Is it possible to keep your hand on your heart or rib cage to hear the third heart sound (s3) or is it possible via the bell of the stethoscope only?
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Tldr: no
S3 is super rare to hear in the first place. You either have to be pregnant, a child, or a high class athlete to be able for it it be heard. Otherwise it’s a low frequency humming sound that’s difficult to hear through a stethoscope by untrained ears. This is because it’s when the ventricles are passively filling with blood so there’s a few things that make finding this sound difficult. First is that it’s pretty quiet. Second, most people have a resting heart rate between 60-100. The lower the heart rate is, hypothetically, you’ll have more time to hear the sounds, but that’s not actually true. There’s more time between the beats, but it doesn’t slow the beat down. So the time from beat 1 to beat 2 is lengthened, but S1-S2-S3 time frame stays the same.
https://www.ncbi.nlm.nih.gov/books/NBK342/
This book from the 1980s suggests that S3 is palpable or visible, albeit rarely so. Or do you mean to say put your hand on someone else’s chest and then your ear against your hand? Historically, physicians would auscultate with the ear against someone’s chest so you could do that and potentially hear S3.
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