heart sound
Posted by hi G on 2011. 9. 8. 01:20YESS!!!!! Just heard the physiological splitting of the S2 for the first time! mwahahaha
These days, I'm learning how to use the stethoscope and listen to the heart. The normal heart produces two sounds for each beat. Some textbooks call it the "lub-dub," lub being the "first heart sound (S1)" and dub being the "second heart sound (S2)." When you are breathing normally, you just hear the lub-dub. When you inhale and hold your breath, however, you can hear that the second heart sound splits into two, as in, lub du-dup.
Well, that's what you're supposed to hear anyway. Like all things doctoring, theory is simple -- you just never see it in practice. This reminds me of the day I learned how to do the breaststroke. Freestyle is easy -- you know you will move forward if you keep paddling. But with the breaststroke, I never moved forward -- only kept drowning. Reading about how to do the breaststroke obviously didn't help. But one day at practice, it just started working and now it's my favorite stroke because it's the easiest. Similarly, the first chapter in Complications by the famous physician-writer Atul Gawande describes the author's struggle to learn how to put in a central line for the first time as a surgical intern. It never works the first few times, and I think he almost ends up killing a patient. And one day, it just works. He did nothing different, but it just worked. And it kept working from that point on.
I always feel bad for turning my friends into the subject of my experiment, so I decided to practice on myself. (It's much easier to put a stethoscope on my own heart than to try to elicit brachioradialis reflex or visualize my own retinal fundus.) Different positions are supposed to help with different kinds of heart sounds, so I tried sitting, standing, leaning forward (which is supposed to help if I want to hear the diastolic murmur in aortic regurgitation), but nothing - just continuous lub-dub, lub-dub, lub-dub...
So I almost gave up and sat back down on my chair. And thought I'd give it one last shot. Breathed in, held my breath, and there we go! Lub-du-dup, lub-du-dup, lub-du-dup, lub-du-dup, exhale, lub-dub, lub-dub, lub-dub...
This is probably the easiest part of cardio exam, but at least I'm making progress. Besides, I wouldn't want to hear any murmur or any other kinds of splitting, anyway. Bad signs!
These days, I'm learning how to use the stethoscope and listen to the heart. The normal heart produces two sounds for each beat. Some textbooks call it the "lub-dub," lub being the "first heart sound (S1)" and dub being the "second heart sound (S2)." When you are breathing normally, you just hear the lub-dub. When you inhale and hold your breath, however, you can hear that the second heart sound splits into two, as in, lub du-dup.
Well, that's what you're supposed to hear anyway. Like all things doctoring, theory is simple -- you just never see it in practice. This reminds me of the day I learned how to do the breaststroke. Freestyle is easy -- you know you will move forward if you keep paddling. But with the breaststroke, I never moved forward -- only kept drowning. Reading about how to do the breaststroke obviously didn't help. But one day at practice, it just started working and now it's my favorite stroke because it's the easiest. Similarly, the first chapter in Complications by the famous physician-writer Atul Gawande describes the author's struggle to learn how to put in a central line for the first time as a surgical intern. It never works the first few times, and I think he almost ends up killing a patient. And one day, it just works. He did nothing different, but it just worked. And it kept working from that point on.
I always feel bad for turning my friends into the subject of my experiment, so I decided to practice on myself. (It's much easier to put a stethoscope on my own heart than to try to elicit brachioradialis reflex or visualize my own retinal fundus.) Different positions are supposed to help with different kinds of heart sounds, so I tried sitting, standing, leaning forward (which is supposed to help if I want to hear the diastolic murmur in aortic regurgitation), but nothing - just continuous lub-dub, lub-dub, lub-dub...
So I almost gave up and sat back down on my chair. And thought I'd give it one last shot. Breathed in, held my breath, and there we go! Lub-du-dup, lub-du-dup, lub-du-dup, lub-du-dup, exhale, lub-dub, lub-dub, lub-dub...
This is probably the easiest part of cardio exam, but at least I'm making progress. Besides, I wouldn't want to hear any murmur or any other kinds of splitting, anyway. Bad signs!