Cardiology

Stanford Medicine 25 Blog

  • The Jugular Venous Pulse – Circa 1957

    In 1902 Sir James Mackenzie published a book entitled “The Study of the Pulse. Arterial, venous, and hepatic and of the movements of the heart” that described his studies on the jugular pulse using what would later and famously be known as the “Mackenzie polygraph”. He was the first to make recordings of the arterial...


  • What Is The Specific Cause of This Patient’s Clubbing?

    The causes of clubbing are a favourite bedside question on rounds. They can be divided into: Pulmonary (commonest – think neoplasm until proven otherwise). Bronchial carcinoma Mesothelioma Bronchiectasis Cystic fibrosis Interstitial fibrosis...


  • Abraham Verghese Asks: Why Are We Doing This Teaching?

    We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the Stanford Medicine 25 was first created). But sometimes it’s important to ask why. In a recent blog post, “Will the Healing Touch Go Out the Door With the Stethoscope?”, we look at the how some think that ultrasound is replacing any need for a stethoscope...


  • Will the Healing Touch Go Out the Door With the Stethoscope?

    We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the Stanford Medicine 25 was first created). But sometimes it’s important to ask why. In a recent blog post, “Will the Healing Touch Go Out the Door With the Stethoscope?”, we look at the how some think that ultrasound is replacing any need for a stethoscope...


  • What is this Kussmaul’s sign?

    A 45 year old woman with a past medical history of Hodgkin’s lymphoma treated with mantle field radiation whose neck veins were incidentally noted on a thorough physical exam. The patient was in sinus rhythm on telemetry throughout the exam...


  • Measuring Central Venous Pressure with the Arm

    In this video, we show how to use a patient’s arm veins to estimate the central venous pressure.


  • This patient presents with chest pain. What’s the diagnosis?

    A majority of adults with Marfan’s syndrome have aortic dilation and if untreated can lead to aortic dissection.


  • Split Fixed Second Heart Sound & Loud P2

    Here is video showing an actual patient from Stanford Hospital describing the fixed split second heart sound and a loud pulmonic valve (P2).


  • The History of Pulsus Paradoxus

    A thyroid bruit is described as a continuous sound that is heard over the thyroid mass. (If you only hear something during systolic, think about a carotid bruit or radiating cardiac murmur.) A thyroid bruit is seen in Grave’s disease from a proliferation of the blood supply when the thyroid enlarges.


  • Do you know how to measure pulsus paradoxus?

    Pulsus paradoxus is an exaggeration of the normal drop in blood pressure that occurs during inspiration. It’s seen in disease states such as cardiac tamponade and less commonly constrictive pericarditis.


  • Do You Know How to Measure an Ankle Brachial Index?

    The ankle brachial index (ABI) is a common and useful exam in the outpatient setting to detect peripheral arterial disease. ABI’s should be measured in all people over the age of 50 if they are a diabetic or a smoker. It should also be checked in patients over the age of 60.


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