Dynamic Auscultation
Fig. 2.1 Normal splitting of S2 during inspiration. P2 sounds later during inspiration due to increased venous return and blood flow through the pulmonic valve (Used with permission of Texas…
The Innocent Murmur
Fig. 23.1 Still’s murmurs are generally Grade 1–3 early systolic murmurs heard best by placing the bell of the stethoscope between the lower left sternal border and the apex of…
The Clinical Assessment of Ejection Fraction and Hemodynamics in Congestive Heart Failure
Fig. 22.1 Pulmonary capillary wedge pressure (PCWP) measurements are reported in relation to the clinical presence (+) or absence (−) of jugular venous distension (JVD) and the presence of a…
The Austin Flint Murmur
Fig. 12.1 Graphical representation of auscultation findings in a patient with the Austin Flint murmur Test Results Color M-mode and 2-D echo (Fig. 12.2a–d). Fig. 12.2 (a–d) Echocardiograms. (a) An…
Aortic Sclerosis
Fig. 4.1 Aortic valve sclerosis is characteristically a soft, early to mid-systolic ejection murmur in the 2nd right interspace with a normally split S2 without a click The carotid pulses…
Palpitations
Figure 3.1 Classification of palpitations according to history and ECG findings. Abbreviations: SVT supraventricular tachycardia, AVNRT atrioventricular nodal reentry tachycardia, AVRT atrioventricular reentry tachycardia, AT atrial tachycardia General Patient Approach…
Chest Pain
Category Syndrome Key features Cardiac Stable angina Precipitated by exertion/relieved by rest Acute coronary syndromes Sudden onset/duration >20 min. Associated with dyspnoea and autonomic symptoms Pericarditis Sharp, pleuritic. Relieved by…
Dyspnoea: Focus on Heart Failure
Figure 2.1 Differential diagnosis of dyspnoea. SOB shortness of breath Definition of Heart Failure Heart failure (HF) is a common clinical syndrome whereby the heart fails to meet the metabolic…
Systemic Hypertension
Clinic BP measurement Category Systolic Diastolic Optimal <120 <80 Normal 120–129 80–84 High-normal 130–139 85–89 Stage 1 hypertension 140–159 90–99 Stage 2 hypertension 160–179 100–109 Severe hypertension ≥180 ≥110…
