Scrubs! This is the first in our Pop Culture Cases series, where we take medical storylines from television and break open the case to get at the smooth, creamy learning inside. Today we’re talking about Mr Burski, JD’s very first patient in the very episode of Scrubs (helpfully entitled My First Day).
If you like Scrubs (and most doctors do!), I’m sure you’ll find this episode interesting.
Mr Burski is admitted with what we think sounds like abdominal pain. JD notices a systolic murmur, which is most likely due to aortic stenosis. Mr Burski’s case is discussed in more depth in the opening video to the series.
Causes of aortic stenosis include…
Senile calcification
Congenital bicuspid valve
Rheumatic fever
Signs include a slow rising pulse, a heave if the ventricles are hypertrophied and the classic ejection systolic murmur, heard best in the second intercostal space just right of the sternum.
For more on identifying heart murmurs, check out our original video on the topic at
https://www.youtube.com/watch?v=YXXiMoEMYmI.In extremis, patients may experience chest pain, dyspnoea or syncopal episodes. Symptoms are usually suggestive of severe underlying disease.
Treatments include percutaneous valvuloplasty and an aortic valve replacement. Valve replacements can be tissue (porcine and bovine grafts, or from a cadaver) or mechanical. A mechanical valve necessitates long-term anti-coagulation.
Hope you find this video series useful! And let us know what topics you’d like to see us cover next.
REFERENCES:
1. Lawrence B (2001). Scrubs – Season 1 Episode 1 “My First Day”. Doozer. Touchstone Television.
2. Longmore M, Wilkinson IB, Davidson EH Foulkes A, Mafi AR (2010). Cardiovascular medicine. In: Oxford Handbook of Clinical Medicine (Eight Edition). Oxford Press. pp 86 – 153
3. Ballinger A (2012). Cardiovascular disease. In: Essentials of Kumar & Clark's Clinical Medicine (Fifth Edition). Saunders Elsevier. pp 407 – 504
4. Davies JER, Nijjer S (2014). Cardiology. In: Kalra, PA. Essential Revision Notes for MRCP (Fourth Edition). PasTest. pp 1 - 64
MUSIC:
Easy Lemon
Airport Lounge
Spy Glass
All courtesy of Kevin Mcleod at Incompetech.com
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