The Cardiac Exam: Auscultation

Ascultation is an essential part of cardiac exam, we use it to get information so we can better assist our patents.


what kind of information we get from listening to the heart:

- heart rate and rhythm

- valve funtion
stenosis
regurgitation
insuffiency

- anatomical defect
hypertropy
atrial septal defect
ventricular septal defect

Where to place your stethoscope

As with palpation of the heart, auscultation should proceed in a logical manner over 4 general areas on the anterior chest, beginning with the patient in the supine position. The 4 percordial areas are examined with diaphragm, including:

Aortic region (between the 2nd and 3rd intercostal spaces at the right sternal border) (RUSB – right upper sternal border).

Pulmonic region (between the 2nd and 3rd intercostal spaces at the left sternal border) (LUSB – left upper sternal border).

Tricuspid region (between the 3rd, 4th, 5th, and 6th intercostal spaces at the left sternal border) (LLSB – left lower sternal border).

Mitral region (near the apex of the heard between the 5th and 6th intercostal spaces in the mid-clavicular line) (apex of the heart).

After this initial examination in the supine positions, several additional maneuvers should be accomplished in the thorough cardiac exam, as follows:

• Instruct the patient to turn onto their left side (left decubitus position) and listen with the bell of the stethoscope at the apex for mitral stenosis (low pitched diastolic murmur).
• Instruct the patient to sit upright and re-examine the 4 percordial regions, again with the diaphragm of the stethoscope.
• Instruct the patient to lean forward, exhale, and hold their breath. Listen with the diaphragm between the second and third intercostal spaces at the right sternal (aortic) and left sternal (pulmonic) areas for aortic regurgitation.

This Article was taken from:filer.case.edu