Cardiology

Evidence-based medicine and bias: the truth about common therapies and clinical trials

Conditions
May 7, 2023

Evidence-based medicine is a term that attendings like to pepper into their teaching rounds, and medical students like to conspicuously incorporate into their assessment and plan. There is so much clinical trial data out there that it is impossible to stay up to date on the most recent guidelines or the newest landmark trial that all of our time goes into scrutinizing the results. However, we rarely delve into the …

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Binary medicine harms our gender-expansive patients

Policy
April 24, 2023

The first time I saw a preceptor use the American College of Cardiology’s atherosclerotic cardiovascular disease (mercifully, ASCVD) risk calculator, I was hooked. As a first-year medical student, data nerd, and aspiring primary care provider, I love a good diagnostic tool. Watching as he entered our patient’s pertinent medical history, I ran down the list of risk factors for cardiovascular disease we’d just learned in my …

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How the NFL could have boosted CPR awareness

Physician
April 22, 2023

January 2nd was a rough day for the sports world. People were captivated by the on-field “death” of a player. Players, coaches, fans, and staff were stunned by seeing cardiopulmonary resuscitation (CPR) in real-time, maybe even for the first time. Thankfully the NFL had excellently trained teams on the sidelines prepared for these emergencies. Chest compressions were started in seconds, and spontaneous circulation returned in less than ten minutes. Damar …

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An anesthesiologist’s story: Going beyond the protocol to save a life

Physician
April 15, 2023

I was waiting for my son at the ice rink in one of Chicago’s northern suburbs. Hundreds of people had gathered to watch the Illinois State Championship games. A parent, who knew I was an anesthesiologist, grabbed me by the elbow and said, “Hey, Doc, someone in the lobby is not feeling well.”

I went to the lobby, where I saw my firefighter friend performing chest compressions (CPR) on an older …

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How do we reduce hypertension in Black Americans?

Conditions
April 8, 2023

Nearly half of all Americans have high blood pressure, but hypertension disproportionately affects Black Americans, with 56 percent of this population affected. The disparity is especially stark for stage II hypertension, which affects 42.1 percent of Black Americans compared with 28.7 percent of white Americans. “In the United States, at any decade of life, blacks have a higher prevalence of hypertension than that of …

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The dark side of immortality: What if we could live forever?

Physician
March 24, 2023

I sat in a lecture hall at Baylor College of Medicine many years ago. It was noon, and though October had bought some respite from Houston’s heat and humidity, the air-conditioned room was still very inviting. To top it, there was lunch. The lunch came with a rider — sitting through Grand Rounds — and I welcomed the occasion to get off my feet for the next hour. With the …

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Breaking down the broken medical system: a physician’s eye-opening experience with patient neglect

Physician
February 24, 2023

I am asking my fellow medical professionals to give a sincere show of hands: How many of you are terrified of your fate should you become the patient?

The prospect of navigating the medical system as a patient should strike fear in your heart, especially if you cannot advocate for yourself (although the system will also make that next to impossible).

The current medical/hospital system of care in the United States has …

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Saving lives, one heart at a time: the fight against women’s heart disease

Conditions
February 23, 2023

Heart disease is the leading cause of death for women in the United States. According to the Centers for Disease Control and Prevention, heart disease killed 314,186 women in 2021. This means that approximately one out of every five female deaths was due to heart disease, with the worst mortality burden on African American women.

It is abundantly clear that we are not where we need to be in terms of …

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Why patients choose who they trust: Understanding the psychology of health care relationships

Physician
February 18, 2023

Most people, should they be in need of a transcatheter aortic “valve-in-valve” replacement procedure for a failed aortic valve replacement, would be delighted to have one of the world’s foremost experts (who has performed over 6,000 of these procedures at one of the world’s foremost heart hospitals) perform the procedure.

But not my father, despite having dyspnea on mild exertion owing to a trans-valvular gradient of 50 mmHg.

Naturally, he wanted a …

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Doctors and dating: the challenges of balancing a demanding career and personal life

Physician
February 10, 2023

The word “career” has two meanings. A career in medicine fulfills both meanings quite neatly. In the traditional sense, it can be defined as an occupation undertaken for a significant period of a person’s life. On the other hand, it can mean moving swiftly and in an uncontrolled way. As in, “Her car careered across the road and into a ditch.”

Being a physician is a blur of late nights, cold …

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A cardiac arrest is a tragedy. Multiple cardiac arrests are a moral injury.

Physician
February 2, 2023

On January 2, 2023, Buffalo Bills Safety Damar Hamlin collapsed secondary to cardiac arrest on live television, horrifying millions of Americans. We saw broadcasters, fans, players, and reporters crying on live TV as they watched the psychological trauma of a resuscitation. “No one should ever have to witness this” was a common refrain during the broadcast. For that one night, America was privy to what thousands of health care workers …

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Life, death, and the balance in between: a cardiac anesthesiologist’s story [PODCAST]

Podcast
January 26, 2023
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

David Alfery is a cardiac anesthesiologist who shares his experiences in the operating room and intensive care unit. In this discussion, he reflects on the lessons he learned about life, death, and the balance in between through …

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Why sharing your complete medical history with your clinicians is important

Physician
January 24, 2023

It’s your first visit to a cardiologist because you’ve had occasional episodes of an irregular heartbeat. As you fill out your pre-appointment paperwork, you carefully list the symptoms you’re experiencing and the treatments your primary care physician has recommended before referring you to a specialist. You don’t mention that you recently started taking Lexapro (escitalopram) to treat depression because you’re focused on your heart issue.

But that accidentally omitted information could …

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How minimizing treatment burden can help patients with chronic conditions

Physician
January 23, 2023

An older patient recently told me that she spent 80 days over the past year in a doctor’s office. This represented over 20 percent of her life. She was relatively well but had several chronic medical conditions that required frequent office visits. In addition to these visits, she navigated scheduling, prescriptions, laboratory testing, and copayments.

Her experience is not unusual. For example, among patients with diabetes (a common chronic medical condition), …

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Saying goodbye: the tragic impact of COVID-19 on families

Physician
January 17, 2023

“No, no, no! I’m having a nightmare!” She shrieked through the phone. I couldn’t bear to hear it as words fell clumsily out of my mouth. “Your husband couldn’t breathe on his own. We had to put him on a ventilator. I’m so sorry.”

I was apologizing already. I’m sure she knew that it wasn’t a good sign when a physician opened with an apology. “What does that mean?” she stuttered. …

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The urgent need for widespread CPR and AED access

Conditions
January 9, 2023

Damar Hamlin, Buffalo Bills safety, collapsed on the field during the Monday Night NFL game against the Cincinnati Bengals with nearly six minutes left in the first quarter. The incident rattled sports fans and left everyone emotionally distraught. The game was postponed and subsequently canceled. CPR (cardiopulmonary resuscitation) and AED (automated external defibrillator) were used as part of resuscitation efforts. It is gratifying to hear the good news that Hamlin …

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The reality of CPR: a powerful tool with serious consequences

Conditions
January 8, 2023

The shocking scene that unfolded during the Bills-Bengals game Monday evening was a play that I’ve seen countless times on a very different stage. Yet as a hospital physician, watching Damar Hamlin’s on-field cardiac arrest was unexpectedly jarring. Seeing the coordinated and professional medical response on the field was inspiring. No doubt, timely and effective CPR and defibrillation saved his life. As I reflect on the events of that evening, …

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The emotional side of CPR: Reflecting on the challenges of resuscitation in the wake of Damar Hamlin’s collapse

Conditions
January 5, 2023

First, I want to extend my thoughts, wishes, and prayers to Damar Hamlin, his family, and his teammates. Seeing his collapse on television stirred many emotions in me; I can’t imagine what those who were on the field or in the stadium experienced.

As a pediatric emergency physician, I can tell you that anything related to cardiopulmonary resuscitation (CPR) is difficult. America got a real glimpse of the horrors of CPR …

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Tragedy strikes Monday Night Football as Buffalo Bills safety Damar Hamlin suffers cardiac arrest. Is commotio cordis to blame?

KevinMD
January 3, 2023

A shocking scene during the Monday night football game between the Buffalo Bills and Cincinnati Bengals. According to the New York Times:

During a Monday Night Football game, Buffalo Bills safety Damar Hamlin tackled Cincinnati Bengals receiver Tee Higgins. After the tackle, Hamlin quickly stood up and took a few steps before collapsing and becoming unconscious. Medical personnel administered CPR and attended to Hamlin for 10 minutes before …

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The duality of being a female physician

Physician
December 10, 2022

I am a female cardiologist that graduated from medical school almost 20 years ago. Although my core personality has remained constant, I have been viewed through multiple different optics. What I find most interesting is that while most of my patients would unanimously agree that I am a smart, talented, and dedicated professional, I have never achieved this level of validation from other professionals in medicine.

I stay the same, but …

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