Do the Eyes Have It?

Even though Beethoven was still able to compose music after he became deaf, it can hardly be denied that deafness to a musician is as calamitous as blindness to a painter. For a physician in search of diagnostic leads to heart disease, both loss of hearing and loss of sight are crippling handicaps. But which of the two evils is the greater?

Pointless as the question may sound (or look), it is not entirely a product of idle curiosity. The answer may shed light on some important changes in our approaches to cardiac diagnosis that have taken place during the past few decades. Earlier in the century, cardiologists might have viewed deafness as the greater handicap. So much depended on auscultatory findings. How else could one diagnose valvular and congenital heart diseases or detect pulmonary hypertension? New technology, however, with its graphic and cinematographic representations, radically altered the relative importance