Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease. Let’s be clear and honest: Lifestyle-related disease is largely unnecessary. These days, there is so much unnecessary disease that caregivers, especially cardiologists, rarely see it. We look past the obesity right to the cholesterol number and ECG. And then we pull out the prescription pad for the guideline-directed pills. Just typing that causes me angst. A man gets referred for AF ablation for symptomatic AF. Indeed he has many AF episodes. But he also drinks alcohol excessively, weighs 300 pounds, and refuses to wear his sleep apnea mask. You refuse to do a $100,000 procedure and soon the reputation arrives: you are too conservative an ablationist. Mandrola won’t do procedures. My interventional cardiology colleagues have it much worse. They are roused from sleep and family time to rush in and save people from mostly unnecessary heart attacks (MIs). One way to see the chorus of emergency PCI (percutaneous coronary intervention) treatment of acute MI is with awe. Another is with utter frustration–because in most cases it was unnecessary. The study: A recent population-based prospective study of Swedish men suggested almost four of five MI...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs