Dynamic auscultation methods of Heart Sounds:
Respiration:
Right sided murmurs are louder during inspiration
Expiration has the opposite effect
Squatting:
This increases both venous return and peripheral resistance and results in almost all murmurs becoming louder
The exception is in hypertrophic obstructive cardiomyopathy(HOCM) where the dilatation of the left ventricle partially relieves the outflow obstruction
A mnemonic for the respiration,
r"I"ght sided murmurs are louder during "I"nspiration
l"E"ft sided murmurs are louder during "E"xpiration.
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