Grrr! My prothrombin time test results are off again, so I’ve been in the doctor’s office twice in a week, getting a blood draw. I’m following the rules and doing my part, but it seems that every now and again, things just go haywire. I have to go in several times close together and my Warfarin dosage is changed several times before it settles down. I can’t explain it, and it seems no one else can either. It might be “just one of those things”.

But I always let the nurse listen to my heart; in fact, I insist on it. I’m always hoping someone can learn something from me, especially since I’m so unusual. The nurse doing my draw has taken my blood (and heard my heart) before, but when we finish, she says “Wait here just a moment,” and then disappears.

In a moment she’s back. The nurse with her is wearing a blue scrub top with the letters ATEC written on the pocket. ATEC is the local high school level technical school, so I’m a bit surprised to see her (it is a school day after all, and during normal school hours. I assume she must be on a study program.) My nurse tells Miss ATEC to have a seat, listen to my heart, and tell her what she hears.

Miss ATEC is well prepared – her stethoscope is made by Littman, which is one of the better brands available. The better Littmans costs more, but good stethoscopes are quality instruments, and you expect to pay more for quality. The young lady does as she is told. Her jaw drops and after a long pause she says “Whoa!”

A normal heart is going to produce two sounds, “lub-dub.” (Some say they hear “lub-dup”, that is acceptable.) That sound is the valves closing: “Lub” occurs when the Mitral and the Tricuspid valves close, and “dub” when the Aortic Valve and the Pulmonary Valve close. Since the valves close in pairs, you should only hear two sounds: Lub-dub.

If you hear a “whoosh” – almost the sound you hear when someone put their finger to their lips and says “Shhhh!” – that is almost certain evidence of a heart murmur. The whoosh sound means that blood flow is turbulent… it may or may not mean there is a problem. Interpreting heart sounds is an equal mixture of art, science, and experience… after you hear a couple of hundred strange noises, sometimes it just “clicks” in your head and you know that sound is a problem. But it takes a lot more to get it right than just reading a blog post by an educated amateur like me!

Your heart can also gallop (Extra lub-dub type sounds) and you could have a thrill (not a moment of excitement, but a tremor or vibration you can actually feel) Your doctor will also ask you to breathe in and out – breathing in usually makes right side heart sounds louder, and breathing out usually makes left side heart sounds louder. And moving the stethoscope around helps him/her hear the sounds better or differently.

So I am hopeful that Miss ATEC remembers me. Not romantically, she’s much too young for me – but you never know where life will take her when she graduates. She may never here another heart with Tricuspid Atresia again…

… or she may be in an Emergency Department somewhere, put her stethoscope on a patient that needs help, and think “Hey, I’ve heard something like this before…”


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One Response to “Miss ATEC”

  1. Awesome Mom Says:

    Evan always needs a dosage adjustment when the weather changes from cold to warm and back again. He always seems to need more coumadin in the winter than he does in the summer. Just another one of those odd things that happens with this medication. Sometimes I think it just likes to mess with me lol!

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