You're listening at the 2nd LICS with the diaphragm.

Patient presents with cyanosis of nail beds.

Split S2

ASD

You're listening at the LLSB with the diaphragm.

Patient appears asymptomatic.

Split S1

RBBB

You're listening to the apex with the bell.

50 y/o patient presents with edema, ascities, and elevated JVP.

S3

CHF

You're listening at the 2nd RICS with the diaphragm.

Ejection Sound

Aortic Stenosis

(without the murmur)

You're listening to the apex with the bell.

21 y/o athlete is asymptomatic.

S3

Normal

You're listening at the 2nd LICS with the diaphragm.

Ejection Sound

Pulmonic Stenosis

You're listening at the apex with the bell.

Patient is asymptomatic.

S4

Normal or Systemic HTN

You're listening at the apex with the bell.

Patient has dyspnea on exertion.

S4

Aortic stenosis

You're listening at the LLSB with the bell.

Patient has dyspnea on exertion.

S4

Pulmonary HTN or

Pulmonary Stenosis

You're listening at the apex with the diaphragm.

Patient presents with dyspnea on exertion.

Ejection Sound

Aortic Stenosis

(heard better at the 2nd RICS)

You're listening at the apex with the diaphragm.

Patient presents with chest pain and dyspnea.

Mid-systolic Click

Mitral Valve Prolapse

(without the murmur)

You're listening at the 4th LICS with the diaphragm.

Patient presents with chest pain and dyspnea on exertion.

Mid-systolic click

Tricuspid Valve Prolapse

(without the murmur)

You're listening at the apex with the diaphragm.

Patient present with a brisk (small water hammer) pulse, hyper dynamic apical impulse displaced down and to the left. Heart sound is heard in the axilla.

Holosystolic murmur

Mitral Regurgitation

You're listening at the LLSB with the diaphragm.

Patient presents with prominent cv waves in JVP. The ear lobes pulsate with each heartbeat. Heart sound changes with inspiration.

Holosystolic Murmur

Tricuspid Regurgitation

You're listening at the LLSB with the diaphragm.

Patient presents with a hyperdynamic apical impulse displaced down and to the left.

Holosystolic murmur

Ventricular septal defect

(The reason why it's not Tricuspid regurgitation is due to the apical finding)

You're listening to the apex with the diaphragm.

Patient presents with a narrow pulse pressure and a slow, delayed carotid upstroke, sustained apical impulse.

Mid-systolic murmur

Aortic Stenosis

(Can be located anywhere else along the aortic band - 2nd RICS, 3rd LICS, apex)

(remember to watch for the ES)

You're listening to the LLSB with the diaphragm.

Patient's murmur increases in intensity with Valsalva and standing and pulsus bisferiens.

Mid-systolic murmur

IHSS

You're listening to the 2nd LICS with the diaphragm.

Patient has prominent "a" waves, and a left parasternal sustained impulse. 

Mid-systolic murmur

pulmonic stenosis

You're listening at the apex with the diaphragm.

Patient presents with chest pain and dyspnea on exertion.

Late systolic murmur

Mitral Valve Prolapse

You're listening at the LLSB with the diaphragm.

Patient presents with chest pain and dyspnea on exertion.

Late-systolic murmur

Tricuspid valve prolapse

You're listening at the apex with the diaphragm.

Patient presents with left parasternal impulse.

Opening Snap

Mitral Stenosis

(You can only hear the snap, since to hear the murmur,  you need to listen with the bell).

You're listening at the LLSB with the diaphragm.

Patient presents with giant "a" waves, elevated JVP, slow "y" descent.

Opening Snap

Triscuspid Stenosis

You're listening at the apex with the bell.

Patient presents with a left parasternal impulse.

Mid-diastlic murmur

Mitral Stenosis

You're listening at the LLSB with the diaphragm.

Patient presents with giant "a" waves, elevated JVP, slow "y" descent.

Mid-diastolic murmur

Tricuspid stenosis

You're listening at the apex with the diaphragm.

Patient presents with wide pulse pressure, water-hammer pulse, Quincke's pulse, head bobbing, apical impulse is displaced downwards, to the left.

Early diastolic murmur

Aortic Regurgitation

(Can listen to it anywhere along the aortic band: 2nd RICS, 3rd LICS, apex)

You're listening at the 2nd LICS with the diaphragm.

Patient is asymtomatic.

Early diastolic murmur

Pulmonary regurgitation