So I attend at the local E.D. at the night shift and this kid, 19y/o, previously healthy, a student of physical education who practises moderate to hight intensity activities on a daily basis comes to the ED with epistaxis.
He tells me this is his second episode of unilateral epistaxis and has a history of rinitis and adenoid removal five years ago.
His physical is unremarkable. His BP is at 130×90.
When he had the first episode he came to the ED and a doctor here did what he had to do, screened for coagulation defects and referred to the otolaryngology as an outpatient. He did tell him about the borderline BP.
This patient then proceeds to scheduling a cardiologist because he thought his BP was high.
And he went to the worst cardiologist I can think of.
As to why I'm mad:
This kid comes today with a briefcase of exams. This cardiologist made him do:
Ergometric Stress Test.
Ambulatory blood pressure monitoring 24h
Holter test 24h
Full blood tests, including ambulatory troponin (I'm like whaaaaat?)
And not once he said anything about the main cause of unilateral epistaxis with normal coagulation tests. Not fucking once.
Why would you do so many tests on a young athlete? WTF dude?
Sorry for the rant.
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