Episode Chapters
- Meds in Pregnancy12:55Peripartum Cardiomyopathy18:48Paper Chase #1 - Opioid Overdose when Prescribed to Family Members6:10Common Outpatient Dental Problems15:11Paper Chase #2 - Sleep and Subclinical Atherosclerosis7:18Cardiac Surgery Pre-Op Part 1Free Chapter25:37Paper Chase #3 - CRP to Guide Abx for COPD Exacerbations7:11TIDBSI: Dysuria in Men14:19Cardiac Surgery Pre-Op Part 29:40Paper Chase #4 - Safety Net Hospitals in Maryland's All-Payer Program5:55Post-Contrast AKI: A Nephrology Perspective24:13Benign Ethnic Neutropenia15:04Paper Chase #5 - Short vs Long Term DAPT in PCI Patients8:58Transitioning from Peds to Adult Providers20:18Mailbag11:02
Primary Care RAP November 2019 Written Summary 1 MB - PDF
Ian L., Dr - November 2, 2019 3:50 PM
For a patient with a calculated high risk of a coronary event within five years defined as the range 3%-6% a year for 5 years wishing to do a gym programme which is rarely “moderate “ exercise I would want a patients to have a stress heart test and if over 50 a anatomical view of the coronary vessels by MRI or low radiation dose computed coronary angiogram .
At the the minimum you are obligated to discuss this with your patient before signing the ok to go to gym form .
So I agree with Dr Simmons a diabetic male aged 60 diabetics of 10 years duration who has smoked for thirty years one 20 packet per day of cigarettes would never be given permission for a private gym programme without comprehensive cardio logical evaluation .
Ian L., Dr - November 3, 2019 8:05 PM
Further to this the Duke Calculator which measures type of pain and risk factors recommends ecg stress test (could be any type )for male and female 60 year old diabetics who smoke .
Based on CCTA one artery showing 70% stenosis .
Flow of blood through the stenosis can be measured on exercise .
Ought help safety of gym exercise programme I believe .