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Areas of Auscultation
Chapter 5
Ara G. Tilkian, MD, FACC
Instructor
Patricia L. Thomas, MBA, RCIS
Outline
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Traditional Areas of Auscultation
Left Ventricular Area
Right Ventricular Area
Left Atrial Area
Right Atrial Area
Aorta Area
Pulmonic Area
Traditional Areas of Auscultation
• Mitral Area –Cardiac Apex
• Tricuspid Area-4th & 5th intercostal space of
left sternal border
• Aortic Area-2nd intercostal space of the right
sternal border
• Pulmonic Area-2nd intercostal space left
sternal border
Left Ventricular Area
• Aortic component of the
2nd heart sound A2
• Cardiac Apex and extends
laterally in the 3rd and 4th
interspaces to left sternal
border in one direction &
to the anterior axillary line
in the other.
Right Ventricular Area
• Tricuspid Stenosis or
regurgitation, pulmonary
regurgitation and
ventricular septal defect.
Left Atrial Area
• Mitral Regurgitation
• Anterior chest-listen
left of apex
• Posterior left thoraxarea between the spine
and the border of the
scapula at the level of
its tip
Right Atrial Area
• Tricuspid insufficiency is
best heard at the right
sternal border in the 4th
and 5th interspaces.
Aortic Area
• Aortic Ejection Click
and A2
• Aortic stenosis &
Insufficiency
• Increased aortic flow
• Dilatation on the
ascending aorta
• Abnormalities of the
carotid or subclavian
arteries
Pulmonic Area
• Pulmonic Ejection & P2
• Pulmonary Stenosis &
insufficiency
• Increased pulmonary flow
& stenosis
• Patent Ductus arteriosus
PDA
THE END
OF
CHAPTER 5
Tilkian, Ara MD Understanding Heart Sounds and Murmurs,
Fourth Edition, W.B. Sunders Company. 2002, pp. 43-48.