Cardiac Auscultation

Overview 

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Abnormal or unusual heart sounds may indicate illness. Auscultating (hearing) those sounds well depends greatly upon chest location.

Auscultation Positions 

There are four positions where heart sounds can be best heard: The aortic sound at the upper right sternal border, 2nd intercostal space; the pulmonic at the upper left sternal border, also 2nd intercostal space; the tricuspid at the lower left sternal border, around the 5th intercostal space; and the mitral at the cardiac apex, around the 6th intercostal space in the midclavicular line. Disease affecting a valve will be heard best at its position (e.g., mitral regurgitation is loudest at the apex).