When it comes to offering medical services, the top priority is providing care that is in the best interest of patient outcomes. Diagnostic imaging services are no exception. While Board Certified Radiologists are trained to interpret multiple modalities, cardiac imaging studies may be best interpreted by Cardiologists. These diagnostic images include Echocardiograms (ECHO), Stress ECHO, Stress Nuclear, and Multi-Gated Acquisition Scans (MUGA). Cardiologists have extensive knowledge of the cardiovascular system and cardiac diseases and can therefore offer specialized reads and recommendations for patients with cardiac issues.
Telecardiology refers to cardiac images being interpreted by Cardiologists in locations where a Cardiologist is not available on-site. These images are sent electronically using a technology called Picture Archiving and Communication System (PACS) to a Cardiologist for interpretation. The Cardiologist then transmits the findings of the study back to the imaging company and/or referring physician to follow-up with the patient and provide the appropriate care.
We recently interviewed Dr. Richard Blake, a Tele-Cardiologist with NRAD, to get his thoughts on the interpretation of cardiac imaging studies.
Q: Why did you decide to specialize in Cardiology?
Dr. Blake: In 1986 I worked for a year in Pathology. I got to go to a Clinical Cardiology Conference almost every week. I saw at the time all the new devices and technologies developing in the field. Angioplasty was very new. Thrombolytic therapy was new. Helicoptering patients to a tertiary center was brand new. There was a lot of excitement in the field. Most things were not figured out. I did not commit to specialize for several more years, but that was the start of it all. I am glad I chose this area of medicine. It is still exciting.
Q: What is your favorite part about practicing in this field?
Dr. Blake: Helping people, definitely. Whether it was taking care of a heart attack patient, or helping guide the treatment of hypertension or congestive heart failure. Watching people get better and get back to their families and normal lives is a huge reward.
Q: What is the most important change you've seen in this field since you've been practicing?
Dr. Blake: Advances in the treatment of heart failure and also atrial fibrillation with not only medications, but also implantable pacemaker and monitoring devices to guide us. They do well now. When I started, it was very difficult and the outcomes were not anywhere near as good as they are today.
Q: Why is it so important that cardiologists read cardiac imaging studies?
Dr. Blake: There are a lot of different ways to image the heart. Each exam has many variables. All of these pieces provide information to diagnose, monitor, and guide clinical decisions to get better outcomes. It takes time to learn all these methods of looking into the heart. Putting these images together to provide better care to our patients is what it is all about.
Q: What information do you want patients to know about having an Echocardiogram?
Dr. Blake: Echo is an easy, painless, repeatable, non toxic, and free of radiation exam that tells us a lot about the size and shape and function of the heart muscle and valves. Different patterns of problems show up fairly predictably for different diseases of the heart. Echos can be repeated at intervals to show the patient that the problem is stable or improving as they are treated. It can help us make decisions to move toward surgery in patients with worsening valve disorders and assist with picking the best time for surgery to get the best chance of recovery. It is the modern stethoscope. Echo does not replace it, but it gives us much more reliable and repeatable data than just a stethoscope.
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