Tag Archives: clinical examination

The past: a historical perspective The earliest description of the heart sounds comes from William Harvey’s De Motu Cordis in 1628, in which he likened the heart sounds to “two clacks of a water bellows to raise water”, but it was not until Laennec invented the stethoscope in 1816 that cardiac auscultation superseded percussion and direct auscultation. Laennec proposed the use of “a cylinder of wood, perforated in its centre longitudinally, by a bore three lines in diameter, and formed so as to come apart in the middle”; this he termed the cylinder or stethoscope. This was followed in 1819 by his landmark work De

A skill in decline Competent cardiac auscultation is clearly in decline and the lack of ability to either hear or interpret an abnormality starts in medical school and continues through to junior doctors of all grades. In a recent study from Aarhus in Denmark, 80 medical students (second year with no clinical experience having only studied anatomy and practised cardiac auscultation for one hour in a skills laboratory (n=40), fifth year with one year of clinical experience (n=40), and 29 doctors (pre-registration house officers [PRHOs; n=20] and cardiologists [n=9]) were assessed with regard to their ability to detect cardiac murmurs and their