Thursday, July 02, 2009

Cardiologist? An open letter to a young friend


I heard you're headed for the cardiologist. Your mom sounds kinda excited about all that, but I wanted to tell you about some cardiac tests I've experienced. First is the basic EKG or electro-cardiogram. Why EKG? I dunno. 'cause of Greek (καρδια?) or German maybe? Anyway you lie on a table and they connect a bunch of suction cups to your body -- the wikipedia link above has a picture showing approximate locations. Wires go from those electrodes to an electronic instrument. They might wipe your skin where they stick those on, to make sure the suction cups will stay there.

Then they'll want you to lie still and think peaceful thoughts, while they chart the electrical impulses that activate your heart muscles. It is quite a complicated problem to estimate what's going on electrically in your heart muscles, when all you have to go on is what you can read from electrical impulses at the surface of your skin. But for the patient it's a simple test; you just lie there while they attach electrodes, and think peaceful thoughts.

Anyway, the EKG is not invasive; nothing goes below your skin. They thought my heart was strange electrically after my EKG, so they had me do a stress EKG, or what I call the treadmill test, which also is not invasive. The setup with the electrodes is the same, but they have you run on a treadmill. At first the treadmill is easy -- like walking. But then they increase the tilt and the speed. The whole time you're walking, jogging, running on the treadmill they're monitoring your heart. When you're just about pooped you signal them and they slow the machine down gradually (so you don't run off it).

I took the treadmill test, and they studied that and said my heart was funny-looking electrically. They wanted me to do a stress echo test. That's like the treadmill test, but just at the point where I wanted to quit running, they put one of these ultrasound gadgets on my chest and took movies of it. There was this cold gel on the end of the instrument, an ultrasonic transducer actually. They studied that and decided my heart was funny-looking.

Bottom line, I do not have a cardiac problem. But my heart is funny-looking both electrically and in ultrasound.

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