General Cardiology and Internal Medicine

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.  And people are complicated.  There are nearly always other medical issues that are pertinent to the rhythm problem.  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.  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.  Too much exercise, however, increases inflammation.

Also, my wife of twenty years is a palliative care specialist.  We talk about cases a lot.   At the heart of palliative care is patient-centered care.  What are a patient’s goals of care?  Cardiologists rarely speak this language.  I had thought, mistakenly, that recommending hospice for a patient was the same as stopping treatment.  Now, I know that hospice and palliative care is simply a different kind of treatment.  This knowledge helps me, both as a person and a doctor.  Wait, that’s the same.

When I write about non-rhythm-related medical topics I will label them General Cardiology or General Medicine. These have included past posts on: