I kicked off 4th year with an elective in cardiology. I have absolutely loved it! I started out in the general consult service where I go and see patients that teams need help in management. The aspect of cardiology that I love the most is that fact that a lot of it makes sense if you understand the principles of heart function. If you have a decent understanding of cardiac physiology, understanding congestive heart failure becomes a little easier and management makes intuitive sense. EKGs make sense if you understand the physics behind how they work. For example, if you have an idea of what the normal electrical vectors are for the heart, you can understand why the electrical signals on the EKG appear they way they do in certain leads. Then, by extension, EKG changes make a bit more sense for disease processes like left ventricular hypertrophy. Don’t get me wrong, there is still a chunk of cardiology that requires memorization (like the cancers), but a significant proportion is intuitive once you understand the principles!
I also enjoy the evidence-based aspects of cardiology. There are weekly journal clubs with the cardiac doctors and fellows. A fellow picks a paper that is relevant to clinical practice and presents it to the team. The paper starts a discussion about the validity of the results and whether the results should be implemented. If you’ve read any of my other posts, you can clearly tell why I’m enjoying cardiology!