History
A 50-year-old man presents for complete neurologic examination due to weakness of left arm and hand during the previous month. There is no history of heart or lung disease.
Use the 'auscultation' link above to virtually listen to this patient's heart and carotid sounds.

Auscultation Tips
Significant independent predictors of the presence of a confirmed cardiac lesion:
- A loud murmur of intensity 3 or greater.
- Best heard at the pulmonic location (2LICS).
- Harsh sound.
- Pansystolic murmur.
- Systolic click.
- Abnormal second heart sound - fixed splitting during respiration.
Authors and Reviewers
Authored by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN. Last Update: 11/29/2021A 50-year-old man with weakness of left arm and hand during the previous month