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October 28, 1939


JAMA. 1939;113(18):1642-1643. doi:10.1001/jama.1939.72800430005008c

It seems that many physicians have little difficulty in learning to recognize normal heart sounds or in detecting the presence of a cardiac murmur but often their determination of the time of a murmur in the heart cycle is faulty. Cabot1 states that the commonest of all errors in diagnosis of diseases of the heart is the misinterpretation of systole for diastole.

In routine examinations, many physicians rely on the ear alone, calling on palpation or observation of the apex, carotid or radial impulse when in doubt. That present clinical procedure is not entirely satisfactory is borne out by the frequent errors every physician sees or makes himself. Mackenzie2 writes from his experience with recognized internists that many doctors never acquire the ability to time murmurs. Warfield, writing in Tice,3 points out the possibility of mistaking a seesaw murmur in mitral stenosis with regurgitation for a prolonged