Thursday, August 16, 2007

Cardiology

So I've got specialty medicine for 2 weeks and I get to choose as many or as few specialties as I want. So I decided to do 4 specialties initially (cardiology, pulmonology, neurology, gastroenterology), but now I've changed my mind and decided to do 3 instead. I spent the 1st 3 days on cardiology. I definitely get to spend a lot more time with the attending physician in specialty medicine (actually the whole time). I spend most of the time shadowing, but I also got to see what the cardiologist did. He reviews 30+ EKGs in the morning which takes him only minutes. But he pointed out certain things to look for in the abnormal ones. So I'm starting to understand EKGs a little bit better - still have a long way to go though. Then I saw a few treadmill stress tests as well as adenosine thallium stress tests (ATST) - not too exciting after you've seen them once. I also saw him do cardiac catheterizations and watched him place a stent in the RCA on the computer screen which was cool because you can see the vessel open up instantly. The patients are usually awake so that they can tell you if they are feeling chest pain. The cardiologist also reviews the echocardiograms on the computer screen which shows multiple images on different views of the heart. Those also get boring after a while because I don't understand about 90% of it. I was able to see the ventricles and aorta that he pointed out as well as blood flow across the valves, but the rest of it just gets more abstract and confusing.

On the second day in the afternoon, we went to outpatient clinic which is just in a different building in the hospital. That was fun. He told me to go see the patient and let him know what it's about afterwards. Then he wrote a prescription for her and told me to tell her to come back if she needed to. I also got to explain her diagnosis and give her some advice (after the cardiologist told me what to say, of course). I was surprised that the doctor didn't even go in to see the patient after I did. Although, her complaint was very straightforward. So I had a chance to be very independent that afternoon which I've very much enjoyed. :) I really liked outpatient medicine (but I haven't really done it much). I'll find out if I still like it next month when I'm on Family medicine rotation.

As far as heart sounds go, I'm attempting to pay more attention to it. It's one thing to hear a murmur and another to identify it as holosystolic vs crescendo-decrescendo, etc, etc.

So cardiology was a fairly short rotation and I'd probably recommend atleast 1 week of it. But I'll probably do 1 month of it in 4th year.

1 comment:

Cinnamon Bagels said...

That sounds neat. I wish we had IM specialties in 3rd year here at Ft. Worth. Whoo Hoo live it up in Corpus.