Research Assessment #1

Date: September 12, 2019

Study: Interventional Cardiology

Citation: G, Floros. “A Case of Remarkable Clinical Recovery After the Initiation of

Sacubitril/Valsartan.” Interventional Cardiology Journal, IMedPub, 2 Jan. 2019,

http://interventional-cardiology.imedpub.com/a-case-of-remarkable-clinical-recovery-

afterthe-initiation-of-sacubitrilvalsartan.php?aid=23952.

Analysis: Physicians are seen to be the wonder of the world to cure a disease or remedy an

illness in a matter of days. In the hospital one day out the same day, however this can not always

happen to everyone. This is where people can face true terror as a physician can not fix you in a

day but, runs test after test to even find a glimpse of hope that their efforts are not in vain. This

case study is a prime example of that and from that has taught me not only the reality of clinical

procedures and duration of treatment but just a minor scope of needed knowledge to pursue the

career.

Before this case study I believed that just a few days in the hospital and then you could be

dismissed for the time being before a follow up exam. However, that is not the case as in this one

particular patient it took nearly 6 weeks for even to see a change in recovery and nearly 2 more

months to have internal assistance implanted. Nevertheless, time is not the only important in the

hospital field but the terminology, those long latin and greek terms, used to describe from a

simple fracture to the complex abdominal aortic aneurysm. The case study brought to my

attention of just how little I knew about the terminology, as one unknown term after another

appeared. This however, led me to define those terms not just diseases but procedures from New

York Heart Association (NYHA) classification for heart failure or ST-segment depression or
many countless others. Finally the case study brought forth just some of the procedures that can

and sometimes must be introduced to find a path for treatment and the statistics they look for

during each test. One of the first procedures that caused a good portion of diagnosis that stood

out was cardiac auscultation which in reality just meant listening to the heart beat. Yet, for

something so simple as listening to the beat of the heart led to the discovery of mitral

regurgitation and a s3 sound and systolic murmur. What i can really take away from this case

study was the use of sacubitril and valsartan in place of normal angiotensin-converting enzyme

(ACE) inhibitors such as ramipril. This is important since in my interview questions I try and

mention the use of new medication implemented that can reduce downtime in hospitals. Where

patients just like in this case study the patient did not begin to recover until the change in drug

that was being administered, leading from 40 days on ramipril to 4 days of sacubitril and

valsartan.

All of the information not only pertains to my field of study which as mentioned, is

interventional cardiology, but also can be utilized to understand terminology and what is

occuring during mentor visit. The terminology I was required to learn just to understand the case

study is a step, a small step, but one that helps me lead to understanding physicians in hospitals

or medical clinics. During a visit if a patient presents symptoms of heart failure and is

categorized as a NYHA class 3 then, I would be able to understand the severity of the diagnosis.

It opens my eyes and the study lets me see a glimpse of what there is to learn and what to study

and pay attention for in visits, or during conversations with potential mentors. In all this case

study stands out not just for the knowledge I gained and intend on utilizing but the recognition of

advancement in medicine that has been achieved. With just a change in drugs a patient with heart

failure was able to go from a NYHA class 4 where without external oxygenation would most
likely suffocate, to a NYHA class 2 with maximum dosage of sacubitril and valsartan. Even

without maximum dosage there was a significant improvement in health within 4 days while he

had been in there for 42 days of treatment. That is absolutely spectacular and highlights what we

have achieved but, pulls into question what can we achieve now? How can we improve our

treatments to lower times and better overall? That is one thing I intend on looking for during

ISM and during mentor visits.