heart murmurs (clinical examination)

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When listening to a patient's heart always consider the physical signs already elicited before auscultation commences.

Some hints concerning listening for murmurs:

  • time the cardiac cycle by palpating one of the patient's carotid arteries

  • the bell is good for hearing low-pitched sounds e.g. mitral stenosis. It should be applied very gently to the skin

  • the diaphragm is good for listening to high pitched mumurs e.g. aortic regurgitation

  • left heart murmurs are louder in expiration

  • right heart murmurs are louder in inspiration

  • exercise makes a mitral stenotic murmur louder

Last reviewed 01/2018

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