The determination of the fitness of the heart for military service presents problems that are seldom encountered in civil practice. Thus it is frequently necessary for the examiner to rely on signs alone, and these may be of questionable significance. Tachycardia, systolic murmurs and slight elevation in the blood pressure are commonly observed. Certain persons with tachycardia give poor response to exercise. This may have resulted from sedentary life or from chronic infection, or perhaps the history may disclose that it has been present since childhood.
Acceleration of the cardiac rate is often the first and maybe the only feature that attracts the attention of the examining physician. This is usually due to excitement incident to the examination and thus promptly subsides as the subject becomes relaxed. If, however, it persists, a careful search for a cause is demanded. Tachycardia may be caused by various conditions but is more commonly
SMITH FM. EXAMINATION OF THE HEART FOR MILITARY SERVICE: CHAIRMAN'S ADDRESS. JAMA. 1941;117(5):329–330. doi:10.1001/jama.1941.02820310001001
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