What is an EKG?
EKG stands for electrocardiogram. It should probably and sometimes is abbreviated ECG, but EKG seems to have stuck as more popular.
Scientists have known for over 120 years that the heart gives off electrical currents when it beats, but it was the Dutch scientist Willem Einthoven in the early 20th century who discovered the nature of this phenomenon and who developed the electrocardiogram as a tool to …
Ready to learn more about nurses who work beyond the bedside? Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care. Amy Sellers, RN blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.
Amy has worked in the Cath Lab for about 6 months now. She previously worked in cardiovascular intensive …
Nurses who work in the cardiac catheterization lab
I find that it takes more effort for me to talk patients out of doing tests than it takes to get them to submit. It doesn’t seem like it should be that way:
I need you to undergo a test where you fast for 12 hours, show up to the hospital 3 hours before the sun comes up, strip down and slide into a breezy hospital …
Talking patients out of doing tests takes effort and time
In the real world of medicine, “great saves” are rare. Most patients that you expect to die will die, and those who experience a cardiac arrest or code rarely survive. Mr. GR is the closest I’ve seen to an exception to both of these rules, and his story illustrates the best but also the worst of what our health care system achieves.
I first met Mr. GR in the emergency room. As …
In medicine, the greatest save is not having to make a save at all
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated during a routine examination. He has a 5 pack-year cigarette smoking history but stopped 12 years ago. He has no history of hypertension, diabetes mellitus, stroke, or transient ischemic attack. He has no claudication. He is being treated for hyperlipidemia. There …
MKSAP: Healthy 68-year-old man with a cigarette smoking history
I had a patient once who wanted an exercise stress test even though he had neither symptoms nor risk factors to suggest the presence of coronary artery disease (such as chest pain with exertion). I argued vociferously against it. However, extenuating circumstances (not relevant here) prompted our mutual decision to go ahead with it anyway. To our surprise and dismay, it came …
Why doctors can’t screen patients for every disease
Omega-3 fatty acids (more properly called “n-3 fatty acids”) are a group of naturally occurring fat molecules.
They are found mainly in fish and other marine-derived oils, but some can also be extracted from plants. Omega-3′s are currently very popular, but the evidence for their usefulness isn’t so clear. A recent study failed to show any benefit in preventing dementia. A new study out …
Omega 3 fatty acids and the prevention of heart disease
by Joe F. Lau, MD and Jeffrey W. Olin, MD
Physicians who perform percutaneous endovascular procedures encounter a multitude of vascular diseases that may masquerade as obstructive atherosclerotic arterial disease. While atherosclerosis is clearly the most common condition seen, complex inflammatory, genetic or structural processes may either not be amenable to an endovascular approach or actually be harmful and thus lead to outcomes that are not …
Vascular diseases that present as obstructive atherosclerotic arterial disease
As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes “providers” to consolidate along the lines of major hospital networks this injustice will only worsen.
A decade-or-so ago when I started private practice it was obvious that referrals came to me because of my association with an established …
Fewer choices for patients with health care consolidation
by Mellanie True Hills
I have heard from thousands of atrial fibrillation patients who have shared their afib experiences with me. For so many of us, the diagnosis and treatment of afib is confusing and scary.
To improve communication between patients and their health-care providers, and ultimately, provide better care, I recently shared with doctors at the Western Atrial Fibrillation …
Improving atrial fibrillation communication between doctors and patients
American Heart Month may be officially over, but don’t let the lack of media attention fool you into thinking heart disease isn’t a critical issue.
We still need to be mindful of the fact that heart disease is the number one killer of women.
There are simple lifestyle choices you can make to help prevent you from heart disease.
I hope after reading this post you don’t just move on, but I hope …
Tips to prevent heart disease in women
by Shanti Bansal, MD
In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.
At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members …
Judicious use of complex medical procedures
I’ve played over a thousand ice hockey games in my life, but I had no idea that yesterday’s adult men’s league game in Cleveland would be the most memorable.
I grew up in Canada, three blocks from Wayne Gretzky, the greatest hockey player ever, but I wouldn’t be surprised if my game last night was more important than any game that my former neighbor played. Tonight’s game was literally a matter …
What happens when two hockey teams and a defibrillator cross paths?
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“Someone needs to take this writer out and kick his ass.”
The quote leaped out at me from a New York Times article.
Now, maybe I’m a little sensitive about using physical threats to try to silence writers, since I am a writer. Maybe I am especially sensitive about threatening to kick someone’s ass for writing about healthcare. To my eyes, the quote stood out as emblematic of the tumor …
Overuse of heart stents and the response of Abbott Labs
by Joanne Wilkinson, MD
I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.
They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on …
Dr. William Follansbee is the chairman of the American College of Cardiology/American Society of Nuclear Cardiology (ACC/ASNC) task force on non-invasive cardiac imaging and the director of nuclear cardiology at the University of Pittsburgh Medical Center Cardiovascular Institute.
He recently published an editorial in the Pittsburgh Post Gazette in which he criticized the local Blue Cross/Blue Shield carrier, Highmark, for restricting the use of nuclear cardiac stress testing in …
Restricting nuclear cardiac stress testing in favor of stress echocardiography
When I had a heart attack two years ago, I was taken immediately from the E.R. to the O.R. for emergency treatment, including cardiac catheterization and a stainless steel stent implanted in a major coronary artery that was 99% blocked. But, overwhelmed and terrified, I knew nothing about what was about to happen, even though I have a vague memory of the cardiologist explaining something to me before I was whisked …
Patients are not to blame for the miscommunication about cardiac stents
by Aditya Mattoo, MD
Not too long ago, a patient came to my clinic and said (I’m paraphrasing of course), “I never cared for alcohol, doctor, so I haven’t had much to drink since my college days. Maybe champagne or wine on the rare special occasion, but I keep hearing about how wine is good for your heart, so I am thinking I should start drinking …
Is alcohol good for me? The data behind drinking and your heart
Implantable defibrillators are truly life saving devices that have prevented sudden death in thousands of patients. No bigger than an iPod nano, the device can sense when the heart is beating irregularly and deliver an electrical jolt that kicks it back into proper rhythm. But like so many of medicine’s miracles, defibrillators are not always used on the right patients. According to a study published recently in the …
Shared decision making to determine implantable defibrillator need
A commenter (I believe a physician) on one of my posts wrote the following: “I can prevent heart attacks and strokes (caused by atherosclerosis – “blockage”) in people (minimal cost) who have no symptoms. If I wait for their heart attack or stroke – it costs a whole lot more.”
The implication is that screening and treating high cholesterol saves money in the long run. Unfortunately, the truth is the opposite. …
Does screening and treating high cholesterol save money?
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