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Test your knowledge or prepare for Boards with this collection of unusual and challenging patient studies focused on detecting valvular, congenital or vascular disease. Contains over 90 case histories with self-test questions designed to test the reader's knowledge and reinforce clinical best practices Focuses on diseases of valvular, vascular or congenital origin, and on comparatively rare disorders/diseases, rather than coronary artery disease, to help readers improve their skills at interpreting and making decisions based on physical examination and basic, non-invasive imaging modalities Each case is paired with original materials - e.g. x-rays, echocardiograms, lab reports, charts – so readers can work through their diagnosis using the same information as the physician who treated the patient originally An ideal companion for those approaching board review or recertification or who want to improve skills in physical diagnosis of cardiovascular disease

This brief guide to visual diagnosis helps the novice develop -- and the veteran refresh -- crucial skills that can spare the patient unnecessary testing and bring the physician one step closer to an accurate diagnosis. Dr Saksena draws on his years of experience in teaching and training to show you the physical signs of cardiovascular disease that can be spotted by visual examination. For each sign, a color photograph is paired with explanatory text that: describes the significant features of the sign explains its use in diagnosis identifies the likeliest causes The book provides corroboration of physical signs and other diagnostic information whenever possible and offers extensive references for further study. After an opening chapter on general observations, the author describes signs that can be found in the face, ear, mouth and nose, neck, hand, upper extremity, thorax and back, abdomen, and lower extremity. An appendix covers rarer syndromes associated with cardiovascular disease. Whether you are just developing your diagnostic skills or want to be better able to identify signs of cardiovascular disease, you can count on this atlas for dependable advice.

It has been our experience that instruction in physical examination of the heart in medical schools has been deteriorating since the advent of such modern diagnostic tools as two-dimensional echocardiography and nuclear imaging. At best, the teaching has been sketchy and too superficial for the student to appreciate the pathophysiological correlates. Both invasive and the noninvasive modern technologies have contributed substantially to our knowledge and understanding of cardiac physical signs and their pathophysiological correlates. However, both students and teachers alike appear to be mesmerized by technological advances to the neglect of the age-old art, as well as the substantial body of science, of cardiac physical examination. It is also sad to see reputed journals give low priority to articles related to the clinical examination. Our experience is substantiated by a nationwide survey of internal medicine and cardiology training programs, which concluded that the teaching and practice of cardiac auscultation received low emphasis, and perhaps other bedside diagnostic skills as well (1). The state of the problem is well reflected in the concerns expressed in previous publications (2–4), including the 2001 editorial in the American Journal of Medicine (Vol. 110, pp. 233–235), entitled “Cardiac auscultation and teaching rounds: how can cardiac auscultation be resuscitated?”, as well as in the rebuttal, “Selections from current literature. Horton hears a Who but no murmurs—does it matter?” (5).