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Unusual seminars in cardiology:Ten simple ways to waste cardiology resources!
August 19, 2009 by drsvenkatesan Do 64-slice MDCT in all patients who has a coronary event and follow it up with catheter based CAG. Use liberally the new biochemical marker , serum B-naturetic peptide (BNP) to diagnose cardiac failure in lieu of basal auscultation. Advice cardiac resynchronisation therapy in all patients who are in class 4 cardiac failure with a wide qrs complex . As it is may be considered a crime to administer empirical heparin, do ventilation perfusion scan in all cases with suspected pulmonary embolism. Do serial CPK MB and troponin levels in all patients with well established STEMI . Open up all occluded coronary arteries irrespective of symptoms and muscle viability. Consider ablation of pulmonary veins as an initial strategy in patients with recurrent idiopathic AF. If it is not feasible atleast occlude their left atrial appendage with watch man device. Never tell your patients the truths about the diet , exercise & lifestyle modification (That can cure most of the early hypertension) . Instead encourage the use of newest ARBs or even try direct renin antoagonists to treat all those patients in stage 1 hypertension. Avoid regular heparin in acute coronary syndromes as it is a disgrace to use it in today’s world. Replace all prescription of heparin with enoxaparine or still better , fondaparinux whenever possible. Finally never discharge a heftily insured patient until he completes all the cardiology investigations that are available in your hospital . |