Famous Among Top Surgeons in the 90s
Chapter 753 - Chapter 753 【753】Heart sounds are strong

Chapter 753: [(753)] Heart sounds are strong Chapter 753: [(753)] Heart sounds are strong “`

She put in her earpieces and placed the head of her stethoscope over the girl’s heart-auscultation area, beginning the routine auscultation at the mitral valve area. The mitral region is located 0.5 to 1 centimeter towards the inside from the left fifth intercostal space along the midclavicular line, where the heart’s apex beat and sounds can be heard.

The human heart, in its appearance, can roughly be compared to a peach. Like a peach which has a tip, the heart does too, and this tip is called the apex, described specifically as the pointed, conical end at the bottom left part of the heart.

When the heart contracts, the apex hits the chest wall in front, causing the intercostal tissues to vibrate outward. In people with a slender build, you can sometimes see this area thudding outward. With a stethoscope, it’s even more apparent.

What should a doctor listen for when auscultating the heart? The first thing is the heart rate, which is the number of beats per minute; the normal rate is 60 to 100 beats per minute.

Many mistakenly think that listening to the heart rate is about listening to the thudding apex beat, but that’s incorrect. The most accurate way to measure the heart rate medically is not by pulse, but by auscultation, and what is being listened to is not the apex beat, but the first heart sound.

There are four heart sounds in medicine, named consecutively from the first to the fourth. The first and second heart sounds can be heard in all healthy individuals. The third heart sound can only be heard in some healthy children and adolescents. Hearing the fourth heart sound suggests illness.

Each heart sound is a noise produced by activity inside the heart. For instance, the first heart sound occurs when the mitral and tricuspid valves close abruptly at the start of cardiac contraction, causing the valve leaflets to tense and vibrate. Understanding this, if a doctor hears an abnormal first heart sound, they can deduce that there is something wrong with the mitral or tricuspid valve.

Xie Wanying furrowed her brows; through her stethoscope, she heard a strong first heart sound coming from the patient’s heart. The rumbling murmur, occurring during the diastolic phase, was a classic sign of mitral stenosis.

“What’s your name, and where is your family?” Xie Wanying first put away her stethoscope, inquiring where the patient’s family was. The girl surely needed to be hospitalized for treatment, but it was unclear why she was sitting at the entrance alone.

Just then, a middle-aged man made his way through the crowd and started walking back towards them.

Upon seeing the man, the girl made an effort to speak to the doctor, “My name is Ma Yunli. He’s my father.”

The man reached Xie Wanying and his widened eyes seemed to betray surprise at her presence.

Wasn’t he bringing his daughter for a consultation? Why such an expression upon seeing the doctor? A flicker of doubt crossed Xie Wanying’s mind as she told the patient’s family member, “Her condition warrants consideration for hospitalization.”

“Hospitalization?” Father Lili said, “The doctors told us she could go home and didn’t need treatment.”

“Which doctor said that?” Xie Wanying did not believe that the emergency department staff of Guoxie could make such a grave error in diagnosing a serious heart condition.

When asked which doctor it was, Father Lili was unable to clarify, saying, “How would I know which one? You all wear white coats. I can’t tell them apart.”

“What did you tell the doctor about her condition when you came to the emergency department?” Xie Wanying pressed the family member for more details. This matter had to be clarified. Otherwise, if something happened to the patient later, and the family came to hold the doctors accountable, the doctor and the hospital would be responsible.

“Her school teacher said she vomited in class and told me to take her to the hospital,” Father Lili expressed his reluctance, “There was no need to go to the hospital to begin with. It could have been dealt with just by getting some medicine. Look at this, now the hospital has turned us away.”

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