History and examination of the cardiovascular system

A full history and physical examination remain an integral part of assessment of the cardiac patient in the twenty-first century. They allow easier rapport with the patient and facilitate assessment of the best management. It is profoundly unwise to rely solely on the results of imaging and other investigations. Total reappraisal is necessary when the history, examination and investigations are discordant – no investigation is infallible and the clinical assessment should never be ignored. Here we summarize the four main symptoms of cardiological problems (chest pain/discomfort, breathlessness, palpitations and light-headedness/syncope) and discuss how they will present in the history. Also, appropriate sections of the examination are detailed.