Editorial| Volume 35, ISSUE 10, P1263-1264, October 2019

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Notes From Cardiology Clinic: Medicine Is More Than Just Pills, Procedures, and Devices

  • Stanley Nattel
    Corresponding author: Dr Stanley Nattel, Montreal Heart Institute Research Centre, 5000 Belanger St. E., Montreal, Quebec H1T 1C8, Canada. Tel.: 514-376-3330; fax: 514-376-1355.
    Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada
    Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
    IHU Liryc and Fondation Bordeaux Université, Bordeaux, France
    Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
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Published:August 21, 2019DOI:
      How often we forget this adage in medicine. I remember when I was a cocky Straight Internal Medicine Intern functioning as the Internal Medicine Resident on Call at the dearly beloved and sadly demised Queen Elizabeth Hospital in Montreal. I admitted a patient from the emergency department to the intensive care unit in cardiogenic shock. Although his presenting symptom was constipation, I noted severe pulmonary congestion, neck veins to the angle of the jaw, sky-high liver enzymes, severe hypotension, and oliguria. I poured all my energies into taking care of him overnight, barely sleeping a wink, and brooded over him for the next few days. Approximately 1 week later, he was ready for discharge, nice and pink, neck veins down, good blood pressure, and liver enzymes normalized. I proudly told him about his imminent departure and asked him how he was feeling. How disappointed and shocked I was when he responded “I dunno doc, I still have that CONSTIPATION.” From his point of view, I had done little for his real problem.
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        • Waters D.D.
        Notes from cardiology clinic: when our responsibilities extend beyond the patient.
        Can J Cardiol. 2019; 35: 1294-1295

      Linked Article

      • Notes From Cardiology Clinic: When Our Responsibilities Extend Beyond the Patient
        Canadian Journal of CardiologyVol. 35Issue 10
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          One day, in the late 1970s, I was called to the emergency department to see a patient with chest pain. Although I had only been practicing for a couple of years, I secretly prided myself on my ability to discern cardiac from noncardiac symptoms. The patient was a gaunt-looking man in his early 60s, with sad, deep-set eyes. He reported retrosternal chest discomfort with physical activity for about 2 years, relieved by rest. The discomfort radiated down his arms and sounded like typical angina. His symptoms had worsened in the past week because of increasing anxiety and now were occurring at rest.
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