Day 2

The Head of Department of Cardiology was on leave so I was passed to another cardiologist. I went for ward rounds with the Consultant(Dr Yew), Cardiologist(Dr Khiew), MOs and HOs plus one new friend who is from Royal College of Surgeons Ireland (RCSI).

After ward round, I went back to CCU and basically I stayed there for the rest of the day.

Most memorable patients:

Patient 1: Indian male with MI with subsequent episodes of AF and VT.

Patient 2: Native male with 3rd degree heart block. He was sent for pacing wire procedure later in the morning. I got to read his ECG and was able to pick out the abnormality- there weres P waves seen but there was no QRS complex.

Patient3: Chinese male with heart failure due to graft blocked. Patient had 2 open heart surgery for 2 CABGs. One of the CABGs was blocked, causing his heart to fail, renal shutdown as a consequence and pulmonary edema. He was put on peritoneal dialysis. I witnessed how femoral vein catheter was inserted.

What I learnt:

When doing incision for any procedure involving the area of the groin, remember not to do it above the inguinal ligament. As the inferior epigastric artery is nearby, if punctured will cause hematoma which will bleed into the peritoneal cavity unnoticed.

Please know the antibiotics well!

What I revised:

Anatomy relations of femoral nerve, femoral artery, femoral vein and femoral canal (lateral to medial).

External iliac artery gives off the inferior epigastric artery.