What technique is used to auscultate aortic regurgitation?

• A. Sit up, lean forward, exhale fully, and auscultate with the diaphragm
• B. Stand up and listen with bell
• C. Lie down and listen with bell
• D. Listen with diaphragm while patient holds breath

Answer: (A)

Aortic regurgitation produces a high-pitched diastolic murmur that is best heard when the heart is positioned close to the chest wall and the murmur’s high-frequency components can be captured. Having the patient sit up and lean forward brings the aortic flow and regurgitant jet toward the chest wall, making the sound more audible at the left sternal border. Listening after full exhalation reduces lung volume, which decreases interference from the lungs and allows the murmur to be heard more clearly. Using the diaphragm is important because it is more sensitive to the high-frequency sounds of AR.

Other techniques are less effective for AR: standing and using the bell emphasizes low-frequency sounds, lying down changes the heart’s position and can dampen the murmur, and listening with the patient holding their breath doesn’t optimize the diastolic flow sound and can alter hemodynamics.