The Physical Examination in Heart Failure—Part I

The major components and merits of the physical examination of patients with heart failure are presented. A staging of the physical examination practiced by most heart failure specialists is proposed based on the information needed at the time of the encounter. The challenges to our subspecialty regarding this diagnostic tool are the prevention of its extinction during an era of seemingly limitless comprehensive laboratory testing, the promotion of its widespread use, and, over the years, the subjection of its components to the rigors of blinded controlled studies. Part I addresses the staging of the physical examination in heart failure, general observation of the patient, vital signs, and assessment of arterial pulse and neck veins.