An important goal of auscultation is not to miss valvular heart disease.

Learning normal auscultory findings may be easiest.

• When auscultation is abnormal in a SYMPTOMATIC patient, echocardiography is generally indicated.
• When an ASYMPTOMATIC patient has evidence of significant cardiac disease, echocardiography is generally indicated.
• The feedback provided by appropriate ordering of echocardiography should permit individuals to improve their auscultatory skills as they care for patients.