Your Medical Device Patient Identification Card: Don’t Leave Home Without It

Back in the 80s, American Express ran a popular series of commercials featuring the logo: “American Express: Don’t Leave home without it.” These commercials featured unnamed stars with their names imprinted on an AMEX card who touted the benefits of the card, especially for those who were frequent travelers.

For select patients, the same phrase can be applied to not leaving home without a record of your implanted medical devices including coronary artery stents, pacemakers and defibrillators.

Patients who have had stents for coronary artery blockages will be provided with a patient identification card listing the type of stent, the date of of implant, and the vessel in which the stent was placed. This information is useful for the physician who has never seen you because it can give clues to how long you should be on anti-platelet medications such as Plavix (clopidogrel). Additionally, the location of the stent will also give your doctor an idea of areas of the heart to pay extra attention to during tests such as echocardiograms or stress tests.

A sample stent card from Boston Scientific:

stent cardFor patients with a pacemaker or implantable cardioverter-defibrillator (ICD), the patient identification card will include your name, type of device, manufacture, lead information, as well as the date of implant.

A sample ICD Card from St. Jude Medical:

st jude icdEach manufacture has a machine called a programmer that is only able to check on its own brand of devices. Your patient identification card will help your doctor select the correct programmer to use. The programmer will provide valuable information such as the presence of life-threatening arrhythmias, battery life, settings, and other diagnostic information.  If many years have passed since your pacemaker or ICD was implanted and the correct programmer can’t link up with your device, it may suggest that the battery has run out and you are due for a replacement, called a generator change.

A sample programmer from St. Jude Medical:

merlin_systemThese are just some of the items that you can carry around to keep you and your doctors better informed about your cardiac history. A medical device patient identification card is just like your drivers license–don’t leave home without it.

What is angina?

Chest pain is one of the most common reasons why patients are referred to me for evaluation. There are several causes of chest pain, and one of the most concerning causes is from blockages within blood vessels that supply the heart.

corart-02

When there is a blockage, less oxygenated blood can flow to the heart tissue causing it to become ischemic. Patients with inadequate blood flow to their heart may experience chest pain that is often described as severe pressure beneath the sternum, that is worst with physical activity, and relieved with rest or nitroglycerin. This pain my spread to the jaw or arms and be associated with nausea, vomiting, and sweating. Angina is a word used to describe this type of chest pain.

angina-01

There are two types of angina: stable angina and unstable angina. Stable angina refers to symptoms that are stable over time and do not change in frequency or severity. Patients with stable angina are comfortable at rest. These patients may experience symptoms of chest discomfort at varying levels of physical activity. Chest pain occurs because the oxygen demands of heart tissues increase as it pumps harder and faster but there is insufficient blood flow due to blockages within the arteries supplying the heart. As soon as the patient rests, the heart can pump less vigorously, demand for oxygen decreases, and the pain goes away.

angina-02

Unstable angina occurs when there is new onset chest pain or an increase in frequency or severity of the chest pain. This may occur when a plaque in one of the major coronary arteries breaks off and causes clot to form around it, acutely blocking the flow of blood to the muscles of the heart and may be a precursor to a heart attack.

Images: Heart.org