Functional Aspects of Myocardial and Valvular Disease: Clinical Correlations
An accurate and complete evaluation of heart function requires a systematic approach. The most commonly used method is composed of five logical steps. The first two elements are a satisfactory history and a thorough physical examination, which in the vast majority of cases permit at least a preliminary diagnosis to be made. The third step in the evaluation of a cardiac patient is the use of noninvasive techniques to define cardiac function. In the remote past, this was limited almost exclusively to the ECG, but in recent years, development of the phonocardiogram, vectorcardiogram, and especially the echocardiogram and noninvasive techniques, such as systolic time intervals and exercise stress, have permitted far more accurate and precise diagnoses. The fourth step includes the chest radiograph, which permits overall estimation of the cardiac and individual chamber sizes. The fifth and last step in this approach to cardiac diagnosis is cardiac catheterization. This technique has classically been reserved for the more difficult cases. It also serves as a foundation for all other diagnostic efforts. During the past ten years however, marked improvement in equipment technology and development of safer new techniques have permitted catheterization to be employed far more frequently.
KeywordsCardiac Catheterization Ventricular Volume Valvular Disease Systolic Time Interval Circumferential Fiber
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