Patients can be examined while lying supine, in the left lateral decubitus position (see picture) and sitting, leaning forward. Use for analyzing the second heart sound, ejection and midsystolic clicks and for the soft but high-pitched early diastolic murmur of aortic regurgitation. The diaphragm, by filtering out low-pitched sounds, highlights high-pitched sounds. Use for mid-diastolic murmur of mitral stenosis or S3 in heart failure. The bell is used to hear low-pitched sounds. Earpieces should be angled forwards to match the direction of the practitioner's external auditory meati. Accuracy in Diagnosis of Diastolic MurmursĪ modern stethoscope consists of two earpieces connected by tubing to a chest piece which usually has both diaphragm and bell attachments.Accuracy in Diagnosis of Systolic Murmurs.
