I noticed the obvious absence
of a "crash cart" in his examination room.
Crash carts are used in the event of a medical emergency
like a heart attack. They carry life saving equipment
such as cardiac monitors and defibrillators,
cardiac drugs including epinephrine and lidocaine, IV
solutions, nitroglycerine and various tubes for performing
airway intubation. These are basic tools needed to
save a life during a cardiac arrest. When I asked the
doctor where the crash cart was, he seemed unfamiliar with
that term. After I explained to him what it was, he
told me that his office was not equipped with that piece of
When asked what would happen
if someone had a heart attack while doing a stress test, he
said, "I would call the paramedics." Well in my
opinion, given the slow response time of of Costa Rican
ambulances, you might as well call a friggin' priest because
you are going to need to administer LAST RIGHTS!
For me, that level of care is
a huge red light indicator telling me that this guy is NOT
going to be my long term cardiologist.
As for the test, it appeared
thorough. Was it sufficient to determine the
likelihood of a cardiac incident? Not in my opinion. A
nuclear stress test is a much better determinant because it
measures blood profusion from the heart. This is a
much better (initial) indicator than just looking at an EKG
or an echo cardiogram.
But the price I paid was
great, considering what we received. For both the Echo
Cardiogram and the Stress Test EKG, our total cost was only
$220 each. This would have been thousands of
dollars back in the States. However, with the advent
of the new CIMA hospital opening near me, there will
inevitably be more qualified and better equipped doctors
from which to choose.