heart murmers

[navigator420]

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is that skill important in clinical decision making in modern day medical practice? i mean every body can identify a systolic murmer but when its a diastolic murmer with a presystolic accentuation and a opening snap..... do we really need to worry about all that?

 

[roja]

Sure.


Heart murmur in someone with a fever.... (endocarditis) kind of important.


Critical AS: kind of important to pick up the murmur.


You don't necessarily need to have the whole schpeal, but you need to be able to pick one up and in the ER know that there are some life threatening things you need to think about with them.

 

[Doczilla]

A new S3 is highly suggestive of CHF.


'zilla

 

[ERMudPhud]

Just to play Devil's Advocate:

Fever with a murmur- Far more likely to be just fever with a flow murmur but fever with a history/risks for endocarditis better worry about endocarditis even if you can't hear a murmur.

I agree CHF should be a clinical diagnosis but I can't ever recall a time that an S3 made the difference in diagnosing it. The hospitalist is going to make you get the BNP before they go upstairs anyway.

 

[MasterintuBater]

I would have to agree that recognizing heart sounds does not do much to change your management.

CHF? Hearing or not hearing an S3 isn't going to change your management any more than hearing crackles but not seeing any JVD.
Endocarditis? Hearing or not hearing a murmur probably won't change your management because it will only be support for suspicion based on history of IVDA, RHD, whatever.
I've also wondered if auscultation of the heart is becoming a lost art based on new technologies. Sure you get cool findings sometimes, and it often supports a diagnosis, but i've never really seen it CHANGE management.
I'm sure someone can sight random isolated examples, which I would be curious in hearing. Just wanted to share my sentiments with the OP.