job shadow: CARDIOLOGY

A morning with an on-call cardiologist can be as variable and exciting as the days the emergency department has graciously prepared me for. Here’s how I spent my morning:

I started the day chatting with Dr. G’s nurse about the schedule, procedures, and variability in patient cases in cardiology. After Dr. G, an interventional cardiologist, had finished rounding for the morning, I joined him to see his first and only clinic patient of the day. The individual had a new onset of shoulder pain when beginning a new exercise regimen, and after both a negative EKG and stress test, was cleared. Dr. G did an exceptional job of explaining everything to his patient, reaffirmed by the genuine “thank you” and kind words he received. This was an excellent reminder of the clinician I aspire to be.

After finishing up with the sole clinic patient of the day, Dr. G and I headed to the cardiac catheterization (cath) lab. Dr. G was on call, but simultaneously had two scheduled angiograms to rule out occlusions.

The first procedure, I observed from the station with the cath lab techs and nurses who explained the procedure to me. I quickly realized how brief the procedure was (only about 15 minutes start to finish), and then reviewed the pictures with Dr. G. It was negative, but very interesting to watch the contrast flowing through the coronary arteries!

The second procedure, another angiogram, Dr. G invited me in the cath lab. I donned surgical scrubs, gowned and gloved (and masked), and wore lead to prevent radiation exposure. This time, I was able to see Dr. G thread the radial artery and inject dye through and into the heart. Unlike the previous angiogram I saw, there was notable blockage and Dr. G concluded that the patient would need either triple or quadruple bypass surgery rather than cardiac stents.

The photo depicts an image similar to what I had seen on the left.

angiogram.png
coronary angiogram – A: before cardiac catheterization (notable blockage) B – after cardiac catheterization; occlusion notably improved **not my image** (see below for image credit)

After talking to Dr. G about conscious sedation, he explained that he uses Versed and fentanyl and only the smallest amounts to start, because it isn’t necessary to completely sedate the patients during the procedure. He explained that he can always increase the dosage if the patient is uncomfortable.

Lastly, Dr. G got a page from the internal medicine doctor for a patient on the floor. This too, presented a learning opportunity for me – I listened to abnormal breath sounds and heard a heart murmur for the first time.


A few things that drew me in:

  • the opportunity to educate patients about their health and how to make lifestyle changes.
  • the near-instantaneously relief that interventional cardiology provides in such a small, minimally invasive procedures.
  • the high-acuity and helping sick, sick individuals recover.

 


Three takeaways: 

  1. Interventional cardiology is more reactive rather than proactive.
  2. Educating the patient is probably the most effective way to not only achieve greater patient satisfaction, but will also increase the probability that the patient will be motivated to make changes. 
  3. The correlation between heart disease and diabetes is notably strong. 

Shadowing physicians and being in the hospital, especially at the beginning of a long semester reminds me why I still choose medicine every day. The opportunity to spend an entire day with the gift of having the ability to improve someone’s quality of life sounds like a career I still hope to have.

455BB269-617E-4101-9B9B-9CDD06C95B2C.JPG
I look like a surgeon.

For my guide to having a positive shadowing experience in the hospital yourself, click here!

Thanks for reading!

xx,

M

 

**Image credit: https://www.researchgate.net/figure/Coronary-angiogram-A-Total-occlusion-of-the-mid-RCA-and-70-narrowing-of-proximal-RCA_6875106_fig2

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s