Robert V. Same, MD

Robert Same, MD, is a cardiologist who specializes in cardiovascular disease, preventative cardiology, echocardiography, and heart failure.

Dr. Same sees patients at:

Barnes-Jewish West County Hospital, Suite 100
12634 Olive Blvd.
Creve Coeur, MO 63141

Please call 314-362-1291 for an appointment.

What happened in the course of schooling to influence you to choose your specialty?

I was always fascinated by science in school, and human physiology was especially interesting to me. I can distinctly remember a time in high school biology class when I learned the inner workings of the kidney. I recall being awestruck at the complex blood-filtering structures of the kidney that work silently every day to keep our bodies working.

During my medical school and residency training, I found that cardiology was a fun combination of complex physiology and interesting patients. The patients vary greatly in their needs – from heart disease prevention in a fairly healthy person, to someone with complicated chronic conditions and a sensitive physiology. This is what drew me to cardiology.

The Same family at Patterson Park in Baltimore, Maryland

What brought you to Washington University?

I was born and raised outside of Baltimore. My wife and I met in medical school –she’s a pediatric infectious disease specialist. When we were both looking for jobs at the same time, it just so happened that St. Louis offered amazing health care opportunities for both of us — in jobs that were really fulfilling.

St. Louis is an amazing city to raise our family. We are enjoying (as much as you can during COVID) all the attractions that St. Louis has to offer young families. It’s a good fit for us – we are excited to call St. Louis home.

Which aspect of your practice do you find most interesting?

The best part of my job is meeting and talking to people all day — every day. I enjoy getting to know my patients and it is endlessly fascinating to learn about their experiences with their illnesses.

Hearing a patient’s personal story is the most effective way to help that particular individual. The same disease can affect different people in different ways — every plan has to be unique.

The scope of cardiology is broad, and that is what drew me to it. You can have patients who are asymptomatic (showing no symptoms), but who have family members who have heart disease. These patients just want to understand their risk – even if they are only in their 30s or 40s.

On the other end of the spectrum, I will have very sick patients who need careful monitoring. This specialty allows me to create long term relationships with all my patients – and that is something I look forward to doing as I build my practice here.

Just to confirm, you also see patients who may show no symptoms of heart disease, and they can come to you because of family history and for prevention?

Absolutely. One of my clinical interests is in preventive cardiology and understanding early cardiac risk factors with emphasis on prevention of cardiovascular disease.

Heart disease is the leading cause of death in the United States. I embrace prevention as part of my job as a cardiologist. It is just as important to understand cardiovascular risk factors and how to prevent heart disease, as it is to treat the disease.

What are a few of the most common risk factors for heart disease?

The largest drivers of heart disease in the United States are high blood pressure, high cholesterol and smoking. Most patients of the appropriate ages would be screened through their primary care physician for these conditions before they see a cardiologist. Most of the patients I see have a diagnosed or suspected heart disease already.

One of the areas I researched during my training was using erectile dysfunction (ED) as an early indicator of heart disease – even though ED may not often raise of heart disease, there is good evidence that ED occurs a few years before patients have symptoms of heart disease.

Obviously, a family history of heart disease or cardiovascular disease should be taken into account to help patients understand their disease risk.

During these times of COVID, what would you say to a patient who is hesitant to come to see you?

I would first say (because I am married to an infectious disease doctor), I think about this question often. I certainly understand the importance of staying safe during these times. Health care is important, and the need does not go away in the setting of a pandemic. Patients still develop diseases and require treatment for those diseases.

As we’ve come to understood COVID19 better, patients should feel safe going to the doctor to receive evaluation and treatment for medical problems. Our offices have safety protocol guidelines in place, we all wear the appropriate protective equipment. We can continue to see and treat patients in a safe way. I would not hesitate to recommend evaluation and treatment for medical problems in the setting of COVID right now.

What are the new developments in your field that most excite you?

There are a lot of powerful tools in cardiology. A relatively newer test is the coronary artery calcium score. It is a CT scan that provides insight into vascular risk and what we call sub clinical heart disease.

This scan can help some of our patients who want to better understand their future risk of heart disease, but who don’t necessarily have symptoms of heart disease right now.

Is it true that heart disease symptoms in women can differ than men’s symptoms?

Yes, heart disease in women is misdiagnosed more frequently. Women are less likely to present with significant chest pain or pressure, and other symptoms like indigestion, fatigue, or shortness of breath. Because of this, doctors may be slower to diagnose heart disease in women.

You went to school in Baltimore, are you also from Baltimore?

I am.  I grew up in Baltimore City, attended college at the University of Maryland, went to medical school and residency at Johns Hopkins University, and then fellowship at the University of Maryland. I have literally never left that area until I moved to St. Louis!

When my wife and I were looking for a place to raise our family and both have careers at a world class academic medical center – St. Louis really fit the bill.

What would you say is “a-don’t-miss attraction” for someone visiting the Baltimore area? (When everyone can travel again!)

You can’t visit Baltimore without having some Maryland crabs at a local restaurant – that’s obligatory. The American Visionary Art Museum is a must-see that encapsulates the spirit of the city. It’s near the inner harbor in downtown and is a collection of quirky artwork from regional artists. It captures the really cool vibe of Baltimore.

Which particular award or achievement is most gratifying to you?

Earning the Eagle Scout award. It was the culmination of achievements and skills that spanned over a decade of my childhood. I learned how to be a leader amongst my peers and in my community.

What I learned while achieving my Eagle Scout award has been influential in how I approach leadership roles to this day.

What is the best advice you’ve received?

Not so much advice, but words that I abide by in my daily practice as a physician and an important reminder of why I went into medicine.

One of my mentors, Dr. David Hellmann, would frequently state that medicine is a public trust.  He meant that our role as physicians is to give back to our society. We have been given a tremendous opportunity to care for patients, to learn about and help them through some of the most difficult times in their lives. Society has invested a lot into us as physicians and it is our responsibility to give back every day.

If you weren’t a doctor, what would you like to be doing?

I would probably be a teacher. In college I volunteered as a teaching assistant for introductory general and organic chemistry classes. I really enjoyed learning the material myself, and it was fun to share some of that excitement with new students every semester. It was a gratifying experience to go into the big lecture halls and provide additional help to students.

Medicine is a lot like that too, which is why I chose this career. But if I weren’t a doctor, I may very well have been teaching chemistry.