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Background/Purpose

Heart sounds are discrete bursts of auditory vibrations of varying intensity (loudness), frequency (pitch), quality, and duration. The first heart sound (S1) is composed of several high-frequency components; only the first two are normally audible. These two sets of audible vibrations are temporally related to closure of the mitral and tricuspid valves. The first heart sound coincides with contraction of the ventricles, thus identifying the onset of ventricular systole and the end of mechanical diastole.
The recommended range is for adults > 18 years old.
A lower heart rate is also associated with athletes and is a normal finding.

Procedure

The examination should be conducted in a warm, quiet room. Place the patient in a supine position after all clothing has been removed from the chest. Explain to the patient that you are going to examine the heart. Warm your hands and stethoscope, but warn the patient that your hands may be cool at first. The most comfortable and satisfactory position for most examiners is on the patient's right side. Since heart sounds may be palpable, attempt to palpate the first sound with the heel of the right hand and/or the finger pads, initially at the cardiac apex and then over the entire precordium. Count the number of beats during 15 seconds and multiply that number by 4 to get the heart rate beats per minute.
Performed: Axially

Dialog

Auscultate the heart rate.

Criteria

• 60-90 bpm

Measurement

60 bpm

LOINC Code

8890-6

Scale/Grading

selection range; grade - LOINC ID
Option - Value option selection range; grade - LOINC IDBradycardia < 60 bpm ; Fail - Normal between 60-90 bpm ; Pass - Tachycardia > 90 bpm ; Fail -