VITAL SIGNS

     In medicine we  have something called vital signs . These include pulse rate ,blood pressure ,temperature and respiratory rate. These are recorded in every patient - in out patient settings and also in ER and in patients setting  or hospitalized patients . The reason these are called Vital Signs , as they tell us about any  disease that needs immediate  treatment. If the Blood Pressure is high or low , it needs treatment and same with temperature - fever or hypothermia  and so on. In an average day in office - clinic , we do not have major issues with anything that needs emergency treatment related to Vital Sings abnormality. Certainly if Blood Pressure is very high we treat it and of someone has fever we treat it . This brings me to the story of this patient for today.

    I had seen this patient few times . He had abnormal CT scan of the chest and after doing the work up , we had done bronchoscopy , PET scan and breathing test and determined that he needed surgery and he had under gone surgery to take out part of the lung that had the growth. It was not a cancer . But we had done follow up CT scan as he was ex-smoker .This time he came to me and had a CT scan that was good , no abnormality was seen. But when I checked his pulse and oxygen saturation , the pulse was 33pwe min. This is very low heart rate - pulse rate . The Blood Pressure was normal , He had no shortness of breath or chest pain . He was not feeling dizzy He felt 'fine'. I checked hos pulse and heart rate to make sure that it was low. I tried to call his cardiologist and could not get anyone to call me . So I called his primary care and told him to see him ASAP. I was concerned that he would need to be admitted or may need pacemaker. 

   The patient and his wife were not very happy as 'he is fine '. I insisted that he goes to his primary doctor NOW . I also called him and he agreed to see him. He was seen and had HEART BLOCK , which means his electric circuit in heart was broken. He was sent to ER and he needed pacemaker . He was ot very happy and initially refused to have pacemaker ,but I called his wife and then he agreed  to have pacemaker. 

      The Vital signs are recorder thousands of time in office and this is one of those rare examples where they proved to be VITAL  and save life .