Relationship Between Accurate Auscultation of the Fourth Heart Sound and the Level of Physician Experience

Gupta, Saurabh; Michaels, Andrew D.

doi:10.1002/clc.20431

Cited by 18 publications

(15 citation statements)

References 15 publications

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“…This detection rate is much higher than previously reported 11–13. Some authors have suggested that changes in prevalence of valvular heart diseases in Western countries made physicians less skillful in identifying them 14. Thirty-three out of our volunteer resident physicians (85%) were international medical graduates from developing countries.…”

Section: Discussionmentioning

confidence: 54%

Comparing the auscultatory accuracy of health care professionals using three different brands of stethoscopes on a simulator

Mehmood¹,

Grara²,

Stewart³

et al. 2014

MDER

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BackgroundIt is considered standard practice to use disposable or patient-dedicated stethoscopes to prevent cross-contamination between patients in contact precautions and others in their vicinity. The literature offers very little information regarding the quality of currently used stethoscopes. This study assessed the fidelity with which acoustics were perceived by a broad range of health care professionals using three brands of stethoscopes.MethodsThis prospective study used a simulation center and volunteer health care professionals to test the sound quality offered by three brands of commonly used stethoscopes. The volunteer’s proficiency in identifying five basic ausculatory sounds (wheezing, stridor, crackles, holosystolic murmur, and hyperdynamic bowel sounds) was tested, as well.ResultsA total of 84 health care professionals (ten attending physicians, 35 resident physicians, and 39 intensive care unit [ICU] nurses) participated in the study. The higher-end stethoscope was more reliable than lower-end stethoscopes in facilitating the diagnosis of the auscultatory sounds, especially stridor and crackles. Our volunteers detected all tested sounds correctly in about 69% of cases. As expected, attending physicians performed the best, followed by resident physicians and subsequently ICU nurses. Neither years of experience nor background noise seemed to affect performance. Postgraduate training continues to offer very little to improve our trainees’ auscultation skills.ConclusionThe results of this study indicate that using low-end stethoscopes to care for patients in contact precautions could compromise identifying important auscultatory findings. Furthermore, there continues to be an opportunity to improve our physicians and ICU nurses’ auscultation skills.

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Section: Discussionmentioning

confidence: 54%

Comparing the auscultatory accuracy of health care professionals using three different brands of stethoscopes on a simulator

Mehmood¹,

Grara²,

Stewart³

et al. 2014

MDER

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“…La sensibilidad y especifi cidad para cada síntoma, signo y examen útiles en el diagnóstico de la IC se revisa en la tabla 1 [13,16,[19][20][21][22][23][24][25][26][27][28][29].…”

Section: ¿Se Despierta Ahogado En La Noche?unclassified

“…El hallazgo de S4 siempre revela anormalidad cardiaca y usualmente está presente en disfunción diastólica [28]. Otras causas de S4 son hipertensión arterial, infarto agudo de miocardio y enfermedad arterial coronaria crónica [28].…”

Section: ¿Se Despierta Ahogado En La Noche?unclassified

Semiología y diagnóstico diferencial de la insuficiencia cardíaca crónica

Giraldo

Salazar

Buitrago-Toro

et al. 2018

Rev. Médica Risaralda

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Resumen: la insuficiencia cardiaca es un síndrome clínico de etiología multifactorial de alta prevalencia en la población mundial y latinoamericana debido al aumento en la expectativa de vida. Actualmente el diagnóstico de este se basa en los hallazgos de pruebas diagnósticas como el ecocardiograma o pépticos natriuréticos, pero es importante para el personal médico conocer e identificar de manera clara los signos y síntomas que presentan los pacientes con insuficiencia cardiaca, pues es una tendencia actual el desconocer datos semiológicos importantes que fueron descritos y refinados durante los siglos XIX y XX, y que ahora son validados por la medicina basada en la evidencia. Lo anterior cobra importancia pues el papel que debe tener la creciente tecnología no es acabar o desplazar el conocimiento clínico, si no ser una herramienta complementaria para el buen cuidado del paciente y así llegar al mejor desenlace posible.Este artículo pretende brindar datos basados en la evidencia para hacer de la clínica la parte fundamental del proceso diagnóstico y de la relación médico paciente. También intenta ser una guía útil para estudiantes de medicina o médicos que se desenvuelven en sitios con pocos recursos económicos, ya que la elección adecuada de un examen diagnóstico solo puede ser llevada a cabo mediante un buen interrogatorio y examen físico.Palabras clave: insuficiencia cardiaca; Diagnóstico; Signos y Síntomas; Colombia Copyright © Facultad de Ciencias de la Salud de la Universidad Tecnológica de Pereira. 1995-2017. Todos los derechos reservados ® Semiology and differential diagnosis of chronic heart failure Abstract: heart failure is a clinical syndrome with multifactorial etiology of high prevalence in the world and Latin American population due to the increase in life expectancy. Currently the diagnosis of this is based on the findings of diagnostic tests such as echocardiogram or natriuretic peptic, but it is important for the medical staff to know and clearly identify the signs and symptoms that patients with heart failure present, as it is a current trend To ignore important semiological data that were described and refined during the nineteenth and twentieth centuries, and which are now validated by evidencebased medicine. This is important because the role of growing technology is not to end or displace clinical knowledge, if not to be a complementary tool for good patient care and thus reach the best possible outcome.This article aims to provide data based on the evidence to make the clinic the fundamental part of the diagnostic process and the patient medical relationship. It is also intended to be a useful guide for medical students or physicians operating in poorly funded areas, as the proper choice of a diagnostic examination can only be carried out through a thorough examination and physical examination.Key words: heart failure; Diagnosis; Signs and Symptoms; Colombia Copyright © Facultad de Ciencias de la Salud de la Universidad Tecnológica de Pereira. 1995-2017. All rights reserved ®. Introducc...

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“…Previous randomized trials have shown the efficacy of slow-release polymeric sirolimus-(Cypher™; Cordis, Warren, NJ, USA), paclitaxel-(Taxus™; Boston Scientific, Natick, MA, USA), and zotarolimus-eluting stents (Endeavor™; Medtronic, Minneapolis, MN, USA) over bare metal stents in reducing neointimal hyperplasia, late luminal loss, and angiographic restenosis, leading to decreased target lesion revascularization [6][7][8][9][10]. Now, DESs are considered as first-line therapy for de novo lesions.…”

mentioning

confidence: 99%

“…Following two cardiac skills development sessions, interns were able to accurately identify over 60% of heart sounds which is comparable, if not favorable to physicians in-practice [5,6,9,10]. Skills were retained an average of 5.8 months after the teaching sessions.…”

mentioning

confidence: 99%