Hey everyone. Just for context, I'm a PGY6 in cardiology. My sister, who is a 35 year old with no significant past medical history, just reached out to me confused about what was being done for her by her physicians.
She went to her PCP, and on review of symptoms, she noted she has a tendency to feel sleepy on long drives. No other daytime tiredness. STOP BANG of 0. So she got a whole slew of lab work, all negative, and got referred to a sleep clinic where they conducted an inpatient sleep study. My sister said she got a really terrible night of sleep there, and she ended up having an AHI of 5. The sleep doc prescribed a CPAP based on this…
Also during the sleep study, she had 1 episode of Mobitz 1 during sleep. This caused the sleep doc to refer her to a general cardiologist. I will remind you again that my sister is asymptomatic throughout all of this.
At the general cardiologist she got an EKG which showed 1 PAC. She got another 30 second Ekg run there in clinic with just NSR. The cardiologist then ordered a 24 hour holter, a 2 week event monitor, an echo, and an exercise stress echo.
This is when my sister called me, confused about what was happening to her. I looked at her EKG, and lab work, which is all totally benign.
Is this what is happening in the community? Useless tests for nothing in asymptomatic patients likely to generate false positives, cause worry, and increase RVUs? Or is it just some absurd form of CYA medicine? I am lucky to be able to help guide my sister through some of this nonsense, but without a health literate person in the family I'm sure that many people are taken advantage of, and it is upsetting to think about.
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