When the puzzle pieces don't fit, consider the whole patient
As practitioners, we risk missing something if we focus too narrowly on our specialty area
24th September 2018
Patricia is 76 years old; a tall, slim retired shop manager.

Many months ago you referred her to a local cardiologist after she had come to you complaining of new ankle oedema.
Examination at the time revealed a loud midsystolic murmur.
She had no other symptoms or signs of note, but you were concerned she may have aortic stenosis or sclerosis.
She has returned a year later for a pre-operative review.
The cardiologist had confirmed severe aortic stenosis and