ANGIN

A common chief complaint in Malaysia. The literal translation is “wind”. But getting a diagnosis out of angin is totally havoc. Everything can be angin from dyspepsia, muscular pain, cardiac event, intestinal obstruction and fluid overload.

Saya rasa angin la doctor. Tengok urat urat saya ni timbul….buuuurppp (as he massages his veins). How is it possible to get angin in veins (urat)….is it AIR EMBOLISM? Why is he not in respiratory 

distress and collapsing?

Otot otot saya ni masuk angin doctor! If silap, it’s not angin in there but MASUK HANTU!

Saya rasa angin dekat belah dada ni….bbbbuuuurrrppp. Says the man triaged to Red Zone for Inferior Myocardial Infarction on inotropes. This must have been some HURRICANE of a WIND!

Angin ni doctor, tengok perut saya kembung ni. Really got angin inside him because of intestinal obstruction as he is unable to  buang angin as well.

Then, there are the confusing terms in Bahasa Malaysia. Who on earth decided to call stroke or CVA as angin ahmar? Who is Ahmar and what has it got to do with angin? Meanwhile, angin pasang is a bit less confusing as an inguinal hernia does look like there are angin in it.

Despite all these non sense, the scariest aspect is to wrongly diagnose a patient based on angin. Most elderly gentlemen will brush off cardiac events (chest pains) as angin which can be deadly. And sometimes when a doctor’s focus is at its lowest, doctors tend to just follow the patient’s assumptions and treat as dyspepsia without ruling out acute coronary syndrome (ACS). Most of the time it may be just dyspepsia and some patients DO get irritated when doctors perform ECG’s repeatedly, less than one hour apart. To junior doctors, please have a high index of suspicion of ACS when patients have risk factors…do at least one ECG just to make sure.