Pain in the heart

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Question: For 3 months now I’ve been having health issues.It started with mild pain in the middle of the breastbone and when after a few days I had constant palpitations.When to the doctor,had an ECG, the results came back fine.Also had a 24hr heart monitor, the results was fine again. Since the palpitations has settled but the pain is still …

Stenting in other arteries

Dr. T Other 3 Comments

I just learned about a snag. Somebody commented after completion of one of the questionnaires on my website:  “my step sister has multiple stents in the femoral arteries in the legs and is currently experiencing great pain in the leg again. The ultrasound shows the stent is intact and working properly.” This website is of course about coronary artery, not …

Point-Counter Point

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Two new articles, published in the July edition of Clinical Research in Cardiology, provide a point-counter point perspective by cardiac surgeons and cardiologists. In them, the proponents used the SYNTAX trial to argue their points. Not surprisingly, the authors reached opposite conclusions. Now, how is that possible? In “Patients should be operated!” Reichenspurner and colleagues argue that “…clinical trials, both …

A patient with Coronary Artery Disease

Dr. T Cardiac Risks 1 Comment

I thought to post a recent evaluation of a patient who contacted me for consultation: Mrs. XYZ, DOB: 1955 57 years old White Female, with low level Angina and progressive loss of exercise tolerance (fatigue, “can’t do much anymore”). (A significant factor in her care may well have included no health insurance, even though she rendered full payments at the …

Unnecessary Procedures

Several recent articles, published earlier on this website, discussed the  excessive use of cardiac catherization and stenting in the evaluation and treatment of coronary artery disease. Despite guidelines, issued repeatedly by the American Heart Association for evaluation of patients suspected to have heart disease, it is not uncommon for these to be ignored. A recent article published by Patel et …

Unnecessary procedures

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In a study, published on-line in the journal Circulation on April 13, 2010, cardiologists were asked under what circumstances they would order a cardiac catheterization. 29% of physicians ordered the test for other than clinical reasons, foremost amongst them malpractice concerns. About 25% of the doctors ordered more tests than were necessary, driving up costs. Others did it because of …