Cardiology

In a whirlwind, two weeks of cardiology went by, so little time to learn an incredible amount of material. I focused primarily on practicing the cardiac exam. I got to see and hear a wide range of normal and abnormal findings, from hepato-jugular reflux to murmurs and gallops to parasternal lifts. The range of patients was diverse, from the standard heart attack (STEMI vs. NSTEMI vs. unstable angina) to common complaints like fainting or cocaine chest pain ("crackycardia") to complicated mysteries (we were transferred a patient from another hospital and the work-up showed constrictive pericarditis vs. restrictive cardiomyopathy vs. reverse Bernheim effect from tricuspid regurgitation). I got to admit and work-up a few patients, follow them through their hospital stay, and decide what tests and treatments to order. I got a little more comfortable at reading EKGs and learned about fancy things like intra-aortic balloon pumps and trans-esophageal echocardiograms. Teaching rounds covered congenital heart disease, stress testing, arrhythmias, and more.

I had a fanastic time on the rotation. The teams were small but the teaching was abundant. The service has a high turnover of patients so I was exposed to a generous amount of cases. We had CCU (cardiology ICU) patients, consults, and regular floor patients. I loved thinking through the physiology of the heart. A cardiology guru Dr. Chatterjee does amazing bedside teaching; his physical exam is unsurpassed and he is known for predicting the results of invasive tests with unbelievable accuracy (he predicted my patient's CVP, EF, and stroke volume just by exam). As a whole, I loved the analytical thinking, the strong evidence-driven medicine, the variety of diseases, tests, and interventions, and the culture of cardiology.