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January 15, 2005

Judging AMI
Last Tuesday's episode of "Judging Amy" featured mother Maxine's long-awaited "big one" -- during her treadmill test yet -- this should put at ease all viewers whose cardiologists want them to take a treadmill test! I had been predicting for three weeks that this story-arc would end in the cath lab, but no! Her cardiologist announced to the family that she was going to have open heart bypass surgery (CABG) instead. They had been prepping her for an angioplasty, but found that she had three narrowed arteries and "angioplasty won't work for that" -- which would be news to the patient who wrote into Angioplasty.Org just today. He had four Taxus stents inserted into three blocked arteries (100%, 80% and 70%) during his heart attack in April. He was asking that we post more "testimonials" from patients whose heart attacks were successfully treated with stents. We will, but meanwhile stay away from TV.

Emergency CABG, while certainly an appropriate treatment for Acute Myocardial Infarction (AMI) in some cases, has become less common with the advent of angioplasty/stenting, as well as thrombolytic therapy (dissolving the clots causing the heart attack). And while the writers obviously felt that bypass surgery sounded so much more dramatic, I've seen thousands of audience members glued to giant TV screens at various live angioplasty demonstration courses, waiting to see if the guide wire can negotiate the next eccentric curve in the LAD -- oh sorry -- they were all interventional cardiologists....

Speaking of which, as is often the case on TV, the medical roles in the "Judging Amy" episode merged. The same cardiologist who gave the stress test, also performed the patient's angiogram AND was scrubbed in on the open heart surgery AND was in the hospital at all hours of the night to talk to the family, with nary a nurse-educator or assistant to help. No wonder they needed Tony-nominee Kate Burton to play the multi-tasking cardiologist.

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