Accuracy of cardiac auscultation in the era of Doppler-echocardiography: A comparison between cardiologists and internists

Cardiac auscultation poorly predicts the presence of valvular heart disease in asymptomatic primary care patients

“…However, its perceived utility has declined as a consequence of diminishing emphasis on the importance of clinical examination and the widespread availability of echocardiography 1. While previous studies have evaluated the use of auscultation in the diagnosis of VHD (mainly in children) among hospital doctors,2–6 none have assessed the auscultation skills of general practitioners (primary care/family doctors) in older subjects (in whom VHD is more common).…”

Variation in effectiveness of a cardiac auscultation training class with a cardiology patient simulator among heart sounds and murmurs

“…Not only does the identification of a typical heart murmur strongly suggest the existence of a certain valvular heart disease or congenital heart disease [2], but the presence of heart murmurs has also been shown to predict new-onset heart failure in primary care outpatients [3]. An abnormality in the second heart sound is also a helpful clue in the diagnostic process of patients with overloaded right ventricle or electrical conduction disturbances that affect right ventricular performance [1].…”

How valuable is physical examination of the cardiovascular system?

“…Since the advent of technological aids to diagnosis (TAD) such as echocardiography in the late 1970s, 4 the central role of physical examination in the practice of clinical cardiology has been challenged, [5][6][7] and its standard of practice has declined in some countries. [8][9][10][11][12] Despite this, many clinicians still use and attach significance to physical examination techniques in daily practice. In acute general internal medicine, the combination of history and physical examination without recourse to TAD still accounts for most diagnoses.…”