The Art & Science of Cardiac Physical Examination 2nd Edition PDF

The Art & Science of Cardiac Physical Examination

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The first edition of our book was the result of our long-lasting interest in promoting the usefulness and value of proper cardiac physical examination in the assessment of cardiac patients. It is a culmination of our long-lasting experience in teaching and training physicians and students of cardiology. We have offered a course annually of the same title in Toronto over the last 35 years. Modern technological advances both invasive and non-invasive have contributed significantly to our knowledge and understanding of cardiac physical signs and their pathophysiologic correlates. Both students and the teachers alike become impressed by these technological tools to the extent of neglecting the age-old art as well as the substantial body of science behind the cardiac physical examination. These technological advances are here to stay. However, some have even gone to the extent of suggesting that a “physician should have an all purpose tool in his or her pocket that would be more in keeping with the 21st century than the stethoscope, a 200-year-old technology whose time should be over”.1 One must never forget that any tool or instrument is only as good as the person using it. The information that can be derived from the proper assessment of the jugular contours, the precordial pulsations, the arterial pulses as well as cardiac auscultation can never be considered waste in terms of the assessment of a cardiac patient, in our opinion. It is not only cost effective and satisfying and can never be counterproductive to the patient’s needs. In addition, it could be lifesaving under certain circumstances (such as in remote locations, during power failure and times of disaster). Neglect of these basic skills, expected of physicians and cardiologists to be, will not augur well for the future generation of the physicians and patients alike.
The positive features of our book include among other things innovative and proven effective teaching methods with the use of recordings of not only heart sounds and murmurs but also the actual video-recordings of both normal and abnormal jugular pulsations as well the precordial pulsations together with arterial flow signals and/or the heart sounds for timing of the events in relation to the cardiac cycle. We were pleased and not totally surprised however, when we discovered that our book was translated into Chinese, a few years ago.2 It suggests also that not all physicians share the opinion of some who would like to name the stethoscope as “archaic instrument” and lock it up in their office chest. In addition, it indicates a need to reach out to more medical schools and the institutions in many developed and developing nations. We are hoping that it would achieve that goal with our current publishers of this new and improved second edition.
In addition to the ‘The Art and Science of Cardiac Physical Examination’, we have also been interested in teaching 12-lead ECG interpretation to physicians and trainees for many years offering annual courses. ECG is often considered an integral part of the office assessment of a cardiac patient and almost considered to be an extension of cardiac physical assessment. Most physicians either have or have access to an ECG machine in their offices. ECG is also indispensable in the assessment of patients presenting with acute symptoms of chest pain and or dyspnea. Therefore, when we were faced with the opportunity of providing a second edition, we wanted to make the book even more comprehensive. In addition to updating new and relevant information in several of the previous chapters of the first edition, we have included three new chapters. These consist of the following: a complete chapter consisting of six different sections which cover fully the 12-lead Electrocardiogram Interpretation, a second chapter showing how to integrate the ECG into Cardiac Diagnosis and a third and final chapter for Self-Assessment at the end with several interesting clinical cases from our own practice. In addition, we have added a self-assessment section in the companion CD with several new clinical examples. We believe that these self-assessment sections would serve as a good review as well as being useful for reinforcement purposes both in self-teaching and/or group learning sessions.

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