日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

The aim of this article is to describe the physical examination and physical findings for pediatric cardiologists. The most important point is to build a diagnostic hypothesis from four diagnostic methods (medical examination by interview, physical examination, laboratory examination, and diagnostic imaging). Subsequently, the findings should be explained by the diagnostic hypothesis. We can more easily conduct a physical examination when we understand the basic concepts, i.e., the cardiac cycle, the three major mechanisms of cardiomegaly (shunt lesions, valvular regurgitation, and myocardial damage), and the anatomical position of the great vessels and cardiac chambers. We estimate the size and pressure of vessels and cardiac chambers while conducting a physical examination. The physical findings should also be explained by the diagnostic hypothesis that is built each time. If the findings cannot be explained by the hypothesis, we should build the hypothesis again.