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Internist, Cardiologist (heart)
18 years of experience
Accepting new patients

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Takes a 'cookbook' approach to patients show details Takes a 'cookbook' approach to patients
Oct 31st, 2013

In 2012 due to my age (54) and a family history of heart disease, my GP though it was worth sending me to a cardiologist (Dr Elizabeth Jackson) for a stress-echo. The results showed I was fine, in fact I was in great shape. I do have a mitral valve prolapse but my MR was 'mild' and my LVef was 65% (Dr Kolias read the echo-cardiogram in 2012). The results inspired me to exercise even more and when I returned to the cardiologist (Dr Jackson) for a scheduled follow up echo in September of 2013 I told her I felt great and I had improved my cardiovascular endurance over the preceding year. My own data from the heart rate monitor I wear during exercise indicated an improvement. I was biking up to 75 miles a day, I lost 8 lbs over the year, and my bench press went from 12 reps at 150 lbs to 12 reps at 205 lbs (I weight 164 lbs). Dr Jackson even said that she saw no point in me seeing her again unless I started to experience problems. However Dr Elina Yamada read the echo-cardiogram from September of 2013 and reported my LVef was now 40-45%, my MR was 'Moderate', and I had sign of mild weakening on the left side of my heart! A week later Dr Jackson referred me to a heart surgeon for possible "valve replacement" (open heart surgery) as a result, despite what I was personally reporting to her about my physical condition. After getting over the initial shock and depression, I started to question how my heart could be dramatically changing for the worse when I had no symptoms and every other indicator said I was actually improving my physical condition. It simply made no sense. I sought a second opinion from Dr David Bach (Professor, Division of Cardiovascular Medicine, at the University of Michigan) who looked at both echo-cardiograms. He told me 1. I didn't need surgery, my MR was still 'mild', my LVef was normal, and I could cancel my appointment with the surgeon. 2. My heart had changed between the 2012 and 2013 echos, but the changes he saw were consistent with an IMPROVEMENT in my cardiolvascular health. 3. My EKG from 2013 also showed changes consistent with an athletic heart. 4. If Dr Yamada's analysis were true, I would NOT be symptom free and NOT be able to exercise as vigorously as I do. Dr Jackson should have realized this as well and questioned the results rather than referring me to a surgeon. At a minimum she should have sought a second reading of the 2013 echo from another experienced cardiologist. She took a 'cookbook' approach, based on one bad echo analysis, and ignored all the evidence to the contrary and worried me and my wife needlessly.

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