The dangers of being an Invasive Cardiologist

Sent in by Cyril Ernest

I must confess to you that although being a Cardiologist was a prestigious assignment,
the position was fraught with many dangers that could be encountered out of the blue when you would least expect it. In my life as an invasive Cardiologist I have been fortunate to have been able to survive many ordeals and save my skin so to speak.

One of the scariest encounters I experienced was when I did a routine coronary angiogram on a young lady in her 40’s,  a heavy smoker with chest pain suggestive of angina - several years ago. Everything went off well in the early part of the test. However, when I engaged the right coronary artery, she started having PVC’s. Initially it was not considered a dangerous feature, but these occurred unrelentingly and the rhythm deteriorated into v.tach and v.fib. The patient was shocked several times without any response. Code blue was called and I decided to inject dye into the RCA to take a look at the status of the artery. To my dismay the artery had completely blocked in a vaso spastic state. I immediately gave the patient an intracoronary bolus of nitro glycerine hoping for the best. With my prayers and the intracoronary NTG, the artery opened up and the v.fib subsided and she awakened. What a relief it was. I probably died a thousand times during this encounter. She did very well subsequently and went home without any residual effects.

The next encounter I remember was of a man in his 60’s. Because of my quiet and unhurried demeanor, the new nurses who needed training were invariably assigned to me. This particular nurse with some experience made a mistake of injecting a bolus of air into the coronary artery instead of the dye by turning the stopcock of the syringe into the wrong port. Heaven helped me! The patient was in such severe pain and the ST segments went sky high on the monitor. Well , the patient was given much pain medications to no avail and we had to just wait till the coronary artery was cleared. He too made a good recovery and went home unscathed.

My next episode that I remember is that of an angry patient who attacked me - a case of me being in the wrong place at the wrong time. As always when I do rounds I visit the ICU first. On this day as I was entering the portals of the ICU there seemed to be pandemonium with a nurse being pursued by a hulk of a man at least 6ft. 2 ins tall and quite muscular. It appeared that this was a patient recovering from an overdose of opioid medication and he was angry that the nurse did not give him the medication that he demanded. He had apparently been released from the jail recently. As luck would have it, he unleashed his fury on me as I was entering the ICU. Well, I am a 2nd. Degree Black Belt in Tae Kwon Do, and I used my skills that I had learned in subduing this angry man until help in the form of Security Personnel arrived. In less than 4 seconds he was down on the ground struggling in the choke hold that I had him in. The more he struggled, the more he choked. It took a good 4 security personnel to keep him down.The nurses and other personnel who witnessed the episode were surprised that I was able to subdue this guy.

There are many other skirmishes that I have been involved in which could be discussed at a different time.