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They occur in 5 phases: First detectable sounds, corresponding to appearance of a palpable pulse Sounds become softer, longer and may occasionally transiently disappear Change in sounds to a thumping quality (loudest) Pitch intensity changes and sounds become muffled Sounds disappear The AHA recommends that clinicians record the systolic BP at the start of phase 1 and the diastolic BP at start of phase 5 Korotkoff sounds [2]