After putting on the earplugs, the earphone was placed on the girl's heart auscultation area. Routine auscultation starts from the mitral valve area. The apex of the heart is 0.5 to 1 cm inside the midclavicular line of the fifth intercostal space on the left side, which is the mitral valve area. The apex beat and heart sounds of the heart can be heard here.

The human heart can be roughly seen as a peach in appearance. A peach has a point, just like the heart. The pointy part is called the apex of the heart, which is specifically described as the conical tip at the lower left part of the heart.

When the heart contracts, the apex of the heart hits the chest wall in front, causing the intercostal tissue to vibrate outward. If you are thin, you can see this area bulging outward with your naked eyes. It is even more obvious when you listen with a stethoscope.

What does a doctor listen to when listening to the heart with a stethoscope? The first thing to listen to is the heart rate, that is, the number of heartbeats per minute. A normal heart rate is 60 to 100 beats per minute.

Many people mistakenly believe that listening to the heart rate means listening to the thumping apex beat, which is wrong. The most accurate way to measure the heart rate in medicine is not to measure the pulse, which must be done with a stethoscope. What you listen to is not the apex beat, but the first heart sound.

There are four names for heart sounds in medicine, which are numbered from the first heart sound to the fourth heart sound. Among them, the first and second heart sounds can be heard by all healthy people, and the third heart sound can only be heard by some healthy children and adolescents. If the fourth heart sound can be heard, it means that the person is sick.

Each heart sound is the sound of the heart's internal activities. For example, the first heart sound is the vibration caused by the sudden closing of the mitral and tricuspid valve leaflets at the beginning of the heart contraction. If you understand this principle, if you hear an abnormal first heart sound, the doctor can determine that there is a problem with the mitral and tricuspid valves.

Xie Wanying frowned as she heard the strong first heart sound from the patient's heart. The rumbling murmur occurred during the diastole phase of the heart, which was a typical sign of mitral stenosis.

"What's your name? Where are your family members?" Xie Wanying put away the stethoscope and asked where the patient's family members were. The girl's illness definitely required hospitalization, but for some reason she was sitting alone at the door.

...

...

Just then, a middle-aged man walked through the crowd and came back towards them.

The girl saw the man and tried hard to speak to the doctor: "My name is Ma Yunli. He is my father."

The man walked up to Xie Wanying, his eyes wide open as if he was surprised by her appearance.

Didn't you bring your daughter to see a doctor? Why did the doctor look like this? Xie Wanying was puzzled and said to the patient's family, "She needs to be considered for hospitalization."

"Hospitalize?" Lily's father said, "Your doctor told her to go home and she doesn't need any treatment."

"Which doctor said that?" Xie Wanying didn't think that the teachers at the National Association's emergency department would misjudge a patient with such a serious heart disease.

When asked which doctor it was, Lily's father couldn't explain clearly, saying, "How would I know which one it was? You were all wearing white coats. I couldn't recognize which one it was."

"What did you tell the doctor about her emergency treatment?" Xie Wanying asked the patient's family. This matter must be clarified. Otherwise, if something happens to the patient later and the family comes to the doctor to hold him accountable, the doctor and the hospital will be held responsible.

"The teacher at school said she vomited in class and asked me to take her to the hospital." Lily's father's expression showed his reluctance. "There was no need to take her to the hospital in the first place. She could have just bought some medicine. Look, now she's been kicked out by the hospital."