Spend time making the patient comfortable. Ideally they should be undressed to the waist but be attentive to modesty. We find it easiest to begin the examination with the patient lying at 45° to examine the periphery and anterior chest. Then assist the patient into a sitting position and examine for lymphadenopathy and the posterior chest. Finally the patient is returned to the original position and further signs (such as the position of the cardiac apex or signs of cor pulmonale) are pursued as needed.