New Cardiomyopathy

This should be obvious, but anyone with a newly diagnosed cardiomyopathy (low ejection fraction) should have a cardiac cath. This should be one of the first steps along with other things as well, such as a good history and TSH.
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Why are we all so attached to our Stethoscopes?

I recently lost an old stethoscope and found myself a bit sad. Interesting feeling to have about something old and outdated, but none-the-less, I found myself looking feverishly around the hospital for this stethoscope which I had since medical school. I think that might have been it, having it so long, I guess I was attached to it and that is why I felt like I lost something of value. There are better ones out now and most likely I need to update anyway.

We have to learn to let go of thing that we lose. No sense it being sad about something that is lost, I had come to that realization…

I found it the next day and it felt great!

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Test 123
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Jupiter Trial

What a joke. Roughly 100 people need to treat at 2 years to prevent 1 MI. So they extrapolate the data to 5 years and state the NNT is 25?

The cost at 2 years to prevent 1 MI. Let's see, 4 dollars a day, 100 people, 400 dollars a day for 2 years is a grand total of 285000 dollars!!

Not to mention the increase in DM.
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Interventional and EP - when to apply??

EP: you can apply at the end of your second/beginning of your third year.

Interventional: is a pain. Some programs go through ERAS and most do not, so you will have 2 waves of applications. The first will be in the middle of your second year through ERAS (I still have nightmares from my residency and fellowship applications), then rest will be paper applications at the end of your second year. So be prepared for 2 waves of letters or recommendation requests to your attendings. There is not a great place for information on all these programs, I will try to put something on this blog soon.

Right Sided EKG for Inferior MI?

How many times have you been asked to get right sided EKG for an inferior MI? I am sure many, but I think it is complete waste of time and at best, a mental exercise. It makes does not make any difference in management or treatment modalities. More than likely, you will manage based on symptoms and not what the EKG shows, so why waste time? If the patient is hypotensive, then you will give fluids, if not, you won't and you are off to the cath lab. So next time you get asked about the right sided leads, stand up for yourself and ask why?