The diagnosis of heart disease by clinical assessment alone

Chizner, Michael A.

doi:10.1067/mcd.2001.115501

Cited by 19 publications

(3 citation statements)

References 120 publications

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“…We assessed the participants’ performance using a standardized checklist (see figure 2 (Fig. 2) ) [ 22 ], [ 23 ]. This checklist has been adapted from a cardiac findings checklist by Hatala et al [ 24 ] to match the participants’ clinical knowledge.…”

Section: Methodsmentioning

confidence: 99%

Evaluating the effectiveness of a structured, simulator-assisted, peer-led training on cardiovascular physical examination in third-year medical students: a prospective, randomized, controlled trial

Kronschnabl

Baerwald

Rotzoll

2021

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Section: Methodsmentioning

confidence: 99%

Evaluating the effectiveness of a structured, simulator-assisted, peer-led training on cardiovascular physical examination in third-year medical students: a prospective, randomized, controlled trial

Kronschnabl

Baerwald

Rotzoll

2021

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“…Subtle cardiovascular signs may be present in pulse wave abnormalities (Table 5). 51,52 The head and neck examination should include the following basic components: inspection of the head; eye gaze and vision; nose and symmetry of turbinates and septum; teeth, posterior oropharynx, and tonsils; ear canals and tympanic membranes; and palpation for enlarged cervical lymph nodes or thyroid. If symptomatic abnormalities are identified, the athlete should be referred for appropriate management.…”

Section: Physical Examinationmentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions

Conley

Bolin

Carek

et al. 2014

Journal of Athletic Training

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Objective: To present athletic trainers with recommendations for the content and administration of the preparticipation physical examination (PPE) as well as considerations for determining safe participation in sports and identifying disqualifying conditions.Background: Preparticipation physical examinations have been used routinely for nearly 40 years. However, considerable debate exists as to their efficacy due to the lack of standardization in the process and the lack of conformity in the information that is gathered. With the continuing rise in sports participation at all levels and the growing number of reported cases of sudden death in organized athletics, the sports medicine community should consider adopting a standardized process for conducting the PPE to protect all parties.Recommendations: Recommendations are provided to equip the sports medicine community with the tools necessary to conduct the PPE as effectively and efficiently as possible using available scientific evidence and best practices. In addition, the recommendations will help clinicians identify those conditions that may threaten the health and safety of participants in organized sports, may require further evaluation and intervention, or may result in potential disqualification.

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“…Cardiovascular examination with the acoustic stethoscope has been a time‐honoured approach for over 200 years (Bedford, 1972; Jay, 2000; Chizner, 2002). The audible presence of extra heart sounds, cardiac murmurs, and accentuations of normal sounds have given the physician insight into cardiac physiology and pathophysiology and have been corroborated by echocardiography (Hanna & Silverman, 2002).…”

mentioning

confidence: 99%

Audiocardiography in the cardiovascular evaluation of the morbidly obese

McCullough

Zerka

Heimbach

et al. 2010

Clin Physio Funct Imaging

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Morbid obesity is believed to limit cardiovascular auscultation. We compared audiocardiography to senior attending physicians using conventional stethoscopes in 190 individuals with morbid obesity. Overall, there were 128 (67.4%) women and 62 (32.6%) men with mean ages of 44.9 +/- 12.3 and 51.3 +/- 10.8 , respectively (P = 0.001). The overall body mass index (BMI) was 47.3 +/- 8.5 kg m(-2). Of those with an S(3) by audiocardiography (n = 7), one had a history of coronary artery disease (CAD), none had a history of heart failure, and one had a left ventricular ejection fraction (LVEF) <45%. The mean LVEF was 58.6 +/- 9.9 versus 61.6 +/- 5.3 for those with and without an S(3) by audiocardiography (P = 0.16). By contrast, of those (n = 6) with an S(3) by stethoscope, one had a history of CAD, two had histories of heart failure, and 3 had LVEF < 45%. The mean LVEF of those with and without S(3) by stethoscope was 53.7 +/- 2.3 and 61.6 +/- 5.5%, respectively (P = 0.02). There were 40 (21.1%) patients with an S(4) (S(4) strength >5) identified by acoustic cardiography while there were 42 (22.1%) heard by the stethoscope and it was heard with both methods in nine patients (21.4% concordance). There were no significant correlations between BMI or peak oxygen consumption and S(3) or S(4) strength by audiocardiography. Acoustic cardiography performed with an electronic device was not helpful in assisting the cardiovascular examination of the morbidly obese. These data suggest the careful clinical exam with attention to traditional cardiac auscultation using a stethoscope in a quiet room should remain the gold standard.

show abstract

The diagnosis of heart disease by clinical assessment alone

Cited by 19 publications

References 120 publications

Evaluating the effectiveness of a structured, simulator-assisted, peer-led training on cardiovascular physical examination in third-year medical students: a prospective, randomized, controlled trial

Evaluating the effectiveness of a structured, simulator-assisted, peer-led training on cardiovascular physical examination in third-year medical students: a prospective, randomized, controlled trial

National Athletic Trainers' Association Position Statement: Preparticipation Physical Examinations and Disqualifying Conditions

Audiocardiography in the cardiovascular evaluation of the morbidly obese

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