Heart exam for woman

Doctors usually tell women to take off their bras to auscultate the heart.

They should, but here in the US they rarely do. In a play exam, I always auscultate the woman's heart with her chest fully exposed. There's no way to listen all around a woman's heart, especially if she has large breasts, without exposing her breasts and lifting the breast to get a good listen at her mitral valve. Several of my "patients" have told me that I was the first one to steth them bare chested since they were children before their breasts developed.

Well said @steth . it's very unfortunate. sometimes I sympathize with the doctors but only because I wanted to be one and was going to med school at one point (long story) and there's literally so many people they see during an average day that they can't possibly spend the time they need nor want to with any of their patients, if they even really wanted to do that. it always feels very rushed or extremely brief. looking forward to the day I get a full auscultation

@nowyouseeme

looking forward to the day I get a full auscultation

If you're close by, my cardio stethoscope and I would be happy to give you the full auscultation you long for. Takes me a while to thoroughly auscultate a woman's heart.

@steth been dming you ..?

@steth your patient is large breasts??

@megaputra90 I've had the good fortune over the past 25 years to steth about a dozen women. Youngest was 19, oldest was 54. Breast sizes ranging from 32A to 40DD.

@steth Wow, you are very lucky to be able to check the health of those girls

@steth How many minutes do you usually perform a thorough auscultation on a female patient??

15-20 minutes to steth the heart of a woman with small to average breasts, add about 5-10 minutes for large breasts.

@steth

Wow, you took quite a long time to auscultate female patients, huh?

When I was a practicing internist seeing a new female patient I would do the History and Review of Systems, then ask the new patient to undress to her underwear but to please remove her bra as well. I left her with a cloth gown and returned in a few minutes, generally after seeing a quick return patient. So when doing the auscultation I had no items in the way. I'd only perform a breast exam if she wanted. On return visits I would only have her remove her bra if she had a cardiac condition making careful auscultation a must. Just my approach.

@pollux

wow you are very professional

where do you practice as a specialist? hospital or private?

Thank you @megaputra90 . I formerly practiced in both a private office and hospital but am now retired.

@Pollux very good

How has your experience been since practicing? Are the patients mostly women?

Half women half men. I retired 15 years ago

@Pollux If you do a heart auscultation examination on a woman, do you ask her to take off her bra too?

If I had a female patient who I needed to listen to carefully, e.g. a difficult murmur, I would have asked her to remove her bra and given her a gown and stepped out while she changed.

@pollux very professional, and what will your job be when you retire now? Are you still doing health checks?

Get this - at the cardiologist the nurse does the ekg with my wife’s shirt pulled up and bra on. Then the shirt goes back down and we wait for the male doctor or male PA. That exam is done by dropping the stethoscope down her shirt part way and then over the clothing for the other spots.

At the male PCP, the ekg is done by opening the gown so she is topless and putting the leads on. The doctor then uses the stethoscope on bare skin after pulling back the gown and exposing the area.

Seems like it should be the other way around!

My wife had a heart attack scare two years ago and we took her to the ER. they imediately stripped her completely and durring the next six hours it seemed like everyone in our town walked by the ER rooms and saw her bare chested. soooooo hot

In my opinion, emergency services in the ER are like that

The main thing is to do an ECG examination

At the gyn they do, my wife has to remove hers every time to be listened to.

In all of my real life doctor visits, except in the ER, did I have to remove my bra...nope. Not expected to be refmove by Iowa doctors.

I was a medic for years and would always auscultate patients topless regardless of gender