Detailed guidance for performing an exam

Who is this for?

✓ Plan: SENSORA™ platform with Structural Murmur Detection

✓ Role: Program Admin, Clinician

Here you’ll find detailed guidance and instructions for performing an exam with the Eko CORE and Eko App. These instructions will help you get the best quality of data with our system.

Quiet surroundings

We recommend only performing an exam in a quiet, closed room. It’s not recommended to record data in a hallway or an area with music, other people talking, or other background noise.


Patient position

The patient’s position can be entered in the Eko App at the end of each spot check or full cardiac exam. This might be helpful for future reference.


Eko CORE placement

Locate the correct recording positions on the patient’s body. Because every person is shaped differently, refer to the image below to find the correct placement locations on the body.

We recommend that you tell the patient that you will palpate (feel) for the correct location, and then use touch to find the sternal border and intercostal spaces. You can use touch and visual aid to find the mid-clavicular line as well. A recording will start automatically once a signal is detected.

Use this guide to find the right placement:



Right Upper Sternal Border (RUSB) (aortic): Place next to right sternum edge between the second and third ribs.


Left Upper Sternal Border (LUSB) (pulmonic): Place next to left sternum edge between the second and third ribs.


Left Lower Sternal Border (LLSB) (tricuspid): Place next to left sternum edge between the fourth and fifth ribs.


Cardiac Apex (mitral): Place between the fifth and sixth ribs, at the mid-clavicular line.


Getting a clean signal

Place the stethoscope in the correct position, press the chestpiece directly on the patient’s skin, and hold securely in place. Try to ensure that clothing does not rub against the CORE.

Instruct the patient:

  • To breathe normally and not to speak for the duration of the recording.

  • If noise is present in the recording, you may need to repeat it.

Example of clean signal


Example of outside noise in the signal


Guidelines for poor quality recordings

If you get a poor quality of recording, here’s what to do:

  • Reposition the CORE and leverage the placement tips that are within the Eko App.

  • Follow all of the guidance in this document.

  • If nothing else is working, revert to a traditional workflow of performing the auscultation with the patient by listening with the CORE. You can still save a poor quality recording in the app.




407 Rev.2.0

Date of Issue:

February 16, 2023

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