There are two kinds of problems in heart auscultation:
- an auscultatory sign can be faint
- an auscultatory picture can be too complex

By the way, I am going to publish the book about solutions of such problems. 

Here I am going to describe a case with very faint and rare musical murmur which was very difficult to hear.  

A lot of information is enciphered in heart sound.  There are two main problems:  it is difficult to perceive this sound because it is too faint, and it is not simple to interpret reaped information.  The later is some kind of understanding a foreign language.  Let us continue our talk about the language of the heart.

I am going to publish a series of posts about issential heart sound and murmurs. I will try to be explicit and breaf. And I will try to give information relevant to clinical use.
The first heart sound will be the first. This is natural, isn't it?

A very loud auscultatory sign can attract our particular interest.  Especially when this sign is palpable.  Especially when this sign is visible.

In patients with lung emphysema, heart sound is faint and sometimes is almost absent while performing auscultation on precordial area. In fact, among many of such patients heart auscultation is useless. Is there any solution?

Is it possible to find left atrial myxoma bedside? 


Sometimes it is possible.  But cardiac myxomas are a rare illness.  It is almost impossible to get corresponding experience auscultating a lot of such patients.  


Our patient described below had clear and bright auscultatory picture of the left atrial myxoma.  You can learn this case and probably one day you will make the correct diagnosis by auscultation alone.

Many cardiologists are not able to perform effective cardiac auscultation and helpless without ultrasound. Sad but true. But some simple skills can significantly improve the situation. In the nearest future, I hope to publish my book which will simplify the development of these skills, one of which I called 'chronological localisation'. This skill is vital. Heart auscultation just does not exist without it.
Fortunately, you need to memorise very little logical information. Later, practice this skill. More in the slideshow.
This is a part of my book which will appear soon.