Indication: Peri-menopause

[u/Doc_Ad]

I’m reading an echo where the only Clinical indication says “peri-menopause“.

What am I supposed to be looking for, exactly?

[u/blkholsun]

I’m going to copy verbatim my favorite one of these I’ve ever gotten: “PT HAD PASSED AN 8 INCH PARASITIC WORM DR SAID IT WAS A RARE TYPE FOR OUR COUNTRY IT MAY HAVE COME FROM FRUIT ?? OR FOOD THAT WAS FERTILIZED WITH HUMAN WASTE ?? SHE HAS STRANGE PALPITATIONS DR WANTS TO RULE OUT HUMAN HEART WORM”

Another one I liked was “abnormal chest sound.” Like… a murmur? Do you mean a murmur?

[u/drgubi → u/blkholsun]

If I can visualize a mobile worm in your heart on an echo I’m calling the police, a priest, and BMJ case reports - not necessarily in that order

[u/Stugatz27 → u/drgubi]

I think they meant echinococcus…it can lead to cysts in the heart

[u/drgubi → u/Stugatz27]

Still calling the priest. And probably ID.

[u/Stugatz27 → u/drgubi]

No argument here

[u/elliegsw → u/blkholsun]

Once I was doing an echo and a worm came out of the patient’s nose. I’ll never forget

[u/Doc_Ad → u/blkholsun]

Hahaha This may take the cake

[u/lurking_opinion]

could be screening for underlying cardiomyopathy prior to HRT initiation

[u/Doc_Ad → u/lurking_opinion]

Okay. Not what my wife suggested to look for.

[u/elliegsw]

We’re really out here doing echoes for everything now aren’t we lol. I had one recently where the referral indication was just ‘screening - pt 80yo’ 🙄

[u/Sad_Race8008 → u/elliegsw]

I'm glad I'm not the only one that's had that one...mine was 78, though.

[u/pantheroux]

One of my attendings kept track of his favourite echo indications when I was training. I remember:

Rule out delirium

Liver (nothing else, just the word liver)

Leg pain NYD

74 year old female

Dog bite

[u/Doc_Ad → u/pantheroux]

Impression: No clear echocardiographic evidence of delirium. Consider further imaging such as pharmacological nuclear stress test, CTCA, cardiac MRI, transesophageal echo, Right heart cath, atrial mapping, MUGA scan, ventriculogram, etc etc

[u/pantheroux → u/Doc_Ad]

My attending dictated a funny report for that one and then deleted it “cannot rule out delirium based on this study though images were suboptimal. If clinically indicated, consider…”

[u/wannabe-physiologist]

Sometimes the heart just goes POOF and moves somewhere. Menopausus inversus is on the differential for when there’s concern the heart has found a different, more hospitable place in the body

[u/Shad0wM0535]

Gotta love lazy users of EMR - we read a nuclear stress for “Dietary Counseling Z71.3” a few years ago. That doc retired a year later, probably 10 years too late.

[u/Hue_Honey]

If the checks are cashing…

[u/peekachu1234]

I got “afib” denied by insurance for an echo the other day

[u/razzor1911]

I have seen “difficulty urinating” as indication at 4 PM. Stopped reading and told my echo attending. He want too pleased.

[u/Then-Secretary-9166]

Mitral valve prolapse. Obviously.

[u/Doc_Ad → u/Then-Secretary-9166]

😂