Medical profession has evolved over centuries with humble discoveries by genuine researchers in the past . As we pursued science vigorously , we looked for innovations , when innovation work ( or many times shown to work !) we jump to sky , even as some of these innovations fail and crash down to earth , many times we continue to be in the clouds . This is the fundamental problem of modern medical science . When our expectations reached unrealistic proportions , we tend to lose the common sense . Prolonging life and reducing human suffering may be the ultimate aim of the medical profession , but If we try to fight the death with science and money without application of mind , our current life may become miserable ! Thats what is happening for the majority of the population of this planet . After all , death is an essential and final component of life !
Coming to the issue of CAD , in our country , a rich gets a 4th generation drug eluting stent for a insignificant asymptomatic PDA lesion , and poor fellow with left main dies without any intervention .This is fairly acceptable to this uneven world , where a rich westerner dies due to obesity related disease and a poor African dies to malnutrition .
This article is in response to my recent experience when . . . I advised
Simple life style modification & few drugs for a patient with chronic multivessel CAD , I was made to look ordinary , inferior and funny by many of the current generation cardiologists .
Further , the term optimal medical therapy(OMT) for chronic stable angina has evoked laughter in one of the interventional cardiology conferences I attended !
It is a sorry state of affairs for the whole cardiology community , a genuine scientific fact , proven by real life experience as well, is being ridiculed.
Richard Conti tells in this excellent editorial in his journal Clinical cardiology about the issue of medical management of CAD
“Respect in clinical trials”
Click here to reach the article http://www3.interscience.wiley.com/cgi-bin/fulltext/122512853/PDFSTART
A similar study which suggested exercise could be better than PCI in the recent 2009 ESC is suffering the same fate !
What if regular exercise were as good as a stent for stable angina?
Dr.S.Venkatesan MD 
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