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It has been sunny and pleasant WAY TOO MUCH. Where did the drizzle go? I'm wondering if it is about to descend. This does not seem to be the same city that I endured last winter. And I'm smiling more too.

Of course my improved mood may have to do with the fact that I am supplementing my vitamin D. Or with the fact that I'm finding some equilibrium in my relationship. Or with the fact that even though I'm not entirely satisfied with my school, at least I'm doing reasonably well. School takes most of my time and energy.

CPD = clinical physical diagnosis

Today in CPD lab we got to listen to 7 different people with anomalous heart sounds. (LONG SENTENCE ALERT) There was a 31 year old female with mitral valve prolapse and a wide S2 split very loud at the pulmonic area, a 15 year old girl with a congenital mitral valve prolapse, a 74 year old female with idiopathic hypertrophy causing a mitral regurge murmur so loud that it nearly obscures both S1 and S2, a 26 year old female with mitral valve prolapse causing an intermittent systolic click and also a physiological S2 split, a 47 year old female with a complete heart block, resulting in irregular irregular heart beats that radiate to her armpit, and a 68 year old man with hypertension who has an S4 sound and an incredible apical heave from just below his nipple all the way to his armpit. (AND THIS CONCLUDES OUR LONG SENTENCE ALERT) I really enjoyed the lab. I thanked each and every person who allowed us all to listen to their hearts, and got stories from each of them. They seemed eager to tell their stories. I think a lot of the students are too freaked out by listening to people's hearts to want to talk to them too. The lady with the complete heart block had the wildest story.

She doesn't remember having an MI, but her doc decided she needed a pacemaker, and so one was installed. She had it in her for 2 years, and in that time suffered greatly. Eventually it was infected, and her heart rate was 172 (so she said) and so they had to take it back out. Now she is in congestive heart failure, as evidenced by her edematous legs. She is tired a lot and cynical about medicine. But the pacemaker was removed in 2002, and she has lived since then with a completely erratic heart beat. Very strange way to live.


It's time for me to get busy with school work. I did almost none over the weekend, but I am feeling productive right now, so I'd better read something before the alertness fades.


Feb. 5th, 2009 01:48 am (UTC)
Re: heart sounds....
Yeah, the profs said that people with musical background usually are best at picking up heart sound patterns and making sense of them....I do OK, not great. Still a rookie for sure. I do plan to listen to the heart and lungs of every patient who comes to me. I think it's not done enough.

Enjoy the snow. And just know that I'm jealous.




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