Feeling the heart before listening

Does your doctor feel your heart before listening--hand flat across the upper chest to feel for thrills and palpating the PMI? Especially interested in responses from women for whom feeling the PMI may be a bit of a challenge. I always do this with my play patients but I've never had a real doctor do it.

For me too its a vital and thoroughly enjoyable part of any play exam. I've never had it done to me explicitly in a real exam, although once in my company physical the doctor actually placed her hand on my heart as she was talking about it - almost as if she was doing it subconsciously, and her training automatically made her bring to mind the size and position if it in my body.

PMI is located under and lateral to the left breast. I don't know what your doctor was palpating on your upper chest.

No I've never had this done by a real doctor. I have had it done it by a special someone though ?

Never by a real doctor, but for a play exam is highly erotic 😃

I learn something every day

http://ruby.fgcu.edu/courses/80277/Cardiac.html

In my experience in India and UK, I have found doctors wanting in their auscultation skills. Many dont even want to listen. Many here in India these days want to treat common ailments with just history. So careful auscultation, as a skill described in textbooks is rarely practiced these days. Leave alone palpating, I have not seen many doctors even listening to all regions of heart properly.

I confess that I rarely do this anymore unless I truly suspect cardiomegaly. I know I should but due to time constraints in a busy ER I simply don't have the time. I was certainly taught to do this as a student. Feeling for thrills is redundant when you can hear them much better.

I was taught to do this as well and generally did so in patients with any reason to suspect cardiac problems. It actually starts with inspection...looking at the precordium, preferably with oblique lighting. In a thin person or one with cardiomegaly you can sometimes see the impulse. Then you lay your hand flat and very gently across the precordium. The tip here is no pressure. If you apply pressure you may not feel an otherwise palpable impulse. Admittedly low yield but...an excellent physical diagnostic technique. Nowadays probably omitted in favor of an echocardiogram. BTW, speaking of relatively nuanced physical diagnosis, has there been a discussion of bell vs diaphragm with the stethoscope? I note with medical students nowadays they all seem to use the diaphragm exclusively. Yet I was taught to use the bell since many cardiac sounds are low frequency and may be obliterated with the diaphragm. Many students are amazed when I show them.

That's why the sprague is better for listening to gallups and low pitched sounds.

Mine never do, apart from the GP that diagnosed me back then - she could feel the thrill around the site of my murmur and got rather concerned. I've got medium sized boobs, but you can see my heartbeat through multiple layers of clothing..

I've only had it felt during a play exam, and that was after listening.

Never had a doctor palpate my heart before but I sure would love it!

I don't have white coat syndrome so when or if my annual doctor listens my heart beats normally but if she was to put her cool hand on my bare chest, my heart would start leaping into her palm. My chest and heart are very sensitive when it comes to being examined in that way. Since she never does it though it's just boring...thinking I will ask her to feel my pulmonic area (loudest most palpable area of my heart) next time I go see her. I don't think there's anything wrong but I would enjoy seeing her hand bounce up and down to my hearts forceful squeezing action

Yes I get palpated before auscultation in my exams, with the doctor placing their hands across my chest under my left nipple to check the apex beat.

This is usually how I precede the stething of my RP patients! I also encourage my RP doctors to do the same. In person, my doctor is usually in such a hurry that she tends not to even bother lifting my shirt. That can't be thorough enough, can it? 😉

Never heard about this. Heart getting palpated, sounds interesting. Would not like to have it by a real doctor, specially if he is a male. Though if required for actual medical purpose, I would let a female doctor do this.

However I would enjoy the same in a play exam.

No, never unfortunately.

I can't remember my GP ever done this to me.

Never had a doctor do this but I would love to experience it 😃

Nope just stethed me

Never, the doctor immediately auscultates me

In my childhood, I remember an exam by an "old style" pediatric surgeon that gave me a very long and detailed clinical exam, including heart palpation and anterior chest percussion (procedures never seen again in other occasions) before a careful heart auscultation in different positions

It happened to me only once.

When I was about 13, I had one of the last visits from my pediatrician, it was for a sport certificate.

That day he was more thorough than usual, he fist percussed on my anterior chest for identify the exact size of my heart, and, while doing that, he marked the four valve spots tracing a cross with a pen, eventually he placed the stethoscope right over each mark and listened for a good about of time.

I have never had this done. He only uses the stethoscope.

IT sounds interesting but my general practitioner has never done like this. It would for sure be quite erotic so maybe in a exam roleplay I could consider that. But I guess that real doctors are usually so experienced they do not need to do so 😢

I saw it done by a doctor back in 2004, while he was examining my then girlfriend. He had just found her murmur. I had spotted it myself and told her about it, so she was astonished when the real doctor's diagnosis agreed with mine 😜

He placed his right hand over the lower end of her left breast. I remember he took his time feeling her heartbeat there. She was a very slim girl, almost flat-chested, so he must have felt her heart in great detail.

Of course, I never neglect to do it in my play exams.

Cheers

He placed his right hand over the lower end of her left breast. I remember he took his time feeling her heartbeat there. She was a very slim girl, almost flat-chested, so he must have felt her heart in great detail.

Man!!! I would crawl on my hands and knees through broken glass just to get the chance to watch such a scene in real life!!! Please, PLEASE, could you write more about her and about the examination itself?

Man!!! I would crawl on my hands and knees through broken glass just to get the chance to watch such a scene in real life!!! Please, PLEASE, could you write more about her and about the examination itself?

Sure, I'll share. 😃

So she was a girl I used to work with. She was a tall, slim girl, short (almost boyish) brown hair, fair skinned. As I said before she was almost flat-chested. She was my first 'relationship' after my divorce, and we became quite close.

She looked a bit like this: https://i.pinimg.com/originals/25/0b/57/250b575600e44da721da4189bf754401.jpg

At one point we went to her GP because she was feeling really really low. He suspected depression (and was right, as it turned out), and prescribed Ladose for her (this is the brand name of Prozac in my home country). The medication would do the trick, and she would be back to her normal self before long. Anyway, he was very helpful and polite, chatting away with both of us, trying to get to the bottom of the problem through consultation. And then he suddenly said, "but let's have a look at you now, why don't you move over to the examination couch". He performed a rather cursory auscultation on her (lifting her blouse, not removing her bra), and spotted her heart murmur. I remember him asking "have you been told you have a heart murmur before", and she said "yes". I was the one who had told her. 😃

Anyway, he referred her to a cardiologist, saying that it wasn't really anything to be concerned about, but best practice was to have a heart ultrasound done.

I went with her to the cardiologist's appointment, which was a week or so later. Needless to say, during that week I broke some personal records. Not only had I seen her examined by her GP, but I was also going to be present for her specialised heart exam.

The cardiologist wasn't alone in his office - he also had a younger doctor with him. He asked her to remove all of her top clothes, and he began by palpating her chest. I remember seeing his hand firmly pressed on her thin chest. He moved it around, felt along various areas, and even pressed his palm on her ribcage around her left side. Then he auscultated directly on her mitral valve and moved on to perform an ultrasound on her. He had her lay down for that, and then turned over on her left side. I remember all of that quite vividly. I observed her heartrate, which was about 95 - 105 as she was laying down. The younger doctor was looking at the ultrasound screen very attentively, and at some point he pointed to a black dot and said "there", and the older doctor said "exactly, well done". So I guess the younger guy was in some kind of training.

At the end, the doctor said that indeed there was a murmur, the GP wasn't wrong. But it was totally benign and nothing to worry about.

That was more or less it. As you can imagine, I have kept those images in my mind and tried to make sure they don't fade over the years (and yet, the bastards do fade). But it was one of those lucky, precious moments that happen very few times over a cardiophile's life time.

Do write to me privately if you want to chat more. 😃

Have a great weekend!

I think that mainly cardiologists do this routinely when examining the heart. Went to one several years ago just to be sure things were ok given some family history and he felt my chest before listening. This was preceded by an ekg and followed by an echo.

Wow!!! Man With Stethoscope, thank you for sharing that wonderful experience! I really do wish I had the chance to just sit and watch such an examination myself! 😃