Yes but, no but, Dr, what you see was...
Dr Dork: I notice in your file here you’ve had some heart trouble ?
Patient: No, never gave me any problems.
Dr Dork : Oh. It says here that you had a triple CABG 5 years ago ?
Patient: Oh. Yeah, that. I went to see my local doc about my indigestion. My indigestion was really giving me grief. And I was feeling dizzy.
Dr Dork: So…you had the operation on your heart and it fixed that ?
Patient: Yes. But I never had any angina, any heart pain, no.
Dr Dork: Okay. So, things were good until last year, then ?
Patient: Yep.
Dr Dork: When you had the stent…
Patient: Yep.
Dr Dork: Was it chest pain, angina, that lead to the stent being put in ?
Patient: No. Never had any chest pain.
Dr Dork: So what led to the stent being done ?
Patient: I was having this pain in my neck. I just wanted the pain in my neck to go away.
So they put the stent in to fix it. Which it did, it went away.
...
Dr Dork: Any angina after the new stent ?
Patient: No. Never had angina doc. Never had any problems with my heart.
Heart disease is no laughing matter. It is our biggest killer in the developed world. It seems to get a fraction of the press of more fashionable but rarer conditions. As our population ages demographically, and our adults and children balloon into obesity, it is unlikely to diminish in impact in coming decades.
Heart disease is often treatable. Even better - it is largely preventable.
Dr Dork recommends discussing how best to reduce your own risk of heart disease with your friendly local medico.
Heart Foundation of Australia
British Heart Foundation
American Heart Association
8 comments:
A classic!
Better yet, finishing the oral part of the H and P and only discovering the CABG scar while auscultating.
"I thought you'd had no major surgeries."
"Oh that . . well yeah I had that."
First laugh of the day! Thanks for that! Reminds me of my sis-in-law. She woke up a couple days ago with swelling on one side of her face, intense pain around her eye, along one side of her nose, and along her cheak bone...an intense headache and discolored gunk when she blew her nose. She broke a tooth about a week ago, so of course this is all due to her tooth...right? No absess, no signs of trouble with said tooth other than it is in fact cracked. She insists her tooth is the problem and won't listen to anyone whom says otherwise. She IS, however, being treated for a sinus infection...just don't tell her that! The really scary/sad part of this is that she is a medical professional...working for a respirologist/sleep doc!
Haha, that is hilarious! Something very similar happened to me when I was on my first rotation. I'll be writing about it soon, when I get time!
I have several patients who deny they have hypertension or diabetes, though they take multiple meds for these conditions. The rationale is with the meds, they are "normal".
I have been so proud of myself for finally getting through to some of my mule-headed farmers/ranchers out here in Podunk-- ever since I began referring to the heart's mechanism-of-action as a "pump". Pumps they can understand. So the other day, after I gave one particular rancher a long lecture about why his irregularly-beating "pump" needed anticoagulants, he smirked and said: "I've got a well out in the pasture with a malfunctioning pump---should I dump a bunch of aspirin down there?"
Hi echodoc,
Thought you might like that.
Hi FA,
Healthcare workers, as a rule, make the worst patients, of course.
Hi Calavera,
Scars can always be a good clue in your clinical exams. This patient was actually an intelligent professional.
Hi Keagirl,
That sounds very familiar.
Any medical probs ? - No doc.
Any medications ? - Just karvea, lipitor, lasix, warfarin, nexium, digoxin....
Boheme,
Perhaps a balloon pumpoplasty ?
Kind regards
Dork
Almost like Abbott and Costello - but with dire consequences. Great post and great info.
Hi Dr Deb,
Or two stooges, maybe ?
Hi Cathy,
You did raise a valid point - but I note your comment is unfortunately removed.
Hope all is well and everyones ticker is ticking like a metronome.
Kind regards
Dork
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