Our PBL case this week is about congestive heart failure. I am doing the pharm learning objective, which no one else wanted to do. That's ok with me, because I like pharm. I have realized though that I suck at hearing heart murmurs. We had some heart sounds to listen to during the PBL case, and I really have a hard time hearing the diastolic murmurs. (Diastole is the point in the heart beat where the heart muscle is relaxing and the chambers are filling with blood.) Systolic sounds, which occur while the heart is contracting, are a lot easier.
Our anatomy session was really a body cavity embryology session. We didn't do much embryo last year, so we're doing it now. It's pretty complex, but kind of interesting how the embryo starts out as more or less a flat disk, and then it starts folding up in all different directions. I don't think I could explain the sequence of events from start to finish though. After Dr. Drake went over the embryo, we went through some prosections to review the chest anatomy. It was a really good review, and I understood a lot more this time around than I did a year ago.
We had a radiology station too just like we used to have last year. I don't know if I've ever mentioned our radiologist. He's awesome. First of all, radiology is just cool anyway. Plus, our radiologist is this really nice older man who has a British accent, so you have to imagine all of this being said with a British accent. He'll start out by showing us a CT of the chest and pointing to something really easy, like the aorta. And he'd say to me, "Can you recognize what this is?" Of course I would say, "The aorta." And he'll say, really enthusiastically, "That's right! It IS the aorta, isn't it! And look, here's the left ventricle attached to it!" I love the radiology station.
This afternoon, we went to the echo lab and listened to several patients who had heart murmurs. That actually really helped, because it's a lot easier to hear a murmur on a real person than it is on the computer, and most of these patients had really loud murmurs. But I still have a hard time making out the diastolic murmurs unless the murmur is practically audible without the stethoscope. I know it's shameful for a Cleveland Clinic medical student, but maybe I'm not cut out to be a cardiologist. ;-)