HEART

Knowledge

The other day I gave a talk on congenital heart defects.  For those who know the complexity of the heart attempting to make the talk direct simple and understandable presented a great challenge.  While in medical school the head of the pediatric cardiology department gave talks on heart defects which I remember the salient points to this day.  So after spending much time gather information heart sounds, video etc. I went back to the basic talk enhanced by heart sounds and videos.  The talk was for medical students who are beginning to learn about physical diagnoses.  So the talk centered on three groups of three.  Shunts, obstruction and cyanotic heart defects.  Shunts are three atrial septal defect, ventricular septal defect and patent ductus arteriosus.  The obstructions are three- pulmonic stenosis, aortic stenosis and coarctation of the aorta. Cheating a bit with the cyanotic heart defects there are three major ones but five is actually a better number.  However, they all begin with the letter T so that helps the memory.  Tetralogy of Fallot, transposition of the great arteries, tricuspid atresia, truncus arteriosus and the a long one- total anomalous pulmonary veinous return.  Even if you remember all the the cyanotic heart diseases you will still be feeling a bit blue along with the discomfort of a blue patient.  

Tetralogy of Fallot four part prove to be easily remembered.  P-pulmonary stenosis  R-right ventricular hypertrophy  O-overriding aorta and V-ventricular septal defect.  All the blue patients tip one off to a heart problem the other heart problems take a bit more investigation and often are picked up by an astute clinician who listen carefully to the patient as well as the heart.  Several are more easily missed than identified.  Some do not matter because they will self correct.  Others need correction to protect the lung and the brain.  

Life gets interesting in that when things get a bit complex we often are forced to study the subject long enough to recognize the simplicity of the topic.  Then often the simply way of adjusting to the problem becomes difficult because we do not embrace the simplicity.  When pride swells up the easy solution is to swallow your pride admit to the problem that may have been made difficult by your own stubbornness and press on with life.  Easy, but taking the courage to admit is the crux of the solution.  So when pride comes our way, we admit to it and press on with life.  So easy right?

Or to often I left the heart defect go undetected and wait for the diagnostic machines to point me to my problem.