SCOPING IT OUT The art of listening

摘要

When was the last time any of us used a stethoscope and felt it made a difference either to clinch a diagnosis or to change the management of a sick patient? DIAGNOSTIC TOOL OR NECKWEAR? How many of us have had a patient with a history of hypertension, diabetes or myocardial infarction (MI), who presented with complaints of chest pain and shortness of breath? On exam, he might have been anxious and diaphoretic, with a heart rate of 130, respirations of 24, blood pressure of 190/110, bilateral pedal edema, oxygen saturation (Sp02) of 89% and 12-lead ECGs showing ST-elevation.