Mitral stenosis is best heard when the patient is in which position?

Mitral stenosis is best heard when the patient is in which position?

• A. Left lateral decubitus
• B. Supine
• C. Seated upright
• D. Right lateral decubitus

Answer: (A)

The key idea is how positioning affects auscultation of a left-sided diastolic murmur like mitral stenosis. Placing the patient in the left lateral decubitus position brings the left ventricle and apex closer to the chest wall, making the low-pitched diastolic rumble easier to hear with the bell, especially during expiration. This orientation maximizes the acoustic contact with the mitral area at the apex (usually the 5th left intercostal space at the midclavicular line). Other positions don’t bring the apex as close, and maneuvers that reduce venous return can lessen the murmur, so the intensity is greatest in the left lateral decubitus position.

The key idea is how positioning affects auscultation of a left-sided diastolic murmur like mitral stenosis. Placing the patient in the left lateral decubitus position brings the left ventricle and apex closer to the chest wall, making the low-pitched diastolic rumble easier to hear with the bell, especially during expiration. This orientation maximizes the acoustic contact with the mitral area at the apex (usually the 5th left intercostal space at the midclavicular line). Other positions don’t bring the apex as close, and maneuvers that reduce venous return can lessen the murmur, so the intensity is greatest in the left lateral decubitus position.