Analysis of precordial movements.

Thorough analysis of precordial movements in patients with known or suspected heart disease provides valuable diagnostic information in most patients and is an important, although often overlooked, part of the initial cardiac examination. As with all physical diagnostic methods, information obtained by analysis of precordial movements must be carefully integrated with the clinical history and other physical findings. Further diagnostic studies may be necessary for certain patients, but failure to obtain readily available information during the initial examination can lead to important mistakes in diagnosis and unnecessary use or misinterpretation of more expensive, risky, and uncomfortable diagnostic tests. The result can be compromised patient care. It takes dedication, patience, and time to develop and maintain excellent skills in cardiac physical diagnosis. Failure to use the time-honored diagnostic methods because of a lack of understanding of their value or dependence on more complicated diagnostic tests shortchanges both the patient and physician. The newer methods of diagnosis complement the physical examination and are valuable when thoughtfully used to answer specific clinical questions, but the therapeutic effects of human interaction and the professional rewards gained from a physician's skillful use of the hands, eyes, and mind cannot be replaced by technology-based techniques.