Broken Hearts

It was a new day.  Wednesday morning.  A good night's sleep and hearty breakfast behind me, I was ready to start clinic again after a rough day on Tuesday.

My first patient walks in.  A 12 year old boy with his father.

Chief complain: chest pain.

Once he sat down I could see his thrill through his t-shirt.  

My heart sank.

In the United States, the complaint of chest pain is fairly common in pediatrics.  It is rarely related to cardiac etiology.  More commonly it is costochondritis, pleuritic, anxiety, etc.  But I was in a third world county and knew within a minute of being in the room that he had rheumatic heart disease.  

I swallowed the lump in the back of my throat and blinked through my tears.

The diagnosis confirmation came later that afternoon when his CXR, EKG, and ECHO returned.  His cardiac function is at about 60% so we placed him on some medications to help him maximize what function he has left.  Inevitably he will need surgery.

There is a group from the United States that replaces heart valves.  They do about 100 surgeries every year.

He's #126 on the list.