Wednesday, May 19, 2010


Today I examined cardio patient.

Couldnt recognise that the pulse was irregular.

Just reminded me that there once I mistaken some auntie's pulse as regular in GP.

And then found out that the patient is long term warfarin for AF.

at that time, it didnt occur to me that this is such an important thing, now only I realised.

Imagine patients with AF, no other signs, except the pulse, and I blardy miss it. Coz it is impossible for my deaf ear to get a mid-diastolic rumbling murmur for mitral stenosis.

And the same patient that I examined today, has got a prosthetic aortic valves, which I tot was normal heart sound.

I went back to the patient after reading his notes.

Put on my stets, listen again.

I still think thats normal heart sound.

And then I took off the stets, and just using my ears,

I can hear CLICK!

and then i put on stets again, and listen...

I cannot hear click, and still convinced it is a normal heart sound.

And then I went back to the docs room, use my stets and listen my own heart sounds,

and i think it sounds like the patient anyways!

maybe a prosthetic valve was inserted into me when I was younger...

or maybe...actually...


1 comment:

ihsan_huhu said...

irregularly irregular? or irregularly regular?

small? regular? large?