So…just had my blood pressure checked at the doctors (annual asthma review). She did it twice but couldn’t “hear” properly? And then she said it sounded funny and she couldn’t hear the second part of the beat… On getting a different stethoscope she tried again and told me my blood pressure is higher than would be expected.

Now, I’m not too worried about the blood pressure since I’ve just got to the end of a stressful two weeks at work. (And have to go back in two weeks for it to be checked again). But the whole not being able to hear half my heartbeat concerns me somewhat. Any medics around that know what it’s meant to sound like??

Lub-dub

thrump-thump, thrump-thump, thrump-thump

Means your doc has been clubbing the night before…

Worried? Get the doc to do an ECG. If it shows a funny trace, get yourself referred to a cardiologist.

I have a heart arrhythmia* (and a v faint murmur). GP knows **** all; cardiologist sees me once a year and tells me to continue exercising hard.

*right bundle branch block – relatively common

Means your doc has been clubbing the night before…

let’s hope it wasn’t baby seals…

Did doc place aforementioned steth to your chest?

If its a No – I doubt that they will have heard bugger all conclusive just via a brachial pulse.

Elbow, not chest. I’ll just assume my heart is fine and her hearing is wrong then. Unless it sounds funny again in two weeks. Thanks for the reassurance 🙂

Yeah the bend in the elbow is where they will listen for the blood pressure…but if having found an odd heart beat or any abnormalities then I would have thought that any doc worth their salt ( if they were concerned about any arrythmia) would have either done an ecg or had a listen in specific places on the chest.

Swish-valves problem…

Seriously relax-just go again-to a different doc though!

Might be worth getting yourself a blood pressure kit for home use.

I had mine checked in the docs, and they kept asking me to come back because it was high time after time. I ended up buying my own kit so I could check it at home – and guess what, it was fine. The doc put it down to nerves in the end which seems quite a common thing.

Do you know what I would do….?

Get a second opinion via another doc…to ease any worries you may/maynot have.If all is fine….

…forget about it.

tsk home bp kits….the bain of my life!

to be honest i’m not surprised your bp was a bit up if the doc struggled to take it. Just go back and get it checked again, you don’t need to see a doc a practice nurse can do it for you.

Most GPs in my experience couldnt distinguish there ar*e from your elbow when doing a BP check get an appointment with the practice nurse. You never know she might be fit like the nurse at my surgery 😈

To answer the original question…

When you’re checking BP you inflate the cuff above the patients Blood pressure and then you slowly deflate the cuf whilst listing for blood flow through the brachial artery (around about the elbow), The first sound that you here is when blood first forces its way past the cuff (Karotkoff sound 1) this is your systolic blood pressure (the amount of pressure your heart is generating). The second sound your listening for is the sound of silence (Karotkoff Sound 5) which is the sound produced as all the turbulent flow created by the pressure of the cuff ceases. This is your diastolic pressure (the resting pressure in your vascular tree).

It is sometimes difficult to catch exactly where it goes from very quiet to silence (especially in the noisy surgery, or with a shit stethoscope).

The machines that measure blood pressure work in approximately the same way but are less accurate.

Non of this means you have an irregular heart beat in any way (you may or may not) but just that they couldn’t hear you Karotkoff sounds properly.

p.s. Ourman – Right bundle is not an arrythmia, it’s a conduction problem…. As you say fairly common in thin young men.

p.p.s. Any questions let me know

Good explanation dr death, I would agree electronic method’s of measuring BP can be unreliable and manual readings are more accurate. That is unless you are using invasive CVP and Arterial lines, which is what I would have demanded! Joking.

Cool explanation Dr D.

Thanks Dr Death, a very clear explanation.

I’ve looked it up on the NHS website and it looks like it’s not really really high (It was 126/90) but higher than it should be for a female cyclist, not obese, early 20s. I was thinking it probably wouldn’t help that she’d told me my heart sounded funny prior to measuring my blood pressure! Ahh well will just wait and see and hope it’s lower in 2weeks.

The doc put it down to nerves in the end which seems quite a common thing.

White Coat Syndrome. My Mrs gets this 🙂

Do the doctors in the house know how those blood oxygen measuring things work? They clipped a thing on Mrs Grips’ finger and it told her what her blood oxygen saturation was. How the hell does it do that without drawing blood?

Nicked from wikipedia…. (Coz I couldn’t be arsed to type it all out in my own words).

A pulse oximeter is a particularly convenient noninvasive measurement instrument. Typically it has a pair of small light-emitting diodes (LEDs) facing a photodiode through a translucent part of the patient’s body, usually a fingertip or an earlobe. One LED is red, with wavelength of 660 nm, and the other is infrared, 905, 910, or 940 nm. Absorption at these wavelengths differs significantly between oxyhemoglobin and its deoxygenated form, therefore from the ratio of the absorption of the red and infrared light the oxy/deoxyhemoglobin ratio can be calculated.