A ^Retired Plastic Surgeon's Notebook

Seattle Plastic Surgeon is happy to be ACLS certified.

This week I saw a post operative patient in my office who happened to mention that her heart was racing and she felt a little weird.  I took a listen and indeed her heart was racing – about twice the normal heart rate!  

Given her excellent health, her middle aged female status and the fact that she is a bit of a stress and caffeine junkie (it takes one to know one), I made the diagnosis of paroxysmal atrial tachycardia also know affectionately as PAT. 

Then I had her do some things that are sometimes effective in breaking an episode of this abnormal heart rhythm.  I had her massage her carotid artery and bear down, like she was pushing out a baby.  And, thankfully, it worked.  She reverted into a normal rhythm and no longer felt weird.   She’s scheduled to see a cardiologist who can recommend further workup or treatment.

These things do not happen often in a plastic surgery office but when they do, I am so thankful that I take the time and effort to remain ACLS certified.  The ACLS classes require me to review the various protocols for cardiac problems and lately, also problems with stroke.  Treatment for some problems have remained the same since I took my first ACLS class in medical school over 25 years ago but treatment for many, many other problems seem to change every time I take a refresher course. 

One thing that always stays the same is the increase in my heart rate when I am taking one of the several in person and in real time tests managing simulated patients with an abnormal heart rhythm.    It is those simulated tests that allow me to “keep calm, think on my feet, and carry on”. 

I’m due to recertifiy this March and am looking forward to spending the better part of a weekend reviewing the stuff I know and learning the stuff I don’t.  I rarely put  this knowledge to work but when I listen to a patient’s heart and they are clipping along at 140 beats per minute, I’m glad it’s there when I need it. 

Thanks for reading!  Dr. Lisa Lynn Sowder

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