History
A 70-year-old man presents to his doctor's office for routine follow-up examination. No history of chest pain, heart failure or fainting episodes. Patient has a heart murmur first noted in his early 50s.
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: 11/29/202170-year-old man in doctor’s office for annual exam