Matters of the Heart

You know it's been a long week when you nearly cry tears of joy upon finding an old, dusty Hershey's Kiss in the bottom of your work desk drawer. Chocolate!! This is what happens when you go away to a fabulous tropical locale for a week. Any small interruption from the clinic routine is pure excitement. But in other news, update on my young women with severe heart disease: 1. 40 something year old woman with rheumatic heart disease (that I came across upon routine "well woman" exam), atrial fibrillation with rapid ventricular rate (and the largest left atrium ever seen by the echo tech), and CHF symtpoms: After multiple cards and cards surgery consults with multiple second opinions (to be summed up like this, "Yes! Your heart is crazy sick. Get thee to the OR stat, do not pass go!") she is having surgery this month. I saw her this week for the complaints of upper respiratory infection and irregular periods. Internal monologue: "Woman. Let's prioritize. Let's take care of your heart first, then tackle the next few problems after you heal, 'kay?" 2. 30 something year old woman newly pregnant, with known large atrial septal defect that should have been repaired many moons ago: After I sent her stat to see cardiology and high risk OB, the consensus (with a fascinating/horrifying dscription of cardiac physiology of pregnancy given her defect and pulmonary hypertension) is actually that carrying a pregnancy to term would be very likely fatal to mom and baby. She, as a result, had a termination of pregnancy.