DEAR DR. ROACH: It has been almost a year now that I had my physical with my general doctor, and I’m mulling over whether to return to her for this year’s physical.
I am a 73-year-old man with usually unremarkable physical exams except for low HDL. I have a history of paroxysmal atrial fibrillation, with having had two cardiac ablations, in 2005 and 2007. I still have intermittent ventricular contractions.
I am still reeling from the fact that during my last physical exam my doctor never gave me an EKG. It was only upon getting ready to conclude the exam that I had to request one. She begrudgingly said, “It’s not really needed, but if you want one …” The result was normal. What is your take on this? — J.S.
ANSWER: There is no good evidence that getting an EKG on an otherwise healthy person leads to any good outcome, and I suspect that’s why your doctor did not order it. However, you aren’t an otherwise healthy person:
You have had a cardiac ablation that has failed, presumably, since you needed a second ablation. Checking periodically to make sure you are still in normal rhythm (not atrial fibrillation) seems to be a very good idea to me.
It may be that she expected your cardiologist to do this, but if you aren’t seeing your cardiologist regularly, or they aren’t doing it, then I think it appropriate for your general doctor to check the EKG.
Communication is the key here. Explaining why you feel you need the EKG given your history is likely to lead to a more satisfying experience.
Alternatively, you should see your cardiologist to make sure your heart issues are dealt with by an expert, and leave to your general doctor the care of the rest of your body.
