The cardiac exam in lung disease.

The physical examination, that is, inspection, palpation, and auscultation, is as valuable today as it ever was, even for structures as inaccessible as the heart and pulmonary circulation. Examination of the heart in patients with lung disease aims to detect changes in the structures or function of the right heart that are secondary to the pulmonary process and to detect the circulatory status of the patient. The most important cause of changes in the right ventricle in patients with lung disease is increased afterload caused by pulmonary hypertension. Auscultation remains one of the most sensitive means of detecting pulmonary hypertension, and the physical signs allow assessment of right ventricular function as well as response to therapy.