Elective Posting At Sarawak General Hospital : First Week

The first department that I was attached to for one week was Cardiology department. Dr Tan was the clinical cardiologist for that week. Every morning, there will be a discussion among the doctors in the seminar room. They will discuss their cases and decide for the best management for each case. Besides, a medical journal related to cardiology will also be presented if there is one. We started with ward rounds in the Cardiac Care Unit (CCU). Over there, I saw patients with rheumatic fever, pericardial effusion and bronchiectasis. Then, we continued with ward rounds in the Cardiac Thoracic wards. There, I saw a real rectal examination for the first time other than a rectal examination on a dummy or in a video. Haha I also saw patients with pedal oedema, heart failure, typical angina, triple vessels block and valvular heart diseases. For valvular heart diseases, the most common case was mitral regurgitation. Other than that, I saw a patient with a pacemaker and her pacemaker actually dropped out but the leads were stuck in her heart. It was difficult to pull out the leads due to long term fibrosis. The doctors are still deciding on what to do with her. I did physical examintaions on the patients. I managed to feel for a collapsing pulse. Lastly, we did ward rounds in the female and male medical and surgical wards where we only looked at patients with cases related to cardiac in origin. The most common case there was acute coronary syndrome. I did physical examinations on the patients too. I managed to listen to a systolic murmur from a patient with vasculitis and feel for a irregularly irregular pulse from a patient with atrial fibrillation. Dr Tan taught my friends and I about pulse deficit. After the ward rounds, we went to the Cardiac clinic to look at patients who came for echocardiogram and International Normalized Ratio (INR) follow up.


Echocardiogram


With the permission from the patient, this is a picture of vasculitis

During my free time, I went to the paediatric ward with my friend, Diana to look at the babies and children.


Arif (One of the twins) who had recovered from diarrhoea. Whenever I put him back on his bed, he would cry. Haha