The chest must be examined by inspection, palpation, percussion and auscultation. In TCM, the four diagnostic methods are&colon; inspection, auscultation and olfaction, inquiring, and palpation. Confirmation of cardiac auscultation can be obtained by non-invasive cardiac ultrasound (echocardiography). Atelectasis&colon; mild to moderate fever, no changes or mild rales on chest auscultation. Crackles upon auscultation and irregular respirations are a normal finding. Listening to the lungs with a stethoscope (auscultation) can also reveal signs associated with CAP. Sometimes fine inspiratory crackles can be heard at the lung bases on auscultation. On examination, crepitations and expiratory rhonchi may be heard with auscultation. A stethoscope is required for auscultation (see below). They are usually heard only with a stethoscope ("on auscultation"). Tension Pneumothorax and Haemothorax can be recognized by percussion and auscultation. A VSD can be detected by cardiac auscultation. Use of this monitor is sometimes known as Doppler auscultation. For this reason, when determining the heart rate in AF, direct cardiac auscultation is recommended. A gallop rhythm refers to a (usually abnormal) rhythm of the heart on auscultation.