The case involved a 70 year-old man with an eight year-old medical device. He suffered the abrupt onset of chest pain and shortness of breath. His ECG is here: Click to enlarge The Answer: First, the ‘medical device’ is an eight year-old Medtronic dual chamber pacemaker. Second, as was correctly stated, the ECG shows a […]
Author: Dr John
“Be the bike.” “Picture the win.” “Visualize success.” In maximizing one’s chance of success in sports (or any of life’s endeavors) such axioms are the conventional wisdom. At least, it is what I have read, been coached on, and overheard from those in the know. But is such optimism the only path to success? Is […]
A first for me: a clinical quiz. The patient has had seventy birthdays. He presents with shortness of breath and constant chest pressure. These symptoms began abruptly 24 hours before presenting. He describes feeling “dreadful.” Past history is remarkable for an implanted device 8 years ago. A thorough physical exam is… you guessed it…normal. Here […]
I have heard this for years, “Doc, that stuff is rat poison!” But only lately have I heard this, “Doctor M, that company who can’t talk about their drug brought lunch again today.” Well, it is finally here (well almost), the first warfarin substitute, dabigatran. Sine antiquity, or at least it seems that long, the blood […]
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A Doctor’s Touch
How important is a doctor’s skill in the physical examination of a patient? To the lay person, a doctor’s examination might seem really important. “Of course it is, Dr M…Come on.” But is it so? Or, perhaps, is the examination a charade, a show, a necessity to complete the medical record. It turns out […]
As if we need more evidence that schools should bring back daily gym class. Researchers at the University of Illinois studied 9-10 year-old children with MRIs (no radiation exposure), VO2 treadmill testing, and memory evaluations. Their findings should spank those in the educational elite who give regular gym class only lip service. “Dr M, you […]
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Middle-age…
“It was the best of times, it was the worst of times…” An intermission, the curtain has closed on youth, but the next act awaits. Caring for hiccups of the heart, like atrial fibrillation for example, often throws me in front of the mirror, of middle-age that is, and sadly the reflections show imperfections. Since […]
Dear Cyclists (or other endurance athletes), Since your heart—a muscle, like any other muscle in your body—is at the crux of cycling performance, I thought a story on a common heart condition might be helpful. The story involves a common cardiac condition called “tachycardia-mediated cardiomyopathy.” Now hold on a minute; don’t click away yet. Let […]
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The solution that isn’t…
I am trying to get off the topic, of fatness, that is. But just when it seems right to move on, to something less hopeless; we hear that even doctors can be felled by obesity’s resilience. To the Physicians Committee for Responsible Medicine, a group of well-meaning doctors who are buying expensive TV ads blaming McDonalds […]
Do you see anything wrong with this picture? (Hint: right column) It is certainly true that atrial fibrillation management guidelines needed an update; the last comprehensive update was in 2006. Much has changed in AF therapy, including the expanded role of catheter ablation and the soon-to-be warfarin substitutes. I guess the European electrophysiologists couldn’t wait […]
I have witnessed this grocery-store checkout phenomenon countless times. Haven’t you? These two paragraphs are a direct quote from the blog, 33 Charts, authored by the very famous blogger, professor, and pediatrician (Dr Bryan Vartabedian)… “So I’m in the checkout line at the grocery store. In front of me is an overweight mother and child. […]