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What are YOU providers doing to us poor civilians?

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Wife got home yesterday and relayed some information to me regarding a co-worker who had sx. palpitations end of last week necessitating ED evaluation.  Apparent "frequent PVCs" on ECG, which by history sounded like quadrigeminy.  She was sent home and told to see her PCP regarding concern for cardiac ischemia.  We stayed in touch with her over the weekend to make sure she was ok, though she has a paramedic boyfriend live-in who actually did a 12 lead on her as a walk-in at his station last Friday while he was on duty.

Here is my concern.  She sees PCP yesterday who says he suspects it's her thyroid replacement medication and says that the dosing needs to be cut back...without checking of lab.   No baseline values.  WTH are they teaching you young 'uns in school present day?  Maybe it was the airline pilot in his 30's that I saw that had CM with development of VT followed by a piss pour response to his heart transplant which resulted in death back around '90 that makes me extra cautious with these folks.

In my case, thyroid profile and a stress/echo (key word here is ECHO) are a minimum for this patient.  Oh, and a FH of early CVD in a patient who is in her late 40's/50ish.

Edited by GetMeOuttaThisMess
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my work up shooting from limited clinical info


long visit to discuss what happened

review ER notes and findings

EKG and rhythm strip for a few min with valsalva

Holter for at least a week - ordered through my office no cards

labs - kidney, cbc, lft, TSH, mag, lipids, FBS, urine

ECHO if here anything on exam

stress maybe if lipids awful, smoker, FMH, prior history

close follow up


if no contraindications start low dose beta met suc 25-50mg a day, asa 81 - to be revisited as work up proceeds



yeah no where on this green earth would I do what the doc did, nope nada

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