I had a patient who has undergone coronary angiogram. His test revealed three-vessel disease with the right coronary artery totally occluded.
It was a pretty smooth shift for me. Benign patients whose only problems are fever. When the supervisor on duty made his rounds, I do not know if he was just annoyed by me butting in with his conversation with the charge nurse, but learning about the result of my patient’s coronary angiogram, he began asking me what I need to watch out for my patients with that diagnosis. I told him the usual, risk for bleeding at the puncture site, chest pain and elevated blood pressure. His poker face did not give me a hint whether I satisfied his query but he told me that since the right coronary artery is occluded, I should watch for bradycardia or the decrease in heartbeat. Sinus atrial node, the primary pacemaker of the heart is locate at the right atrium where the right coronary is occluded, as such having that occlusion, the SA node may not be able to fire at normal range which is from 60-100 beat per minute.
I am really thankful for having probing mentors. They give me the opportunity to think and learn at the same time.