Abstract
The cardiovascular history and physical examination remain an essential components of understanding cardiovascular physiology and in the management of patients with hemodynamic decompensation. Although newer technologies aid in the assessment of those with hemodynamic compromise, they by no means replace a thorough history and physical examination. A comprehensive understanding of key clinical findings remains invaluable.
From inability to let well alone;
from too much zeal for the new and contempt for what is old;
from putting knowledge before wisdom, science before art, and
cleverness before common sense;
from treating patients as cases;
and from making the cure of the disease more grievous than the
endurance of the same, Good Lord, deliver us.
– Sir Robert Hutchison MD FRCP (1871–1960)
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Stevenson LW, Perloff JK. The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA. 1989;261:884–8.
Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA. 2006;296:2217–26.
Drazner MH, Hamilton MA, Fonarow G, Creaser J, Flavell C, Stevenson LW. Relationship between right and left-sided filling pressures in 1000 patients with advanced heart failure. J Heart Lung Transplant. 1999;18:1126–32.
Butman SM, Ewy GA, Standen JR, Kern KB, Hahn E. Bedside cardiovascular examination in patients with severe chronic heart failure: importance of rest or inducible jugular venous distension. J Am Coll Cardiol. 1993;22:968–74.
Braunwald EPJ. Physical examination of the heart and circulation. New York: Elsevier; 2005. p. 817–8.
Marcus GM, Gerber IL, McKeown BH, Vessey JC, Jordan MV, Huddleston M, McCulloch CE, Foster E, Chatterjee K, Michaels AD. Association between phonocardiographic third and fourth heart sounds and objective measures of left ventricular function. JAMA. 2005;293:2238–44.
Wang CS, FitzGerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive heart failure? JAMA. 2005;294:1944–56.
Marcus GM, Vessey J, Jordan MV, Huddleston M, McKeown B, Gerber IL, Foster E, Chatterjee K, McCulloch CE, Michaels AD. Relationship between accurate auscultation of a clinically useful third heart sound and level of experience. Arch Intern Med. 2006;166:617–22.
Shah SJ, Marcus GM, Gerber IL, McKeown BH, Vessey JC, Jordan MV, Huddleston M, Foster E, Chatterjee K, Michaels AD. Physiology of the third heart sound: novel insights from tissue Doppler imaging. J Am Soc Echocardiogr. 2008;21:394–400.
Nagueh SF, Mikati I, Kopelen HA, Middleton KJ, Quinones MA, Zoghbi WA. Doppler estimation of left ventricular filling pressure in sinus tachycardia. A new application of tissue doppler imaging. Circulation. 1998;98:1644–50.
Nohria A, Mielniczuk LM, Stevenson LW. Evaluation and monitoring of patients with acute heart failure syndromes. Am J Cardiol. 2005;96:32G–40G.
Weis AJ, Salcedo EE, Stewart WJ, Lever HM, Klein AL, Thomas JD. Anatomic explanation of mobile systolic clicks: implications for the clinical and echocardiographic diagnosis of mitral valve prolapse. Am Heart J. 1995;129:314–20.
Little WC, Freeman GL. Pericardial disease. Circulation. 2006;113:1622–32.
Tyberg TI, Goodyer AV, Langou RA. Genesis of pericardial knock in constrictive pericarditis. Am J Cardiol. 1980;46:570–5.
Freeman GL, LeWinter MM. Pericardial adaptations during chronic cardiac dilation in dogs. Circ Res. 1984;54:294–300.
Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349:684–90.
Munt B, Legget ME, Kraft CD, Miyake-Hull CY, Fujioka M, Otto CM. Physical examination in valvular aortic stenosis: correlation with stenosis severity and prediction of clinical outcome. Am Heart J. 1999;137:298–306.
Leach RM, McBrien DJ. Brachioradial delay: a new clinical indicator of the severity of aortic stenosis. Lancet. 1990;335:1199–201.
Etchells E, Glenns V, Shadowitz S, Bell C, Siu S. A bedside clinical prediction rule for detecting moderate or severe aortic stenosis. J Gen Intern Med. 1998;13:699–704.
Babu AN, Kymes SM, Carpenter Fryer SM. Eponyms and the diagnosis of aortic regurgitation: what says the evidence? Ann Intern Med. 2003;138:736–42.
Choudhry NK, Etchells EE. The rational clinical examination. Does this patient have aortic regurgitation? JAMA. 1999;281:2231–8.
Reynolds HR, Hochman JS. Cardiogenic shock: current concepts and improving outcomes. Circulation. 2008;117:686–97.
Kohsaka S, Menon V, Lowe AM, Lange M, Dzavik V, Sleeper LA, Hochman JS. Systemic inflammatory response syndrome after acute myocardial infarction complicated by cardiogenic shock. Arch Intern Med. 2005;165:1643–50.
Landry DW, Oliver JA. The pathogenesis of vasodilatory shock. N Engl J Med. 2001;345:588–95.
Annane D, Bellissant E, Cavaillon JM. Septic shock. Lancet. 2005;365:63–78.
McGee S, Abernethy WB 3rd, Simel DL. The rational clinical examination. Is this patient hypovolemic? JAMA. 1999;281:1022–9.
Shaver JA, Leonard JJ, Leon DF. Examination of the heart. Part IV: auscultation of the heart. Dallas: American Heart Association; 1990. p. 13.
Roy CL, et al. Does this patient with pericardial effusion have cardiac tamponade. JAMA. 2007;297:1810–8.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Goel, S.S., Stewart, W.J. (2019). Key Clinical Findings. In: Askari, A., Messerli, A. (eds) Cardiovascular Hemodynamics. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-19131-3_10
Download citation
DOI: https://doi.org/10.1007/978-3-030-19131-3_10
Published:
Publisher Name: Humana, Cham
Print ISBN: 978-3-030-19130-6
Online ISBN: 978-3-030-19131-3
eBook Packages: MedicineMedicine (R0)