Cardiology Consult

For the next month, I am on the cardiology consult service at San Francisco General Hospital. Again, as a consult team, it is generally less work than being a primary cardiology service, but we get to see a variety of cases when other teams call us about potential cardiac issues. The team consists of a fellow, intern, and two medical students, and we see about one new patient a day, rounding in the afternoon. Consults commonly come from the surgery services, including surgical ICU, and so far, seem to involve either a question of chest pain or arrhythmia management. Most of the chest pain, it seems, is not cardiac in nature, but of course, patients are taken very seriously so they cycle troponins, get an EKG, and call cardiology. The most common arrhythmia question so far has involved atrial fibrillation and flutter. It's good for me to review these bread and butter topics.

Cardiology is one of the few fields that still champions the physical exam, and I hope that on this rotation, I get better with seeing jugular venous pulsations, feeling the heart, and listening to murmurs. The older attendings spend an inordinate and inspiring amount of time examining, listening, and taking care of the patient. Tests like EKGs and echocardiograms have also become staples of hospital medicine, and I hope to increase my familiarity with them in the next few weeks.

Image by Heikenwaelder Hugo, shown under Creative Commons Attribution ShareAlike 2.5, from Wikipedia.