* 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
Cardiac auscultation--Aortic area
2nd R intercostal space
Cardiac auscultation--Pulmonic area
2nd L intercostal space
Cardiac auscultation--Erb's point
3rd L intercostal space
Cardiac auscultation--tricuspid area
4th L intercostal space (L lower sternal border)
Cardiac auscultation--mitral area or apex
5th L intercostal space (midclavicular line)
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)