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Pulmonary puzzles
I hear the heartbeat, or things that go bump-bump in the night…
  1. Laurence Drake
  1. Correspondence to Dr Laurence Drake, Greensands Medical Practice, Brook End, Potton, Bedfordshire SG19 2QS, UK; laurence.drake{at}doctors.org.uk

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A 47-year-old woman telephones your surgery and says, “I can hear my boyfriend's heartbeat—from three feet away!” Do you:

  1. arrange an urgent psychiatric review for this obviously delusional woman?

  2. arrange an urgent psychiatric review for the Editors of Thorax for publishing a cardiology case report?

  3. or do something else?

On urgent review after the phone call, you can hear what sounds like his amplified heart sounds from over a metre away, especially if he leans backwards.

This …

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