Heart examination question plz - egyptwithin

[ArchivalUser]

in examining the heart.. must be auscultate both with the pnt lying down and with the pnt sitting up. Can we just do it with him lying down or will pints be lost. I want to save as much time as i can..

[ArchivalUser]

My recommendation is to listen both lying down and sitting up. Most murmurs become louder or audible when lying down. Only mitral valve prolapse and hypertrophic cardiomyopathy (also known as ASH or IHSS) murmurs are louder when sitting than lying down. When you have the patient lie down for the abdominal exam, listen to the heart then. It saves about 30 seconds. Good luck to you from competentmed.com.

[ArchivalUser]

Practice this method. It saves time and makes you look more confident. During the physical exam, start at the head and work your way down. Based on your history, accomplish what you need to do at each body area before moving downward. Do as much as you can with the SP sitting, then complete the remaining essentials of the exam with the SP lying down. If you walk in and the SP is supine, perform the PE with them lying first, then complete it sitting if necessary. Example, if the CC requires a neuro exam and an HEENT exam, check the cranial nerves along with the HEENT exam. Move down to the neck, chest, and then lower extremities. In the LEs, check pulses, strength, DTRs, joint exam, whatever...do it all while you're there. Then asked the SP to lie supine and listen to the heart and examine the abdomen. Having the SP change position more than once wastes time.