Abnormal heart sound?

[YellowTurtle]

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I saw a patient with pulmonary htn.

In his left upper parasternal region I heard something abnormal and I'm not sure what it was.
It had a pattern of every other pulse. I heard S1-S2 ... S1-S2 and then a whooshing noise. S1S2 ...S1S2-whoosh ...S1S2, etc.
I watched and it wasn't timed to his breathing so I'm pretty sure it wasn't abnormal breath sounds. I could hear it slightly in a few other areas, but it was loudest over what I thought was his pulmonic valve.

Asked my attending and she said he didn't have a murmur. By that time though he had been discharged so she wasn't able to go check what I was hearing for me.

Anybody have an idea of what I heard?

 

[DrBowtie]

I saw a patient with pulmonary htn.

In his left upper parasternal region I heard something abnormal and I'm not sure what it was.
It had a pattern of every other pulse. I heard S1-S2 ... S1-S2 and then a whooshing noise. S1S2 ...S1S2-whoosh ...S1S2, etc.
I watched and it wasn't timed to his breathing so I'm pretty sure it wasn't abnormal breath sounds. I could hear it slightly in a few other areas, but it was loudest over what I thought was his pulmonic valve.

Asked my attending and she said he didn't have a murmur. By that time though he had been discharged so she wasn't able to go check what I was hearing for me.

Anybody have an idea of what I heard?

You heard an echo order writing itself

 

[FlowRate]

I saw a patient with pulmonary htn.

In his left upper parasternal region I heard something abnormal and I'm not sure what it was.
It had a pattern of every other pulse. I heard S1-S2 ... S1-S2 and then a whooshing noise. S1S2 ...S1S2-whoosh ...S1S2, etc.
I watched and it wasn't timed to his breathing so I'm pretty sure it wasn't abnormal breath sounds. I could hear it slightly in a few other areas, but it was loudest over what I thought was his pulmonic valve.

Asked my attending and she said he didn't have a murmur. By that time though he had been discharged so she wasn't able to go check what I was hearing for me.

Anybody have an idea of what I heard?

Did you control for the patient's breathing?

 

[Instatewaiter]

I saw a patient with pulmonary htn.

In his left upper parasternal region I heard something abnormal and I'm not sure what it was.
It had a pattern of every other pulse. I heard S1-S2 ... S1-S2 and then a whooshing noise. S1S2 ...S1S2-whoosh ...S1S2, etc.
I watched and it wasn't timed to his breathing so I'm pretty sure it wasn't abnormal breath sounds. I could hear it slightly in a few other areas, but it was loudest over what I thought was his pulmonic valve.

Asked my attending and she said he didn't have a murmur. By that time though he had been discharged so she wasn't able to go check what I was hearing for me.

Anybody have an idea of what I heard?

I'm guessing it was either TR or PI with respiratory variation.

Or nothing.

 

[Doctor Bob]

I saw a patient with pulmonary htn.
...
Anybody have an idea of what I heard?

What kind of pulmonary HTN?