It is time to review the four essential heart sounds. Second sound splitting is best heard at the upper left sternal edge with firm pressure on the diaphragm.

Third and fourth diastolic filling sounds are most often best heard at the apex. Use light pressure on the bell due to their low frequency.

Systolic clicks are most often heard at the apex with firm pressure on the diaphragm.

Select each finding to hear these sounds. By listening repetitively and practicing on patients, you will be able to master these auscultatory events.