auscultation
Last reviewed 01/2018
Auscultation should begin in the mitral region:
- use the bell initially to detect the low frequency sounds of mitral stenosis or a third heart sound
- use the diaphragm to detect the higher frequency sounds of mitral incompetence or a fourth heart sound
Using the bell and diaphragm, listen in the following locations detailed in the submenu:
- tricuspid area
- pulmonary area
- aortic area
The patient should now be repositioned:
- lie the patient in the left lateral position:
- assess the apex beat
- auscultate in the mitral area
- sit the patient forwards in full expiration:
- palpate for thrills over the left sternal border
- auscultate for murmurs from aortic regurgitation
Dynamic auscultation should now be performed.
Accurate and sensitive auscultation of the praecordium requires experience. Learning is made easier by mentally separating out the different sounds and analysing a single sound over several beats.