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Chiropractic Research Review

The Essentials of Cardiac Assessment

Cardiovascular disease accounts for approximately one million U.S. deaths annually, and more than 14 million Americans suffer from angina, have a history of a heart attack, or have experienced both.

The evaluation of cardiac heart sounds (auscultation) is one of the most demanding and challenging of all assessment skills. However, it is a necessary skill for chiropractors who perform physical examinations, school physicals, pre-employment examinations, sports participation physicals, or are monitoring patients with known cardiac conditions.

This article discusses the fundamentals of the cardiac examination, including assessment and identification of heart sounds. The article also focuses on normal or expected cardiac examination findings and common pathologies that may produce "extra" heart sounds. Also included is a discussion of:

* peripheral and precordial inspection;
* palpation techniques;
* cardiac percussion;
* specific heart sounds (S1, S2, S3, S4);
* systolic and diastolic clicks; and
* heart murmurs.

Cardiac evaluation is vital to appropriate clinical assessment procedures. This skill is particularly important for doctors of chiropractic because they often see patients more regularly than do other health care professionals.

Mannello DM. The fundamentals of the cardiac examination. Topics in Clinical Chiropractic 2000:7(3), pp28-37. Reprints: (800) 638-8437

Chiropractic Research Review

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