A worm in the right atrium, video
It is great to achieve the best result of treatment with minimum cost and risk. This is such story. Watch the video:
Dramatic but not very frequent course of events
It is more likely to make a correct diagnosis of unfrequent disease when you remember this disease. 


A middle aged woman, apex of the heart: ...
Check your cardiac auscultation skill
Asymptomatic middle aged woman with some severe heart problem. Soon she had cardiac surgery. Can you make a diagnosis from this audio fragment of her heart sound:
Typical case but difficult diagnosis
It is simpler to make a correct diagnosis when you have an appropriate experience. If you have extensive experience, you can make the diagnosis almost automatically without any mental strain.
It 's hard to make a diagnosis when you meet some disease for the first time, especially when this disease is rare. That is why it is useful to read good descriptions of clinical cases. Here is another one challenging case.
The first heart sound`s analysis, part 3: splitting of S1
The first heart sound consists of two components: mitral  and tricuspid.  These two components are separated by a short interval which creates an audible narrow splitting of S1.  Here, you can find more information and a good example of the normal splitting of S1.
learn more about wide splitting of the first heart sound
I have never read and hear about such a murmur before
I have never read and hear about such a murmur beforeThere are two kinds of problems in heart auscultation:
- an auscultatory sign can be faint
- an auscultatory picture can be too complex

By the way, I am going to publish the book about solutions of such problems. 

Here I am going to describe a case with very faint and rare musical murmur which was very difficult to hear.  
read about a rare musical diastolic murmur
The first heart sound, part 2: loudness of S1
A lot of information is enciphered in heart sound.  There are two main problems:  it is difficult to perceive this sound because it is too faint, and it is not simple to interpret reaped information.  The later is some kind of understanding a foreign language.  Let us continue our talk about the language of the heart.
Learn about intensity of the first heart sound
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