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Case Reports
. 2017 May 2;9(5):e1212.
doi: 10.7759/cureus.1212.

Importance Of Thorough Physical Examination: A Lost Art

Talal Asif  1 , Amena Mohiuddin  1 , Badar Hasan  1 , Rebecca R Pauly  1
Affiliations
Case Reports

Importance Of Thorough Physical Examination: A Lost Art

Talal Asif et al. Cureus. .

Abstract

Several recent studies have described a deterioration in physical examination skills among modern physicians. Reasons hypothesized for this change are improvements in technology and time constraints. Poor physical exam skills are a noteworthy threat to patient safety as they can lead to incorrect as well as missed diagnoses, causing delays in timely implementation of life-saving treatments. Here, we present a case of extensive acute embolic strokes secondary to infective endocarditis. The patient was initially misdiagnosed as having Bell's palsy due to incorrect physical examination. Through this case, we highlight the importance of management guided by a thorough history and physical examination to minimize diagnostic errors.

Keywords: central facial nerve palsy; embolic stroke; infective endocarditis; physical examination skills.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Transthoracic echocardiogram (TTE) showing mobile echodensity (arrow) on the mitral valve leaflet measuring 1.5 x 1.3 cm
Figure 2
Figure 2. Magnetic resonance imaging (MRI) of the brain showing area of diffusion restriction (arrow) in the left parietal region
Figure 3
Figure 3. Transesophageal echocardiogram (TEE) showing the mitral valve vegetation (arrow)
See this image and copyright information in PMC

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