Teaching Heart Sounds to Health ProfessionalsTeaching Heart Sounds to Health Professionals

Adult Cases : Heart Auscultation Quiz

Adult Case 4

40 year old male, works on a lobster fishing boat. Generally fit but noticed a bit more fatigue in the last year. Mild breathlessness when pulling 75 Kg lobster pots aboard. No chest pain, palpitations or dizziness. Followed from early childhood for a murmur. No family history of heart disease but has two young children, one of whom has a murmur but is healthy. On examination this man looks healthy and muscular, BMI 24. BP 125/75. Heart rate is 60 and regular. Breath sounds are normal. Apex beat is not displaced but appears a bit increased although he is slim. There is a suprasternal notch thrill and a thrill at the right upper sternal edge. Pulses are a bit increased. You listen in the left and right upper sternal edges as well as the apex. This recording was made at the left sternal border, 3rd interspace.

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