Cardiovascular System Abnormal Findings II: Auscultation

Abnormal heart sounds such as S3 and S4 gallops, opening snaps, systolic clicks, and murmurs occur due to structural or functional issues during systole or diastole.

First, an S3 gallop, indicative of heart failure, and an S4, associated with hypertension, are audible at the apex in the fifth intercostal space along the midclavicular line.

Next, an opening snap, often related to mitral stenosis, follows S2 and is best heard at the apex.

Then, systolic clicks include ejection clicks after S1, heard at the upper sternal border, and mid-systolic clicks from mitral valve prolapse, audible at the apex.

Additionally, systolic murmurs, suggesting aortic stenosis, produce a harsh sound at the right upper sternal edge and extend to the carotids. Mitral regurgitation causes a high-pitched murmur at the apex, radiating to the axilla.

Diastolic murmurs indicate aortic or mitral regurgitation with characteristic sounds at the left sternal border and apex, respectively.

Lastly, a continuous murmur from a patent ductus arteriosus is heard at the left infraclavicular area.