The rate at which technological advances in cardiology have emerged and subsequently integrated into common practices hascontinually accelerated during the past few decades. Although many paradigms are shifting, some remain foundational and changeless, the most important of which is the bedside clinical examination. There has been a perceptible reduction in the skills andabilities of medical students and residents in diagnosing and interpreting heart sounds and murmurs. In experienced hands, thecardiac physical examination is a sensitive and specific instrument for detecting cardiac pathology. The term dynamic auscultationrefers to a technique of altering circulatory dynamics by means of respiration and a variety of physiological and pharmacologicalmanoeuvres and determining the effect of these manoeuvres on heart sounds and murmurs
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