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It is true that for a neurologist, the yield from general medical examination is fairly small, in proportion to the time taken. Why use a stethoscope when carotid duplex or an echocardiogram will give infinitely superior information? When did you last diagnose mitral stenosis with a stethoscope? I guess not for many years. And what about an atrial myxoma? I have diagnosed this twice (by chance) but only after an echocardiogram. A carotid bruit is nice to pick up but it is sometimes due to turbulence without serious stenosis, or it is on the “wrong” side, and it cannot measure reliably the degree …