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Secrets Heart and Lung Sounds Workshop (Audio CD) FREE TO VIEW

David S. James, MD, FCCP
Chest. 2003;123(2):658. doi:10.1378/chest.123.2.658
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By Salvatore Mangione, MD. Philadelphia, PA: Hanley & Belfus, Inc, 2000; Manual, 38 pp; CD total running time, 75:58; $19.95

Is that a rhonchus or a crackle? How are wheezes produced? Is that murmur pathologic? These are some of the questions that the user will be able to answer after listening to the audio CD Secrets Heart and Lung Sounds Workshop and studying the companion manual. Dr. Salvatore Mangione is the creator and narrator of this effective learning tool, consisting mainly of an audio CD divided into two general sections. The first section runs 72 min, and it covers heart and lung sounds accompanied by an explanatory narrative. To facilitate review, the second section consists of four minutes of the same sounds, in the same order as previously presented, but this time without the narrative. The manual includes a list of the sounds being discussed on each track with written explanatory material.

Each sound is first reproduced (the audio quality is excellent) and then is followed by a discussion of how the physical finding in question is best detected. The applicable physiology or pathophysiology and the clinical setting in which the sound may be heard are explained, all the while repeating the sound at intervals to facilitate learning. The narrative is easily followed and has a logical order in presenting the material. Dr. Mangione also covers areas that can be confusing to the budding clinician, such as the reasoning behind the use of the term crackles instead of rales to describe those adventitious sounds, and provides full coverage of other sounds, including the less familiar squawk or squeak. The common abnormal cardiac sounds are covered, including murmurs from aortic and mitral regurgitation and stenosis, S3 and S4 gallops, midsystolic clicks, and pericardial friction rubs.

The written narrative in the manual accompanying the CD follows the audio discussion closely. The figures and sound tracings effectively assist the reader in understanding the material. However, for the portion of the manual covering heart sounds, a few additional figures showing the cardiac cycle mechanics would have been helpful.

Dr. Mangione begins Secrets Heart and Lung Sounds Workshop with the statement “Auscultation of the chest is a very difficult art.” Periodic review of this difficult art can be useful for all physicians, both specialists and generalists, and Dr. Mangione has created an exceptionally useful and engaging tool to accomplish this task. Most users will probably review the CD in sections rather than in a single session, while new students of auscultation will benefit from a shorter and simpler overview before embarking on listening to Dr. Mangione’s CD in depth. It should also be noted that Secrets Heart and Lung Sounds Workshop can be used in combination with the textbook by the same publisher, Physical Diagnosis Secrets.




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