Julie Brothers, MD, FAAP

Cardiologist Julie Brothers, MD, has one overarching ambition: to help children lead the healthiest lives possible.

She pursues that goal through two main avenues: as the director of CHOP’s Lipid Heart Clinic and as the medical director of its Coronary Anomaly Management Program.

In these roles, Dr. Brothers strives to prevent potentially life-threatening medical crises, both in the clinic and through clinical research.

“I want patients and their families to know that we truly care about their children and hope they have the best experience possible during their time at CHOP,” she says.

The Lipid Heart Clinic addresses dyslipidemia, or abnormal levels of fats (including cholesterol) in the blood. Dyslipidemia in children, which elevates the risk of heart disease later in life, is sometimes hereditary, but most often it results from lifestyle factors like diet and lack of physical activity.

“I am drawn to the patients with dyslipidemia,” Dr. Brothers says, “because there are many ways to work with kids and their families to get healthier, be it changing the diet, adding more physical activity and less screen time, or both.”

A promising area for dyslipidemia treatment, she says, is “teaching children and families the importance of choosing more whole, plant-based food and getting away from processed foods in helping reduce cardiovascular risk.”

Although most patients with dyslipidemia improve with lifestyle changes, children with inherited dyslipidemia may need medication as well.

In recent years, researchers have made significant advances in understanding the genetic basis of inherited dyslipidemia, and Dr. Brothers is enthusiastic about the prospects of improving treatments on the basis of this research: “I envision targeted medication for certain inherited lipid disorders based on the patient's genotype,” she says.

Coronary artery anomalies, the other focus of Dr. Brothers’ work, are considerably rarer than dyslipidemia.

Coronary arteries lead from the aorta (the large blood vessel that arises from the heart) and supply oxygen to the heart muscle. When these blood vessels are not located in their usual location on the aorta, it may lead to cardiovascular symptoms and may place the child at increased risk of sudden cardiac arrest, especially after vigorous exercise.

While some children with coronary artery anomalies experience symptoms such as chest pain, dizziness, palpitations or fainting, some patients have no symptoms and are diagnosed only when they undergo a diagnostic imaging procedure for some other reason.

Treatment of this condition is very challenging, as little is currently known about which factors increase the risk of sudden cardiac death in children with coronary artery anomalies. Dr. Brothers is actively researching this question.

“I am hopeful that we will be able to better determine which patients with certain coronary anomalies are at high risk for sudden cardiac arrest and which are at low risk. This would change the way we manage these patients,” she says. “I want to help figure this out and work with these families to allow their children to exercise safely.”

Director, Lipid Heart Clinic

Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania

Pediatric exercise testing and cardiovascular disease prevention
Coronary artery anomalies