Auscultation at the doctor

Hi all,

So today at the doctor I had my blood pressure check (I'm on meds for high bp), and the doctor auscultated my heart and lungs (briefly). However, he only auscultated my heart at aortic and pulmonic. Is this normal? How do others' doctors auscultate? Thanks!

For a routine check with an established patient, you're lucky he listened at all.

The question is, what are you listening for? I would want to know if there is an arrhythmia -- easy enough. Also any new murmur. The one of most concern would be aortic regurgitation from a developing aortic aneurysm or root dilatation in a hypertensive individual. And certainly any new gallop, S3 or S4. It would not require an in depth auscultation with each follow up visit.

I'm surprised he did such a cursory exam on a very overweight patient with a nine month old especially since you are on BP meds.

Say what Susie? Do you know something we don't know? I'm with Rayme. It depends in what clinical setting. In a patient with no history and no risk factors a brief thirty second listen over the apex is more than adequate. In that time it's easy to hear arrhythmias possible murmurs and gallops. For patients with a history of valvular heart disease a longer exam is required in all positions both sitting and lying with respiration and in full expiration. With suspected pericarditis a longer listen to hear pericardial friction rubs is required. The clinical setting is paramount in deciding what to do. This is true for most examinations. Do whatever you like in play situations and leave the rest to us.

Read her posts from a year ago

Oh I see. Sorry. I'm in agreement. Yes I would expect to hear an S4 from a thickened noncompliant LV wall. The money is in the blood pressure reading. The gallup will persist lifelong even though the pressure has been controlled. From previous posts I would have to agree about the wisdom of being pregnant. Pregnancy simply is not a benign condition for even the healthiest woman.