Category: Elective summary

I was fortunate to spend my elective in Dunedin, New Zealand, at the Otago Vascular Diagnostics department.

They offered me a three week placement where I was able to enhance upon my existing ultrasound technique and had the opportunity to watch numerous vascular interventional procedures. I was also able to spend time in multidisciplinary clinics, with the diabetic foot team and with the dialysis team. At the weekends I explored New Zealand’s South Island going skiing in Wanaka and whale watching in Kaikoura before making my way up through the North Island on route home.

My aim was to see how different healthcare science disciplines interact in patient care.

I saw patients with cystic fibrosis and familial hypercholesterolaemia (a genetic lipid disorder) at the Royal Brompton hospital at clinics and followed their samples in the biochemistry, microbiology and genetics departments for diagnosis and management. Using the contacts I made, I conducted a clinical audit into whether patients with suggestive biochemistry, symptoms and family history of familial hypercholesterolaemia were referred for genetic screening.

This has had a practical outcome by changing how high cholesterol results are communicated to clinicians to improve referral rates.

Optimising the timings of an implanted cardiac device’s (e.g. pacemaker’s) electrical pulse between the top and bottom heart chambers using information from a simple heart scan can improve the health of patients born with structurally normal hearts. There have been no prospective studies indicating whether this is beneficial in adult congenital heart disease (ACHD) patients.

In our study, ACHD patients will undergo device optimisation and a series of tests to evaluate heart function and exercise capacity. The tests will be repeated 8 weeks later to determine the effect of device optimisation on their health. This will indicate whether personalised device optimisation is advantageous in this unique patient group and may inform future clinical care for ACHD patients with devices.