It rained all night and poured constantly until 2PM. The hospital corridors are all covered and one can stay sort of dry, if you step carefully. Now that the doctors and staff are aware that Penn has provided a cardiologist, the floodgates quickly opened. My first consult today was a patient who had been admitted as probable gastroenteritis. However, his week-long symptoms were very concerning and the admission ECG was misinterpreted by the admitting team -- it was a classic heart attack (anteroapical STEMI). We had to turn around the inital medical approach and get him treated properly. I echoed the young woman I saw yesterday with the dramatic examination and indeed she did have rheumatic heart disease, not a VSD. She had torrential MR and TR, severe PA hypertension, mild AR, huge atria, and LV systolic dysfunction. I have never experienced a patient with a palpable thrill (grade 4/6 systolic murmurs) due to MR and TR. What an eye-opener! I did several consults and 4 echoes today, all on a GE Vivid S6 machine on which I have to learn what buttons to push.
I gave an ECG talk to the residents today, well received. It's a challenge speaking to so disparate a group as African medical officers and Penn students and residents. They all were politely appreciative.
Barbara has been working hard on her Muskie projects, and has made contact with a faculty member at the law school. Also, the young Ethiopian woman who attended Wayneflete in the 90s who stayed a semester with us has a sister here who works in research for WashU. We'll see her next wk.
I am taking 1/2 day off tomorrow...the links are calling!
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