Cardiology Central

Morning report was especially good. The new chief of medicine insisted on cases being listed on the board and to have a special case presentation which would engender didactic interchange and allow the housestaff to hear from the various attendings on the matter of the moment. The
session was less like a Quaker meeting (soto voce) as it had been in the past, and more like an academic exericise.


I saw several cases, as usual pathology in the extreme. A young woman with infective endocarditis and severe mitral regurgitation was especially interesting, with large leaflet vegetations who will certainly need to be sent to South Africa for MV repair or replacement. A man with severe heart failure was existing with insufficient cardiac function to keep his blood from stagnating in the middle of his main pumping chamber, the left ventricle. His ejection fraction was 5%.
I gave the resident lecture at 4pm: my subject was non-ST elevation MI and unstable angina pectoris. I recognize that these conditions are not frequently encountered, but when they occur the housestaff must not be caught flat-footed.
It was wonderful arriving back at the flat and sitting with Barbara and Rob (still here until the weekend) and reviewing the day over Tanqueray on ice (no bourbon here). We checked in with Barbara's mother by Skype and called it a night.