If the case is CVS-related, heart needs to be examined in three positions: Sitting, lying and again sitting. In the first sitting u listen to the four areas of the heart.
In lying position, u inspect the pericordium and look for PMI deviation, auscultate the four areas. When examine the mitral area, remember to ask the patient to roll over to the left side to auscultate the axilla for any murmur radiation (MR). Now ask the patient
In the second sitting you auscultate the aortic area. Ask the patient to exhale and hold his breath.
Regarding carotid artery, listen to it when the patient is lying down. Let the patient know that you are listening to his blood channel in his neck.
I hope this clarify some of the doubts.
If you have some thing to add please do.
Good luck