Forces Beyond The Grave

8.5

"What?" Stephanie glared. 

"Who can tell me why she's wrong?" 

"I'm not wrong, professor you said very good," 

"For your explanation, yes. I told you, extra points for if you can explain yourself. In diagnostics, when the answer could be a million different things you need a million different answers. It doesn't mean that you're right, but if you can justify your answer then at least you're not just shooting in the dark. You work as a team in diagnostics, you have to learn to bounce ideas off each other, and not get hurt if someone says your idea is stupid or wrong. So, who wants to bounce another idea?" 

"It's ejection systolic." Lennox said slowly, now having read the question thoroughly. 

The class's eyes fell on her again as the professor narrowed an eye. "Why?" 

"You can't be serious." Stephanie whispered, crossing her arms over her chest in frustration as Lennox spoke. 

"ESM happens when there's a problem with the blood flow coming out of the heart going to the rest of the body, right? Not in. The high blood pressure is a symptom of the murmur, the slow-rising pulse is happening because with ESM, there's a suggestion that proper blood flow is being prohibited, such as there being a block or an obstruction. If there is an obstruction in the blood flow then yes it's most likely in a valve, but ESM is most commonly associated with aortic stenosis, which is where the main valve to the heart is narrower than it should be, making proper blood flow difficult. If that's the case then the blood struggling to get through the narrowed valve would create the sound of a murmur on auscultation because it's flowing abnormally. It's also a more age appropriate condition because it generally affects those matching or around this patient's age range."

Professor Ashmont nodded to himself as he started smiling. "Nicely done. What would you do next?" 

"I would refer the patient to cardio for an echocardiographic evaluation and maybe an angiogram to identify any blockages in the heart valves." 

"Good." Sporting a look of pride, the professor went to change the slide on his computer. "In cases like this, it could've been any of the options suggested, any good diagnostic team would be running each of them simultaneously, but in this case, you just saved your patient." 

He nodded to Lennox, who resisted a cocky smile as she looked at Stephanie. "That's what happens when you don't kiss the professor's ass. You should try it sometime."