Symptoms or physical examination findings may suggest a cardiovascular disorder. For confirmation, selected noninvasive and invasive cardiac tests are usually done (1).
History
A thorough history is fundamental; it cannot be replaced by testing. The history must include a thorough systems review because many symptoms apparently involving other systems (eg, dyspnea, indigestion) may be caused by cardiac disease. A family history is important because many cardiac disorders (eg, coronary artery disease, systemic hypertension, bicuspid aortic valve, hypertrophic cardiomyopathy, mitral valve prolapse) have a heritable basis.
Serious cardiac symptoms include chest pain or discomfort, dyspnea, weakness, fatigue, palpitations, light-headedness, sense of an impending faint, syncope , and edema. These symptoms are common in multiple cardiac diseases as well as in noncardiac diseases.
Physical Examination
The general cardiovascular examination and cardiac auscultation are discussed elsewhere.
Despite the ever-increasing use of cardiac imaging, bedside examination remains useful as it is always available and can be repeated as often as desired without the cost of a formal imaging test. Clinician-operated bedside devices, such as the sphygmomanometer and the stethoscope, have long been a part of the physical examination.
Point-of-care ultrasound done by the clinician at the bedside is an important adjunct to physical examination.
Reference
1. Fang JC, O'Gara PT: History and Physical Examination: An Evidence-Based Approach. In Libby P, Bonoow RO, Mann DL, et al (eds): Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed. Philadelphia, Elsevier, 2022, pp 123-140.
