Introduction to My Internship

               Starting last week I began my internship with Dr. Lee Goldberg. Dr. Goldberg is a cardiologist in Tucson, and I have been shadowing him as he conducts his daily activities. In this time I have seen him diagnose patients with severely occluded arteries in the legs and the LAD coronary artery. I have also observed a very interesting case study where a patient, according to their EKG, had a complete heart block. The puzzling part of this predicament was that the patient was completely asymptomatic. The patient later received a pacemaker, and is recovering very well.

                 I also observed many procedures in my internship. I have seen two Stress Echo tests in office, as well as two angiogram procedures at TMC. These stress echo tests are used to see if the patient has a blockage in the heart. If the patient's myocardium is squeezing efficiently after exercise, then Dr. Goldberg can have a 90% certainty that the patient does not have a severe coronary blockage. In the angiogram procedures (cardiac catheterization) I observed, I saw a catheter being inserted through a blood vessel in the groin. Using fiber optic imaging, I saw the catheter being fed up to the coronary arteries in the heart to identify any blockages the patient might have. I am really excited to observe a stenting case this Friday on a patient's superficial femoral artery.

                For my independent research I have studied coronary artery disease (CAD) in-depth, while focusing my research on its symptoms and treatment options. I have also spent a lot of time researching medical vernacular in order to fully understand the procedures I am witnessing. I have also studied the Fick oxygen method when calculating cardiac output, because I observed this being used in the angiogram procedure. I will further research how cardiac output is diminished by a weak heart muscle, a moderately severe to severe leaky valve, or a severe case of CAD by patients who have had heart attacks. Therefore I will draw correlations between cardiac output and the need for bypass surgery in the coronary arteries of patients who have had previous heart attacks.