Remember the mnemonic “AllPatients Take Medicine”

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Dr.K.G.MoniGandhi

Tips for Heart Auscultation

Aortic: found right of the sternal border in the 2nd intercostal space REPRESENTS S2 “dub”

Pulmonic: found left of the sternal border in the 2nd intercostal space REPRESENTS S2 “dub”

Erb’s Point: found left of the sternal border in the 3rd intercostal space

Tricuspid: found right of the sternal border in the 4th intercostal space REPRESENTS S1 “lub”

Mitral: found midclavicular in the 5th intercostal space REPRESENTS S1 “lub” (also the site of point of maximal impulse)

The Base of the heart includes the aortic and pulmonic areas, and S2 will be loudest at the base. Aortic and pulmonic murmurs are heard best at the base with the patient leaning forward and sitting up with the diaphragm of the stethoscope.

The Apex of the heart includes the tricuspid and mitral areas, and S1 will be loudest at the apex. S3 and S4 along with mitral stenosis murmurs will be heard best at this position with the patient lying on their left side with the bell of the stethoscope.

Patient Positioning for Heart Auscultation

Supine or sitting-up: Use the diaphragm and listen at all 5 auscultation sites (noting S1 and S2 and if there are any splits presents). In addition, distinguish S1 from S2. Then repeat with the bell of the stethoscope…noting any other extra sounds.
Left side: turn the patient onto their left side and auscultate with the bell of the stethoscope at the APEX area and listen for S3, S4, or mitral stenosis murmurs.
Sit up, lean forward, and have patient exhale: Listen with the diaphragm at the aortic and pulmonic sites for murmurs.

Tips for Heart Auscultation

Recent MCQs

Recent flashcard sets