THOMAS KILLIP, M.D.
KILLIP T. Cardiac Auscultation. Ann Intern Med. 1983;99:881. doi: 10.7326/0003-4819-99-6-881
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Published: Ann Intern Med. 1983;99(6):881.
To the editor: Rothman and Goldberger (1) recently reviewed the usefulness of aids for cardiac auscultation and noted that their diagnostic efficacy has not been fully evaluated. I would like to supplement the review with several points.
Interpretation of murmurs can often be enhanced by careful palpation before auscultation. This is an art neglected by many physicians, especially young house officers. Palpation of a thrill implies that a murmur will be found at that site. In the patient with several murmurs, this observation offers the physician a fixed point from which to analyze other findings. For example, clinically significant valvular
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