Carotid Bruit 85-year-old-man-with-recent-onset-of-shortness-of-breath-with-exertion Use toggle button to access additional pages in this lesson. Chart Auscultation Diagnosis 85-year-old man is seen in doctor's office due to recent onset of shortness of breath with exertion. No history of chest pain, palpitations or fainting episodes. Listen Heart Sounds The turbulence is loudest below the clavicle on the right hand side.The turbulence is a heart murmur.A medium duration diamond shaped turbulence is heard in systole and a 4th heart sound gallop is heard in diastole. Carotid Sounds The first heart sound is loudest at the Right ICS.The turbulence is at the beginning of systole.The turbulence is only heard on the right side. Lessons70-year-old man in doctor’s office for annual exam.✓85-year-old man with recent onset of shortness of breath with exertion.60-year-old woman executive requests physical for life insurance authorization.A 50-year-old man with weakness of left arm and hand during the previous month.A 60-year-old man complaining of slurred speech and left leg paralysis.A 65-year-old man in emergency room after fainting episode.Signed-in users can take quizzes and earn certificates.