Often in the middle of the night, a patient having discomfort in the chest calls a family physician. On arrival, after eliciting a detailed history about risk factors, the site of the chest symptoms and the associated sweating or vomiting make the doctor suspect that he may be having ‘Acute coronary syndrome’.

He now starts telephoning for a cardiologist, who will come at the odd hour. Very often the cardiologist comes after one hour of hunting, and asks for a fat fee of around Rs.3000/- to 5000/-, after taking a cardiogram.

Companies like Healthcare have recently introduced transtelephone portable Tele-medical ECG machine, which is double the size of an ordinary mobile. The GP need not know how to take a cardiogram because the device is only to be put on the chest for two minutes. And then, through the mobile phone, the electronic impulses are transferred to a central station. If the family physician also has a fax machine (which is now being supplied by these companies for a mere cost of Rs.5,500/-, when the market price is Rs.8,000/-), within four minutes, the full ECG comes out from the machine along with the diagnosis, which has been signed by one of the cardiologists sitting on the station. The GP will have to pay only Rs.75/- for this report.

I would like to strongly advise all family physicians to buy this machine and save the patient’s money and precious time, besides pacifying a number of patients during their panic symptoms, when they disturb family doctors in the middle of the night.

Finally, doctors should be aware that in certain circumstances the ECG might be normal in acute coronary syndrome. In that case, it could be repeated every half-hourly and when in doubt, the cardiologist should be called.

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.