Table Of Contents:
Preface vii
A Complete Course in Heart Sounds and Murmurs on CD

The Checklist in History Taking 1(16)

Advantages of a Checklist 1(1)

Reminder List History 2(1)

Etiologies 3(4)

Follow-Up Questions 7(7)

New York Heart Association Functional and Therapeutic Classification 14(3)

Cardiac Clues From Physical Appearance 17(12)

Skin 17(3)

Congenital and Acquired Facies 20(2)

Eyes 22(3)

Edema 25(1)

Extremities 26(1)

Chest and Respiration 27(2)

Arterial Pulses and Pressures 29(34)

Method of Arm Palpation 29(1)

Rates of Rise and Pulse Volume 30(7)

Pulsus Bisferiens 37(1)

Palpation of the Leg Pulses 38(1)

Estimating Systolic Blood Pressure by Palpation Alone 39(1)

Accurate Blood Pressure Measurement 40(1)

Korotkoff Sounds 41(1)

Chest Piece Placement and Choice 42(1)

Equipment Sources of Error 43(1)

Systolic Pressure Measurement 44(1)

Diastolic Blood Pressure Recording 45(1)

Accuracy of Blood Pressure Recording 46(2)

Summary of How to Take Arm Blood Pressures by Listening for Korotkoff Sounds 48(1)

Pseudohypertension 49(1)

Pulsus Alternans 49(2)

Blood Pressure and Pulses in the Legs 51(4)

Pulsus Paradoxus 55(3)

Capillary Pulsation 58(1)

Abdominal Aortic Aneurysm (AAA) 58(1)

How to Tell Cardiac Function by Blood Pressure Response to a Valsalva Maneuver 58(5)

Jugular Pressure and Pulsations 63(26)

Venous Pressure by Jugular Inspection 63(2)

How to Use the Internal Jugulars as a Manometer 65(1)

Method of Obtaining an Accurate Measurement of Venous Pressure 66(2)

How to Tell Jugular from Carotid Pulsations 68(2)

The Abdominal Compression Test (Hepatojugular Reflux) 70(3)

Jugular Pulse Contours 73(16)

Inspection and Palpation of the Chest 89(22)

Ventricular Enlargement from Examination of the Chest 89(5)

Cardiac Dilatation Signs in the Left Lateral Decubitis Position 94(2)

Right Ventricular Enlargement 96(3)

Left-Sided Causes of Left Parasternal Movement 99(2)

X-ray Evaluation of Cardiac Size 101(2)

Diagnosis of Ventricular Hypertrophy by Physical Examination of the Precordium 103(8)

The Stethoscope 111(6)

The Bell Chest Piece 111(2)

The Smooth Diaphragm 113(1)

The Tubing 114(1)

Air Leaks and Ear Tips 115(1)

Summary of Good Stethoscope Characteristics 116(1)

Diagramming and Grading Heart Sounds and Murmurs 117(4)

The Auscultogram 117(2)

Grading of Heart Sounds and Murmurs 119(2)

The First Heart Sound (S1) 121(12)

Physiology of the First Sound Components 121(2)

The M1 Plus Aortic Ejection Sound as the Cause of a Split S1 123(2)

The Pulmonary Ejection Sound 125(4)

Loudness of the M1 129(4)

The Second Heart Sound (S2) 133(22)

Physiology and Nomenclature for the S2 133(1)

Explanation of Normal Splitting Sequence of S2 134(2)

Physiology of the Normally Moving Split 136(1)

Loudness of the Components of S2 137(6)

The Widely Split S2 143(1)

The A2--P2 in Pulmonary Stenosis 144(2)

ASDs with Narrow Splits 146(1)

Differential Diagnosis of the Fixed Split 147(1)

The Narrowly Split S2 148(1)

The S2 Split in Pulmonary Hypertension 149(1)

The Reversed or Paradoxically Split S2 150(5)

The Opening Snap 155(8)

Mechanism and Timing 155(1)

Relation Between the 2--OS Interval and the Severity of Mitral Stenosis 156(3)

The Loudness of the Opening Snap 159(1)

How to Tell an A2--P2 from an A2--OS 160(3)

The Third Heart Sound (S3) 163(12)

Nomenclature 163(1)

Timing 163(2)

Mechanism of Production 165(1)

The Physiological S3 166(1)

Loudness of the S3 167(2)

The Exaggerated Physiological S3 169(1)

The Pathological S3 170(1)

The Physiological Versus the Pathological S3 170(1)

The Right Versus the Left Ventricular S3 171(1)

The S3 Versus the Opening Snap 172(3)

The Fourth Heart Sound (S4) 175(12)

Nomenclature 175(1)

Mode of Production 175(2)

Recognizing the Rhythm of the S4 Gallop 177(1)

The Physiological S4 177(1)

The Pathological S4 178(2)

Loudness and Audibility of the S4 180(1)

Differentiation of the S4 from the S3 181(1)

Differentiation of an S4-S1 from a Split S1 (M1--A1 or M1--T1) 182(1)

Severity of Cardiac Dysfunction and Presence of an S4 183(1)

The S4--S1 Interval and Severity of Dysfunction 184(1)

Summation and Augmented Gallops 184(2)

The Pacemaker S4-Like Click 186(1)

Ejection Murmurs 187(26)

Physical Causes 187(1)

Characteristics of the Ejection Murmur 188(5)

Types of Ejection Murmurs 193(1)

Systolic Flow Murmurs 193(7)

Aortic Stenosis Ejection Murmurs 200(6)

Pulmonary Stenosis Ejection Murmurs 206(2)

The Effect of Respiration on PS Ejection Murmurs 208(1)

Thoracic, Subclavian, Carotid, and Thyroid Artery Flow Murmurs 209(4)

Systolic Regurgitant Murmurs 213(30)

The Effect of a Sudden Long Diastole on Left-Sided Regurgitant Murmurs 214(1)

Mitral Regurgitation Murmurs 215(8)

Effect of Drugs and Maneuvers on Systolic Regurgitant Murmurs 223(2)

The Prolapsed Mitral Valve Syndrome (Barlow's Syndrome) 225(4)

Tricuspid Regurgitation (TR) Murmurs 229(1)

The Cardiorespiratory Murmur 230(1)

VSD Murmurs 231(3)

Continuous Murmurs 234(9)

Diastolic Murmurs 243(22)

Diastolic Atrioventricular Valve Murmurs 243(10)

Tricuspid Diastolic Flow Murmurs 253(1)

Tricuspid Stenosis (TS) Diastolic Murmurs 253(1)

Diastolic Semilunar Valve Murmurs 254(4)

Pulmonary Regurgitation Murmurs 258(1)

Pericardial Friction Rubs 259(6)

Abdominal Murmurs 265(2)

Normal Abdominal Murmurs 265(1)

Abnormal Abdominal Murmurs 265(2)
Glossary 267(20)
Index 287