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What produces the two normal heart sounds?
- * S1: closure of AV (tricuspid and mitral) valves
- * S2: closure of semilunar (aortic and pulmonary) valves
- - S3: in early diastole produced by vibration of ventricular filling; heard over apex while patient is at supine or left lateral position; early diastolic low pitch extra heart sound; increases with inspiration, exercise, elevation of legs, and with increased venous return
- - S4: late diastole due to forceful atrial ejection
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Cardiac auscultation--Aortic area
2nd R intercostal space
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Cardiac auscultation--Pulmonic area
2nd L intercostal space
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Cardiac auscultation--Erb's point
3rd L intercostal space
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Cardiac auscultation--tricuspid area
4th L intercostal space (L lower sternal border)
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Cardiac auscultation--mitral area or apex
5th L intercostal space (midclavicular line)
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Cardiac auscultation
- - Aortic area: 2nd R intercostal space
- - Pulmonic area: 2nd L intercostal space
- - Erb's point: 3rd L intercostal space
- - Tricuspid area: 4th L intercostal space (L lower sternal border)
- - Mitral area/apex: 5th L intercostal space (midclavicular line)
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