Auscultation of the heart: the algorithm of conducting, points, conclusion, video

Auscultation of the heart is one of the diagnostic techniques that help to listen to the tones and sounds of the beating of the heart muscle. Tones are usually called jerky sounds, but the sounds have a more prolonged echo.

By means of auscultation an experienced specialist evaluates the work of the main "motor" of the organism and identifies probable deviations. This diagnostic technique is familiar to everyone, and it is carried out with the help of a stethoscope.

What is the procedure for and to whom is it assigned?

The procedure is carried out with complaints from the patient and in cases where there are suspicions of the development of cardiac problems. Auscultation is also carried out with routine examinations, medical examination.

The procedure is carried out when examining the patient, including simply for preventive purposes. Auscultation can be done often if the patient wishes, but usually a healthy person is exposed to it 1-2 times a year. The procedure is needed to determine

the problems in the operation of the heart muscle.

The list of diseases that can be primarily diagnosed is extensive:

  • weakening of the contractility of the left ventricle;
  • hypertrophy of the ventricle, which is expressed in the slowing of its contraction;
  • mitral valve insufficiency;
  • stenosis;
  • tachycardia;
  • cardiac blockade;
  • extrasystole;
  • atrioventricular block;
  • myocardial damage,
  • heart failure,
  • myocardial infarction.

Projections of the heart valves on the front surface of the chest and the location of their best auscultation

auscultation of the heart

Types of diagnosis

The procedure is divided by listening mode to:


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The opinion of doctors. .. & gt; & gt;

  1. straight,
  2. indirect.

In the first case, not a special device but the doctor's ear is applied to the patient's chest. In the second, a stethoscope is already used. A direct method of listening is used to determine the tones of the heart muscle. Sounds are heard more clearly and the probability of their distortion is very low. Nevertheless, the method is used very rarely because of ethical and hygienic considerations.

With the help of modern instruments it turns out to listen not only low, but also high sound frequencies. Of course, distortion with indirect listening occurs, but it is usually insignificant. The plus is the fact that the tones are perceived better, they are easier to distinguish. Through auscultation, the vessels, belly, and lungs are also listened.

Indications for

Indications for auscultation are complaints made by the patient about their condition. The doctor, after the interview himself, is able to conduct the procedure, if he deems it necessary. Old patients and children, pregnant women are subject to examination. This simple measure allows early identification of possible cardiological problems.

People from the "risk group" who have a tendency to develop cardiac pathologies are subject to examination. Such features include:

  • diabetes,
  • sedentary work,
  • alcohol and cigarette abuse,
  • heredity,
  • obesity.

The following video will describe in more detail about the procedure for auscultation of the heart:

Contraindications and safety

Contraindications for auscultation do not exist, because it is safe for absolutely any category of citizens, including pregnant, elderly and children.

Is the procedure safe? Auscultation of the heart in heart diseases, IHD, hypertension and other ailments in the medical history - the procedure is absolutely safe.

Preparing for the

auscultation of the heart in children procedure No specific preparatory measures exist. The patient should only do physical activity before it does, avoid dangerous situations and experience less, so as not to distort the testimony. It is possible before the test, but from drinking it is necessary to exclude alcohol and drinks that tonic the cardiac muscle. These are energy, various teas, coffee.

If the chest has a thick scalp, it is advisable to remove it or moisten it so that it does not interfere with the study of beating tones. Good conductivity during the examination is important, since the doctor must hear the slightest extraneous sounds in the chest.

Next, we will describe how auscultation of the heart assumes an algorithm of action and which listening points of tones are involved in newborns, children and adults.

How is auscultation of the heart?

During the auscultation you need to fulfill all the doctor's requests: take the necessary position, do physical exercises, hold your breath.

There are a number of rules for performing a heart auscultation procedure:

  1. The doctor spends some time in silence. This allows you to better hear the extraneous noise in the study.
  2. Indoors, there should be no extraneous sounds. Comfort temperature is also important.
  3. Listening to the work of the heart muscle is done in a recumbent or standing position.
  4. The doctor sets the instrument strictly at certain points in the body. These are special areas of noise, they are the exact projection of the heart valves on the chest.
  5. Tones are heard at different periods of breathing, as some of the noises can intensify during exhalation or inspiration.

The doctor, having conducted a survey, starts examining and auscultation. The patient should lift the outer clothing, exposing the thorax. Next, the doctor applies the stethoscope to the following points on the body with auscultation of the heart:

  • pulmonary valve;
  • mitral valve;
  • tricuspid valve;
  • Botkin point;
  • carotid artery, axillary region and above the clavicles;
  • aortic valve,
  • heart surface.

Next, we will talk about the conclusion and results of the characteristics of heart tones at the points of auscultation.

The video below shows the listening points for auscultation of the heart:

Decoding of the results

During the auscultation, the doctor reveals a number of characteristics of the heart sounds heard:

  1. presence of extraneous noise;
  2. rhythm of tones and correct rhythm;
  3. audibility and volume;
  4. timbre, compatibility and other features of heart tones.

Tones a healthy person listens to just two.

  • The first( i) occurs when the pulmonary artery and aorta fluctuate due to contraction of the ventricles and closure of AV valve flaps.
  • The second( II) manifests itself at the voltage of the closing valves of the valves of the pulmonary artery and aorta, their oscillations at the stage of completion of ventricular systole. III tone can be heard only from a small circle of people, and IV will be recorded only through phonocardiography.

In the upper part of the heart, I will hear I tone very loud, then there will be a short lull, and after that you can hear a short II tone. This is followed by a longer pause. In the presence of cardiac pathologies, the severity of these tones and strength changes.

  • Sometimes the weakness of the manifested sounds is not related to the disease, but is due only to the general condition of the body, obesity, etc. Loud tones are noted in children and the elderly. In adult patients, this feature can talk about heart disease and other serious diseases.
  • Isolated changes in heart tone indicate serious pathologies, therefore, if abnormalities are detected, additional examination methods are immediately assigned in addition to performing auscultation of the heart.
  • Noises in the heart often indicate the development of cardiac diseases, but sometimes they are audible even in healthy people. Particular importance is attached to their intensity, nature and area of ‚Äč‚Äčorigin. Necessarily other diagnostic methods are prescribed, and after the results are obtained, the necessary treatment is selected.

Average cost of

Auscultation is free. When applying to private clinics, this procedure is included in the consultation of a specialized specialist and is not paid separately.

About additional tones in the auscultation of the heart tells the video below:

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