The Northwest Times

TRENDS IN THE DIAGNOSIS OF HEART DISEASE

The diagnosis of heart disease is generally dependent upon a careful history of the symptoms developed by the patient, determination of blood pressure, listening to the sounds emitted by the heart, by x-rays and electrocardiographic records.

Rapid advances in electronics have stimulated a great deal of research to provide additional types of recording devices to aid in the diagnosis of heart disease. However, in general, the physician still relies upon the history of the disease, his five senses and years of study and training to arrive at a diagnosis.

It is now possible to provide electronic devices to supplement his five senses and provide an objective record which can be studied and reviewed at will. Such supplemental information takes the form of records of the sounds and murmurs emitted by the heart by several different methods, motion pictures of the x-ray shadows of the heart indicating its size and motion during contraction, records of the pulse, improved methods of determining blood pressure, indications of the amount of oxygen in the blood and many others.

There are two significant features of this trend toward the development of instruments to learn more about the function of the heart in health and disease. (1) In most cases, the five senses of a well-trained physician are entirely adequate to arrive at a correct diagnosis. (2) In an occasional case, recording instruments may bring out information which cannot be gained by the most meticulous study by a physician.

For example, the exact size and shape of the heart cannot be determined with accuracy except by means of an x-ray examination.

On the contrary, a physician listening with a stethoscope can detect and distinguish sounds which cannot be recognized by the finest sound recording device, just as you can recognize the voice of a friend, even after that voice has been seriously distorted by passing through a telephone.

No recording device exists today which would permit the accurate recognition of a person's voice under these conditions. In the same way, a trained physician may recognize the sounds emitted by the heart as similar to those observed in other cases in his past experience.

In general, the rapid advances in recording techniques are of value in particular types of cases and in learning more about the signs and symptoms of disease. In routine clinical practice, they may supplement the information obtained by the five senses of a physician and his judgment and experience.

IT'S YOUR HEALTH!

Prepared by the Staff of the
HEALTH SCIENCES DIVISION
UNIVERSITY
OF WASHINGTON