Hang up the earplugs and place the listening head on the auscultation area of the girl's heart. Routine auscultation starts from the mitral valve area. The left fifth intercostal space is 0.5 to 1 cm inward from the midclavicular line, and the apex of the heart is the mitral valve area. Here
The heart's apical beat and heart sounds can be heard.
The appearance of the human heart can be roughly seen as a peach. The peach has a point, just like the heart. The point is called the apex, which is specifically described as the cone-shaped tip of the lower left part of the heart.
When the heart contracts, the apex of the heart will hit the front chest wall, causing the intercostal tissue to vibrate outward. If you are a thin person, you can see this place protruding outward with the naked eye. It will be more obvious when listening with a stethoscope.
What does a doctor listen for when using a stethoscope to listen to the heart? The first thing to listen for is the heart rate, that is, the number of heartbeats per minute. A normal heart rate is 60 to 100 beats per minute.
Many people mistakenly think that listening to the heart rate means listening to the booming apical beat, which is wrong. The most accurate medically accurate heart rate measurement does not measure the pulse. You must listen with a stethoscope. What you hear is not the apical beat, but the first heart sound.
There are four names for heart sounds in medicine, counting from the first to the fourth heart sound. Among them, the first and second heart sounds can be heard by all healthy people, while the third heart sound can only be heard by some healthy children and adolescents.
If you can hear the four heart sounds, you are sick.
Each heart sound is the sound produced by the activity in the heart. For example, the first heart sound is the sudden closing of the mitral and tricuspid valve leaflets at the beginning of heart contraction. The resulting tension in the valve leaflets causes vibration. Understand this principle, listen
If the first heart sound is abnormal, the doctor can determine that there is a problem with the mitral and tricuspid valves.
Xie Wanying frowned. She heard the strong first heart sound from the patient's heart in her ears. The rumbling murmur occurred during the diastole phase of the heart and was a typical sign of mitral stenosis.
"What's your name? Where are your family members?" Xie Wanying first put away the stethoscope and asked where the patient's family members were. The girl's disease must have required hospitalization, but she didn't know why she was sitting alone at the door.
Just then, a middle-aged man walked through the crowd and came back to them.
The girl saw the man and tried her best to open her mouth and said to the doctor: "My name is Ma Yunli. He is my father."
The man walked up to Xie Wanying, his eyes wide open as if he was surprised by her appearance.
Didn't you bring your daughter to see a doctor? Why did you see the doctor's expression like this? Xie Wanying was filled with doubts and said to the patient's family: "Her situation requires hospitalization."
"Hospitalized?" Lily's father said, "Your doctor told her to go home and she won't need any treatment."
"Which doctor said that?" Xie Wanying didn't think the teachers at the National Association of Emergency Medicine would misjudge such a serious heart disease patient.
When asked which doctor it was, Lily's father couldn't tell clearly and said, "How do I know which one it is? You are all wearing white coats. I can't recognize which one it is."
"What did you tell the doctor about when she came to the emergency room for medical treatment?" Xie Wanying asked the patient's family. This matter must be clarified. Otherwise, if something happens to the patient later, the family will come to the doctor to hold him accountable, and the doctor and hospital must be responsible.
"The school teacher said she vomited in class and asked me to send her to the hospital." Lily's father's expression fully showed his reluctance, "There was no need to send her to the hospital in the first place. She could just buy some medicine. Look, now she is being taken to the hospital.