USE OF THE STETHOSCOPE IN PEDIATRIC CARDIOLOGY

The stethoscope, as contrasted with numerous diagnostic auxiliaries, remains the major instrument in pediatric cardiology. It is portable, immediately informative, and adaptable to countless special situations; its usefulness is not limited to auscultation of the chest. Following hemodynamic sounds either to their point of maximum intensity or to their disappearance often leads to the neck and head. In children the pliability of the thoracic wall makes auscultation especially informative because heart sounds in some cases appear and in other cases disappear during manipulation of the chest. The investigation of both functional and organic murmurs is thus facilitated. Four characteristic murmurs or cardiovascular noises not related to disease occur in children up to 12 or 15 years of age and are here described. The stethoscope is the only instrument sufficiently versatile to permit bed-side investigation of these interesting and significant phenomena.