Sunday, October 26, 2008

Dobutamine Stress ECHO (We Call It DSE for short)


I may confuse all of you again with some of the medical terms in this entry but don't worry , i will make easy for you to understand....yeah and this entry is not about makan makan but an entry which requires skill and your experienced interpretation.

You probably read our Dr. Shah's blog regarding his Exercise Stress Test (EST) which requires one to walk in different stages and the ECG tracings will then show wether the test renders a positive or negative outcome. Similarly, DSE (Dobutamine) stress ECHO is a functional study whereby we resort it to people who has inconclusive EST or patients who basically cannot run for example they have knee problems or neurological problems and etc. Dobutamine infusion helps to increase your heart rate to mimic the exercise actually..and even we inject bolus of Atropine if the target heart rate is not achieved. In addition, during the test, we observe the ECG tracings and the Echocardiography (Heart Ultrasound) to see any wall proportionate augmentation. We need to take heart moving pictures during baseline, low dose, peak dose and resting/ recovery period and it usually takes about 30 to 45 minutes per patient. My interpretation has to be certified by my consultant first before i report it on paper.

DSE helps to diagnose/suggest coronary artery disease (yeah..angiogram still a golden method), viability study before deciding bypass is a good option in severe heart disease with poor heart contractily or either a vessel has added benefit for angioplasty (coronary stenting)

Picture above : i was doing DSE for a diagnostic purpose....CAN YOU GUESS THE MACHINE PRICE ????(clue : very expensive !! ha ha ha)

Talking about sub-cardiology specialties : we branch into ; EPS study , cardio imaging (eg . cardiac MRI, MSCT), Peripherals, non-interventional, heart failure and etc.... And insyaAllah...my interest will be in heart failure therapy whereby one has to deal with chronic heart failure management, ICD's, heart and lung transplant options ...etc ..and i think this field is very challenging and i love challenge but yeah..it is a long long way to go...

18 comments:

Inah said...

oohh..cardio specialist rupanya :)

good luck in ur field doc!!

have a great sunday :)

syukur said...

uiiiii...cepatnya Inah komen.baru ajer post entry ni...tq Inah...but i am not a specialist yet...baru jadi cardio registrar . Registrar tu maksudnya Final Year in post graduate study tapi some of professors pun tak suka term tu and they accolade us as JUNIOR SPECIALIST ! sbb kata mereka we already acquired enough skill to become full general physician.. he he he

Inah said...

junior specialist or cardio registrar..what ever it is..i know u will be one of the known cardiologist in Malaysia

insyaAllah :)

masa tu jgn buat2 x kenal inah pulek :D

CAHAYA said...

is passive exercise safe?

budleee said...

ooh i know how much the price is. price of a mercedes e class perhaps, or a porche cayenne.

maybe that is a bit to much, perhaps the price of a new honda accord 3.5 V6?

:D

nice job, although i do hope i don't have to see you in your office for treatment doc syuk :D

syukur said...

Inah :
Amin...berkat doa doa kawan kawan..TQ Inah for believing in me...ada one of my friend dah bayangkan I will be the Head of
IJN....ha ha very ambitious !


Cahaya :
Are u asking about the Test ??? If it is about the test...yeah we encountered patient who developed heart attack during the test and even some life-threatening irregular heart beat (cardiac Arrthymia)

Budlee :
Ha ha ha your guess is below the actual cost Budd...Wrong answer ..please try again !! ha ha

Ms B said...

i echo inah! *smiles*

As long as we believe in ourselves, we'll get there. It wont be an easy journey but once we get there, sweet success.

G luck syuk!

ps: London is very depressing today. Grey skies everywhere!!!

syukur said...

Ms B , thanks....yup we have to gain our own belief and do what we want in life....of course sometimes things we planned may not be successful....but with the courage and determination, everyone has something to achieve in their life.

Wahidah said...

wow...Junior Cardiologist...amazing...future Head of IJN ?? who knows one fien day nanti rite...hehehe...anyway...best of luck.....u will when u believe

Catz said...

hem..saya membaca entry ini dgn sgt lambat sekali..hiks..jenuh nak memaham segala termnya..
rasanya u akan jadi cardio specialist yg terkenal nanti doc.

as said...

ok la tu syuks. kau jadi boss ijn. aku jadi bos kat sarawak heart centre jadi laaa...

wahdi said...

Sungguh bergaya Doc ni menjalankan tugas ;)

Ms B said...

syuk,

I have moved. the new add: the-mocha-lover.blogspot.com

btw, it's a beautiful day in London, despite it is freezing cold.

hv a lovely day! Smell the roses along the way.

syukur said...

Wahidah :
Tu cakap orang ajer...tetapi besar tanggungjawab tu kalau jadi bos besar IJN ..they go to work as 6 to 7 am and back home after 10 pm ONLY !!! Can you imagine..You have to sacrifice your life, time and your moments with your loved ones !!

Catz :
ha haha i jadi celebrity cardiologist boleh tak ?? he he


As ;
Yup ..ataupun aku join kau kat Sarawak Cardiology Centre boleh tak ??

Wahdi :
Oooo yer ker...pasal tu la kot my boss semua pass all the Datin's patient to me...he he he

Ms B :
Nice one...smell the roses..hey any empty job for a Malaysian doctor like me??...i wanna migrate ..ha ha ha

syukur said...

Wahidah :
Tu cakap orang ajer...tetapi besar tanggungjawab tu kalau jadi bos besar IJN ..they go to work as 6 to 7 am and back home after 10 pm ONLY !!! Can you imagine..You have to sacrifice your life, time and your moments with your loved ones !!

Catz :
ha haha i jadi celebrity cardiologist boleh tak ?? he he


As ;
Yup ..ataupun aku join kau kat Sarawak Cardiology Centre boleh tak ??

Wahdi :
Oooo yer ker...pasal tu la kot my boss semua pass all the Datin's patient to me...he he he

Ms B :
Nice one...smell the roses..hey any empty job for a Malaysian doctor like me??...i wanna migrate ..ha ha ha

PUTUBAMBU said...

walaupun aku tak paham..tapi buat2 paham gak ni..

all the best to you doc...!

** bertambah glamer le doc. kita lepas ni yek? hehehe..

alhaqimi said...

~~menarik nyer, mcm baca jurnal medical laks~~ :P

Faisal Admar said...

ah i wanna buy this machine and put it at home. so that i don't need to do exercise anymore! haha.

just kidding. i love sports a lot! :)