Sounds
Medical Auscultation Sounds
Essential sounds for physical examination and diagnosis
Learning Auscultation
Practice with quality headphones or speakers. Listen multiple times to each sound. Compare normal vs. abnormal findings. Use in conjunction with clinical examination skills training.
Location
All areas
Timing
S1 at start of systole, S2 at end
Pitch/Quality
S1 lower pitched, S2 higher pitched
Clinical
Clinical Significance: Baseline normal cardiac auscultation
Location
Apex, best heard with bell in left lateral position
Timing
Early diastole after S2
Pitch/Quality
Low frequency
Clinical
Clinical Significance: Heart failure, volume overload, cardiomyopathy. Normal in children/young adults
Location
Apex, best with bell
Timing
Late diastole, just before S1
Pitch/Quality
Low frequency
Clinical
Clinical Significance: Hypertension, MI, aortic stenosis, hypertrophic cardiomyopathy
Location
Varies by etiology
Timing
Between S1 and S2 (systole)
Pitch/Quality
Variable
Clinical
Clinical Significance: Aortic stenosis, mitral regurgitation, VSD, flow murmurs
Location
Varies by etiology
Timing
Between S2 and next S1 (diastole)
Pitch/Quality
Variable
Clinical
Clinical Significance: Aortic regurgitation, mitral stenosis. Always pathological
Location
Apex, best in left lateral position
Timing
Diastolic, opening snap after S2
Pitch/Quality
Low-pitched rumble
Clinical
Clinical Significance: Rheumatic heart disease, calcification
Location
Right 2nd ICS, radiates to carotids
Timing
Mid-systolic, peaks then decreases
Pitch/Quality
Harsh, high-pitched
Clinical
Clinical Significance: Calcific degeneration, bicuspid valve, rheumatic disease
Location
Apex, radiates to axilla
Timing
Throughout systole (S1 to S2)
Pitch/Quality
High-pitched, blowing
Clinical
Clinical Significance: Valve prolapse, papillary muscle dysfunction, endocarditis
Location
Left sternal border, best leaning forward
Timing
Systole and diastole (triphasic)
Pitch/Quality
High-pitched, scratchy
Clinical
Clinical Significance: Pericarditis, post-MI, uremia, post-cardiac surgery
Auscultation Technique Tips:
Environment: Quiet room, warm stethoscope
Patient Position: Sitting, supine, or left lateral as indicated
Chest Piece: Diaphragm for high-pitched, bell for low-pitched
Pressure: Firm for diaphragm, light for bell
Breathing: Normal, then deep as needed. Hold breath for heart
Documentation: Note location, timing, quality, radiation
Created by Safana Abdullah
For educational purposes only. Always consult a medical professional for diagnosis and treatment.
