Steve Jobs is such an ass for developing this thing without a camera and logical mouse support!!

This month, I will have to request for donations from some of my current and prospective visitors. I am within the window for taking my cardiac sonographer registry exam. This test will be done in two parts and consist of 3 hour sitins per test. Below is but an example of how some of the registry tests could go:

History:

A 44 year old male presents with a fever of 12 days duration and increasing shortness of breath. There is no history of heart disease in the family. He had a routine teeth cleaning performed 5 weeks prior to presenting at the emergency room.

Physical Examination:

Blood pressure is 146/55, pulse is 122bpm. the left ventricular impulse is hyperdynamic and palpable at the 6th intercostal space 1.5 cm to the left of the midclavicular line. there is an early 4/6 early diastolic decrescendo murmur heard at the left upper and mid sternal border. The CXR demonstrates cardiomegaly. the EKG is normal.

The main key for these symptoms for me that stand out are the in the history. The tooth cleaning and abrasions of the gum can possibly loosen clot or bacteria into the bloodstream. Although the innocence of cleaning the teeth is well known these clots can create blood infections. So my choice regarding this examination would be for a diagnosis of “aortic valve endocarditis”.

I don’t feel like a mysterious brooding House character. Listening to patients complain about the pain they have during a cardiac event is very stressful. Everyone’s concerns and actions are guarded, which can sometimes put me off.

I try to make them feel very comfortable before the doctor comes in and tells them to stress their heart. There is nothing to worry about since we can inject a reversing agent to make the heart and body feel as though nothing ever happened.

Hopefully you will never have to see me leaning over you asking questions about the pains in your chest or arms.