THERE ARE TIMES when it is an advantage to perform auscultation of the heart with the patient in the prone position. In patients with deep chests, the sound produced by the heart may be very faint when they are in the recumbent position and not well heard when they assume the left lateral position. Occasionally, pericardial rubs may be heard only if the patient is in the prone position. Listening to the heart when the patent is lying on the abdomen with the thorax supported by the elbows puts both the patient and the doctor in an awkward position.
We have found that the position shown in Fig 1, which we have called the "standing-flexion" position, is a very satisfactory one for auscultation of the heart in such patients. The patient's chest muscles are relaxed because there is essentially no weight supported by the arms and the listener is in
Ravin A, Craddock LD, de la Fuente LM. The Standing-Flexion Position for Auscultation of the Heart. JAMA. 1965;192(1):60-61. doi:10.1001/jama.1965.03080140066022