heart sound(s)

Introduction

Sequence of cardiac examination:

• patient supine with head elevated 30 degrees
  • inspect & palpate precordium
  • palpate point of maximum impulse (PMI)
    • diameter, location, amplitude, duration
• patient in left lateral decubitus
  • point of maximum impulse (PMI) if not previously felt
  • listen at apex with bell of stethoscope
• patient supine with head elevated 30 degrees
  • listen at tricuspid area with bell of stethoscope
  • listen at all ausculatory areas with diaphragm of stethoscope
• sitting, leaning forward, after full exhalation
  • listen along left sternal border & at apex
  • enhances murmur of aortic insufficiency

More general terms

• physiologic process
• sign/symptom

More specific terms

• distant heart sound; muffled heart sound
• ejection click
• first heart sound (S1)
• fourth heart sound (S4)
• heart murmur
• midsystolic click
• opening snap (OS)
• second heart sound (S2)
• third heart sound (S3), S3 gallop