Accuracy of cardiac auscultation in the era of Doppler-echocardiography: A comparison between cardiologists and internists

Abstract To investigate the present accuracy of cardiac auscultation, we asked a group of senior cardiologists and internists to auscultate respectively 72 and 70 selected patients and to give a diagnosis of the type of lesions heard and their degree of severity, using transthoracic Doppler-echocard...

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Bibliographic Details
Published in:International journal of cardiology 2010-02, Vol.138 (3), p.308-310
Main Authors: Sztajzel, Juan M, Picard-Kossovsky, Michel, Lerch, René, Vuille, Cédric, Sarasin, François P
Format: Article
Language:English
Subjects:
Accuracy
Aged
Aged, 80 and over
Biological and medical sciences
Cardiac auscultation
Cardiologists
Cardiology - standards
Cardiology. Vascular system
Cardiovascular
Cardiovascular system
Echocardiography, Doppler
Female
Heart Auscultation - standards
Heart Valve Diseases - diagnosis
Heart Valve Diseases - diagnostic imaging
Humans
Internal Medicine - standards
Internists
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Reproducibility of Results
Residents
Ultrasonic investigative techniques
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Summary:Abstract To investigate the present accuracy of cardiac auscultation, we asked a group of senior cardiologists and internists to auscultate respectively 72 and 70 selected patients and to give a diagnosis of the type of lesions heard and their degree of severity, using transthoracic Doppler-echocardiography as the standard reference. The percentage of correctly identified auscultations by cardiologists and by internists, particularly for common valvular lesions, such as aortic stenosis and mitral regurgitation, was respectively 76.1 vs 64.9% ( P = 0.0787) for all types of lesions taken together, 57.1 vs 48%.0 ( P = 0.5057) for mild, 82.4 vs 76.0% ( P = 0.3335) for moderate–severe and 81.8 vs 27.3% ( P = 0.0300) for lesions without degree of severity, which included cases of atrial septal defect (ASD) and of hypertrophic cardiomyopathiy (HCM). Our findings show that in the Doppler-echocardiographic era overall cardiac auscultatory proficiency for common valvular lesions is similar in cardiologists and internists. Cardiologists perform better than internists only when auscultating more rare cadiac lesions, such as cases of ASD or HCM.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2008.06.066