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From: David Rind <>
Subject: Re: What are "Distant Heart Sounds"?
Date: Mon, 30 May 2005 15:44:30 -0400
Message-ID: <d7fqf8$kkj$>

James E. wrote:
> What are "distant heart sounds" when noticed during a physical for cancer?
> My hematologist did not mention it to me when he did a physical but it shows
> up in his written report.
> I can't get hold of my doctor to explain this to me. Something new to worry
> about?

"Distant heart sounds" is doctorspeak for "I couldn't hear the heart
sounds very well and I think that was because the heart is far away from
my stethoscope." Typically the reason for this is obvious -- either the
patient is overweight or has an expanded chest because of lung disease
such that either fat or air has created distance between the heart and
the surface of the chest. In any case, it is not a comment that implies
any sort of heart problem.

David Rind

From: David Rind <>
Subject: Re: What are "Distant Heart Sounds"?
Date: Tue, 31 May 2005 07:24:08 -0400
Message-ID: <d7hhgu$jit$>

Andrew B. Chung, MD/PhD wrote:
> If this is a **new** finding in someone with a history of cancer, there
> would be a concern that there might be the **new** development of
> increased fluid around the heart (pericardial effusion).  Would suggest
> you ask for a referral to consult with a cardiologist about this if
> indeed it is a **new** finding.

If the doctor had actually been worried about that, he or she would have
written "muffled heart sounds" (yet more doctorspeak for "I didn't hear
the heart very well and I'm worried it was because of a pericardial
effusion"). Suggesting that a comment like "distant heart sounds" (that
is written by doctors all the time without any negative implication) is
an indication for a referral to a cardiologist is just worrying the OP
for no reason.

David Rind

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