in a great deal of pain. The patient’s teenage daughter was her sole caregiver. “As much as the mother was suffering, her daughter was also suffering,” said Dr. Ip. “She would crawl in bed with her mother, and was still grappling with the fact that her mother would be passing soon. I learned to just be with the daughter, spend time with her, and connect her with support services. Now when I do procedures on patients, I always meet the family beforehand and have conversations with them, because I know they are a very integral part of patient care.”

As an interventional cardiologist, she believes her job is not only about having the technical mastery to perform complex procedures, but also the finesse to advise patients whether an intervention aligns with their goals of care. “During my fellowship at Cornell, the team always emphasized that you’re not just a proceduralist, but a physician caring for the whole patient,” said Dr. Ip.

She remembered one older patient who was quite ill. “On paper, she appeared to be a great candidate for an interventional procedure to close a hole in her heart, which could help make her feel better,” said Dr. Ip. “She was a patient that said, ‘Yes, whatever you want is fine,’ and had consented. But when we saw her in person, she was quite deconditioned. We found out that she lived alone and hadn’t left her house for almost a year. In addition, she wasn’t sure if she could continue to take care of herself at home. I thought it would be too dangerous for her to undergo this procedure, and worried that she might not recover very well after the procedure. After talking further about the possible risks and benefits, she ultimately changed her mind. Obviously, learning the technical skills are very important, but it’s equally important to learn how to recommend the right treatment plan for each patient.”

A related learning she often shares with trainees is the importance of personally looking at all the data. “The very analytical side of my brain wants to talk to the patient, get their history, and look through all the imaging data myself,” said Dr. Ip. “That’s why we spend a lot of time in clinic talking with patients before we do procedures, so we can have these thorough discussions with them.”

Serving the Community

Dr. Ip returned to the Bay Area both for the opportunity to be closer to family, and to serve more patients like her parents. “I grew up in an immigrant household where my parents and grandparents spoke Cantonese, and I wanted to be in a community where I could take care of similar kinds of patients,” she said. She is conversant in Cantonese, and about 10 to 20 percent of her patients are Cantonese speakers.

“Both my parents seek out physicians who can speak their language, and it’s important for my own satisfaction to be in a community where patients are as happy as my parents are when their physician speaks their language,” said Dr. Ip.

After completing her interventional cardiology fellowship, Dr. Ip joined the UCSF Division of Cardiology faculty in 2024. She performs heart procedures in the Adult Cardiac Catheterization Lab at UCSF Medical Center, provides care at the cardiology clinic at 1 Daniel Burnham Court, and serves as an attending physician for hospitalized patients at UCSF Medical Center as well as California Pacific Medical Center, where UCSF faculty help staff the inpatient cardiology service. She is also a part of the Asian Heart and Vascular Center at UCSF.

In the cath lab, she performs many diagnostic coronary angiograms to examine the blood vessels of the heart for problems. If she detects a blockage in a coronary artery, she may place a cardiac stent. This sometimes requires calcium modification to reduce hard plaques that interfere with stent placement, accomplished via procedures such as atherectomy and intravascular lithotripsy.

Other common procedures include intravascular ultrasound imaging of the coronary arteries, which involves threading a tiny camera into the heart to image the lining of the blood vessels. Dr. Ip also provides mechanical circulatory support to sick patients, placing devices such as an intra-aortic balloon pump or an Impella, which can temporarily help the heart pump blood while it is recovering from a heart attack, open heart surgery or cardiogenic shock.

Dr. Ip also performs coronary physiologic testing to identify microvascular dysfunction or coronary vasospasms, which can reduce blood flow and cause sometimes debilitating chest pain. In addition to measuring the blood flow in the larger coronary blood vessels as a surrogate marker for blood flow in the tiny blood vessels that are too small to visualize, she and her colleagues administer an intravenous medication that may induce vasospasm to determine whether that is causing the chest pain.

“Vasospasm can be triggered by things like tobacco use and stress, and certain patients are more prone to them than others,” said Dr. Ip. “By administering the IV medication during a cardiac catheterization, we can see if they have a reaction, which we can visualize on our screen. This is the only way to do this test – it can’t be determined by a cardiac MRI [magnetic resonance imaging], PET [positron emission tomography] scan, or a traditional stress test.” Once diagnosed, patients can take oral medications to help prevent vasospasm, and can address lifestyle factors such as smoking which may exacerbate the condition.

Training the Next Generation

Dr. Ip appreciates being part of the UCSF Cardiology faculty. “I like having supportive colleagues who are available to discuss cases offline, run ideas by each other, or just talk if you’re having a rough day,” she said. “I really enjoy interacting with a wide range of people, including general cardiologists, interventional cardiologists and electrophysiologists. I also love the diverse patient population, including many immigrants.”

She also values the opportunity to work with trainees. “I enjoy clinical teaching because I like seeing trainees grow,” said Dr. Ip. “That’s very rewarding. You can teach technical aspects of medicine, like how to manipulate the catheter in the cath lab, but growth as a person is also very important. At the beginning of the year, I have fellows with me on the consult service. Sometimes they aren’t very confident about their assessment and plan, but as time goes on and you give them more encouragement and reinforcement, they are happier and more confident. That’s my favorite part of teaching.”

“Dr. Ip has been a wonderful addition to our interventional cardiology team and to the UCSF family,” said Sammy Elmariah, chief of Interventional Cardiology in the UCSF Division of Cardiology and medical director of the Adult Cardiac Catheterization Laboratory. “She effortlessly applies deep clinical knowledge, technical expertise, and compassion to deliver personalized, high-quality care to her patients.”

In the future, Dr. Ip hopes to use her bioengineering background to contribute to research and development of new cardiac interventional tools. “It would be fun and rewarding to help develop the newest technology in stents or mechanical circulatory support, as well as ways to treat heart disease,” she said.

Outside of medicine, Dr. Ip enjoys taking walks and going on hikes with her dog, Archer, a Taiwanese mountain dog. She also loves traveling the world with her partner, Richard Hwang, who works in tech startups.

-Elizabeth Chur