November 16, 2020 | by The Level Ex Team

Medlife Crisis Takes On Cardio Ex

What happens when a cardiologist YouTuber records himself playing Cardio Ex levels for the first time? Dr. Rohin Francis, UK-based cardiologist with a “sub-specialization in YouTube” and author of the Medlife Crisis blog, took a break from the cath lab to play Cardio Ex for his fans at their recommendation (thanks!). We’ve pulled a few of our favorite moments for your viewing pleasure. We’re not sure which is better—his angioplasties or his jokes.

The Ultimate Play Test

It’s not everyday that we wake up to an in-depth review of our games with over 70,000 views on YouTube! Even better than the surprise was the honest, funny, and unfiltered point-of-view. Technical Designer Jacob Mooney, who designed the majority of the levels in Cardio Ex, likened Francis’ rolling commentary to “putting a plug on [a player’s] forehead and just downloading all their thoughts while playing the game.” “It was really awesome to see,” he added.

But it can also be a bit nerve wracking, too. Elsa Varghese, MD and Medical Team Manager who led the medical content development for Cardio Ex, said, “It’s always the weirdest feeling when you have a certified physician, who’s an interventionalist, that will play a game that you basically built and to critique the content. I go through two emotions: I sometimes cringe, and then my other emotion is like, ‘Oh, okay, I did something pretty cool.’”

Wins & Losses

We weren’t the only ones experiencing a range of emotions throughout the gameplay. Dr. Francis had the opportunity to feel the thrill of victory…and the agony of defeat. But we could tell he was enjoying himself because, win or lose, he kept on playing. Cardio Ex levels vary in difficulty, ranging from common to complex and rare cases. Additionally, there are three types of gameplay in the most current version of Cardio Ex: diagnosis, treatment, and PCI. In our efforts to deliver the latest and most critical content to our players, we have developed a COVID-19 unit to help cardiologists recognize and treat cardiac manifestations and complications of COVID-19, as well as explore comorbidities.


There may not be victory signs flashing in the cath lab, but our gameplay recreates the thrills and challenges of practicing cardiology. Our in-house medical team consults with physician advisors to create levels that not only capture the complexities of cardiology, but also provide healthcare professionals with an engaging format to hone skills relevant to their specialties.

Elsa explains what it was like to see Dr. Francis play through one of our more challenging cases: “He sent a balloon that was a tad bit oversized, which caused a tear in the vessel, and it started bleeding, causing a dissection. So the next step, if there are multiple dissections, is to occlude the artery a little bit further up so you can try to control the bleeding at the lower parts of the artery, or you can directly go in with a covered stent, which has a thin mesh-like material that covers the metal struts of the stent. This special stent is then deployed over the dissection to stop the bleeding. There were scenarios where he used both of them. It was really fun to watch how he approached such a complex case.”

Patients of All Weather Conditions

Visual and audio effects create a big impact, but players don’t always notice them right away. We were delighted to see Dr. Francis highlight them—even if he did poke fun at our “snow.” Jacob says “Visual effects are like that. I would bet most people notice the level is blue and there’s snow in it, but they don’t notice that it gets heavier as you get to harder levels. It was really gratifying to see him pick up on all the more subtle elements that probably most people don’t consciously pick up on. But even if they don’t ‘see’ it, they still feel it.”

Same goes for sound. Our in-house audio engineer, Jeff Linville, created the heart-pounding environment for every level. Jacob shares an example: “Our most difficult level, Perforation Hunt, has a heavy metal soundtrack with wailing guitars and crazy drums that Jeff did an amazing job creating. It was tons of fun to see that get input into the game. And then to watch a doctor play through it and be like “ok…[laughs].” If you’d like to hear for yourself, the soundtrack is available on Spotify.

Studio Art Director Ryan Blake explains the visual and musical progression of the PCI levels: “Easier levels only contain the heart, simple colors, and chill music. We don’t want to overwhelm the player, so we introduce them to this new visual style slowly. As they progress and tackle difficult challenges, we introduce more turbulent visual effects and increase the music intensity. We want the player to know on multiple levels that things are getting serious.”

Compliments for Cardio Ex

We consider it high praise to be called “the nerdiest game possible!” Thank you, Dr. Francis, for taking the time to play Cardio Ex. We hope a follow-up video is in the works!

Enjoyed the highlights? Here’s the full Medlife Crisis video.

And, in case you missed it, Stanford-trained doctor, entertainer, and host of The ZDoggMD Show, ZDoggMD played Cardio Ex with CEO Sam Glassenberg when the game first launched in 2019. Check it out!

If you like what you see, consider checking out our open positions!

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