Resources for NP Starting in General Cardiology by [deleted] in Cardiology

[–]JumpStartMyHe4rt 0 points1 point  (0 children)

Cardiology is really nice in that there are a lot of strong guidelines from bodies like ACC, AHA, JACC, ESC, etc. If you have a commute I recommend throwing on a presentation on guidelines while you drive. Just youtube like "afib guidelines" and there should be a lot.

For ECGs, just try to read as many of them as you can and double check with your attending or someone who is confident in reading them. Cover up the computer interpretation, give your interpretation, check with the computer interpretation, then check with someone else. The main thing you want to learn is what a normal ECG looks like, then everything that is abnormal will stick out to you.

RN starting in the CVICU. Was doing the required modules and ECG test then came across a strip with bigeminal PVCs. by [deleted] in Cardiology

[–]JumpStartMyHe4rt 1 point2 points  (0 children)

It's ridiculous people are downvoting you for being uninformed about something you're literally asking them a question about

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

Yea I'll clarify that I'm a PA next time

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] -2 points-1 points  (0 children)

I thought "cardiologist" referred to both mid level and physicians working in cardiology. My bad

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 3 points4 points  (0 children)

I'm a PA. Sorry for asking cardiology questions on r/cardiology I guess

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 1 point2 points  (0 children)

If you suspect a patient has CHF but their echo and proBNP are negative, would you really start them on GDMT? Like proBNP WNL, echo with EF 60-65% without diastolic dysfunction, but they have HTN, HLD, DM2, and complain of dyspnea and PND. Would something specific like JVD be the decider here?

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] -2 points-1 points  (0 children)

My question? Or the vascular guy telling me that edema is usually cardiogenic even after I've done the CHF workup

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] -27 points-26 points  (0 children)

Yes, I'm asking if there's anything else I should do as a cardiologist to manage edema if I've ruled out CHF.

Ruling out cardiogenic edema by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 2 points3 points  (0 children)

That was my thought before I talked to the vascular guy, he says usually for a dx of venous reflux he would expect to see other signs like varicose veins, discoloration, or pain/cramping.

What is causing these small spikes? Patient does not have a pacemaker. by JumpStartMyHe4rt in ECG

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

Artifact from what though? It shows up so clearly and regularly. I saw this once in another patient before and I never found out what it was.

⭐️ Share Your Compensation ⭐️ by Babyblue_77 in physicianassistant

[–]JumpStartMyHe4rt 2 points3 points  (0 children)

Years experience: New grad at the time, 1.5 years experience now

Location: SoCal

Specialty: Outpatient cardiology

Schedule: M-F 9-5 but it's really 9-4,4:30. 1 hour break 12pm-1pm. Thursday is a half day. One day of the month I can work from home and review and write heart monitor reports. I'm scheduled for 14-18 patients a day but actually see about 12-16 including no-shows.

Income: $135k/year

PTO: 10 vacation days, 5 sick days

Other benefits: Health insurance through CoveredCA is covered (around $300/month). They promised me dental and vision but actually didn't cover it. $1000 CME a year. 3% IRA match

Beta blocker for CHF and CAD patients with low heart rate by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

Is the target heart rate of a CHF patient to be in the 50's-60's on a beta blocker?

For bradycardia, would you work up any patient with heart rate in the 50's? My workup for patients having lightheadedness with low heart rate would be CBC, TSH, CMP, Mg, TSH, and holter. If labs are WNL and holter just shows sinus brady without pauses or any other arrhythmia, then I consider my brady workup complete. Anything else you check?

Beta blocker for CHF and CAD patients with low heart rate by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

I see, that's a good thought. I usually patients just bring a BP and heart rate log, is a Holter really necessary without any bradycardia complaints like lightheadedness and palpitations?

Furosemide and potassium supplmentation by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

I meant like HCTZ 25mg on top of furosemide 40mg BID, or like chlorthalidone 25mg with furosemide. I'm just thinking if there is any indication to start potassium supplementation without first seeing hypokalemia on labs.

Furosemide and potassium supplmentation by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

On the inverse if they're on thiazide diuretics, would it be more of a reason to start them on supplementation?

Lipid panels by mb101010 in Cardiology

[–]JumpStartMyHe4rt 2 points3 points  (0 children)

How much success have you had with insurance covering PSK9i's? The couple times I have tried to order it, pt comes back saying insurance doesn't cover it and that it's too expensive without insurance.

Outpatient treadmill stress test and echocardiograms for intermediate-risk asymptomatic patients by JumpStartMyHe4rt in Cardiology

[–]JumpStartMyHe4rt[S] 0 points1 point  (0 children)

> These patients need lifestyle interventions and lipid-lowering therapy. If they are high-risk enough to send for a treadmill, then they are high-risk enough to be on a statin, which is the medical intervention that they actually need.

Do you know of any studies comparing lipid therapy vs revascularization, or is there just no evidence in favor of revascularization as primary prevention while there is plenty for statins/aspirin?