Auscultation: Normal and Abnormal Heart Sounds: Aid in Diagnosis and Relationship to Echocardiogram

Auscultation with a stethoscope (Diaphragm/Bell) is the first specific step towards clinical examination after inspection, palpation and percussion are complete. This is a non-invasive procedure that can shed a light on the cardiac pathology, if the requisite skill is developed, especially if other modes of examination like EKG/Echocardiogram are not immediately available. Moreover, it may narrow down the differential diagnosis and targeted Echocardiogram may fetch the diagnosis sooner. The clinician should develop the skill to use both the bell and the diaphragm of the stethoscope efficiently. After reading this chapter, the reader would become familiar with the different heart sounds, normal and abnormal, the timing of the heart sounds, when they get accentuated and muffled, the causes of 3rd and 4th heart sounds, the effect of posture on the heart sounds, the effect of respiration on the heart sounds and why, the cause of murmurs and their differentiation, the link between heart sounds and EKG/Echocardiogram, and their usefulness in the diagnostic process.