Friday, June 25, 2010

Week 2 -- Mitch Cooper

Week two was an interesting week for me. I started my first week of rotating through all of the services in the radiology department. This week I was based in Nuclear Cardiology with Dr. Frank Wong and his Fellows Helena and Hasan. Nuclear Cardiology is particularly interesting to me, because it is close to my research topic of myocardial perfusion with MRI. Nuclear cardiology though looks at cardiac perfusion through using a radio-isotope tracer that is injected through intervenously and then imaged using a SPECT machine (i.e. gamma camera). To see perfusion two sets of images are taken -- one set before exercise when the patient is at rest. The other set is taken after the patient runs on a treadmill until their peak heart rate (220-age) is achieved, they are then injected with a tracer, and imaged later. The advantage over stress MRI, is that 1. the patient is doing real stress, where symptoms can be re-created with a doctor present, and 2. there is not a need to have the patient be stressed during imaging. In some cases though, as with in-patients, they do need to artificially stress the heart using drugs like adenosine, lexascan, or dobutamine. These can be problematic though for patients with COPD/asthma, since bronchiospasms can occur.

I also found it very interesting to watch the doctors communicate with patients. The doctors have great skill in being able to sympathize with the patient, and make an instant connection with them. This skill is very important in situations such as with the stress test, because it is important for the doctor to be able to push the patient to keep exercising to maintain peak heart rate. I never had realized before the skill that doctors have in relating to the patients, and how important it is to patient care and treatment.

Experiencing nuclear cardiology this week was very useful. Next week I hope to go on to watch echo-cardiograms, then hopefully cardiac characterization the following week. I find this very useful for my future research. Since I research cardiac MRI, it is very helpful to see what other modalities are out there, what they are used for, and what their advantages/disadvantages are compared to MRI.

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