Abstract
Both cardiac size and dynamics are first estimated by precordial palpation. Descriptions of auscultation include definition of a cycle’s four basic cardiac sounds. Mitral valve prolapse, owing to its variability, prevalence, and historic place in cardiac imaging, is singled out for detailed description.
A method is presented to identify normal sinus rhythm, thus excluding ectopic rhythms. Variations in cardiac rate variations, normal and otherwise, are described in some detail as they may be assessed by physical examination. Reviewed are inappropriate rate responses to various positions and activities that can help detect autonomic neuropathies and that, by inference, may explain abnormalities in other visceral systems.
The syndromes of high and low cardiac output are described. The measureable results of high cardiac output can reflect diffuse vasodilation, arteriovenous shunting, or anemia. In the low-output syndromes, the cause is the inability of the central mechanism to match the peripheral need, whether the failing is in the central pump itself or from inadequate circulating volume.
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Phillips, R.E. (2018). Heart. In: The Physical Exam. Springer, Cham. https://doi.org/10.1007/978-3-319-63847-8_18
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DOI: https://doi.org/10.1007/978-3-319-63847-8_18
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