As with all systems, skill in the cardiovascular examination is a result of practice. The student should focus on developing their own system of examination that completes all aspects of the exam and becomes faster and more rhythmic with repetition. The sections in this chapter discuss the salient features of the exam, but the order of the exam is up to the individual examiner. Eventually, the pragmatic steps of the examination are so ingrained and routine that the examiner can perform them while observing the patient’s responses.
The physical exam is not a substitute for the clinical history. It is an adjunct that builds on the suspicions generated from the history, and should provide a basis for focused testing to rule in in or rule out the diagnoses.