- Do 64slice MDCT in all patients who has a coronary event and follow it up with catheter based CAG.
- Use liberally the new biochemical marker , serum B-naturetic peptide (BNP) to diagnose cardiac failure in lieu of basal auscultation.
- Advice cardiac resynchronisation therapy in all patients who are in class 4 cardiac failure with a wide qrs complex .
- As it is may be considered a crime to administer empirical heparin, do ventilation perfusion scan in all cases with suspected pulmonary embolism.
- Do serial CPK MB and troponin levels in all patients with well established STEMI .
- Open up all occluded coronary arteries irrespective of symptoms and muscle viability.
- Consider ablation of pulmonary veins as an initial strategy in patients with recurrent idiopathic AF. If it is not feasible atleast occlude their left atrial appendage with watch man device.
- Never tell your patients the truths about the diet , exercise & lifestyle modification (That can cure most of the early hypertension) . Instead encourage the use of newest ARBs or even try direct renin antoagonists to treat all those patients in stage 1 hypertension.
- Avoid regular heparin in acute coronary syndromes as it is a disgrace to use it in today’s world. Replace all prescription of heparin with enoxaparine or still better , fondaparinux whenever possible.
- Finally never discharge a heftily insured patient until he completes all the cardiology investigations that are available in your hospital .
Coming soon : 10 more ways to increase cost of cardiology care . . .beyond common man’s reach
Dr.S.Venkatesan MD 