Interventional stethoscopy

[Strength&Speed]

Interventional stethoscopy is a new and upcoming modality that many cardiologists are now using. Anybody know how hard it is to match? What is the job outlook looking like?

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[redzz]

Interventional stethoscopy is a new and upcoming modality that many cardiologists are now using. Anybody know how hard it is to match? What is the job outlook looking like?

At my institution I've had the privilege to work with the grandfather of interventional stethoscopy. He wrote the book on and pioneered such procedures as the percutaneous stethoscoplasty as well as more invasive techniques like open-heart stethoscoping. He basically gave me the impression that the sky is the limit for this field. Of course as it's popularity rises, the 3 year fellowship required to master it is becoming more and more difficult to enter.

 

[Trifling Jester]

Interventional stethoscopy is a new and upcoming modality that many cardiologists are now using. Anybody know how hard it is to match? What is the job outlook looking like?

Interventional stethoscopy was pioneered by Dr. Allan Schwartz, the Seymour Milstein and Harold Ames Hatch Professor of Clinical Medicine at Columbia University. It was initially heralded as the most significant breakthrough in the field of cardiovascular disease since the advent of percutaneous sphygmomanometry. However, an unfortunate set of circumstances would soon derail a once promising field.

One patient, Deborah Peel, was admitted to the cardiology service and prepped to undergo interventional stethoscopy without complications. However, post-procedure she developed atrial fibrillation devolving into more and more frequent premature ventricular contractions and eventually ventricular fibrillation resulting in death. These arrhythmias were linked to interventional stethoscopy by medical malpractice attorney John Edwards Esq., when he channelled the voice of Ms. Peel's bundle of his in the courtroom. The jury was convinced, and now all patients undergoing stethoscopy must be pre-opped with the most stringent set of criteria.

Consents are obtained in triplicate prior to any actual stethoscopy being performed. Patients must be warned against bleeding, infection, death, and, of course, arrhythmias. Failure to consent before actual stethoscopy has resulted in the revocation of several medical licenses.

First all patients are prepped and draped in sterile fashion, and the anterior surface of the patient's sternum is coated with a penetrating lidocaine solution that not only anesthetizes the skin surface, but also acts to prophylax against any arrythmic activity during the procedure.

After stethoscopy the patient is monitored on telemetry for at least 24 hours to guard against any resultant adverse effects. Patients also require followup monitoring at 3 and 6 month intervals after the procedure.

The costs associated with performing stethoscopy has resulted in a demonstrable decline in the number of procedures being performed. Many cardiologists now instead opt for the less dangerous echocardiography.

So, to answer your question, the job outlook is bleak but matching is fairly easy.

Sincerely,
The Trifling Jester

 

[Strength&Speed]

I dont know about for the other practicing cardiologists, but for percutaneous sphygmomanometry I like to do a cut-down with 1-2 inch incision and then bluntly dissect down to the artery. Then you get the tiniest cuff you can find (sterile) and wind it around the desired artery...leaving the trailing edge with the balloon outside, so you can listen for Korotkoff sounds. MUCH more accurate readings, and I don't have to worry about bulky and inaccurate external sphygmomanometry. Plus, the reimbursement for external sphygmomanometry is crap.

 

[deleted87716]

I have found the Magna Fortis Epicardia VsT plus H Diaphragm to be the optimal instrument for interventional stethoscopy.

For best results, position the pointed tip of the diaphram in the intercostal space and press firmly until you make contact with the anterior wall of the left ventricle.

You'll never hear clearer heart sounds. Truly amazing.

I usually do this under conscious sedation using Versed and Fentanyl. Sometimes, I even give some to the patient.

 

[redzz]

I have found the Magna Fortis Epicardia VsT plus H Diaphragm to be the optimal instrument for interventional stethoscopy.

For best results, position the pointed tip of the diaphram in the intercostal space and press firmly until you make contact with the anterior wall of the left ventricle.

You'll never hear clearer heart sounds. Truly amazing.

I usually do this under conscious sedation using Versed and Fentanyl. Sometimes, I even give some to the patient.