Automating the Heart of Cardiology - iCardio.ai

What if an echocardiogram could read itself?

Our latest episode features Joseph Sokol and Roman Sandler, the co-founders and CEO/CTO of iCardio.ai, a startup on a mission to fully automate echocardiograms from acquisition to diagnosis, transforming the most widely used exam in cardiology.

Joseph's inspiration came from watching physicians lose hours to manual echo interpretation at a national ultrasound company. When Roman joined in late 2021, bringing deep expertise in computer vision and deep learning honed in defense and neuroprosthetics, what started as a basement science project became a serious company. Today, iCardio.ai operates with just 11 full-time employees and two FDA clearances.

Their flagship product, EchoMeasure, automates over 60 core echocardiographic measurements, reducing sonographer fatigue and diagnostic variability by integrating directly into existing PACS workflows. Their second product, CardioVision, screens for aortic stenosis using only a standard B-mode ultrasound image, making it viable for handheld devices in upstream settings and creating perfectly aligned economic incentives across patients, hospitals, and device manufacturers.

The founders share hard-won lessons on navigating FDA bureaucracy, the "bitter lesson" that saving doctors time alone doesn't drive hospital purchasing decisions, and why the most durable healthtech businesses are built around solutions that justify their own reimbursement.

Looking ahead, iCardio.ai is expanding into mitral and tricuspid regurgitation detection, developing an AI system for intracardiac echo in partnership with Abbott, and pushing toward a fully autonomous "self-driving" echo.

This episode is a must-listen for anyone interested in AI-powered diagnostics, cardiovascular innovation, or building FDA-cleared healthtech companies from the ground up.