At the core of my doctoring self, I am an internist and cardiologist–just like a heart surgeon is a surgeon, a judge a lawyer, and an electrical engineer an engineer.
Heart rhythm disorders do not occur in a vacuum, they occur in people.Â And people are complicated.Â There are nearly always other medical issues that are pertinent to the rhythm problem.Â Examples include:
- Sleep disorders are relevant to AF, so is high blood pressure, alcohol intake and about a hundred other non-rhythm problems.
- Coronary artery disease (CAD) is always relevant.
- Kidney function affects drug metabolism.
- Infections can increase the heart’s susceptibility to rhythm disturbances.
- Successful management of–not just installation of–cardiac devices mandates understanding the patient as a whole person.
My advocacy for healthy living as a means for preventing (and treating) heart disease often leads me to general cardiology and internal medicine topics. Examples include…
- The role of exercise in preventing and treating heart disease.Â And how much intensity is OK?
- What are the effects of alcohol on the heart?
- What is the real scoop on statins?
- Exercise lowers inflammation.Â Too much exercise, however, increases inflammation.
Also, my wife of twenty years is a palliative care specialist.Â We talk about cases a lot. Â At the heart of palliative care is patient-centered care.Â What are a patient’s goals of care?Â Cardiologists rarely speak this language.Â I had thought, mistakenly, that recommending hospice for a patient was the same as stopping treatment.Â Now, I know that hospice and palliative care is simply a different kind of treatment.Â This knowledge helps me, both as a person and a doctor.Â Wait, that’s the same.