On PVCs, think anew but think slowly

Premature ventricular complexes (PVCs) remain a common and vexing problem in cardiology. PVCs deserve attention because they often induce fear in both patient and doctor. In US healthcare, fear is bad. Fear sets the stage for over-treatment. The approach to the funny-looking beats has not changed much in the last two decades. That may be […]

Should you get a cardiac stress test?

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Heart disease remains the leading killer of humans. People want to be protected. The fast-thinking notion is early detection is good, the more knowledge, the better. I wish it were that easy. What follows is my most recent post on WebMD on the basics of cardiac stress testing: **** A middle-aged surgeon recently asked me […]

Avoiding a bad death requires preparation

If there was a hashtag for sub-specialty healthcare and ICU medicine in the United States it would be: #WeCanButShouldWe A recent study led by Dr. Harlan Krumholz (Yale University) showed that we have become more efficient at keeping elders alive. This is not surprising. And it’s good news in the sense that technology–if used wisely–can […]

The PCSK9 Drugs — Epic success or epic failure?

This week, an FDA advisory committee recommended approval for the potent cholesterol-lowering drugs, evolocumab and alirocumab. The funny-sounding medications are called PCSK-9 inhibitor drugs. (Keep reading; I’ll tell you more.) Advisory committee members felt the benefits of the drugs outweighed the potential risks, especially in high-risk patients, such as those with Familial Hypercholesterolemia (FH). The […]

Writing update: Lown Institute Conference and ACC2015

Lown Institute Core Values

Hi all, I have been busy in the last few weeks. Here is an update of my happenings and posts. From March 8-11, I attended and presented at the third annual Lown Institute Conference in San Diego. I have never felt more at home in a conference than I did at the Lown conference. Take […]

A scary new medical intervention…

This is a story about a new medical intervention. It’s an important story because it affects all doctors—and therefore all patients. 1. It’s expensive. Of course. 2. There is no credible evidence that it works. But its marketing is aggressive. 3. The overwhelming majority of physicians disapprove of it. 4. Cheaper alternatives exist. 5. The […]

The year in Cardiology 2014 — a top-10 list

When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]

Opposition to ABIM — A tipping point for physicians?

Dr Wes Blog

I know physicians. They are smart, hard-working and prideful. They do a lot of good in this world. But one thing we have been utterly incapable of doing is organizing together and speaking as one voice. The American Board of Internal Medicine may have changed that. The hubris, overreach, and tone-deafness of ABIM may have […]

Where is Cardiology in 2014? An AHA Review

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Last week, I attended the American Heart Association (AHA) 2014 Scientific Sessions in Chicago. I was there as both a learner and physician-writer for theHeart.org. Here are a few paragraphs on the meeting. The main purpose of this post is to introduce the five editorials I wrote. The links to the posts are at the […]

Staying Alive — Start The Heart Foundation taking off in Louisville

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My friend and colleague William Dillon (@wmdillon) is an interventional cardiologist. He and his wife Sally have started a non-profit foundation called Start the Heart Foundation. Their goal is to improve survival of patients who suffer cardiac arrest in Louisville Kentucky. The odds of surviving cardiac arrest here in Louisville are dismal: more than 90% […]

Sudden death and a common antibiotic

The longer I practice medicine, the more nervous I get about medications, especially when patients are already on other drugs for chronic diseases. I much prefer deprescribing. A recent study on the common antibiotic cotrimoxazole, which is a combination of sulfamethoxazole and trimethoprim, and often referred to by its brand name, Bactrim or Septra, lends […]