Question

what is the purpose of the cardiac assessment technique of having the client lean forward, and to the left lateral position?

Answer 1

(A modern stethoscope consists of two earpieces connected by tubing to a chest piece which usually has both diaphragm and bell attachments. Earpieces should be angled forwards to match the direction of the practitioner's external auditory meati.

The bell is used to hear low-pitched sounds. Use for mid-diastolic murmur of mitral stenosis or S3 in heart failure

The diaphragm, by filtering out low-pitched sounds, highlights high-pitched sounds. Use for analyzing the second heart sound, ejection and midsystolic clicks and for the soft but high-pitched early diastolic murmur of aortic regurgitation).

1. Patient can be examined in the position of lean forward & left lateral position because pericardial sounds are sometimes best heard.
2. In this position the examiner should be listen specifically and selectively for left sided S3 or S4 , and the diastolic rumble of mitral stenosis.

auscultating at the Left lower sternal border, one should determine if there is an S3 or S4 heart sound heard. S3 heart sound can be physiologic in children and athletes but can also be heard in patients with heart failure. S4 heart sound is produced from blood ejecting into a stiff ventricle and is also present in heart failure. The examiner should then turn the patient into the lateral decubitus position to listen for the low pitched diastolic murmur of mitral stenosis.