The article by Woywodt and colleagues1 addresses a very important issue. It highlights the clinical value of cardiac auscultation. The authors showed their enthusiasm to establish the diagnosis of an anomalous chordae in the right ventricle based on careful physical examination. Their suspicion was not substantiated until they requested a second echocardiogram.
Physical examination is an integral part of evaluating the patient. The more thorough the history and clinical examination, the more focused and cost-effective will be the subsequent laboratory evaluation.2 However, it is disappointing that many physicians have lost their faith in clinical skills, relying too heavily on laboratory and diagnostic investigations for solving clinical problems. As an example, it has become common practice to refer patients for echocardiogram to "evaluate a murmur."
Studies that showed low performance in clinical examination of physicians in training3 should not be surprising, as there is less emphasis on physical examination in medical . . . [Full Text of this Article]
