Cardiology Rotation Day 5 The finale 24-June-2011

Bor-Han and I had another day in the ultrasound room to see move echocardiograms. In the morning we followed Dr. Huang Chieh-Yuan (Dr. 黃建元). Of all the cases in the morning the most interesting was that of a patient that is a heart transplant candidate. From the echo that Dr. Huang performed it was estimated that his ejection faction was to be around 20% from multiple views. The patient also had a mitral valve anulus dilation, a tricuspid valve lesion, and a part of the left ventricle that was not contracting much at all. As the patient is also suffering from Diabetes Mellitus and is on hemodialysis, Dr. Huang suspects that the heart condition could be due to ischemic heart disease with multi-vessel involvement. He also commented that it could also be dilated cardiomyopathy, but every other cause had to excluded before that conclusion. In the afternoon we followed Dr. Fung. The highlight was a patient suffering from peripheral arterial occlusive disease (PAOD) and ischemic ulcers. Her Ankle Brachial Pressure index (ABI) was in the 0.2 - 0.3 range much under 0.5 which is a sign of severe arterial disease. After looking through her medications Dr. Fung also commented that is was not a good choice to use beta-blockers to control her hypertension as it might result in vessel spasm further worsening her PAOD. All in all it was a good week in cardiology and I learned quite a bit from the different experiences with all the preceptors.