Feb. 22/29 issue of the Journal of the American Medical Association showed that women have higher mortality in MI and no chest pain.
- Women more often have no chest pain with a myocardial infarction and have a greater risk of dying in hospital than men do.
- Almost 40% more women had no chest pain at diagnosis, and they had a 42% higher inhospital mortality.
- The youngest women with MI were most likely to have no chest pain and also had the highest mortality.
- Note that the disparities between men and women existed in all age groups, but the magnitude of the differences diminished with increasing age, with the youngest women with MI most likely to have no chest pain and also the highest mortality.
I did a presentation on the new AHA evidence-based guidelines for cardiovascular disease prevention in women in December. It is definitely worth a read to help guide your patients.
Fat, unfit, unmotivated: Cardiologist, heal thyself
Practice what you preach: Better physician habits, better patient care
A recent study in Vancouver, showed that cardiologists are not living, eating, and acting like the kind of physicians who can truly motivate patients to improve their own health.
Dr. McCrindle reviewed studies looking at what factors influenced the likelihood of physicians counseling their patients about healthy behaviors, diet, and weight loss, citing data showing that physicians who had better health habits themselves were more likely to counsel patients about their habits.
Similarly, physicians who exercised regularly were more likely to recommend regular exercise in their patients, and among female doctors, those who practiced a health habit themselves or were currently attempting to improve a health habit were more likely to urge a similar behavior in the patients. Other studies clearly show that patients are more likely to be receptive to counseling if their physicians are normal weight or if they are open about their own healthy habits.
If we expect our patients to make health behavior changes (e.g., exercising, eating a healthy diet, reducing salt intake, etc.) to prevent disease or prevent the progression of their chronic illnesses, than docs should also set an example.
I’m at the Tea Lounge in Park Slope studying EKGs and learning more about acute coronary syndrome, whilst enjoying the somewhat whimsical music and a crowd of assorted characters.
I’m beginning to think I love endocrinology and cardiology after just 2 weeks in this elective. I spent a week in endocrinology and really enjoyed it. Only to be followed up by one week of very intimidating cardiology which by the end of the week became less intimidating and more manageable. I’m going back to endocrine on Monday but will hopefully time-share with cardio since I’m just not ready to leave.
And for the first time since Step 1 studying overload, I really want to learn. Not just out of the sake of necessity but since I want to know everything and understand everything I am seeing everyday in the hospital. A resident told me the other day to take the most common illnesses you see and go home everyday and learn as much as you can. I am gaining an even better understanding since I can relate so much better. It’s not just a theoretical infective endocarditis patient from the books, but it’s guy in room whatever that I’ve been talking to and examining for a past couple days. It makes sense.
So despite how little time I have in the evenings to learn stuff, I really want to learn more about what I see. Even on the weekends.
"Take the world apart and figure out how it works." - Built to Spill, 1994.
