The earplugs were hung up and the listening head was placed on the auscultation area of the girl's heart. Routine auscultation started from the mitral valve area. The mitral valve area is located 0.5 to 1 cm inward from the midclavicular line of the left fifth intercostal space, and the apex of the heart. Here you can hear the heart's apical beat and heart sounds.
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 hits 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. Listening with a stethoscope is more obvious.
The doctor uses a stethoscope to listen to the heart. The first thing to listen to is the heart rate, which 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 boom-boom-boom apex beat, which is incorrect. The most accurate heart rate measurement in medicine is not even a pulse measurement. You must listen with a stethoscope. What you hear is not the apex beat, but the first heart sound.
Heart sounds have four names in medicine, counting from the first heart sound 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 fourth heart sound, you are sick.
Each heart sound is a sound produced by the activity of the heart. For example, the first heart sound is the sudden closing of the mitral and tricuspid valve leaflets at the beginning of cardiac contraction, resulting in tension in the leaflets and vibrations. Understand this principle, 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 do you see the doctor with this expression? Xie Wanying had doubts in her mind and said to the patient's family: "Her situation requires hospitalization."
"Hospitalized?" Lily's father said, "Your doctor told her to go home. She doesn'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?" Xie Wanying asked the patient's family. This matter must be clarified. Otherwise, if something happens to the patient later and the family comes to find the doctor to hold him accountable, the doctor and the hospital will be held 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. Rushed."
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