Heart and cardiology

1,642 articles · Since 2004

Articles, page 17

Don’t ask caregivers to be data entry clerks for the Joint Commission

June 27, 2019Jun 27, 20193

I received an email from our hospital accreditation coordinator/quality coordinator in a manner that wasn’t clear if it was directed to me personally or if it was sent to the entire medical staff. It said that she was reviewing the Joint Commission’s recent survey which found that the charts did a poor job of reflecting the patient’s “code status.” The institution only received a 40 percent rating.

Some patients were listed …

Physician voices

A lack of understanding for what physicians really do

Robert J. Wagner, MD

June 25, 2019Jun 25, 20199

I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care. The case was appealed to the qualified independent contractor, who also believed that…

I recently had the pleasure of participating in an administrative law judge (ALJ) hearing. Novitas, the Medicare administrative contractor had denied the E/M code 99291, critical care.

The case was appealed to the qualified independent contractor, who also believed that the care, in this case, did not meet the CMS and CPT definitions of critical care. Subsequently, the case was appealed to the administrative law judge. The encounter occurred in an …

Conditions and diseases

Remembering a physician, suddenly taken away

Debbie Moore-Black, RN

June 25, 2019Jun 25, 2019

Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7. Of course, they all practiced professionally with expertise. But I remembered this…

Our 20-bed ICU finally captured 10 intensivists — all board-certified in critical care medicine. We were fortunate enough to have one of these doctors in our ICU 24-7.

Of course, they all practiced professionally with expertise.

But I remembered this one the most: Dr. Jason McKenzie (name changed for privacy).

He easily became our friend and “go-to” person.

Clocking in at night and finding out that Dr. J was our doc, would give me …

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Physician voices

When medical science becomes fake news

Brian C. Joondeph, MD

June 22, 2019Jun 22, 20195

Every week there is another health pronouncement saying what is now good for you and what is going to kill you. Unfortunately, the “what” is often interchangeable -- what was supposed to kill you last week is now suddenly good…

Every week there is another health pronouncement saying what is now good for you and what is going to kill you. Unfortunately, the “what” is often interchangeable — what was supposed to kill you last week is now suddenly good for you or vice versa.

Foods, supplements, and activities, all studied extensively and determined to be either good or bad, then subject to a new study, with the opposite conclusion. How …

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When medical science becomes fake news

Physician voices

Physicians-in-training learn to cook for improved health outcomes

Joshua Rothman, MD & Tara Mataraza Desmond

June 4, 2019Jun 4, 20192

If an apple a day can keep the doctor away, how much more can a delicious burrito bowl with citrus lime vinaigrette do? About half of all American adults – 117 million -- have one or more preventable chronic diseases,…

If an apple a day can keep the doctor away, how much more can a delicious burrito bowl with citrus lime vinaigrette do?

About half of all American adults – 117 million — have one or more preventable chronic diseases, many of which are related to poor quality eating patterns and physical inactivity. According to the U.S. Office of Disease Prevention and Health Promotion, more than two-thirds of adults and nearly …

Physician voices

Physician patients shouldn’t be special

Howard Rosenfield, MD

May 24, 2019May 24, 20193

Physicians often, by virtue of their degree, have easier access to medical care. Yet the care they actually receive may be substandard. Here's why. Years ago, I broke my wrist. Visiting a local hand surgeon, I was relieved to hear…

Physicians often, by virtue of their degree, have easier access to medical care. Yet the care they actually receive may be substandard. Here’s why.

Years ago, I broke my wrist. Visiting a local hand surgeon, I was relieved to hear that surgery would not be required — wearing a cast for a few months would probably do the trick. But then the doctor, knowing that I’m a swimmer, asked if I …

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Physician patients shouldn’t be special

Conditions and diseases

Sex in the elderly is not a need. It’s a privilege.

Rada Jones, MD

May 20, 2019May 20, 20195

If you’re sexy, fit and nimble, if you can part your thighs and bend your knees, if you can see your private parts without a mirror, ignore this. Move on. This is not for you. This is for those with…

If you’re sexy, fit and nimble, if you can part your thighs and bend your knees, if you can see your private parts without a mirror, ignore this. Move on. This is not for you.

This is for those with flailing sex-drive and failing abilities whose sex life is a challenge, but they’d like to make their partners happy and have some fun. Maybe your parents or grandparents. This must be an …

Conditions and diseases

MKSAP: 44-year-old man with HIV, hypertension, and hyperlipidemia

mksap

May 18, 2019May 18, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 44-year-old man is evaluated in the office during a routine visit. Medical history is significant for HIV diagnosed at age 25 years, hypertension,…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 44-year-old man is evaluated in the office during a routine visit. Medical history is significant for HIV diagnosed at age 25 years, hypertension, and hyperlipidemia. He is a current smoker. Medications are chlorthalidone, tenofovir-emtricitabine, and raltegravir.

On physical examination, the patient is afebrile, and blood pressure is 126/74 mm …

Medical education

The benefits of compassion always outweigh its risks

Nidhi Desai

May 14, 2019May 14, 2019

It was an ordinary afternoon in my outpatient internal medicine rotation. I prepared to enter a room for a congestive heart failure hospital follow-up patient. I mentally prepared myself. I was going to ask for his hospital records (particularly looking for the echocardiogram), make sure he was started on an ACE inhibitor and a beta-blocker, and ensure he had a follow up with a cardiologist in the coming weeks. “This …

Drugs and prescribing

The new aspirin guidelines: The media does a disservice to patients

Olubadewa A. Fatunde, MD, MPH

May 13, 2019May 13, 2019

Much media attention has been paid to the new guidelines from American College of Cardiology/American Heart Association (ACC/AHA) on the primary prevention of cardiovascular disease. Based on new clinical trial data, ACC/AHA no longer recommends that healthy adults without cardiovascular disease — emphasis on without cardiovascular disease — take daily aspirin for the primary prevention of cardiovascular disease.

This change, while significant, is highly nuanced and dependent on …

Physician voices

The brutal emotional challenge of medical training

Nyembezi L. Dhliwayo, MD

May 12, 2019May 12, 2019

I can vividly remember the day the phone call came. My cousin screaming over the phone, trying to make out words but unable to speak, disbelief, horror, the fear in her voice palpable even though she was thousands of miles away. It was barely 5:30 a.m., I was frantically rushing out to beat traffic, hoping to get a head start on pre rounding since I was on call. Confused, I …

Conditions and diseases

It’s time we approach heart failure like cancer

Brian Lima, MD

May 10, 2019May 10, 2019

“I’m sorry, Mr. Smith. Your heart is very sick, and your body has irreversible damage. It’s too dangerous to attempt a transplant or implant a heart pump. There’s nothing more we can do.” I’ve encountered this scenario more often than…

“I’m sorry, Mr. Smith. Your heart is very sick, and your body has irreversible damage. It’s too dangerous to attempt a transplant or implant a heart pump. There’s nothing more we can do.”

I’ve encountered this scenario more often than I care to admit as a cardiac surgeon that treats advanced heart failure. Tragically, many of these patients present long after being followed closely by their referring providers—“I’ve been seeing Mr. …

Medical education

I’m sorry that we couldn’t save you

Evan Schauer

May 5, 2019May 5, 2019

Five days into my emergency medicine clerkship, I had experienced a lot of firsts: My first participation in a code, my first CPR compressions, and my first patient death. This was specifically a code blue for a patient with pulseless…

An elderly woman was brought in by her family after not feeling well for several days and quickly became unresponsive. As the room flooded with staff, my upper-level resident …

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I’m sorry that we couldn’t save you

Conditions and diseases

Many diseases represent an arbitrary number

Edward Hoffer, MD

May 4, 2019May 4, 20197

A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.” As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to…

A wag once said: “There is no such thing as a healthy person, just one who has not had enough tests.”

As we make every minor deviation from the average into a disease, that jest is becoming uncomfortably close to the way our current medical system behaves.

Part of the problem is that many diseases represent an arbitrary cut-off of a number. Thus, hypertension is defined as a blood pressure above a …

Physician voices

How I share my creativity with others in medicine

Sherry-Ann Brown, MD, PhD

May 3, 2019May 3, 2019

The creative platform Lyrical Mezzanine (@LyricalMezz) aims to nurture resilience or resiliency in clinicians, caregivers, patients, chaplains, family members, friends, scientists, teachers, and others — and to combat burnout simultaneously. I created the platform out of a need to profoundly…

A mezzanine is usually considered a …

Conditions and diseases

MKSAP: 62-year-old woman with hypertension

mksap

April 27, 2019Apr 27, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated during a routine examination. She feels well and has no exercise limitations. Medical history is significant for hypertension treated…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 62-year-old woman is evaluated during a routine examination. She feels well and has no exercise limitations. Medical history is significant for hypertension treated with enalapril. She does not smoke. At her last examination 4 years ago, her blood pressure was 122/76 mm Hg. Laboratory studies at that time …

Conditions and diseases

We need more than medicine to prevent heart disease

Robert M. Kaplan, PhD

April 22, 2019Apr 22, 2019

Like more than half of older men, I take a cholesterol-lowering medication called a statin. Sometimes that seems a bit strange, because I don’t have high cholesterol. My doctor prescribed it based on a formula that largely hinges on age…

I’m 71 and male. Those two factors alone put me in the high-risk category for …

Conditions and diseases

As a cardiologist, I’m concerned that California isn’t very heart healthy

Heather Shenkman, MD

April 13, 2019Apr 13, 2019

California is often perceived as a state where healthy habits abound — with a yoga studio on every block and kale salads on every plate. Unfortunately, I know in my daily practice as a cardiologist that this is far from…

As a cardiologist, I’m especially concerned that California isn’t very heart healthy: Just like …

Physician voices

What do we do when guidelines come crashing into the real world?

Fred N. Pelzman, MD

April 8, 2019Apr 8, 2019

Every day, as we care for our patients, we are placed in a unique position, where we are armed with the world of literature, randomized controlled trials, society recommendations, national screening and practice guidelines, and more, working to prompt us…

And patients come to us armed …

Conditions and diseases

MKSAP: 52-year-old woman with shortness of breath

mksap

April 6, 2019Apr 6, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman is evaluated during a follow-up visit. She was discharged from the hospital 3 weeks ago following a small non–ST-elevation myocardial infarction…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 52-year-old woman is evaluated during a follow-up visit. She was discharged from the hospital 3 weeks ago following a small non–ST-elevation myocardial infarction treated with drug-eluting stent placement in the right coronary artery. An echocardiogram obtained during hospitalization showed normal left ventricular function and normal valvular function. Her …

Heart and cardiology

Articles, page 17

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