Bare chest auscultation

My current GP listens over my shirt. Shirt is always off in play exams though.

Bare chested, never a good idea to auscultate over clothing, it can muffle the sound?

Next time you auscultate someone, try listening over clothing, then repeat on a bare chest. You'll be convinced how much clothing degrades what you hear.

@Pollux No experience, but I’ve read auscultation over light clothing attenuates 5-18 dB (that’s significant). Light to moderate pressure eliminates most of this, except at the higher frequencies. No idea what is lost in the evaluation, or how much or how consistent the pressure should be, but it seems pretty simple to loosen clothing and do it on bear skin, while respecting modesty.

My doc routinely listens to my lungs over my shirt without noticeable pressure. Guess she’s just looking for low freq rumbles. Listening to my heart over clothing gives her a pretty good indication that I’ve got one, probably nothing more! When in for surgery or a colonoscopy it’s always been on my skin.

@Rigel , when I learned physical diagnosis we were taught to use the bell of the stethoscope to focus on lower frequency heart and breath sounds. To best use the bell it should be touched very lightly against the skin. Most breath sounds (including rales and rhonchi) are lower frequency, along with heart sounds and murmurs. Just a few murmurs are higher frequency and best heard with a diaphragm. Bowel sounds and bruits are better heard with the diaphragm as well. You can approximate the improved ability to hear higher pitched sounds with the bell by pressing it firmly against the skin which, in effect, stretches the skin under the bell, in effect turning it into a diaphragm. Through clothing, i think you're correct--about all one can discern is rhythm.