When enquire about his heart, patient confirm hole in heart disease since childhood.
Take note of the break in the collarette at the heart reflex zone. (‘1’) According to him, he had undergone corrective for this problem twice.
Patient also indicate that he felt pulsating pain at his back (box 2) probably due to his heart problem.
Patients confirm hole in heart disease and experience shortness of breath.
Take note of the lacuna at the heart reflex zone. (‘1’). As the collarette is not broken, the heart can still function except for the illness that a hole in heart patient will experience. Also take note of the corneal opacity affecting circulation (‘2’). The light bluish gray ring (box ‘3’) is indicative of anemia of the body.