Tuesday,  July 16, 2013 • Vol. 15--No. 003 • 6 of 32

The telltale heart

Do you remember the short story "The Tell-Tale Heart" by Edgar Allan Poe? It ends with these words:
 "… - no, no! They heard! - they suspected! - they KNEW! - they were making a mockery of my hor

ror! … and now - again! - hark! louder! louder! louder! …
'Villains!' I shrieked, '… I admit the deed! - tear up the planks! here, here! - It is the beating of his hideous heart!"
I have a real story of a telltale heart. His wife almost had to force him to come to the E.R. She said he was unusually irritable. Although he typically kidded with me, this evening the smile was gone. He complained of a throbbing abdominal discomfort that spread into a tearing pain into his back. On exam he had a pulsating abdominal mass and upon listening with the stethoscope I could hear a repeating and prominent whoosh. My patient had the telltale indications of a dissecting abdominal aortic aneurysm.

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