"Do you just do EKGs, or do you read EKGs?"
"Do you know what PVCs are?"
"Premature ventricular contractions -- or sometimes people say complexes. They're early beats originating from ventricles, the bottom chambers of your heart"
"Are they really bad? I went to the emergency department and they said I had PVCs," says the clerk.
"Usually they're not a very big deal unless you're having a ton of them. It's not uncommon for healthy people to have a few.."
"Hang on a sec.."
She then proceeds to pull out her cell phone and show me a picture that she took of her EKG. I'm amazed that she actually took a picture of a chunk of her EKG. I have no idea how she would have been able to do that.
"Yup. That's a PVC," I confirm.
"They told me that I might have already had a heart attack and that I'll need to have an echo and see a cardiologist."
I look at the EKG again. Only a few leads are visible, but my eyes settle on Q-waves.
"Sometimes people can have 'silent heart attacks' without even knowing it. You'll probably need to have more testing to figure out what's going on."
She toys with her cell phone for a few seconds, and shows it to me again. This time she brings up a video clip of her heart monitor in the ED. It shows ventricular bigeminy.
She tells me that her family has a cardiac history, that she's overweight (obese), that she's only in her thirties, and that she's scared. We talk for a few more minutes, about different kinds of cardiac testing, her cardiologist, and that she's working to change her lifestyle.
This entire situation was bizarre for me. I've never had a stranger stop and question me like this. Is this what happens to doctors?
And what about the whole cell phone thing? I don't know about you, but it makes me sort of uneasy. I am all for keeping patients informed, but it seems like there's a high likelihood of the patient misunderstanding these data. And from a medicolegal standpoint, it seems sketchy.