WITH THE PROFUSION of cardiac diagnostic tools that have appeared in the past few years, the continued importance of careful physical examination of the heart must be emphasized. In spite of the great benefits that have been reaped from invasive and noninvasive studies of the cardiovascular system, all too frequently the decision to obtain such studies and the interpretation of their results are not firmly based on careful assessment of the physical findings. Heart disease is sometimes diagnosed where none exists and is missed where it does because of too great a reliance on the infallibility of technologic tools of cardiac diagnosis. The pathophysiologic lessons learned from echocardiography, cardiac catheterization, and angiocardiography have been especially helpful in extending our understanding of heart sounds and murmurs. Noting the changes in auscultatory findings that result from physical maneuvers and vasoactive drugs administered at the bedside has been recently emphasized by deLeon and
Cochran PT. Bedside Aids to Auscultation of the Heart. JAMA. 1978;239(1):54–55. doi:10.1001/jama.1978.03280280054032
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